Search

Abstract Background There is a growing concern with inappropriate, excessive perioperative blood transfusions. Understanding the influence of low preoperative hemoglobin (Hgb) on perioperative blood transfusion (PBT) in head and neck cancer (HNC) surgery with free flap reconstruction may help guide clinical practice to reduce inappropriate treatment among these patients. The objective is to synthesize evidence regarding the association between preoperative Hgb and PBT among major HNC free flap surgeries. Methods Terms and synonyms for HNC surgical procedures, Hgb and PBT were used to search MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials and Cochrane Database of Reviews from inception to February 2020. Reference lists of included full texts and studies reporting the preoperative Hgb, anemia or hematocrit (exposure) and the PBT (outcome) in major HNC surgery with free flap reconstruction were eligible. Studies examining esophageal, thyroid and parathyroid neoplasms were excluded; as were case reports, case series (n

The US withdrawal from Afghanistan in 2021 changed Afghanistan's strategic dynamics. The Afghan Taliban now control the whole Afghanistan and have taken some adverse measures that affect not only Pakistan but also regional and global security. After 2021, Transnational terrorist groups like Al-Qaeda, Islamic Movement of Uzbekistan (IMU), Tehrik-i-Taliban Pakistan (TTP), Islamic State Khorasan Province (ISKP), Baloch Liberation Army (BLA) and East Turkestan Islamic Movement operate in Afghanistan with greater impunity and freedom. The Afghan Taliban also welcomed India to Afghanistan after 2021 to get financial assistance and support in reconstruction and development. But India’s renewed hybrid warfare from Afghanistan has seriously jeopardised the internal security of Pakistan. Pakistan-focused groups like TTP, BLA, and ISKP suddenly got reorganised under the umbrella of India in Afghanistan. They started a vicious cycle of violence against the civil and military installations of Pakistan in Balochistan and the ex-FATA region, besides attacks on the Chinese citizens to disrupt CPEC and slow down FDI to Pakistan. This article analyses the whole debate under the regional security complex theory, which evaluates that simple physical adjacency generates more security interaction among neighbours than among states located in different areas. Adjacency is potent for security because many threats travel more easily over short distances than long ones. The RSCT aptly applies to Afghanistan’s changing strategic dynamics and regional implications, focusing on Pakistan. Bibliography Entry Bukhari, Syed Munib Ali and Masood Ur Rehman Khattak. 2024. " Post 2021 Changing Strategic Dynamics in Afghanistan: Implications for Pakistan." Margalla Papers 28 (1): 198-210.