Imagine this. A young teenager, 17, years old, who is fully developed. Now imagine this, the same teenager has a fully developed extra set of limbs and a pelvis. That extra set of pair is attached with chest artery. But, how can this happen?

While it is extremely rare, and has a chance of less than one case occurring per 100,000 births. Such things do happen. This is called parasitic twin.

What Is A Parasitic Twin?

It is an extremely rare type of cojoined twin where a baby is born with an underdeveloped twin attached to its body. This condition is also known as vestigial twins. The condition is very closely related to conjoined twins, where babies are connected at birth and share organs. However, the main difference is that in conjoined twins, there are two developed babies, whereas in parasitic twins, only one is fully developed, other one is underdeveloped and non functional.

In such a case, the twin who is developed is medically known as the autositic or the dominant twin. The dominant twin is healthy in most aspect but may have extra tissue, organs, or limbs from the parasitic twin.

The parasitic twin may be attached with the dominant twin through several places. The common joints are at the head, torso, chest, pelvis, buttocks, or back. In these cases, the parasitic twin is not alive and they die either in the womb or during the childbirth.

Doctors Remove Parasitic Twin

Now, let's go back to the case we referred to, where a young teenager had an extra pair of limbs attached to chest. The teenager who has not been named is from Uttar Pradesh's Unnao neighbourhood, and was treated in AIIMS, Delhi. The team of doctors successfully removed the extra set of limbs from his body.

Dr Asuri Krishna, who led the team of specialist who surgically removed the extra limbs told the BBC that only 40 to 50 cases of parasitic twins have been documented in world medical literature, and in those cases, the surgery had been attempted on children. The doctor said that without much medical literature to guide them, the team of doctors depended on "intuition, skill and knowledge".

The doctor shared that the child had two fully formed legs, buttocks and external genitalia, which weighed around 15kg "protruding from his abdomen".

How Was The Surgery Performed?

The doctor shared that first they identified how interconnected the parasitic and host twins were. The doctors took scans and found that parasitic twin was attached to the teen's breastbone. The blood was being supplied from a vessel in his chest. However, "there wasn't much connection with other main organs like the liver or kidneys," said Dr Krishna. The team also found a large cyst in the teen's abdomen.

Then the surgery was performed in two stages. In the first stage, the parasitic twin was removed. Then the cystic mass was extracted from the surrounded area. The entire surgery was completed in two and a half hours and the team of doctors included radiologists, anaesthetists, and plastic surgeons.

The biggest challenge was when the teen's blood pressure dropped as 30 to 40% of his blood flowed to the parasitic twin, however, the doctors were prepared for it and they stabilized him.

Even as heatwave conditions continue to intensify across parts of the country, cases of heat-related illnesses are on the rise, leaving many confused between heat stroke and heat exhaustion.

While both are caused by prolonged exposure to high temperatures, their severity, warning signs, and management can differ significantly.

Speaking to HealthandMe, Dr. Naval Vikram, Professor, Department of Medicine, at the AII India Institute of Medical Sciences (AIIMS), explained the key symptoms to watch out for, how to tell the difference between the two conditions, and the simple yet crucial steps individuals can take to protect themselves during extreme heat.

“The general features of a patient with heat stroke are: first, his or her body temperature will be very high. It will not be around normal levels like 104, 105, or 106—it will be significantly elevated. Second, the person may be delirious, confused, or even in a state of unconsciousness or coma. The breathing will also be labored. These are the features of heat stroke,” Dr Vikram said.

On the other hand, a person with heat exhaustion remains conscious, but looks and feels very tired. The individual is also likely to experience

• body ache,
• muscle pain,
• headache,
• muscle cramp,
• body pain or fatigue.

"If this has happened after exposure to heat, it is similar to the feeling one gets after jogging, running, or playing for about half an hour and then feeling exhausted. If that same feeling occurs without doing any such activity, then it is a stage of heat exhaustion, because it is happening due to the heat,” Dr Vikram told HealthandMe.

Who Is More At Risk With Heat-related Problems?

The most vulnerable category for heat-related problems is the extremes of age—the younger children and older adults.

The expert noted that younger children may not be able to express their symptoms completely. They may not be able to tell you exactly what they are feeling.

At the other end, older adults often have multiple health issues—neurological conditions, diabetes, hypertension, and kidney problems.

"So multiple organs may already be affected to some extent. In such situations, if heat-related illness occurs, it becomes difficult to diagnose, especially if they already have neurological problems like confusion or altered behavior," Dr Vikram said.

With existing comorbidities, other organs may already be compromised, so the tipping point towards severity happens very quickly. In contrast, younger individuals generally have greater body reserves.

Therefore, people at the extremes of age are more vulnerable, also because it can sometimes be difficult to recognize and diagnose the condition in them.

How Can One Prevent?

While it may be impossible to avoid rising temperatures, the focus should be on how much you can protect yourself. The expert suggested measures such as:

• Try to avoid exposure to extreme heat as much as possible.

• In case of being exposed, make sure to cover yourself—cover your head and upper body, use an umbrella, stay hydrated, and take breaks in between.

• If you have to work in a hot environment for a couple of hours, take a break in a cooler or temperature-controlled environment for at least half an hour before resuming, rather than continuously working in the heat. These steps can help prevent heat-related problems.

• If symptoms do occur, and it is heat exhaustion, take rest and avoid further activity for some time.

• In more severe cases—if someone shows symptoms like loss of consciousness or very high body temperature—they should be taken to a hospital immediately. Do not try to manage such cases at home.”

Complex pesticides can be now be found in food, water and the surrounding environment and while previous research has noted that they can cause damage to vital organs, a new Nature Health study has revealed that high-exposure to such chemicals can increase a person's risk of certain cancers by over 100 percent.

The researchers analyzed 31 pesticides across Peru and compared the health data from more than 150,000 cancer patients recorded between 2007 and 2020 with areas to discover that people living in regions with higher environmental pesticide exposure were 150 percent more at risk of developing cancer. It remains unclear which kind of cancers they are most prone to.

Stéphane Bertani, a researcher in molecular biology at the French National Research Institute for Sustainable Development (IRD), at the PHARMA-DEV laboratory (IRD/University of Toulouse) said of the results: "This is the first time we have been able to link pesticide exposure, on a national scale, to biological changes suggesting an increased risk of cancer."

The study also highlights how pesticide exposure may affect the body long before cancer is diagnosed. Although tumors can develop in different organs, some share underlying biological weaknesses tied to their cellular origins and vulnerabilities which may be influenced by pesticide exposure.

Previous studies conducted at the Institut Pasteur, led by Pascal Pineau, also show that pesticides can slowly interfere with processes that maintain normal cell function and identity.

Over time, these disruptions accumulate without obvious symptoms and make tissues more susceptible to other harmful influences, including infections, inflammation and environmental stress, paving the way for cancer development.

Pesticides Can Also Increase Risk Of Lung Cancer

The research from the University of Southern California, presented at the annual meeting of the American Association for Cancer Research, found that patients under 50 diagnosed with lung cancer often had better-than-average diets. The experts zeroed in on the culprit, pesticide exposure from conventionally grown produce.

"Our research shows that younger non-smokers who eat a higher quantity of healthy foods than the general population are more likely to develop lung cancer," said lead investigator Jorge Nieva, a medical oncologist and lung cancer specialist with USC.

"These counter-intuitive findings raise important questions about an unknown environmental risk factor for lung cancer related to otherwise beneficial food that needs to be addressed," Nieva added.

Pesticides In Healthy Foods — A Hidden Risk

According to the researchers, the reason may lie in environmental exposure, particularly pesticides used in agriculture. Nieva noted that commercially produced (non-organic) fruits, vegetables, and whole grains are more likely to carry higher levels of pesticide residue compared to dairy, meat, and many processed foods.

He also pointed out that agricultural workers who are regularly exposed to pesticides tend to have higher rates of lung cancer, which supports the possibility of a connection.

The study also found that young women who do not smoke are diagnosed with lung cancer more often than men in the same age group. Women in the study also tended to consume more fruits, vegetables, and whole grains than men.

Kidney stone incidences increase significantly in the summer months; the main reason for this increase is the effect of summer on people's hydration levels. As we get hotter, we sweat a lot, and when we sweat, we lose fluids. If we don't drink enough fluids to replace what we have lost through sweating, our urine will become more concentrated.

Concentrated urine provides a good environment to crystallize minerals, calcium, oxalate, uric acid, and eventually create stones.

In hot weather, it is easy for people to think that they don't need to drink as much water as they really do. The effects of mild dehydration can have a major impact on how many liters of urine a person produces, which is one of the most significant contributors to protecting against developing kidney stones.

When urine production decreases, waste products in the urine become less diluted, so the chances of forming crystals are increased. People who do not exercise much or who don't pay attention to their hydration habits can be at greater risk than others for developing kidney stones.

Poor eating habits in the summertime can add to the problem. Increasing your consumption of salty and processed foods can raise your calcium excretion in the urine, leading to more stones. A high intake of animal protein can increase your uric acid level and decrease your citrate level, a natural inhibitor of stones. Many people will also reduce the amount of fluids and water-rich foods they consume when travelling or working, which further increases the risk of developing stones.

Another factor that isn’t frequently considered is delaying urination. Holding urine for long periods will cause the minerals to settle in the urinary tract and may crystallize, which increases the likelihood of developing stones. Delaying urination in combination with dehydration provides the ideal environment for the formation of stones.

It is important to know and recognize the early symptoms of kidney stones so that you can seek help in a timely manner. Symptoms to watch for are:

• Severe flank pain (back or side),
• burning sensation when urinating,
• nausea and vomiting,
• blood in urine.

Failure to seek treatment for these symptoms can result in complications, such as urinary tract infection or obstruction due to kidney stones.

There are several commonly used methods of preventing kidney stones during the summer months, and they involve very basic lifestyle changes. Consistently drinking enough water so that your urine is clear or light in color is the single most important thing you can do to avoid a kidney stone.

Limiting your intake of additional salt and moderating your animal protein consumption will help as well. Including citrus fruits (lemons and oranges) in your diet may also prevent kidney stones, because they contain citrates, which help to inhibit the formation of kidney stones.

By using proper hydration, good nutrition, and an awareness of the early warning signs of kidney stones, your kidney stone risk will be considerably lowered throughout the summer months.