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Dr Kuldeep Singh is a distinguished plastic surgeon and senior consultant at Indraprastha Apollo Hospital in New Delhi, specializing in aesthetic plastic and reconstructive surgery. With over 25 years of experience, Dr Singh has developed exceptional skills and expertise in the field, establishing a reputation for excellence and professionalism in cosmetic and aesthetic surgical procedures throughout his nearly three-decade-long career.

Can you tell us about your journey into the field of plastic and reconstructive surgery?

I embarked on my medical career after earning my MBBS in 1982, followed by a master’s degree in surgery in 1986. I completed my plastic surgery training at PGI Chandigarh in December 1989. In January 1990, I began working as an Assistant Professor in Plastic Surgery at KMC Manipal, a position I held until November 1995. Subsequently, I relocated to Delhi and joined Apollo Hospital as a resident consultant. I have since been a full-time consultant at Apollo Hospital, where I continue to practice today.

What inspired you to specialize in this area of medicine?

After completing my master’s in surgery, I hadn't initially considered a career in plastic surgery until my move to Delhi. Upon arriving in Delhi, I secured a position as a registrar at Saptajain Hospital, specifically in the plastic surgery department. The department was exceptionally well-run and efficient, which piqued my interest in the field of plastic surgery. Although I joined as a resident, I soon realized that many people there were preparing for entrance exams for the super specialty course in plastic surgery. Motivated by this environment, I decided to apply for the course as well. This decision led to my admission to PGI Chandigarh, where I completed my advanced training in plastic surgery. Following my time at PGI, I landed my first professional role in Manipal, which marked the beginning of my dedicated career in plastic surgery.

What are some of the latest trends and advancements in cosmetic surgery that you find particularly interesting?

Plastic surgery encompasses two main branches: reconstructive and cosmetic surgery. Reconstructive surgery corrects defects, deformities, and injuries to restore normal function and appearance, while cosmetic surgery focuses on enhancing the features of those who are already normal. In our practice, 30 to 40 percent involves cosmetic procedures, with the rest being reconstructive. Cosmetic surgery primarily deals with rejuvenation or restoration, addressing age-related changes such as skin pigmentation, texture, and sagging. Previously, surgical options were mainly available for those over 50, but now non-surgical methods like Botox, fillers, and lasers are accessible for younger patients, helping to minimize aging changes early on. By intervening early, we can prevent more severe issues later in life. The best cosmetic treatments are subtle, aiming to make you look like a healthier, fresher version of yourself without obvious signs of intervention, maintaining a natural and unique appearance.

How do cultural perceptions and societal attitudes toward cosmetic surgery differ between countries, such as India and Nepal ?

Traditionally, in India and Nepal, people lived in joint families and typically began earning in their late twenties or early thirties, often continuing to reside in the family home. Cosmetic surgery was generally frowned upon, seen as vain, and reserved for life-saving situations. This perspective is now evolving as young people gain professional and financial independence earlier, choosing to live separately and make personal decisions, including opting for cosmetic procedures without seeking family permission. Increased purchasing power and cultural shifts towards personal autonomy have led to more young people spending on travel, health, exercise, and cosmetic procedures. This trend mirrors practices in the West, where children often leave home at 16, becoming financially independent and personally funding their education and surgeries. Consequently, cosmetic procedures became more common there sooner. Over the past five to ten years, similar trends have emerged in India and Nepal, with more young people embracing independence, reflecting a broader cultural shift towards self-sufficiency and personal well-being.

How do technological innovations such as 3D printing and robotics play a role in modern plastic and reconstructive surgery?

Technological advancements have significantly impacted both cosmetic and reconstructive surgery. In cosmetic work, three primary types of energy, including radio frequency, are now delivered through advanced systems that enable precise and safe treatments for skin tightening, fat reduction, and texture improvement. These systems have evolved to offer highly selective treatment options, with modern machines incorporating sophisticated software that includes preset settings tailored to specific skin types and issues, making non-surgical procedures more effective and safer. In reconstructive surgery, significant progress includes the development of microsurgery, which allows surgeons to join arteries and veins less than one millimeter in size under a microscope, restoring blood flow to amputated limbs and tissues used in cancer reconstruction. Additionally, super microsurgery has emerged as a groundbreaking technique for repairing lymphatic vessels, which are less than 0.5 millimeters in diameter. This is particularly beneficial for conditions like post-breast cancer treatment, where tissue removal can cause swelling due to blocked lymphatic channels. By repairing these channels, the fluid flow is restored, preventing limb swelling. While robotics has not yet significantly influenced plastic surgery, 3D printing is proving to be highly beneficial, allowing for the creation of customized bone and dental implants, especially useful after injuries or cancer surgeries. These advancements collectively enhance the precision, safety, and outcomes of both cosmetic and reconstructive procedures.

What advice would you give to young medical professionals who are considering a career in plastic surgery?

For young medical professionals contemplating a career in plastic surgery, my advice would be to embrace the captivating nature of our specialty. Unlike other fields, plastic surgery knows no geographical bounds, encompassing the entire human body. It offers a constant source of stimulation and creativity, demanding innovative thinking and adaptability on a daily basis. Those with an artistic inclination will find plastic surgery particularly rewarding. Before each procedure, envisioning the desired outcome and working towards it requires a blend of surgical skill and creative vision. If you’re drawn to the artistic side of medicine, plastic surgery is a field worth exploring and committing to.

The 2024 Indian general elections have concluded with unexpected results, prompting a re-evaluation of the political landscape. The National Democratic Alliance (NDA), led by the Bharatiya Janata Party (BJP), secured a majority in parliament, marking Narendra Modi’s third term as Prime Minister. However, the BJP did not achieve a majority on its own, revealing a shift in voter sentiment.

In 2014, the BJP won 282 seats, and in 2019, it increased its tally to 303 seats, both times securing a clear majority on its own. However, in 2024, the BJP’s seat count dropped to 240, falling short of the 272 seats needed for a majority, which necessitated reliance on its allies within the NDA to form the government.

Since 2014, the BJP has dominated Indian politics, winning commanding majorities in the 2014 and 2019 elections under Modi’s leadership. This period saw significant policies and reforms aimed at economic growth, national security and cultural resurgence. However, the 2024 election results reveal a more complex narrative.

Public perception of BJP leadership, especially Narendra Modi and Home Minister Amit Shah, significantly influenced the 2024 results. Critics have often pointed to their approach toward the opposition, characterized by a lack of tolerance for dissent, suppression and the use of pressure tactics. Many voters expressed dissatisfaction with this attitude, feeling it undermined the democratic fabric of the country. The electorate seemed eager to curb this perceived authoritarian streak, signaling a desire for a more inclusive and accommodative leadership style.

The Muslim community notably voiced its discontent, feeling marginalized and oppressed under BJP’s rule. High-profile projects like the Ram Mandir construction and consecration only deepened these concerns, further alienating this significant voter base. Even in the Ram Mandir area, the BJP didn’t win.

Modi’s government faced criticism for its SAARC (South Asian Association for Regional Cooperation) policy, which some analysts believe neglected regional cooperation and damaged relationships with neighboring countries, contrary to its ‘neighborhood first’ policy. This aspect may have also contributed to the dip in voter support, as citizens recognized the importance of strong regional ties for national stability and growth.

The decrease in voter support for the BJP in 2024 should be a wake-up call for the party. Despite Modi being hailed as one of India’s most impactful leaders since Jawaharlal Nehru, and his commendable performance on the global stage, the electorate’s diminishing enthusiasm suggests a need for introspection. The Indian populace seems to be advocating for a diversification in leadership to prevent the stagnation of Modi’s image and to ensure a dynamic governance model.

The current political landscape reveals a fragile NDA, with allies like Nitish Kumar and Chandrababu Naidu failing to inspire confidence due to their history of shifting alliances. This uncertainty paves the way for potential shifts in power, with the Indian National Developmental Inclusive Alliance (INDIA) emerging as a possible alternative. The INDIA alliance, comprising several opposition parties, won 210 seats in the 2024 elections. While still behind the NDA, their growing influence suggests they could be a formidable contender in the near future if power dynamics change. However, the specter of a midterm election also looms large, which could have detrimental effects on India’s economy and its standing on the global stage.

Despite these challenges, ministers like Nirmala Sitharaman and S Jaishankar have demonstrated exceptional competence. Sitharaman’s economic policies have strengthened India’s financial position, while Jaishankar’s diplomatic efforts have bolstered India’s global image. Retaining them in their respective ministries is crucial for maintaining continuity and progress in these areas.

The coming days are fraught with challenges for India. Internal power struggles, developmental hurdles, economic uncertainties, and maintaining global and regional presence will test the resilience of Modi’s government. The electorate’s message is clear: The BJP must adapt, evolve, and embrace a more inclusive and democratic approach to governance. Only then can Modi hope to lead India effectively through the complexities of contemporary geopolitics and domestic affairs.

As India stands at a crossroads, the hope is that Modi and his government will heed these lessons, striving for a more inclusive, democratic and progressive India. The nation's future hinges on their response to this electoral wake-up call.

The author, a member of the Supreme Court Bar, has been practicing corporate law for around three decades

There are 56 airports in the country. Of these, three are international, 10 are regional, and 43 are in the hilly districts. Likewise, Nijgadh International Airport in Bara, and the airports in Arghakhanchi, Achham and Kalikot, are at different stages of construction.

According to the Civil Aviation Authority of Nepal (CAAN), air service has reached 46 out of 77 districts in the country so far. This data shows that the government is actively engaged in constructing airports. However, the state-owned aviation regulator and airport operator seems indifferent towards operating the constructed airports. Airfields in 12 districts have turned into grazing grounds due to a lack of flights. Small aircraft operate flights to some remote STOL (Short Takeoff and Landing) airfields in the country. However, even this service is not reliable at present.

Nepal Airlines is providing services to some remote hilly districts. However, the state-owned carrier has only two Twin Otter aircraft for domestic flights. Currently, both planes are grounded due to technical issues.

Hansa Raj Pandey, the spokesperson and deputy director general of CAAN, said that air service was not being effective due to the lack of an integrated transport policy. “Air service falls under the jurisdiction of the Ministry of Culture, Tourism and Civil Aviation. It should now be linked with transportation because foreign tourists are not the only ones who travel by air,” he added.

No flights after 14 years of operation

NAC operated flights to an airfield in Badachaur of Lungri-5, Rolpa regularly for 14 years. However,it stopped flights to the remote airfield in the 1990s. The Badachaur airfield has not seen any flight since that time. Despite this, the political leadership has shown little interest in resuming flights to the airfield.

“We have requested the federal government to resume flights to the airfield. They have been paying lip service only,” Bharat Kumar Thapa, chairperson of Lungri Rural Municipality, said. “We learned from the budget for the fiscal year 2024/25 that the Badachaur airfield will be upgraded. We are yet to receive further details.”

Thapa said that the number of tourists to Swargadwari in Pyuthan, Dhorpatan Hunting Reserve in Baglung, and the Jaljala region of Rolpa could increase once flights to Badachaur become regular.

Irregular flights

Sher Bahadur Thapa from Tamghas, Gulmi, booked a flight to Resunga airfield from Kathmandu earlier this week. He was excited as the air service reduces travel time from an entire day to just 40 minutes. However, Thapa could not fly. Although the Twin Otter aircraft of Nepal Airlines took off from Kathmandu airport, it returned after 15 minutes citing a technical problem.

“We were told by the pilot that the flight was being turned back due to low visibility. Only after landing were we told that there was a technical problem,” Thapa said.

NAC has been operating scheduled flights to Resunga airfield since April last year. The airline initially operated two flights a week but soon increased the frequency to four flights a week.

However, the flight has now become uncertain as both Twin Otter aircraft of NAC remain grounded.

NAC Spokesperson Ramesh Poudel said both aircraft are likely to be airborne after repairs this week. “We lose Rs 600,000 per day if these aircraft serving 20 remote airfields are grounded,” Poudel added.

Private airlines also interested

Former Spokesperson of the Airline Operators Association of Nepal (AOAN), Yograj Kandel, said private carriers have also been requesting the government to operate flights to remote airfields. “Tara Air is interested in operating flights to Resunga airfield in Gulmi. The airfare could be about Rs 300 higher compared to NAC,” he said. “Tara Air is positive about operating daily flights.”

NAC currently charges Rs 7,500 for Resunga flights.

Former Minister for Culture, Tourism, and Civil Aviation Sudan Kirati said many airfields are turning into grazing grounds for cattle due to a lack of flights. “Public service delivery has been affected due to frequent changes in government and political instability,” Kirati said. “People in remote areas have been deprived of air service due to a lack of aircraft in NAC’s fleet.”

Pandey from CAAN said there is not much demand for flights to some remote airfields due to the construction of roads.

Barn owl (Tyto alba), also locally known as Gothe Latokosero of the family Tyonidae, is a nocturnal and mystical bird. It can be identified by its heart-shaped facial characteristics and a distinct screeching call.

Barn owls can be found on almost every continent except Antarctica. Globally it is concerned but categorized as vulnerable under the National Red List of Nepal Birds. It is one of the commonly known bird species and found in folklore and myths of almost every culture. They are associated with wealth, prosperity, patience, intelligence, and spiritual purity. Culturally it is believed that barn owls possesse the mystical power of fortune telling. 

Since barn owls are  nocturnal birds of prey, most people do not know about their habits and habitat. A barn owl can be found in elevations between 75 meters to 1,320 meters in Nepal. 

We do not have the scientific study that relates to the population of the barn owl; however, there is an expert guess which suggests that the population of the species is below one thousand in Nepal.

Ecological and economic significance

Barn owls and humans coexist with each other in a human-made environment. They can be found roosting and nesting in old buildings, especially inner areas of the roofs under the houses. It hunts rats, mice, and also small birds and bats. They play an important role as nocturnal predators by controlling the population of rodents and maintaining balance in the ecosystem.They safeguard the stored grains and agricultural products from pests like rodents. 

Threats

Globally the population of barn owls is stable but in the context of Nepal, their number is decreasing. Barn owls readily utilize human-made structures and live near human settlements.

The threats for this species range from habitat loss and degradation, illegal hunting and trade, use of pesticides, and lack of public awareness. Due to the extent of urbanization and the decrease in agricultural land, the barn owl lost its nesting and roosting site, and hunting area. Modernization of houses and lack of open lands negatively impact on barn owl population and its existence. An increase in the number of vehicles may raise the number of collisions as barn owls have low-flying flight patterns to catch their prey.

As this species merges and utilizes the human environment, change in that area directly impacts on existence. Lack of nesting and roosting places in modern houses, lack of hunting grounds is severely affecting the species. 

Furthermore, a study done in 2015 revealed that the earthquake caused an adverse effect on potential sites for barn owls in the Kathmandu Valley, as many old houses which have structures that support the nesting of the bird were damaged.

The use of pesticides to control the rodent population to increase agricultural products have also affected barn owls. Rodents after consuming rodenticides show reduced mobility, which makes them vulnerable to predation by barn owls. Consuming such rodents in turn may be causing the death of barn owls. 

What can be done?

While the barn owl is considered a resident bird species, it is essential to study its ecology, hunting behavior, habitat preferences, and zoonotic diseases. Public awareness about the benefit of barn owls can also help. One of the ongoing practices is the Nepal Owl Festival which is celebrated every year. These types of collective efforts promote owl conservation through the involvement of the community. As the effort is made on the localized scale, the government should support the concerned organizations to amplify the scale of coverage of the initiatives.  

Nepal has prepared a conservation action plan for barn owls. The action plan stipulates that the existence of the species depends on the safety of its habitat and availability of prey to hunt. Restoring its old habitats, encouraging the building of artificial nests in semi urban cities like Lumbini, Pokhara, Koshi and Bhaktapur helps in improving their habitat qualities. In the finer scale, practicing agroforestry with layers of trees, bushes and vegetation of native plants, helps maintain local biodiversity and also provides a safe habitat and hunting ground for barn owls. The approach will serve the dual purpose of providing important fodder and fuelwood for the household, as well as providing the protective layer for the crops.

To reduce illegal hunting, trade and harm to this bird, a penalty of Rs 20,000 to Rs 50,000 or an imprisonment of six months to one year or both, is in place. But most people are unaware about this law, so it would be good if we invest in awareness drives. 

Despite being the least concerned species in other parts of the range, the situation of barn owls in Nepal is terrifying. And most of the threats to the species finds their root in anthropogenic interferences. However, the species are yet to receive the conservation attention they deserve. We need to shift our focus to preserve the nesting, roosting and hunting sites of the barn owl and alleviate other threats to prevent the local extirpation of the species.