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Turkish Surgeons Successfully Separate Conjoined Pakistani Twins After 14-Hour Operation

Turkish Surgeons Successfully Separate Conjoined Pakistani Twins After 14-Hour Operation 

Pakistani conjoined twins, Mirha and Minal, separated after successful surgery by Turkish doctors at Bilkent City Hospital, Ankara. — Anadolu Agency

Pakistani twins Mirha and Minal, born with their heads fused, were successfully separated by a team of 60 medical experts in Turkey after a 14-hour, two-phase surgery, according to the state-run Anadolu news agency. The operation took place at Bilkent City Hospital in Ankara, following Turkish President Recep Tayyip Erdogan's intervention, as the family could not find appropriate treatment in Pakistan.

After being contacted by renowned London-based pediatric neurosurgeon Owase Jeelani, President Erdogan assured him that the twins' treatment would be provided in Turkey, according to Anadolu.

The 11-month-old twin girls arrived in Ankara in May, where they were placed under close medical supervision. The final 14-hour surgery took place on July 19, led by Dr. Jeelani alongside Turkish doctors Dr. Harun Demirci and Dr. Hasan Murat Ergani.

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Highlighting the collaboration involved, Namik Yasar Ozbek, head of the Department of Pediatric Hematology-Oncology, told the Turkish news agency, "The babies had difficulty sitting and using their hands due to their conjoined state. Post-surgery, our neurologists, physical therapists, and neurodevelopmental specialists helped resolve these issues."

Ozbek added, "The babies are now doing well, starting to use their hands and arms, and gaining control of their heads. In 10 days, they will celebrate their first birthdays separately."

Dr. Ergani, part of the surgical team led by Dr. Jeelani, shared the emotional experience, saying, "Seeing the babies healthy now brings immense joy. When we successfully separated them, the entire team looked at each other and applauded. It was one of the most unforgettable moments of my life."

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The twins' parents, Rehan Ali and Nazia Parveen, expressed deep gratitude to President Erdogan, the medical team, and all those involved in their daughters' treatment. "We are extremely happy and indebted to everyone who contributed," said the father, adding that they hope to meet Erdogan personally to thank him.

Are the Latest Alzheimer's Drugs the Solution Doctors Have Been Hoping?

 Are the Latest Alzheimer's Drugs the Solution Doctors Have Been Hoping?

A doctor points out evidence of Alzheimer's disease on PET scans at the Center for Alzheimer Research and Treatment (CART) at Brigham And Women's Hospital in Boston, Massachusetts, US, March 30, 2023. — Reuters

Two new drugs, called "lecanemab" and "donanemab", are gaining significant attention as the first is capable of slowing down the debilitating progression of Alzheimer's disease.

However, while their defenders view them as a significant breakthrough in medical research, critics view them as another disappointment after a series of costly failures.

"We have turned a corner" thanks to these treatments, British biologist John Hardy, who has been studying Alzheimer's since the 1990s, told AFP.

Rob Howard, a professor of old age psychiatry at University College London and a critic of the drugs, said: "I think that the drugs have been used to raise false and unrealistic hopes in people with Alzheimer's disease and their families."

These opposing statements sum up the entrenched positions on the recently introduced drugs for Alzheimer's, the most common form of dementia which millions of people across the world suffer from.

Lecanemab, sold under the name Leqembi, was developed by US pharma firms Biogen and Eisai. Donanemab, developed by pharma giant Eli Lilly, is sold as Kisunla.

The controversy has seen countries take different stances on whether to approve the drugs or not.

The United States gave the green light to lecanemab in 2023, then donanemab earlier this year. However, the European Union rejected lecanemab in July, a bad omen for donanemab's chance of approval.

Last month, the UK steered a middle course, approving the use of lecanemab but not making it available on the state National Health Service. 

What no one denies is that the two drugs are the most effective Alzheimer's treatments ever but their effectiveness is limited.

Both appear to reduce cognitive decline in patients at the onset of their disease by around 30%, which seems high but represents a relatively small difference over the year-and-a-half period when the studies were carried out.

"The benefits are so tiny as to be practically invisible in an individual patient," Howard said.

Expensive

Critics argue that the drugs, that can sometimes cause brain swelling or bleeding, are not worth the risks and are highly expensive.

At the prices being charged by Biogen and Eisai in the US, lecanemab would cost 133 billion euros if given to all eligible patients in the EU, according to a 2023 study.

Meanwhile, advocates of the drugs, including many neurologists, believe they can offer patients a few more precious months of autonomy and that the effectiveness of the drugs could be multiplied if patients started taking them earlier in the disease's progression. 

This could soon be more practicable as research on diagnosing Alzheimer's more quickly has recently been making significant strides.

The differing national policies could also mean that poorer patients are left behind.

"We will see rich people going to the US" for the drugs, Hardy said.

The debate can be traced back in part to a seminal 1992 article by Hardy about how the disease actually works.

The article argues that clumps of protein called amyloid plaques — a constant in the brains of Alzheimer's patients — are not just one element among others, but the main factor triggering the disease.

Over the decades, many drugs targeting these amyloid plaques were developed, all of which failed — until lecanemab and donanemab.

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