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BACKGROUND As immune mediators, cytokines are thought to regulate many biological functions. Tissue injury affects the immune system which rapidly produces pro-inflammatory and anti-inflammatory cytokines that causes injury and spread of infection to provide an appropriate environment for tissue healing. The surgery causes stressful response which leads to changes in cytokine level. Our aim was to evaluate the effects of anti-inflammatory and hemodynamic stress response of clonidine during laparoscopic cholecystectomy. METHODS Thirty patients [American Society of Anesthesiologists (ASA) Grade I and Grade II] were selected and randomly assigned into two groups. Group A (Normal Saline Group): Patients received 20 ml of normal saline intravenous and Group B (Clonidine Group): patients received clonidine 1 µgm/Kg + normal saline (20 ml) intravenous, 15 minutes before induction. Blood concentrations of antiinflammatory cytokines IL-10, was determined preoperatively, just after extubation and 12 hours after the operation. The cytokines assay was performed with the help of commercially available ELISA kit. RESULTS The demographic data age, gender, weight, height, BMI, ASA grade and baseline hemodynamic variables were comparable between group A and group B. Clonidine (1 µgm/kg) as a premedication for general anaesthesia had significantly better hemodynamic control as compared to normal saline group. IL-10 level was increased at extubation and at 12 hours postoperatively in both groups, but level was comparatively more in clonidine group as compared to normal saline group (at extubation (53.73±12.85 vs. 47.96±14.99) and at 12 hrs. postoperatively (110.43±13.58 vs. 96.64±44.76). Therefore, anti-inflammatory response IL-10 was higher in clonidine group as compared to the normal saline group. CONCLUSIONS Intravenous clonidine as a pre-medication could be recommended to maintain hemodynamic stability with minimal side effects during laparoscopic surgeries in ASA I/II patients. The anti-inflammatory response was greater in clonidine group as compared to saline group but not significantly different.

Dams as barrier that restrict the flow of water. Dams not only suppress floods but also provide water for human activities such as aquaculture, consumption, irrigation, industrial use and navigability. One of the finest environmental challenges of this century is to preserve the natural organic structural and functional attributes of aquatic ecosystems and rivers mainly. The construction of dams effects the fish population. Dams change the migratory fish habit. Changes in discharge regime or water satisfaction can also have indirect results on fish species. Anthropogenic effects on migratory fishes are observed. Total number of fish species were found 44, belonging to 8 orders, 17 families and 27 genera.

Introduction: Multimodal anaesthesia techniques include regional anaesthesia in the form of paravertebral block and various anaesthetic drugs which acts on different sites of pain pathway with different mechanism of action, results in good quality of analgesia with minimal side effects. They improve recovery along with early mobilization and rehabilitation and early resumption. This technique lowers the level of inflammatory cytokines. Due to this we aim to evaluate the effects multimodal anaesthesia technique on level of IL-6 inflammatory cytokines in breast carcinoma surgery. Material and Methods: Patients were randomized into following three groups (n=30 in each group) using a computer generated random number tables. Group I: paracetamol 10 mg/ kg, Group II: paracetamol at 10 mg/kg and dexmedetomidine 0.5μg/kg, Group III: paracetamol 10 mg/kg, dexmedetomidine 0.5 μg/kg and paravertebral block with levobupivacaine. Fentany (2 μg/kg) with general anaesthesia were common in all three groups. Statistical Analysis: All the categorical data was compared by using student "t" test, chi-square test and parametric data by analysis of variance (ANOVA). Results: Patients of group III was haemodynamically more stable as compared to group II and I. IL-6 level was 358.15, in group I, 354 in group II and 346.65 in group III preoperatively while 324.85 in group I, 320.95 in group II, 278.35 in group III after 2 hour surgery. IL-6 level was significantly different in group III as compared to group II and group I postoperatively. Conclusion: Multimodal approach is a better anesthetic technique in terms of hemodynamic stability with decreased levels of IL-6 inflammatory cytokines.