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.

Massive wildfires have ravaged several parts of Canada and other regions of the world, filling the air with hazardous smoke. This has triggered health warnings far beyond the fire zones.

While most people experience immediate breathing problems during and after wildfires, experts say that some health effects can persist long after the skies clear.

Why Is Wildfire Smoke Harmful?

Wildfire smoke is composed of harmful gases and microscopic particles known as PM2.5. These tiny particles are small enough to travel into our lungs and enter the bloodstream, where they can trigger inflammation throughout the body.

Unlike typical air pollution, wildfire smoke also contains toxic substances released from burning homes, plastics, furniture, vehicles, electronics, and industrial materials, making prolonged exposure particularly harmful.

Long-Term Health Risks After Wildfire Exposure

Also read: Delhi's Poor AQI, Monsoon Conditions Put Children's Lungs at Risk: Ways to Keep Kids Safe

Lung And Chronic Respiratory Disease

Prolonged exposure to wildfire smoke can have long-term effects on the respiratory system. Possible health effects may include:

• Persistent cough
• Poor lung function
• Worsening asthma symptoms
• Increased COPD episodes
• Greater risk to respiratory infections

Children, older adults, and people with existing lung conditions face the highest risk because their lung function is already compromised.

Heart Disease

Also read: Phones, Pollution, AI: What Is Driving Cognitive Decline In Humans?

The tiny particles in wildfire smoke don't just stay confined to the lungs. Once they enter the bloodstream, they can affect the cardiovascular system. In the long run, research says wildfire smoke exposure can lead to:

• Heart attacks
• Stroke
• Irregular heart rhythms
• Elevated blood pressure
• Increased inflammation in blood vessels
• Effects on Brain Health

With frequent incidences of wildfires, scientists are looking into how wildfire smoke affects the brain. Emerging evidence suggests smoke exposure may contribute to:

Headaches

• Difficulty concentrating
• Memory problems
• Cognitive decline
• Increased inflammation affecting brain function

Mental Health Consequences

Wildfires can affect mental health in more than one way. Besides the stress of evacuation and property loss, smoke exposure itself may contribute to mental health problems directly. One is at the risk of the following mental health issues after exposure:

• Anxiety
• Depression
• Post-traumatic stress disorder (PTSD)
• Sleep disturbances

Communities repeatedly exposed to wildfire events may experience prolonged psychological distress that could often go undetected.

Possible Cancer Risk

Growing evidence suggests that long-term exposure to wildfire smoke may increase the risk of several cancers. Studies have reported possible associations with lung cancer, breast cancer, colorectal cancer, bladder cancer, and certain blood cancers

Although researchers say more studies are needed to establish a direct cause-and-effect relationship, the findings highlight the importance of limiting repeated smoke exposure.

Also read: How Air Pollution Puts Heart Patients At Risk - What You Can Do About It

Pregnancy And Infant Health

Pregnant women are among the groups considered most vulnerable to wildfire smoke. Research suggests exposure during pregnancy may increase the risk of preterm birth, low birth weight and other pregnancy complications.

Healthcare providers recommend minimizing outdoor exposure whenever air quality deteriorates.

How To Protect Yourself After Wildfire Exposure?

Even after visible smoke disappears, harmful particles may remain in the air. Experts recommend:

• Monitor local air quality before going outdoors.
• Stay indoors when pollution levels are high.
• Use HEPA air purifiers if available.
• Wear a well-fitted N95 mask if exposure is unavoidable.
• Keep doors and windows closed when it is smoky outside.
• Continue taking prescribed medications for asthma or heart disease.
• Seek medical attention if coughing, chest pain, breathlessness, or other symptoms persist.

When we think of dialysis, we often picture a machine filtering blood and keeping patients alive. What rarely comes to mind is the small blood vessel in the arm that makes the entire process possible.

For every patient on haemodialysis, the arteriovenous (AV) fistula is quite literally a lifeline. Without it, dialysis cannot be performed effectively. Yet, despite being one of the most important parts of treatment, fistula care remains one of the least understood aspects of kidney disease.

This silent gap in awareness is costing patients their lifeline.

A Growing Burden That We Cannot Ignore

India adds nearly 2.2 lakh new patients with end-stage kidney disease every year, creating a demand for over 3.4 crore dialysis sessions annually.

One of the biggest challenges we see in clinical practice is that patients often seek medical help only after the fistula has already stopped functioning.

The warning signs are usually ignored.

The vibration over the fistula becomes weaker. The arm begins to swell. Bleeding continues longer than usual after dialysis. Needle insertion becomes increasingly difficult. Sometimes dialysis itself becomes less effective.

By the time patients reach an interventional radiologist or vascular specialist, the fistula may already have developed significant narrowing (stenosis) or complete blockage.

Unfortunately, many of these complications are preventable if detected early.

In our experience, nearly 30% of patients eventually lose their fistula because they report too late, when timely intervention could have salvaged access.

Also read: COVID Spikes In India: Experts Allay Fears, Stress Vaccination And Masks

Why Does This Keep Happening?

Unlike diabetes or blood pressure, there is no widespread public awareness around fistula surveillance.

Many dialysis patients receive instructions on medicines and dialysis schedules but very little education on how to examine their fistula every day.

There is also no universally implemented patient education protocol across dialysis centres, leading to inconsistent awareness about fistula care.

The result is simple: patients unknowingly damage the very access that keeps them alive.

Your Fistula Speaks Every Day - Learn To Listen

Patients should examine their fistula daily.

A healthy fistula has a continuous buzzing sensation or “thrill.” If this vibration becomes weak or disappears, medical attention should be sought immediately.

Similarly, swelling of the arm, redness, prolonged bleeding after dialysis, pain around the fistula, or difficulty during needle insertion should never be dismissed as routine.

These are early warning signs - not inconveniences.

Also read: Omicron Sub-Lineages Likely Behind COVID Surge In India: Why Deaths Are Occurring

Five Simple Habits That Can Save A Fistula

• Feel the fistula every day for its characteristic vibration.
• Never allow blood pressure measurement, blood draws or intravenous injections on the fistula arm.
• Avoid carrying heavy weights or sleeping on the access arm.
• Maintain good hygiene around the fistula site.
• Report any change in blood flow, swelling or bleeding immediately instead of waiting for the next dialysis session.

These small daily habits can often extend the life of a fistula by years.

Early Detection Can Prevent Major Procedures

One of the greatest advances in dialysis access care is that many fistula problems no longer require open surgery.

If narrowing is detected early, minimally invasive image-guided procedures such as fistuloplasty (balloon angioplasty) can restore blood flow, preserve the existing fistula and help patients continue dialysis without interruption.

The key, however, is timing.

A fistula that is evaluated early is often salvageable.

A fistula ignored for weeks may not be.

We Must Shift Our Focus from Creating Fistulas To Preserving Them

Every successful fistula represents months of planning, surgery and healing. Losing it means additional procedures, temporary catheters, higher infection risk, increased costs and emotional distress for patients already living with chronic kidney disease.

As doctors, we have become increasingly skilled at creating dialysis access.

The next challenge is ensuring patients know how to protect it.

Because for someone living with kidney failure, the fistula is not just another blood vessel.

It is the lifeline that keeps life moving.

By Dr. Avik Bhattacharyya, Senior Consultant - Interventional Radiology, CK Birla Hospitals, CMRI

GLP-1 drugs such as Ozempic, Wegovy, Mounjaro and liraglutide, best known for regulating appetite and aiding weight loss, may also help reduce symptoms of binge eating disorder (BED), which affects more than 17 million people worldwide, according to a new study.

The systematic review and meta-analysis, published in the journal eClinicalMedicine, found that GLP-1 drugs, with semaglutide as its key ingredient, reduced binge eating episodes, loss-of-control eating and emotional eating, highlighting their potential role in treating binge eating disorder alongside obesity.

Binge eating disorder affects over 17 million people globally, and around two-thirds of people with the condition also live with overweight or obesity. It is also common among individuals seeking weight-loss treatment.

"Binge eating disorder, where people regularly eat an excessive amount of food while feeling they have lost control, is common and highly impairing, affecting over 17 million people worldwide," said lead author Dr Ilaria Costantini from the Psychiatry Department at University College London (UCL), UK.

"But treatment options are limited and there are currently no approved medications, so there remains a need for better ways to help people living with this condition. We found evidence that weight loss drugs may help to manage some key symptoms of binge eating disorder," Costantini added.

Also read: Babies Without Vitamin K Shot At Higher Risk Of Brain Bleeding: Study

What Did The Study Find?

The researchers analyzed 25 randomized controlled trials conducted across 12 countries on four continents, involving 8,069 participants.

The trials evaluated GLP-1 drugs that target the appetite-regulating hormone GLP-1, including semaglutide (marketed as Ozempic or Wegovy), tirzepatide (Mounjaro) and liraglutide.

These medications suppress appetite by acting on the central nervous system and insulin secretion, delay stomach emptying, and may also influence brain pathways involved in reward and impulse control.

Compared with placebo or other treatments, people taking GLP-1 drugs reported:

• Moderate reductions in binge eating severity
• Reduced loss-of-control eating
• Lower levels of uncontrolled eating
• Reduced emotional eating

Read More: Obesity-Driven CKM Syndrome A Growing Public Health Threat, Warns American Heart Association

The researchers also found that participants taking GLP-1 drugs reported greater cognitive or dietary restraint, meaning they made more deliberate efforts to limit what they ate.

The benefits extended beyond weight loss, with improvements seen in several behaviors associated with binge eating disorder.

More Research Needed on Dietary Restraint

While increased dietary restraint was observed, the researchers cautioned that it remains unclear whether this represents healthy self-regulation or a more rigid, potentially harmful eating pattern that could worsen binge eating over time.

"From the evidence available, we cannot say whether the increase in dietary restraint reflects a positive and helpful form of self-regulation or if it is a more dysfunctional pattern of eating. We hope that future research can clarify whether or not taking weight loss drugs might contribute to more pathological forms of eating restriction such as meal skipping," said Izzy Emptage from UCL Psychiatry.

Researchers Urge Caution

The researchers said GLP-1 drugs could become an important addition to treatment plans for binge eating disorder when used alongside psychological therapies and social support.

However, they also highlighted important limitations. Most of the studies included in the review had a high risk of bias, were funded by pharmaceutical companies, and rarely included participants with a clinical diagnosis of binge eating disorder, reducing the certainty of the findings.

"GLP-1s may offer a promising additional treatment option for people living with both binge eating and obesity," the researchers said, while stressing that these drugs "should not be viewed as a standalone solution to binge eating disorder."

They added that larger, independently funded clinical trials are needed before these medications can be routinely recommended for treating binge eating disorders.