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Background: A posterior lumbar spine fusion surgery always associated with significant amount of blood loss and requires blood transfusion. The purpose of this study is to evaluate the efficacy of intravenous clonidine premedication to achieve bloodless surgical field and decrease the need for blood transfusion by controlled hypotension. Methods: Sixty patients scheduled for posterior lumbar fusion surgery were included in this randomized placebo controlled trail. Patients were classified into two groups: Group 1 received intravenous clonidine 3 µg/kg by infusion over 15 minutes before surgery and Group 2 received placebo as same. Hemodynamic variables, quality of surgical field by bleeding severity score, estimated amount of blood loss, duration of surgery and any blood transfusion were analyzed. Results: Heart rate and mean arterial pressure found less in clonidine group than placebo but not significant. The estimated blood loss (390.8±99.99 mL vs 741.13±79.90 mL; P = 0.001*) and duration of surgery (160.67±16.91 vs 205.9±16.72 min, P=0.001*) were significantly less in clonidine group compared to placebo. The quality of surgical field was better in clonidine group than placebo at all times. No cases of severe bradycardia or clinically significant hypotension were observed in clonidine group. Conclusion: Premedication with intravenous clonidine 3 µg/kg found clinically safe & effective drug in controlling blood loss and improves quality of surgical field in posterior lumbar fusion surgeries as a sole agent.

BACKGROUNDOne Lung Anaesthesia (OLA) is used in thoracic surgery for prevention of spillage of blood and pus into the healthy lung to facilitate surgical exposure. During OLA since the collapsed lung continues to be perfused, there will be large right to left shunt which leads to hypoxaemia.

Background: Otitis externa is frequently seen illness by ENT practitioners predominantly in children and old age people. The severity sometimes varies from it ranges in severity from a trivial infection to dangerous malignant otitis externa. Furthermore, due to absurd consumption of antibiotics, though there is a fall in development of complications, there is a rise in resistance to various infectious organisms. Mostly, we start treating patients with empirical therapy where sometimes, it leads to occurrence of various antibiotic-resistant infections. For that reason, recent evidence about the organism which is mostly involved in infection and also most importantly the pattern of their response to various pharmacological agents is crucial for the sensible use of the medications for the management. Aim and Objectives: Our study was planned to evaluate and find out the causative organism which is most commonly seen in otitis externa, particularly focusing on drug sensitivity for those organisms, so that efficient management of otitis externa can be done. Materials and Methods: It is a retrospective study conducted in acute otitis externa patients from Novemver 2019 to January 2020. Patients who all presented with ear discharge within 3 months of period, samples were collected with clinically diagnosed acute otitis externa and sent for culture in blood agar, chocolate agar, and Mcconkey medium in vitro and drug sensitivity pattern was identified for individual organisms. Inclusion criteria: Patients more than 18 years having ear discharge within 3 months were included in the study. Exclusion criteria: Chronically discharging ear >3 months were excluded from the study. Results: Pseudomonas organism was frequently encountered pathogen in our study, trailed by Staphylococcus aureus. The organisms identified were very much sensitive to drugs like fluoroquinolones particularly Ciprofloxacin, and Aminoglycosides like Amikacin and almost all were responding to treatment with Piperacillin-Tazobactam, these drugs have an cidal activity over pathogens and are suitable for any age and safety-wise better too. Conclusion: Intermittent assessment and awareness of the bacteriological summary and their drug response profile in a particular geographical area will only help in rational drug prescription. Furthermore, rational usage of drugs will help in reducing any morbidity due to infection which may sometimes develop when treated inappropriately, further decreasing development of dangerous drug resistance.

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