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How these conjoined twins were separated in Saudi Arabia

 Filipino conjoined twins joined at the head have been successfully separated in Saudi Arabia after an intricate and high-risk operation described by doctors as “one of the most complex cases worldwide.”

The surgery, which lasted for 18 and a half hours, has been carried out at King Abdullah Specialised Children’s Hospital in Riyadh by a team of 30 consultants, specialists, and nursing and technical staff across multiple disciplines.

A complex case

In a statement, the King Salman Humanitarian Aid and Relief Centre (KSrelief) has noted that the twins, Klea Ann and Maurice Ann Misa, involved severe medical complications.

Dr. Abdullah bin Abdulaziz Al Rabeeah, supervisor general of KSrelief and head of the medical and surgical team of the programme, has revealed that Klea Ann was suffering from cardiac muscle insufficiency and severe kidney atrophy with complete renal failure, which further increased the complexity of the procedure.

“The twins’ case is among the most complex in the world due to several medical factors, most notably the complex angular positioning of the two heads, extensive sharing of the cerebral venous sinuses, and intertwining of brain tissue between the two girls,” explained Al Rabeeah.

He has bared that the case carried significant risk even before surgery.

“Based on the multidisciplinary medical evaluation and precise diagnostic studies, the level of risk reaches 50 percent due to the medical challenges associated with the case, with the possibility of severe neurological complications that may result in disability at a rate of up to 60 percent.”

Five-stage surgical plan

The twins have arrived in Saudi Arabia on May 17 last year, and underwent a series of precise examinations, imaging tests, and medical consultations.

Following several discussions, the surgical team has developed a five-stage plan. The operation has been led by Dr. Muatasim Al-Zoubi, consultant paediatric neurosurgeon, and involved specialists in anaesthesia, intensive care, advanced imaging, neurosurgery, and plastic surgery.

Doctors have initially estimated the procedure to take up to 24 hours.

70th case under programme

In a post on X (formerly Twitter), KSrelief has announced the successful operation after nearly 13 hours of continuous surgery. 

“This marks the 70th operation in the programme’s history and the third case involving twins from the Philippines, with subsequent stages continuing for reconstruction and closure.”

The procedure has been performed under the Saudi Conjoined Twins Programme, which has handled 157 cases from 28 countries since 1990.

Family relief after surgery

Meanwhile, the twins’ mother has expressed relief after the success of the separation surgery. 

“Truly a miracle for our family. Our hearts are full of gratitude and happiness because we have prayed and waited for this moment for so long,” said the mother in a video.

She added, “To all the doctors, nurses, and the entire medical team, thank you for your dedication and compassion. You did not only perform surgery, you gave my twins a chance to live their lives separately.”

After 18 and a half hours of hope and waiting… the mother of the twins “Klea and Maurice Ann” shares her joy over the success of the separation surgery, after it opened the door for them to an independent life and endless hope.

GN

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Health

PCOS: Matter Of Eggs And Far Beyond

Dr. Pooja Vaswani – Consultant Obstetrics & Gynaecology.

NMC Royal Hospital, Abu Dhabi

Quite many times in our daily practice we come across women who are diagnosed to have Polycystic Ovarian Syndrome (PCOS), the incidence of which is on an increase. It affects about 10% of women. It’s the word “PCOS” that catches any woman’s attention, as more often than not she would have heard about PCOS from her friends/ mother or sisters. Immediate question that comes to the mind of the woman is “will I be able to conceive?”

Ofcourse maternal instinct is paramount and being a gynecologist women with PCOS come to me with concerns that are either cosmetic or reproductive. As gynecologist we cater to reproductive goal,however it is to be kept in mind that as a doctor our role does not end there. PCOS has long term implications too which can go far beyond the reproductive age.Many studies confirm that the insulin resistance associated with PCOS can expose women to higher risk of metabolic syndrome which could be a combination of hypertension; hyperlipidemia, diabetes and cardiovascular disease.

Apart from these metabolic disorders, women with PCOS are also at an increased risk of developing endometrial, ovarian and possibly also breast cancer in later life.

 There is a need for a holistic approach in dealing with PCOS keeping in mind that contrary to what the name implies, PCOS implications are not restricted just to sex organs but go way beyond, affecting many other organs in the body which can have profound effect on long term health of the women. These women should be evaluated for these conditions accordingly on a more frequent basis.

 Every responsible gynecologist should utilize every potential opportunity to evaluate and educate the patients about ways to prevent these potentially threatening long term metabolic and malignant disorders by intervening at the earliest.

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Health

Novartis: Rare muscle disease drug shows early promise

 Novartis (NOVN.S), opens new tab said on Thursday an experimental drug, which it acquired ​as part of its $12 billion takeover of ‌Avidity, showed promise in an early-to-mid-stage study in patients with a type ​of genetic muscle disorder characterized ​by slowly progressive muscle weakness.

  • The Swiss ⁠drugmaker said the drug, known as ​del-brax, lowered two blood markers linked ​to the disease and showed reduced signs of muscle damage in patients with facioscapulohumeral ​muscular dystrophy.
  • Novartis said the drug ​shows potential to become the first disease-modifying ‌treatment ⁠for FSHD, which can cause weakness in the face, shoulders, arms and other muscles.
  • The company estimates it affects ​about ​45,000 to ⁠87,000 people in the U.S. and EU.
  • The drug’s safety ​profile was consistent with ​previous ⁠results, the company said.
  • Novartis plans to discuss the data with health regulators ⁠around ​the world, while a ​late-stage study of the drug is currently enrolling ​patients.

 The Thomson Reuters

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Health

Obesity drug shows promise in reducing belly and liver fat

Boehringer Ingelheim said on Sunday ​its experimental obesity drug cut visceral and liver fat while minimizing loss of lean mass in ‌a late-stage study, data showed, bolstering its case for benefits beyond weight loss as competition in obesity drugs intensifies.

The drug, survodutide, was licensed from Denmark’s Zealand Pharma (ZELA.CO), opens new tab. An injectable that mimics the proteins GLP-1 and glucagon to create a feeling of fullness, its weight-loss trial results were ​announced in April, showing patients lost an average of 16.6% over 76 weeks.

Analysis of a group of ​patients who had MRI measurements at the start and end of a 76-week trial showed that survodutide reduced harmful ⁠abdominal fat by up to 34% and liver fat by up to 63.1% from the baseline, Boehringer said.

Analysts have ​said the weight-loss numbers were broadly comparable to existing GLP-1 injections from Novo Nordisk (NOVOb.CO), opens new tab and Eli Lilly (LLY.N), opens new tab and below newer ​rivals in development, and that the company needed to differentiate the drug’s benefits.

Lean mass accounted for no more than 10.8% of the change in body composition at the highest dose of 6 milligrams, suggesting the weight loss was driven mainly by fat reduction.

The drug’s effect ​on liver-fat reduction and preservation of lean mass are central to whether it will be able to stand out ​commercially, alongside tolerability and how long patients stay on the drug. Detailed data from the study could help Boehringer make a ‌stronger case ⁠that survodutide should be judged not only by pounds lost but by where weight is lost.

“We believe survodutide will become an important new option at the intersection of obesity and liver disease, two conditions that are deeply connected but rarely addressed together,” said Boehringer executive Shashank Deshpande, who leads the company’s human medicines business.

Boehringer acquired the rights in ​2011 to solely develop and ​commercialise survodutide from Zealand, which is ⁠entitled to royalty payments on global revenue.

PATIENTS WITH LIVER DISEASE BENEFIT

In a separate late-stage study of overweight or obese patients with a fatty liver disease called MASLD, survodutide ​met both its main goals.

After 48 weeks, up to 84.2% of patients on the ​drug showed ⁠a liver fat reduction of at least 30%, compared with 24.3% for those on placebo. Patients on survodutide also lost up to 12.2% of their body weight, versus 1% for placebo.

In 61% of the patients the drug helped achieve liver fat ⁠normalization, or ​a liver fat content below 5%, compared with 5.7% on placebo.

U.S. ​biotech Altimmune (ALT.O), opens new tab is also developing a drug that targets both the appetite-suppressing gut hormone, GLP-1, and glucagon.

Survodutide is also being tested in other late-stage ​studies, including for patients with fatty liver disease and fibrosis.

 REUTERS

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