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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.
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.
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".
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.
Credit: Guy's and St. Thomas Specialist Care
Dry cough and breathing difficulty aren’t always caused by asthma, COPD, or infections. They can also be signs of interstitial lung disease (ILD), a group of lung conditions that can cause inflammation and scarring and, in some cases, progressive loss of lung function.
ILD can go unnoticed in its early stages because its symptoms are often mistaken for more common respiratory conditions. By the time a patient undergoes a CT scan and reaches an ILD clinic, significant lung scarring may have already developed — and some of that damage may be irreversible.
A Global Burden of Disease Study 2023 analysis, published in December 2025, estimated that 4.58 million people were living with ILD and pulmonary sarcoidosis worldwide in 2023, with 112,650 deaths attributed to the conditions that year.
“The true global burden of ILD is higher than currently reported, particularly in underserved populations and low- and middle-income countries,” Prof. Marlies Wijsenbeek-Lourens, Pulmonologist and Head of the Center for Interstitial Lung Diseases and Sarcoidosis at Erasmus University Medical Center, Netherlands, told HealthandMe.
The global expert said most available epidemiological data come from Europe, North America, Japan, South Korea and Australia, where access to specialist care, multidisciplinary diagnosis and high-resolution CT imaging is generally more available.
“As a result, large parts of Africa, South America, South and Southeast Asia remain underrepresented in current estimates. In these regions, more limited access to diagnostic facilities, fewer ILD specialists and under-recognition of disease undoubtedly result in substantial underdiagnosis.”
Even in high-income countries, she added, some patients with ILD likely remain undiagnosed because symptoms such as breathlessness and cough are often attributed to more common conditions.
ILD is not a single disease but a group of more than 200 lung conditions. The disease affects the interstitium, the tissue surrounding and supporting the lungs’ air sacs, or alveoli. In ILD, this tissue can become inflamed and/or scarred.
As scarring progresses, the lungs can become stiffer, making it harder for them to expand and reducing the efficiency of oxygen transfer. As the disease progresses, the lung shrinks, making it difficult for the patient to breathe.
According to Prof. Marlies, there is a rise in ILD diagnoses due to several factors, such as:
Some forms of ILD can be treated more effectively when identified early, before permanent lung damage occurs.
“Unfortunately, many patients still reach an ILD specialist late. Breathlessness and cough may initially be treated as asthma, infection or sometimes even tuberculosis. By the time a CT scan is done and the patient reaches an ILD clinic, significant scarring may already have developed,” Dr Asmita Mehta, Professor and Head, Department of Respiratory Medicine at Amrita Institute of Medical Sciences, Kochi, told HealthandMe.
“A dry cough and gradually progressive breathlessness lasting for more than three months, particularly breathlessness while walking or climbing stairs, should raise suspicion of ILD rather than simply being attributed to asthma, infection or ageing,” she added.
Doctors should think of ILD especially when these symptoms do not improve with usual treatment, when fine crackling sounds are heard in the lungs, or when oxygen levels fall during walking.
It is also important to ask about joint pain, skin changes, dry eyes or mouth, and exposure to birds, mould, biomass smoke or occupational dust. Sometimes the clue to ILD is outside the lungs, the expert said.
Pre-existing ILD was associated with worse outcomes during COVID-19. Now, six years later, some patients who had severe COVID-19 also continue to show persistent lung abnormalities.
“The reassuring part is that not every abnormal CT after COVID means progressive lung fibrosis. In many patients, the lung changes gradually improve or remain stable. Some patients who had very severe COVID, prolonged ICU admission, or required ventilation may be left with persistent scarring and may need longer follow-up,” Dr Asmita said.
Common ILD diagnoses seen in India include connective tissue disease-associated ILD (CTD-ILD), hypersensitivity pneumonitis (HP), idiopathic pulmonary fibrosis (IPF), sarcoidosis and idiopathic nonspecific interstitial pneumonia (NSIP).
Dr Asmita said that, apart from idiopathic pulmonary fibrosis, ILD related to autoimmune diseases and environmental exposures is also commonly seen in India. These exposures can include birds, mould, biomass smoke and certain occupations.
Epidemiological reviews estimate the overall prevalence of ILD in India to range between 49.0 and 98.1 per 100,000 people, with an annual crude incidence rate of 10.1 to 20.2 per 100,000 population.
India is also building a larger national evidence base through the ICMR-led Indian Network of Pulmonary Fibrosis (INPF) registry.
“We therefore need not only earlier diagnosis, but better awareness, affordable treatment, wider access to ILD specialists and stronger advanced-care and transplant programs,” Dr Asmita said.
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Humans and most mammals have two sex chromosomes, X and Y. Females typically have two X chromosomes (XX), while males typically have one X and one Y chromosome (XY). As men age, many of their cells gradually lose the Y chromosome, due to a common genetic change.
Research has shown that cancer incidence and mortality rate are more among men than women. A new study may offer clues as to why.
Researchers from the University of Arizona found that loss of the Y chromosome in men’s tissues could create conditions that allow cancer to develop.
The research, published in JCI Insights, found that Y chromosome loss creates a pre-neoplastic field effect — a hidden zone of genetic vulnerability in normal-appearing tissue that may provide fertile ground for cancer development.
Also read: US Cancer Death Rates Fall For Men, Women: Lung Cancer Progress Drives Decline
Previous studies have linked loss of the Y chromosome in blood cells to an increased risk of disease. The new study systematically profiled Y chromosome loss across normal, precancerous and cancerous tissues from 11 major human organs.
“We were able to show that the loss of the Y chromosome is found in normal-appearing tissues adjacent to a tumor,” said physician-scientist Dr. Dan Theodorescu of the University of Arizona Cancer Center.
“That finding is what makes this discovery so exciting. It suggests we may be looking at one of the earliest signposts of cancer forming.”
The team analyzed 1,000 tissue samples from 405 men, using an automated fluorescent imaging system to examine more than 4.3 million individual cell nuclei and measure the ratio of Y to X chromosomes.
In one part of the study, researchers created detailed maps of bladder tissue removed during cancer surgery.
The maps showed that Y chromosome loss increased as tissue progressed from normal tissue to early abnormal cells and then to cancer.
Y chromosome loss in normal-appearing tissue was highest in samples from colon, rectal, esophageal, pancreatic and lung cancers.
“We are now thinking of this as a gradient, similar to a hillside that slowly gets steeper,” Theodorescu said. “The closer the tissue is to a cancer, the more Y chromosome loss we see. That gradient could one day help doctors suspect trouble in biopsies that miss a smaller cancer.”
Read More: UK NHS Trust To Review 4,500 More Breast Cancer Cases After 20 Unnecessary Mastectomies
Theodorescu’s previous research examined how loss of the Y chromosome in cancer cells can help them evade the immune system. This may help explain why Y chromosome loss has been associated with higher mortality from certain carcinomas.
The Y chromosome spans more than 59 million DNA base pairs and accounts for almost 2% of the DNA in human cells. It contains roughly 70 to 200 genes involved in protein production.
The chromosome contains genes that play important roles in male sex development and fertility, including sperm production.
Beyond reproduction, research suggests that the Y chromosome can influence immune and inflammatory responses in men, potentially affecting susceptibility to certain diseases.
Globally, cancer is diagnosed more often in men than in women, with men having roughly a 25% higher incidence rate. Men also account for a greater share of cancer deaths worldwide.
Some of the most common cancers affecting men include prostate, lung, colorectal and skin cancers. Early detection and appropriate screening can improve the chances of successful treatment for several types of cancer.
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Shortness of breath can happen for many reasons. Low activity, extra pounds and long hours of sitting can all play a role. But ongoing symptoms may be due to asthma or other lung problems. It can be linked to anemia as well. Heart problems are another possibility, along with other conditions that involve the lungs or the heart and blood flow. Sometimes breathing trouble shows up before other clear signs appear.
A clinician will try to sort out what is going on by looking at your pattern of symptoms. They may ask how fast it happens, when it begins and if it’s getting worse over time. They also inquire about other symptoms, such as pain or tightness in the chest, a persistent cough, wheezing, feeling lightheaded, unusual tiredness or swelling of the legs. A careful history and a physical exam can guide the next steps and whether tests are needed.
More detailed checks are now available for breathlessness that has no clear cause. What gets done depends on what the doctor suspects. You might have oxygen level checks, blood tests, breathing tests, chest scans, an ECG, or an echocardiogram. In some cases, doctors may suggest a more focused look at the airways, such as bronchoscopy, or other procedures to find a specific problem and address it.
Try not to panic every time you feel short of breath. Instead, pay attention to how your breathing has been changing from your normal pattern. If simple daily tasks that used to feel fine suddenly make you unusually breathless, or if the symptoms do not go away and start to get worse, it is a good idea to get checked by a clinician. Getting help sooner can support an early look at what is causing it and can help set up the right care.
(By Dr Anjan Siotia, Director of Cardiology at BM Birla Heart Hospital)
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