Leveraging Indian Space Capability through Military Diplomacy in South Asia

The Indian Space domain capability can be expanded in the South Asian Neighbourhood for offering solutions in the ISR, Communication, Meteorology, Navigation, Guest Astronauts for the Human space flight programme, and space infrastructure building. India’s South Asian communication satellite launched in 2017 was one such initiative leveraging the space capability for diplomatic outreach and developing the new space services market for Indian enterprises. The Indian Military has a strategic and friendly relationship with the neighbouring militaries and now the time has come to upgrade the existing security cooperation through Military Diplomacy and believe in the dictum of India’s ‘Neighbourhood First Policy’. India’s growth is tethered to a secure and well-governed South Asia and the emerging space market is one of the sunshine sectors which like India’s outreach to evolve the digital payments ecosystem can also be employed to improve the cooperation in South Asia

Leveraging Indian Space Capability through Military Diplomacy in South Asia

The Indian Space domain capability can be expanded in the South Asian Neighbourhood for offering solutions in the ISR, Communication, Meteorology, Navigation, Guest Astronauts for the Human space flight programme, and space infrastructure building. India’s South Asian communication satellite launched in 2017 was one such initiative leveraging the space capability for diplomatic outreach and developing the new space services market for Indian enterprises. The Indian Military has a strategic and friendly relationship with the neighbouring militaries and now the time has come to upgrade the existing security cooperation through Military Diplomacy and believe in the dictum of India’s ‘Neighbourhood First Policy’. India’s growth is tethered to a secure and well-governed South Asia and the emerging space market is one of the sunshine sectors which like India’s outreach to evolve the digital payments ecosystem can also be employed to improve the cooperation in South Asia

Leveraging Indian Space Capability through Military Diplomacy in South Asia

The Indian Space domain capability can be expanded in the South Asian Neighbourhood for offering solutions in the ISR, communication, Meteorology, Navigation, Guest Astronauts for the Human space flight programme and space infrastructure building. India's South Asian communication satellite launched in 2017 was one such initiative leveraging the space capability for diplomatic outreach and developing the new space services market for Indian enterprises. The Indian Military has a strategic and friendly relationship with the neighbouring militaries and now the time has come to upgrade the existing security cooperation through Military Diplomacy and believe in the dictum of India's 'Neighbourhood First Policy'. India's growth is tethered to a secure and well-governed South Asia and the emerging space market is one of the sunshine sectors which like India's outreach to evolve the digital payments ecosystem can also be employed to improve the cooperation in South Asia

Endocrinopathies: The current and changing perspectives in anesthesia practice

The gateways to advancements in medical fields have always been accessed through the coalition between various specialties. It is almost impossible for any specialty to make rapid strides of its own. However, the understanding of deeper perspectives of each specialty or super specialty is essential to take initiatives for the progress of the other specialty. Endocrinology and anesthesiology are two such examples which have made rapid progress in the last three decades. Somehow the interaction and relationship among these medical streams have been only scarcely studied. Diabetes and thyroid pathophysiologies have been the most researched endocrine disorders so far in anesthesia practice but even their management strategies have undergone significant metamorphosis over the last three decades. As such, anesthesia practice has been influenced vastly by these advancements in endocrinology. However, a comprehensive understanding of the relationship between these two partially related specialties is considered to be an essential cornerstone for further progress in anesthesia and surgical sciences. The current review is an attempt to imbibe the current and the changing perspectives so as to make the understanding of the relationship between these two medical streams a little simple and clearer

Carcinoid tumors: Challenges and considerations during anesthetic management

Carcinoid tumors are rare, slow-growing neoplasms of neuroendocrine tissues from enterochromaffin or kulchitsky cells, which have the potential to metastasize. The mediators released from these tumors when bypass the hepatic metabolism, can lead to the possible development of carcinoid syndrome. This is a life-threatening complication, which can lead to profound hemodynamic instability, especially in a peri-operative period, when the patient is exposed to various types of noxious stimuli. Off late, use of octreotide, a synthetic analog of somatostatin, has significantly reduced the peri-operative morbidity and mortality. The current review discusses the various anesthetic challenges and considerations during peri-operative management of carcinoid tumors

Dexmedetomidine and clonidine in epidural anaesthesia: A comparative evaluation

Efforts to find a better adjuvant in regional anaesthesia are underway since long. Aims and objectives are to compare the efficacy and clinical profile of two α-2 adrenergic agonists, dexmedetomidine and clonidine, in epidural anaesthesia with special emphasis on their sedative properties and an ability to provide smooth intra-operative and post-operative analgesia. A prospective randomized study was carried out which included 50 adult female patients between the ages of 44 and 65 years of (American Society of Anaesthesiologists) ASAI/II grade who underwent vaginal hysterectomies. The patients were randomly allocated into two groups; ropivacaine + dexmedetomidine (RD) and ropivacaine + clonidine (RC), comprising of 25 patients each. Group RD was administered 17 ml of 0.75% epidural ropivacaine and 1.5 μg/kg of dexmedetomidine, while group RC received admixture of 17 ml of 0.75% ropivacaine and 2 μg/kg of clonidine. Onset of analgesia, sensory and motor block levels, sedation, duration of analgesia and side effects were observed. The data obtained was subjected to statistical computation with analysis of variance and chi-square test using statistical package for social science (SPSS) version 10.0 for windows and value of P < 0.05 was considered significant and P < 0.0001 as highly significant. The demographic profile, initial and post-operative block characteristics and cardio-respiratory parameters were comparable and statistically non-significant in both the groups. However, sedation scores with dexmedetomidine were better than clonidine and turned out to be statistically significant (P < 0.05). The side effect profile was also comparable with a little higher incidence of nausea and dry mouth in both the groups which was again a non-significant entity (P > 0.05). Dexmedetomidine is a better neuraxial adjuvant compared to clonidine for providing early onset of sensory analgesia, adequate sedation and a prolonged post-operative analgesia

Attenuation of pressor response and dose sparing of opioids and anaesthetics with pre-operative dexmedetomidine

Background and Aims: Alpha-2 agonists are being increasingly used as adjuncts in general anaesthesia, and the present study was carried out to investigate the ability of intravenous dexmedetomidine in decreasing the dose of opioids and anaesthetics for attenuation of haemodynamic responses during laryngoscopy and tracheal intubation. Methods: One hundred patients scheduled for elective general surgery were randomized into two groups: D and F (n=50 in each group). Group D were administered 1 μg/kg each of dexmedetomidine and fentanyl while group F received 2 μg/kg of fentanyl pre-operatively. Thiopental was given until eyelash reflex disappeared. Anaesthesia was maintained with 33:66 oxygen: nitrous oxide. Isoflurane concentration was adjusted to maintain systolic blood pressure within 20% of the pre-operative values. Haemodynamic parameters were recorded at regular intervals during induction, intubation, surgery and extubation. Statistical analysis was carried out using analysis of variance, chi-square test, Student′s t test and Mann-Whitney U test. Results: The demographic profile was comparable. The pressor response to laryngoscopy, intubation, surgery and extubation were effectively decreased by dexmedetomidine, and were highly significant on comparison (P50%) by the administration of dexmedetomidine. The mean recovery time was also shorter in group D as compared with group F (P=0.014). Conclusions: Dexmedetomidine is an excellent drug as it not only decreased the magnitude of haemodynamic response to intubation, surgery and extubation but also decreased the dose of opioids and isoflurane in achieving adequate analgesia and anaesthesia, respectively