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.

Irritable Bowel Syndrome (IBS) is a common but often overlooked gastrointestinal disorder; as a result, IBS is very prevalent, with less than 15% being diagnosed.

Individuals frequently experience recurrent symptoms such as bloated abdomen, abdominal pain, gas, diarrhea, or constipation, and normalize these symptoms over time or attribute them to "something they ate" or everyday stresses. Therefore, IBS remains undiagnosed for many years.

Why Diagnosis Is Often Delayed

One reason for this delay in being diagnosed is that the symptoms occur intermittently. It is also important to note that the presentation of these symptoms is inconsistent and unpredictable; there may be episodes where the IBS can last many days, and then completely resolve, thus providing a false sense of relief. Therefore, many individuals choose to delay consulting with a physician due to their belief that the symptoms they are experiencing are not serious.

Stigma Around Digestive Health

Another contributing factor is that there is still a degree of reluctance or discomfort associated with discussing problems related to the gastrointestinal tract openly; this only further complicates under-reporting statistics.

A ‘Functional’ Disorder Adds to Confusion

Finally, IBS is a functional disorder. Therefore, routine diagnostic testing will not reveal any visible abnormalities. Many patients may assume that the symptoms they are experiencing are not "real" or are not significant enough to warrant seeking medical attention, even though the discomfort they experience can be quite significant and affect their daily lives.

If you continually ignore symptoms of IBS, it will hurt your quality of life, productivity, and mental health. If you have persistent discomfort, you are likely to develop anxious feelings about eating, socializing, and travelling. Furthermore, if you don't manage your symptoms, you may experience a combination of untreated IBS with one or more other illnesses that are either gastrointestinal or metabolic; consequently, establishing the correct diagnosis for your IBS will be increasingly difficult as time goes on.

Why Early Action Matters

It is of the utmost importance to identify and respond to early warning signs of IBS as quickly as possible. A thorough evaluation can rule out other illnesses and provide a pathway for appropriate management, including dietary modifications, stress management techniques, and, if necessary, medical treatment.

Once you address your IBS, you will experience better control of your symptoms and eliminate the long-term consequences of IBS, both physically and psychologically.

Colorectal Cancer is not only one of the most common and deadly cancers, but is also one of the most preventable ones.

Unlike many other cancers, patients have a clear window of opportunity to stop it before it even begins. Almost always, these cancers start as small growths called polyps or precancerous lesions on the inner lining of the colon or rectum.

There is a long interval of time before polyps develop into cancer. During this time, they can be removed if they are identified. If a doctor removes a precancerous polyp during a routine screening, they would not only have nipped the cancer in the bud, but would have also prevented it from occurring.

However, there is a persistent taboo surrounding discussing bowel movements and other risk factors, and public understanding of its symptoms and crucial screening procedures frequently lags.

Dr Jeremy Clark, a consultant general surgeon specializing in colorectal diseases at Nuffield Health in Brighton, has underscored five critical warning signs the public must recognize, The Independent reported.

1. Blood in stool

“Passing blood when you go to the toilet is a worrying feature that you should flag to your GP,” Clark said, adding that the color can vary from bright red to almost black.

“If you see blood in the stools, particularly darker-colored blood or blood that’s actually mixed in with the stools, just once, and it’s significant, that should be reported to your doctor straight away. Don’t wait for that to keep on happening,” he added.

2. Changes in Bowel Habits

Dr. Clark stated that although more constipation may not be a risk factor, any sudden changes in bowel movements that last for a couple of weeks and do not go back to normal must be checked.

“If your bowels go from working once a day like clockwork, and then suddenly you’re going two or three times a day, and the bowels are a bit looser, that’s something that needs to be looked into,” the expert added.

3. Abdominal pain

Dr Clark highlighted that bowel cancers can cause abdominal pain, even in the initial days.

4. Bloatedness

The feeling of being 'quite often’ bloated may also indicate that something is going wrong in the bowel, Dr. Clark said.

5. Unexplained weight loss

Bowel cancers can impact digestion and cause weight loss

Dr Clark said that as these symptoms are common with other conditions, such as hemorrhoids or irritable bowel syndrome (IBS), people often ignore or easily dismiss these symptoms. He urged patients not to ignore and visit their doctor if they notice any of these symptoms.

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What Is Colorectal Cancer?

The American Cancer Society notes that colorectal cancer is a cancer that starts in the colon or the rectum. Colorectal cancer impacts around 1.9 million people every year, noted the World Health Organization (WHO) as per its 2022 data.

It is a disease of the large bowel and a type of cancer that originates from the rectum or colon. A person's colon, cecum, rectum, and anus make up the large intestine.

According to experts, if you are above 45 years of age or have high-risk factors, you need to take the initiative to be screened.

The FIT (Fecal Immunochemical Test) is a simple, non-invasive at-home stool test kit that can collect a small sample of your feces, which can then be tested.

“If it comes back as positive, that means there is blood in your stools which needs to be investigated,” Clark said, adding that the next step is typically the Colonoscopy – the gold standard.

Genetic diseases in India constitute one of the most understated issues in the realm of public health in the country, owing to the presence of several interconnected factors. As per estimates, there are at least tens of millions of affected individuals who suffer from various genetic diseases. However, most of them remain undiagnosed until they become seriously ill. There could be several reasons behind this problem; one of the key factors contributing to this is the complexity associated with genetic diseases. Most of these diseases have non-specific presentations that can easily mimic other common ailments. As a result, the diagnosis process becomes protracted, whereby patients may require consulting several physicians and receive treatments before their exact condition is diagnosed.

What are the challenges in accessing genetic diagnostic services?

Dr Bhavini Shah, Head of Clinical Microbiology at Neuberg Diagnostics, Ahmedabad, said, “The first major barrier relates to the availability of genetic services. Currently, most advanced diagnostic tools, such as next-generation sequencing, molecular tests, and other methods, are only available in tertiary care centres situated in urban areas, leaving out a considerable percentage of the population. Additionally, there is a significant lack of trained medical geneticists and counsellors. Currently, the number of trained medical geneticists and counsellors in India is minimal, leading to many specialists managing various responsibilities and being involved in different tasks. Consequently, the process becomes less efficient, with medical experts unable to provide patients with adequate attention.”

Why is there a lack of reliable data on genetic diseases in India?

The second major barrier includes the lack of a unified and integrated framework to monitor and collect national-level data on genetic diseases. There have been several initiatives to create a registry or monitoring system; however, the process remains fragmented and incomplete. Therefore, there is no comprehensive information on the actual prevalence and geographical distribution of genetic diseases in India. For example, certain regions in India have more cases of beta-thalassaemia and sickle cell disease than other places.

How do financial limitations affect diagnosis and treatment?

Dr Shah also spoke about financial limitations. The expert said that financial limitations play another important role in complicating the issue. Although there have been many advancements in diagnosing diseases, such procedures can still be quite costly and are not always covered by public health insurance, limiting their accessibility to a wide range of people. Without the availability of low-cost or free testing facilities, many individuals are unable to undergo diagnosis at all or only do so when the disease has already developed considerably. Moreover, the unavailability of extensive newborn or prenatal screenings leads to many genetic disorders being overlooked.

What steps can help address the issue of undiagnosed genetic disorders?

Dr Shah said that to overcome the issue of genetic disorders going unnoticed in India, there needs to be a systematic approach towards solving this problem. Some ways through which this can be achieved would be by providing affordable genetic testing facilities to people, ensuring that clinicians have adequate knowledge regarding genetics, and incorporating the use of genome screenings within the framework of preventive care for the population. In addition, it is necessary to develop region-specific research initiatives and databases, which will help us understand the unique genetics of each region.

Why is awareness about genetic testing still low?

"An important yet not much talked about reason for underdiagnosis is the low level of awareness and knowledge about genetic testing among healthcare professionals and patients. Several primary care doctors and specialists do not immediately suspect a genetic cause in illnesses that present with a variety of symptoms and can be confused with other diseases, which means patients do not get the right tests on time. On the other hand, patients are often not informed about genetic testing and may consider it to be related only to very rare or family diseases. They are not aware that it can be used as a preventive or diagnostic method. The consequence of this is that the chances of early detection, the use of targeted medicines, and informed family planning are lost. Therefore, enhancing understanding of genetics among doctors through continuous education, along with raising public awareness through health campaigns, is key to addressing this problem of underdiagnosis," Dr Shah concluded.