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(WASHINGTON- Study- More pilots testing positive for drugs)
(Baby boy with eight limbs progressing well after successful operation)
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(CNN) On May 27, Margaret Awino gave birth to Paul Mukisa with the help of her mother-in-law inside her home in Nabigingo, a small village in eastern Uganda. But instead of joy and jubilation for the birth of <a href=http://www.aec-ist.com/css/Gucci-Discount-Buy-Online-Purses-Handbags-Outlet.html>Gucci Purses</a>  her fifth child, the 28-year-old mother was shocked: her newborn son had been born with four legs and four arms.
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The family rushed to a nearby district hospital for help but they were quickly referred to Mulago Hospital in the Ugandan capital of Kampala. There, a team of doctors examined the infant and made the diagnosis of parasitic twinning, a variant of conjoint twinning in which one of the twins is not fully developed baby Paul had been born with a full set of arms and legs and another set from a headless and heartless mirror image twin that never fully grew.
  
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WASHINGTON Tests of pilots killed in plane crashes over more than two decades show an increasing use of both legal and illegal drugs, including some that could impair flying, according to a study released Tuesday by the National Transportation Safety Board.The study examined toxicology reports for almost 6,700 pilots killed in crashes from 1990 to 2012. Not only did the share of pilots testing positive for a drug increase over that period, but the share of pilots who tested positive for multiple drugs increased as well. Pilots testing <a href=http://www.avanttravel.com/page.php?sale=Watches-Michael-Kors>Watches Michael Kors</a>  positive for at least one drug increased from 9.6 percent to 39 percent, while positive tests for two drugs rose from 2 percent to 20 percent and three drugs from zero to 8.3 percent.Over the same period, new drugs were coming into use and the U.S. population was aging, creating greater demand for drugs. The toxicology tests "reflect tends in the general population and likely indicate a significant increase in drug use" by pilots as well, the study said.However, the share of accidents the board has investigated in which impairment from a drug was found to be a factor hasn't increased appreciably, the report said. Since 1990, the NTSB has cited pilot impairment due to drugs as a cause or a contributing factor in about 3 percent of fatal civil aviation accidents.Acting NTSB Chairman Chris Hart said the board "is concerned about possible safety implications of increased drug use in all modes of transportation." He called the report "an important first step toward understanding those implications."Dr. Mary Pat McKay, the board's chief medical officer, said the study was limited to aviation because similarly comprehensive drug test data doesn't exist for fatal highway, rail and maritime accidents. But it's likely there are similar trends in those modes as well, she said.The board also voted to issue a safety alert to pilots, warning of the risk of impairment from many over-the-counter drugs. The board issued several recommendations to the Federal Aviation <a href=http://www.avanttravel.com/page.php?sale=Buy-Michael-Kors>Buy Michael Kors</a>  Administration and state governments aimed at better communication of drug risks to pilots and operators in all transportation modes.More than 9 out of 10 of the pilots tested were private rather than commercial pilots, and 98 percent were male. The average age of pilots killed also increased markedly, from 46 years old in 1990 to 57 in 2012. The average age of pilots killed was 5 to 15 years older than the general population of active pilots.The tests also revealed increased pilot use of all kinds of drugs, including drugs that could impair a pilot's functioning as well as drugs used to treat potentially impairing conditions such as seizure disorders and psychiatric illness.The most common drug found in the tests was an antihistamine that causes drowsiness and is a key ingredient in many over-the-counter medications for <a href=http://www.avanttravel.com/page.php?sale=Michael-Michael-Kors-Handbags>Michael Michael Kors Handbags</a>  allergies, colds and sleep. Sedating antihistamines in general were found in 9.9 percent of pilots tested during the last five years studied, up from 2.1 percent of the cases during the early years examined.The share of pilots testing positive for illegal drugs was small, but increased from 2.3 percent to 3.8 percent. The study attributed the increase mostly to greater marijuana use in the last 10 years.A statement by the Aircraft Owners and Pilots Association, which represents private pilots, called the NTSB study incomplete and said its results "should be regarded with caution.""There are just far too many gaps and unknowns in the study for us to be able to draw any meaningful conclusions about aviation safety," said Mark Baker, the association's president.  
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The Ugandan doctors ran a series of tests on the eight-limbed newborn which showed that the host and parasitic twin shared part of the pelvic bone. Examinations of Paul s internal organs revealed further abnormalities: his heart was on the right side of his body, instead of the left, while his liver was on the left side as opposed to the right.
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Follow Joan Lowy on Twitter at http://www.twitter.com/AP-Joan-Lowy
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After these initial investigations, Paul was discharged home for three months as the surgeons wanted to allow him to grow before performing an operation to separate the twins.
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Finally, on August 18, a Ugandan team of three surgeons, three anesthesiologists and two nurses successfully completed a three-hour operation to remove parts of the parasitic twin from the normal body.
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The baby was given general anesthesia and the torso and trunk of the parasitic twin which had two arms but no head or heart was detached from the host baby, said Dr Nasser Kakembo, one of the surgeons who carried out the operation.
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<a href=http://www.aec-ist.com/css/Gucci-Belts-Sale-Leather-Jackets-Laptop-Sleeve-Men-Boots.html>Gucci Leather Jackets</a>  Then we also detached the lower limbs of the parasitic twin from the host, which included disarticulating the right and left lower limbs as they were attached by joints. We controlled the bleeding and fashioned skin flaps to close the resulting wound, he added. There were no intra-operative or post-operative complications and mild blood loss and a precautionary blood transfusion was given.  
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Paul Mukisa
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Three weeks after the surgery, the baby is progressing and breastfeeding well, according to the doctors.
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The father and mother were very grateful because at first they thought it was due to witchcraft, and their baby was a laughing stock because of the abnormalities, says Kakembo.
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The incidence of conjoined twins is one in 50,000, while parasitic twins are extremely rare. The condition is typically created after one of the twins stops developing at a certain point <a href=http://www.aec-ist.com/css/Cheap-Gucci-Sale-Gym-Shoes-Kids-Clothes-Authentic.html>Gucci Gym Shoes</a>  during the pregnancy, and the remnants of that twin merge with the twin that has continued developing.
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Back in 2007, an eight-limbed girl in India made global headlines after a team of 30 surgeons successfully completed a mammoth 27-hour operation to remove her parasitic twin.
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For the doctors at Mulago Hospital, this was the first time they had ever performed a surgery like this.
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We have not had a prior experience with a parasitic twin but we work on many other children with multiple complex multi-organ congenital anomalies such as intestinal, urologic, cardiac, and orthopedic defects, said Kakembo. Although twinning is very rare worldwide, he continued, we have an increased incidence in Africa we <have> seen numerous sets of conjoint twins, five to six sets in the last few years.  
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Baby Paul Mukisa is still at the hospital and will remain there for the next two weeks, being treated by medics.
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Looking ahead, doctors say that they anticipate a healthy baby that may have a wide gait due to the large pelvic bone, and this may require orthopedic reconstruction in the future.

Revision as of 23:24, 30 September 2014

@@@ (CNN) On May 27, Margaret Awino gave birth to Paul Mukisa with the help of her mother-in-law inside her home in Nabigingo, a small village in eastern Uganda. But instead of joy and jubilation for the birth of <a href=http://www.aec-ist.com/css/Gucci-Discount-Buy-Online-Purses-Handbags-Outlet.html>Gucci Purses</a> her fifth child, the 28-year-old mother was shocked: her newborn son had been born with four legs and four arms. The family rushed to a nearby district hospital for help but they were quickly referred to Mulago Hospital in the Ugandan capital of Kampala. There, a team of doctors examined the infant and made the diagnosis of parasitic twinning, a variant of conjoint twinning in which one of the twins is not fully developed baby Paul had been born with a full set of arms and legs and another set from a headless and heartless mirror image twin that never fully grew.

The Ugandan doctors ran a series of tests on the eight-limbed newborn which showed that the host and parasitic twin shared part of the pelvic bone. Examinations of Paul s internal organs revealed further abnormalities: his heart was on the right side of his body, instead of the left, while his liver was on the left side as opposed to the right. After these initial investigations, Paul was discharged home for three months as the surgeons wanted to allow him to grow before performing an operation to separate the twins. Finally, on August 18, a Ugandan team of three surgeons, three anesthesiologists and two nurses successfully completed a three-hour operation to remove parts of the parasitic twin from the normal body.

The baby was given general anesthesia and the torso and trunk of the parasitic twin which had two arms but no head or heart was detached from the host baby, said Dr Nasser Kakembo, one of the surgeons who carried out the operation.
<a href=http://www.aec-ist.com/css/Gucci-Belts-Sale-Leather-Jackets-Laptop-Sleeve-Men-Boots.html>Gucci Leather Jackets</a>  Then we also detached the lower limbs of the parasitic twin from the host, which included disarticulating the right and left lower limbs as they were attached by joints. We controlled the bleeding and fashioned skin flaps to close the resulting wound, he added. There were no intra-operative or post-operative complications and mild blood loss and a precautionary blood transfusion was given. 

Paul Mukisa Three weeks after the surgery, the baby is progressing and breastfeeding well, according to the doctors.

The father and mother were very grateful because at first they thought it was due to witchcraft, and their baby was a laughing stock because of the abnormalities, says Kakembo.

The incidence of conjoined twins is one in 50,000, while parasitic twins are extremely rare. The condition is typically created after one of the twins stops developing at a certain point <a href=http://www.aec-ist.com/css/Cheap-Gucci-Sale-Gym-Shoes-Kids-Clothes-Authentic.html>Gucci Gym Shoes</a> during the pregnancy, and the remnants of that twin merge with the twin that has continued developing. Back in 2007, an eight-limbed girl in India made global headlines after a team of 30 surgeons successfully completed a mammoth 27-hour operation to remove her parasitic twin. For the doctors at Mulago Hospital, this was the first time they had ever performed a surgery like this.

We have not had a prior experience with a parasitic twin but we work on many other children with multiple complex multi-organ congenital anomalies such as intestinal, urologic, cardiac, and orthopedic defects, said Kakembo. Although twinning is very rare worldwide, he continued, we have an increased incidence in Africa we <have> seen numerous sets of conjoint twins, five to six sets in the last few years. 

Baby Paul Mukisa is still at the hospital and will remain there for the next two weeks, being treated by medics. Looking ahead, doctors say that they anticipate a healthy baby that may have a wide gait due to the large pelvic bone, and this may require orthopedic reconstruction in the future.

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