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.

Although monsoon rains provide relief from the unbearable summer heat, they also increase the risk of infections, dehydration, and diseases that are transmitted through water and that can affect the functioning of your kidneys. Since kidneys play a crucial role in eliminating toxins from your body and maintaining fluid balance, kidney care during the monsoon season becomes necessary.

Stay Hydrated

Though it is cooler during monsoon rains, your body needs enough water to help the kidneys filter the toxins efficiently. Try drinking 2-3 liters of clean water daily, or according to the requirement advised by your doctor. Avoid drinking contaminated water, as it increases the risk of infections in the kidneys.

Eat Healthy and Fresh Food

Eat fresh and cooked food at home instead of junk food that might get contaminated during the monsoon rains. Include seasonal fruits, vegetables, whole grains, and healthy protein sources in your diet. Restrict the intake of excess salt, canned products, and sugar drinks.

Prevent Infections

The monsoon season is prone to UTIs that may eventually reach the kidneys if not treated on time. Keep your body clean, wear dry clothes, and never keep urine in your bladder for a prolonged period. In case you have burning sensations while passing urine, fever, or pain in your lower abdomen, do see a doctor.

Control Health Problems

Individuals suffering from diabetes, hypertension, or pre-existing kidney problems should take special care of themselves throughout the monsoon. They should be taking their medications, measuring their sugar and blood pressure levels, and undergoing regular medical examinations to avoid kidney diseases.

No Self-medication

Analgesics and other OTC medications can cause damage to the kidneys when consumed frequently and without consulting a doctor.

Conclusion

It does not take much effort to maintain the health of your kidneys during the monsoon season. Simple things such as staying well-hydrated, consuming hygienic food, preventing any infection, keeping control of existing illnesses, and taking no medicines unnecessarily will ensure that your kidneys continue to perform at their best. In case of any swelling, change in urine output, fever, or back pain, you must see a doctor right away. The importance of the kidneys is undeniable for your well-being.

(By Dr. Bhanu Mishra, a Consultant- Nephrologist at Fortis Hospital, Shalimar Bagh)

When one hears about plastic surgery, he or she usually associates it with beauty operations designed to improve one's appearance.

Reconstructive plastic surgery is a very particular field of medicine that addresses problems with the restoration of patients' form and functions who suffer from trauma, cancer, birth defects, burns, and complicated wounds. For many people, reconstructive surgery is far from beautification. It is all about getting back to an independent life.

Reconstructive Surgery After Trauma and Cancer

Injuries that can occur following accidents on the road, incidents at industries, electric burns, and animal bites often lead to severe destruction to the skin, muscles, tendons, nerves, blood vessels, and bones. In addition, cancers of the breast, head and neck, mouth, skin, and limb regions are often treated with extensive surgical excisions to provide complete clearance from the disease.

Though these operations are necessary to save lives, they might lead to considerable impairment and deformities in the patients. Reconstructive plastic surgery helps solve these problems.

Advanced Techniques in Modern Reconstruction

Today's reconstruction surgery uses sophisticated methods, including microsurgical free tissue transfer, perforator flaps, local and regional flap reconstruction, split-thickness and full-thickness skin grafting, nerve grafting, tendon reconstruction, and vascular anastomosis.

The application of microsurgery, in particular, has greatly improved the possibilities for performing reconstruction surgeries through transferring viable tissue from one region of the body to another with the re-establishment of blood supply from blood vessels of just one to three millimeters in diameter using a surgical microscope.

Restoring Function After Cancer Surgery

One of the biggest breakthroughs in the field of reconstructive surgery has been in the area of post-cancer treatment. Women who have undergone surgery due to breast cancer have the option to undergo either immediate or delayed breast reconstruction surgery through implants or through autologous tissues to help restore their self-image and mental well-being.

Similarly, patients who have undergone surgery due to oral, jaw, or facial cancer can improve their functionality and social standing through microvascular surgery.

Burn Reconstruction and Functional Recovery

The other significant factor to consider is the importance of reconstructive surgery in the treatment of burns. Severe burns typically lead to contracture scars and limited movement of joints.

Excision, skin grafting, flaps, and scar revision surgeries are key in improving function, aesthetics, and reducing disability. Reconstruction of hands following injuries or burns allows people to carry out their daily tasks and work.

Restoring Hope Beyond Surgery

Reconstruction is not limited to the surgical theater but is best done using a multi-disciplinary team comprising plastic surgeons, oncologists, trauma surgeons, physiotherapists, occupational therapists, psychologists, dietitians, and rehabilitators. Rehabilitation, scar management, physiotherapy, and follow-up are just as important after surgery as the surgery itself.

Reconstructive plastic surgery is thus much more than a field of surgery; it is a specialty whose goal is to restore hope. Through a blend of surgical skills and compassion, it gives people an opportunity to transcend the physical and psychological effects of injuries or cancers. For many people, it changes the experience of survival into that of recovery.

With the onset of the monsoon, the risk of several water-borne, mosquito-borne, and bacterial infections increases significantly due to stagnant water, flooding, poor sanitation, and contaminated food and water.

Many of these diseases can start with mild symptoms similar to the flu, but if they're diagnosed early, you can get the appropriate medical care in time, avoiding serious complications.

Early Symptoms Of Various Monsoon Diseases

One of the important ways to prevent monsoon infections and diseases is to identify warning signs early, Dr. Amit Saraf, Director, Department of Internal Medicine, Jupiter Hospital, told HealthandMe.

Leptospirosis

Leptospirosis gained attention after its cases surged in Kerala recently. The infection has also been reported in Maharashtra, Gujarat, Tamil Nadu, and Karnataka. The bacterial infection typically spreads via contact with water or soil that has been contaminated by the urine of animals infected with leptospirosis, especially during floods.

Initial signs and symptoms include:

• High fever

• Chills

• Intense muscle pain (especially in calves)

• Headache

• Red eyes

• Nausea

• Vomiting

“Wearing protective footwear, avoiding wading in floodwaters, and covering any open wounds will help minimize the risk of infection,” Dr Saraf recommended.

Typhoid

• High fever

• Headache

• Weakness

• Loss of appetite,

• Abdominal pain

• Constipation or diarrhea

• Body aches

Dr. Saraf said: “It can cause serious gastrointestinal issues if not treated. Safe drinking water, good hand hygiene, and freshly cooked food are important preventive measures.”

Cholera

Cholera is a water-borne bacterial disease that commonly occurs during monsoons. It often begins with excessive watery stools, vomiting, leg cramps, and rapid dehydration. Dehydration can quickly become an immediate danger of cholera.

The doctor said: “Prevention includes drinking clean water, eating hygienically prepared food, and practicing proper sanitation and handwashing.”

Dengue

Dengue is one of the most common viral diseases spread by Aedes mosquitoes. Often reported in various Indian states during the monsoon, dengue presents with flu-like symptoms. Dengue usually begins with high fever, severe headache, pain behind the eyes, extreme muscle and joint pain, nausea, skin rash, and fatigue.

Malaria

Malaria, a common monsoon disease, is spread by infected mosquitoes and characterized by the following symptoms:

• Recurrent fever

• Shivering or sweats

• Headache

• Muscle pain

• Weakness

• Nausea

• Vomiting

Dr Saraf said, “Early diagnosis is important to prevent severe diseases. The best ways of preventing mosquito bites are by using mosquito repellents, mosquito nets, and the elimination of breeding sites.”

Chikungunya

Mosquito-borne viral diseases are reported to be the highest during the rainy season. One of them is Chikungunya. The infection is usually marked by sudden high fever and severe joint pain in the limbs. Other early symptoms may include headache, muscle pain, fatigue, and skin rash.

“The infection is usually not deadly but can cause joint pain for weeks or months. Preventive measures include mosquito control and avoidance of mosquito bites,” the expert advises.

Gastrointestinal Infections

During the monsoon period, gastrointestinal infections are also more common as food and water sources are more likely to get contaminated. Early signs of gut infections may include diarrhea, vomiting, cramps, nausea, bloating, fever, and dehydration.

The majority are due to bacteria, viruses, or parasites. The expert said that the risks can be minimized by maintaining food hygiene, drinking boiled or purified water, washing fruit and vegetables before cooking and consuming, and refraining from eating street foods and drinks.