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.

In today’s hyper-connected world, access to health information has never been easier. Yet, ironically, the ability to understand and apply that information remains one of the biggest barriers to better health outcomes.

This is where health literacy comes in, not just the ability to read a pamphlet or follow a doctor’s prescription, but the broader skill of accessing, comprehending, and using health information to make informed decisions for oneself, one’s family, and one’s community.

While definitions vary, there is consensus that health literacy is multi-dimensional. It involves confidence, critical thinking, and practical skills, knowing when to seek care, how to evaluate health claims, and how to follow treatment correctly. In essence, health literacy is the foundation of preventive care and treatment adherence, and its absence can be devastating.

The Challenge of Low Health Literacy in India

The scale of the problem in India is stark: nearly 90 percent of Indians have low health literacy. This gap directly affects patient outcomes, from delayed diagnoses and poor compliance with treatment to preventable complications and higher healthcare costs.

Several factors explain this reality:

• Low literacy levels: A significant proportion of the population cannot read or interpret basic medical instructions, leading to mismanagement of conditions.

• Poverty and affordability: For millions living on less than INR 100 a day, awareness alone is not enough when healthy choices remain unaffordable.

• Gender and cultural barriers: Women often have lower access to information and autonomy in health decisions, particularly around reproductive and maternal health.

• Distrust in healthcare systems: Overcrowded facilities and inconsistent care erode confidence, driving many to informal or unverified sources.

Low health literacy doesn’t just harm individuals; it amplifies inequities and strains the entire healthcare ecosystem. It also worsens misinformation, as people turn to social media or word-of-mouth for guidance, often encountering unverified or unsafe advice.

Blockbuster drug Ozempic, known for treating type 2 diabetes and obesity, has a surprising side effect. A new study published in The Lancet Psychiatry showed that the GLP-1 receptor agonists might prevent worsening of depression and anxiety.

People with diabetes or obesity are generally more likely than the general population to suffer from depression and anxiety. It is because both diabetes and obesity increase the risk of mental ill-health, and vice versa.

The findings showed that people with diabetes using semaglutide had a substantial decrease in hospitalizations and sick leave due to mental illness, including less worsening of depression, anxiety, and self-harm.

“Our findings suggest that GLP-1 drugs, particularly semaglutide, might contribute to better mental health in people with diabetes and obesity, but since this was an observational study, controlled clinical trials are needed to confirm the results,” said Jari Tiihonen, specialist physician and professor at the Centre for Psychiatry Research, Karolinska Institutet.

What Did The Study Find?

The research, led by an international team from Griffith University, the Karolinska Institutet, and the University of Eastern Finland, tracked Swedish national registers between 2009 and 2022.

It included 95,490 people, of which GLP-1 receptor agonists were used by 22,480 individuals during the follow-up period.

Semaglutide was associated with a decreased risk of worsening

• depression
• anxiety
• substance use disorder
• self-harm.

Patients using semaglutide experienced a 42 percent lower risk of hospitalization for mental health issues during periods of use, compared to periods when they were not taking the drug.

More specifically, the risk reduction was 44 per cent for sickness absence or hospital care due to depression, 38 per cent for anxiety disorders, and 47 per cent for substance use.

Also read: Can Weight Loss Jabs Surge Divorce Rates? What Experts Are Saying

The team also found some benefits with Liraglutide. The drug was associated with an 18 per cent lower risk of sickness absence and hospital care due to psychiatric reasons.

How Does Semaglutide Work?

Semaglutide works as a GLP-1 receptor agonist that mimics the GLP-1 hormone to regulate appetite and blood sugar. It slows gastric emptying and makes you feel fuller longer. It also signals the brain to reduce hunger and cravings, and triggers the pancreas to release insulin when blood sugar is high.

They work by increasing insulin release in a glucose-dependent manner, decreasing the liver's production of glucagon, and slowing down the emptying of the stomach, which helps lower blood sugar levels after a meal. They also act on the brain to suppress appetite and increase feelings of fullness, leading to reduced calorie intake.

Read More: Can Semaglutide Help Fight Cancer In The Brain?

In people with type 2 diabetes, notes Harvard Health, the body's cells are resistant to the effects of insulin and the body does not produce enough insulin, or both. This is when GLP-1 agonists stimulate the pancreas to release insulin and suppress the release of another hormone called glucagon.

These drugs also act in the brain to reduce hunger and act on the stomach to delay emptying, so you feel full for a longer time. These effects can lead to weight loss, which can be an important part of managing diabetes.

In the wake of a young doctor from Chandigarh accusing a well-known private hospital of unnecessarily admitting patients to Intensive Care Units (ICUs), it is imperative to understand who truly requires critical care.

In a widely shared video posted on the social media platform Instagram, Dr Prabhleen Kaur alleged that the hospital is making the patients remain admitted in the ICU for as long as possible to mint money.

The doctor did not mention the name of the hospital. And HealthandMe could not independently verify the details and the authenticity of the post.

However, the incident reignited concerns over accountability, patient safety, and standards of care in the country.

Speaking to HealthandMe, Dr. Sachna Shetty, Consultant Emergency Medicine at Jaslok Hospital and Research Centre, said that: "ICU admissions are for patients with life-threatening conditions needing intensive support".

"This includes shock, respiratory failure, neurological emergencies, cardiac issues, and multi-organ dysfunction," the doctor added.

What Is ICU? Who Needs Critical Care?

The NHS UK explains that intensive care units (ICUs) are specialist hospital wards that provide treatment and monitoring for people who are very ill.

They're staffed with specially trained healthcare professionals and contain sophisticated monitoring equipment.

Also called critical care units (CCUs) or intensive therapy units (ITUs), it is required in cases where a person is seriously ill and requires intensive treatment and close monitoring.

Most people in an ICU have problems with one or more organs. For example, they may be unable to breathe on their own. Some common reasons include:

• a serious accident
• a serious short-term condition
• a serious infection
• a major surgery.

"ICU beds are limited, reserved for those who'll benefit most. Decisions are time-sensitive, based on triage and clinical scoring. It's about who needs advanced life support, not just who looks critical. Fair use of resources is key," the doctor added.

ICU Admissions: What India’s Guidelines Say

India’s ICU admission guidelines—issued by the Ministry of Health and Family Welfare in January 2024 — clearly defines who should and should not be admitted to an ICU. According to the guidelines:

• ICU admissions must be based on the severity of organ failure and the necessity for organ support or in anticipation of a potential deterioration in the patient's medical condition.
• Hospitals cannot admit critically ill patients in ICU in case of refusal by them and their relatives.
• ICU is not recommended in cases where there is no treatment possible or available, and if the continuation of therapy is not going to make an impact on the outcome, especially survival.
• Anyone with a living will or advanced directive against ICU care should not be admitted to ICU.
• Low priority criteria in case of a pandemic or disaster situation, where there is resource limitation, should be taken into account for keeping a patient in the ICU.
• Blood pressure, pulse rate, respiratory rate, breathing pattern, heart rate, oxygen saturation, urine output and neurological status among other parameters should be monitored in a patient awaiting an ICU bed

1. patients with altered level of consciousness,
2. hemodynamic instability,
3. need for respiratory support,
4. patients with acute illness requiring intensive monitoring
5. organ support or any medical condition or disease with anticipation of deterioration.

Guidelines For ICU Discharge Criteria In India

The guidelines stress the importance of physiological parameters returning to near-normal or baseline status.

Furthermore, reasonable resolution and stability of the acute illness that led to ICU admission are essential factors.

Patient and family agreement for ICU discharge, particularly in cases where a treatment-limiting decision or palliative care is opted for, is also highlighted.