CHINA'S FOREIGN POLICY SHIFT FROM BELT AND ROAD INITIATIVE TO GLOBAL DEVELOPMENT INITIATIVE: IMPACTS ON MARITIME GEOPOLITICS OF THE INDIAN OCEAN REGION

China's Belt and Road Initiative (BRI) is the foreign policy strategy that has changed world politics. It has compelled states to revisit their foreign policies either in favour of BRI or countering it. BRI has created a difficult situation for international power structure and status quo states due to transitioning power from west to east and emerging geopolitical reconfiguration. However, in September 2021, President Xi Jinping announced China's Global Development Initiative (GDI) at the opening session of the UN General Assembly, which renewed debate about the impacts of China's strategy. As China has a strong foothold in the Indian Ocean region through BRI, the undertaken research is an endeavour to study the effect of shifting China's foreign policy from BRI to GDI over the maritime geopolitics of the region. This research aims at determining GDI's role in supporting UN Agenda 2030 through focused efforts on sustainable development goals in the maritime domain. It is an exploratory and qualitative research conducted through deductive reasoning to seek an explanation of the core proposition. This research has used secondary sources for determining these upshots with potential changes in the maritime geopolitics of the Indian Ocean region.   Bibliography Entry Khan, Maliha Zeba, and Zohaib Altaf. 2022. "China's Foreign Policy Shift from Belt and Road Initiative to Global Development Initiative: Impacts on Maritime Geopolitics of the Indian Ocean Region." Margalla Papers 26 (2): 14-27

Strategic Posturing of China in IOR: Implications for Regional Peace and Stability

China has been working on a modernization plan for its military. Particularly, the People’s Liberation Army-Navy (PLAN) has been the focus of modernization due to China’s seaward economic growth and development for protecting its maritime economic interests. China’s Belt and Road Initiative (BRI) is an example of strategic envisioning which has multiple facades besides dividends. Since China has a massive trade volume transiting Indian Ocean Region, PLAN has increased engagement in this region. Its modernization including its naval capabilities, surface and underwater vessels, unmanned maritime vehicles (UMVs), acoustic systems for information, and other technological advancements has made China’s strategic posture in IOR dynamic and is threatening India’s intrinsic naval supremacy in the region with certain implications over regional peace and stability. This is exploratory research conducted to determine the nature of naval competition and the resulting balance of power to identify implications for regional peace and stability

Minimally invasive endoscopic selective parathyroidectomy

Primary hyperparathyroidism is a common condition with surgery being the definitive treatment modality. Controversy exists over the extent of optimal neck exploration, whether unilateral or bilateral exploration should be performed, particularly since 85-90% of primary hyperparathyroidism results from single gland disease. Unilateral neck exploration is now considered to be adequate unless a definitive adenoma is not identified on ipsilateral exploration and where the serum intact Parathyroid Hormone (iPTH) level does not show a decline greater than 60% after removal of a suspected adenoma. It also avoids the potential risk of hypocalcaemia, recurrent laryngeal nerve injury along with extended anaesthesia and operative time and in-patient stay. With the advent of advanced imaging modalities and peri-operative localization techniques the hyper-functioning gland can be identified and minimally invasive procedures can be performed, limiting the neck exploration to only the abnormal gland. Here we would like to describe our procedure for a minimally invasive endoscopic selective parathyroidectomy, performed on five patients. We describe our standard setup, procedure and the outcomes

Dermatofibrosarcoma protuberans: an unusual case of neck swelling

Dermatofibrosarcoma protuberans (DFSP) is a relatively intermediate to low grade malignant tumour with high proclivity for local recurrence if excised inadequately. It is a locally aggressive tumour and despite sharing some histological features with fibrohistiocytic tumours, it tends to grow in a more infiltrative manner. We are reporting this rare tumour in a 30-year-old woman where the diagnosis of DFSP was confirmed histologically and by positive immunomarkers at immunohistochemistry

Leadership for Social Justice: Capacity-Building Resource Manual

This manual supports the development of new leaders committed to social justice. As a resource for facilitators of workshops and other education and training events, it shares session designs, exercises, handouts, short readings, and other materials that were developed through our work on Leadership for Social Justice Institutes organized at the request of the Ford Foundation International Fellowships Program

Utility of clinical examination and CT scan in assessment of penetrating neck trauma

Managing penetrating injuries adequately and effectively depends a great deal on proper assessment of the injury. This study carried out was done at The Aga Khan University Hospital to assess the role of clinical examination and CT scan imaging in evaluation of penetrating neck injuries. A total of 68 students were included, with ages ranging from 3 to 74 years. The involved zones and the injured structures were noted. Results showed a high sensitivity of clinical examination in assessing vascular (81%) and airway trauma (77%), with a low sensitivity for esophageal trauma (34%). For CT scan the sensitivity was 90% for vascular trauma, 83% for airway trauma and 53% for esophageal injuries. Clinical findings and CT scan imaging are important assessment tools for evaluation of penetrating neck traumas, with a high sensitivity for vascular and airway injuries

Nasal encephaloceles presenting at later ages: experience of otorhinolaryngology department at a tertiary care center in Karachi, Pakistan

Encephaloceles are anomalous herniations of the meninges, with or without brain matter. Globally the incidence of encephalocele is about 1 per 35,000 births, but it is more frequently reported in Southeast Asia. As the defect is more pertinent to embryological development, an encephalocele is a more common entity in an infant with a mean age of presentation ranging between 15.5 and 21 months; making an encephalocele presenting for the first time in a relatively, older individual a rare occurrence. Consequently a surgeon might not consider an encephalocele among his differentials. Here we present a series of encephaloceles that presented at a later than usual age as nasal masses to the otorhinolaryngology department of our hospital, and recommend that the differential of encephalocele be entertained for nasal masses as proceeding with routine procedures may result in potentially lethal complications

Frequency of cervical nodal metastasis in early stage squamous cell carcinoma of the tongue

ntroduction Oral cavity carcinoma is an aggressive tumor, with the tongue being one of the most common subsites of involvement. Surgery is a gold standard method of dealing with advanced-stage tumors. However, for early-stage carcinomas of the tongue, the management remains controversial. Several studies have indicated that early-stage cancers have a high chance of occult cervical node metastasis, which, if left untreated, can greatly affect the prognosis. Certain parameters can help identify patients with occult cervical node metastases, and can avoid unnecessary neck dissection in node negative patients. Tumor thickness is one such objective parameter. Objective To estimate the frequency of cervical lymph node metastasis in patients with early-stage, node-negative (N0) squamous cell carcinoma of the tongue. Methods In-patient hospital data was reviewed from January 2013 until March 2014, and 78 patients who underwent primary resection of the tumor and neck dissection for biopsy-proven, early stage squamous cell carcinoma of the tongue were included. Data such as tumor thickness, tumor differentiation and presence of occult nodal metastasis in the surgical specimen were gathered from the histopathology reports. The frequency of subclinical cervical lymph node metastasis in patients with early-stage squamous cell carcinoma of the tongue was estimated. Results A total of 69% of the patients with tumor thicknesses \u3e 5 mm had tumor metastases in the neck nodes, while 100% of the patients with tumor thicknesses \u3c 5 mm had no neck nodal metastasis. Conclusion A tumor thickness \u3e 5 mm is significantly associated with subclinical metastasis, and prophylactic neck dissection is warranted in such cases