Imagine living with not one, not two, but five kidneys—two that are failing, two that have been transplanted but are non-functioning, and one that is a new implant sustaining you. This is the incredible reality of 47-year-old researcher Devendra Barlewar, whose relentless battle with chronic kidney disease led a groundbreaking third kidney transplant. After years of dialysis, unsuccessful surgeries, and the crippling effect of COVID-19, his survival is not only about living but a result of the extraordinary progress in modern medicine. Here's how a group of expert doctors in India made history with one of the rarest transplant cases on record.

Mr. Barlewar's story is a testament to the advances of medicine and the strength of the human spirit. Having fought chronic kidney disease (CKD) for more than 15 years, he had his third kidney transplant after two earlier failed attempts. His situation poses a special surgical challenge and immunological risk, an unprecedented accomplishment in organ transplantation.

The battle of the scientist with kidney disease was first encountered in 2008 when he was diagnosed with high blood pressure. Lacking any underlying conditions, his health rapidly worsened, and he became dependent on dialysis by 2009. In the following years, he received two kidney transplants, one in 2010 and the other in 2012, both of which failed, making him depend on dialysis again. The second kidney transplant survived for a number of years before it was sabotaged by COVID-19 in 2022, leading to total organ failure. Lacking close family members for a live donation, he enrolled for a deceased donor transplant at Amrita Hospital in 2023. His turn arrived on January 7, 2025, when a matching kidney from a brain-dead donor was made available.

Challenges of Kidney Transplant

A third renal transplant is very uncommon and has special medical complications, such as:

Immunological Risks: As he had two non-functioning native kidneys and two formerly transplanted kidneys, his immune system was extremely sensitized, which raised the risk of organ rejection. To counteract this, physicians used cutting-edge immunosuppressive techniques to hinder a reaction by the immune system against the newly transplanted organ.

Surgical Complexity: Four kidneys created a space limitation inside the abdominal cavity. The surgeons needed to tread carefully to provide space for the new kidney without compromising its blood supply.

Vascular Limitations: The blood vessels used in his previous transplants had already been utilized, making it crucial to identify and connect the new kidney to the largest available abdominal blood vessels. Extensive preoperative imaging and surgical expertise were required to navigate this challenge.

Dr. Ahmed Kamaal, Senior Urology Consultant, who was a member of the surgical team, added, "This was an unprecedented case. With four existing kidneys, there were huge immunological risks involved and the need for special protocols. We maximized the patient with immunosuppression pre-transplant to preserve his new kidney transplant from the threat of rejection."

Role of the Organ Donor

Organ donation was instrumental in making this operation feasible. The 50-year-old farmer was certified brain dead after suffering a stroke. His family decided to donate his organs out of kindness, and the kidney that was a perfect match for Mr. Barlewar was one of them. Being a long-standing member of the transplant program's registration history, he was prioritized to undergo the procedure.

The operation itself involved careful planning and execution. The surgical team utilized high-tech medical imaging, immunological testing, and microvascular equipment to achieve precision. The four-hour operation entailed:

Preoperative Planning: High-resolution CT scans were employed to establish the most appropriate position of the kidney and check viability of the blood vessels.

Immunological Preparation: Advanced laboratory testing was performed to assess antibody levels, ensuring compatibility and reducing rejection risk.

Surgical Performance: The kidney was attached to the largest blood vessels in the abdomen, with utmost care being taken to prevent any complications.

Postoperative Care: After the transplant, the patient was transferred to intensive care for careful monitoring of vital signs, kidney function, and complications like internal bleeding, infection, or graft rejection.

Dr. Kunal Gandhi, Senior Nephrology Consultant, stressed, "Two non-functioning kidneys pose severe immunological issues, especially during the initial post-operative period. They cause organ rejection if not treated. High-tech medicine and in-house immunology testing were a must to provide the optimal result."

After the successful transplant, Mr. Barlewar's new transplanted kidney started secreting urine within hours, an important sign of graft function. He spent some days in intensive care, where he was continuously monitored to ensure his body received the organ well. After ten days, he was discharged with stable kidney function and his levels of creatinine normalized within two weeks, which was a major improvement in his condition.

Dr. Sameer Bhate, Head of Cardiac Surgery and Senior Consultant, emphasized the importance of the surgical skill involved: "The anastomosis of renal vessels to the largest abdominal blood vessels is a delicate process that calls for skillful surgery."

Although Mr. Barlewar's case is medically unprecedented, it also highlights the significance of organ donation and the evolution of transplantation methods. His experience shows the strength of patients with chronic illnesses and the life-changing effects of novel medical treatments.

Now dialysis-free for the first time in years, Mr. Barlewar is independent once more and back in his routine daily activities. His case provides a precedent within the medical profession, hope for thousands of patients around the globe who are waiting for kidney transplants.

The successful third kidney transplant of Mr. Devendra Barlewar is an affirmation of the latest advances in medicine, unparalleled surgical skill, and organ donor generosity. The tale emphasizes the significance of organ donation in saving lives and the pursuit of medical perfection in addressing complicated medical problems. With ongoing developments in transplantation research, the case is an inspiration to patients and the international medical community as well.

All the doctors who were part of the surgical team are practising doctors at Amrita Hospital in India

Sleep takes up nearly one-third of a person’s life, yet many still wonder what really happens while we rest. Until the mid-20th century, scientists believed sleep was simply a time when the body and brain shut down.

Research now shows that sleep is far from passive, it’s an active, restorative process essential for mental and physical health. As Johns Hopkins neurologist and sleep expert Dr. Mark Wu explains, the brain remains deeply engaged during sleep, performing vital tasks that influence memory, mood, and overall well-being.

The Stages of Sleep

Experts say the human sleep cycle has four main stages that repeat throughout the night. The first three make up non-rapid eye movement (non-REM) sleep, while the fourth is REM sleep, the stage most closely linked with dreaming.

In the first stage of non-REM sleep, the brain and body begin to shift from wakefulness to rest. Brain activity slows, muscles relax, and it is common to experience small, sudden twitches.

During the second stage, the body’s temperature drops slightly, and breathing and heart rate slow. Brainwaves continue to decelerate, though quick bursts of activity may still appear as the brain processes and stores information.

The third stage marks deep sleep, which is the most restorative phase. Here, the body fully relaxes, and the heart rate, breathing, and brain activity reach their lowest levels. This stage is crucial for waking up feeling refreshed and for healing and repair processes throughout the body.

The final stage is REM sleep, which begins about 90 minutes after you fall asleep. It starts short, roughly 10 minutes, but lasts longer with each cycle. During REM, the eyes move rapidly beneath the eyelids, breathing quickens, and heart rate and blood pressure rise to near waking levels. This is when most dreaming occurs. Interestingly, as people age, the amount of REM sleep they experience gradually decreases.

How The Body Regulates Sleep

According to Dr. Wu, two main forces govern sleep: the circadian rhythm and the body’s sleep drive.

The circadian rhythm acts as the body’s internal clock, controlled by a cluster of brain cells that respond to light and darkness. This rhythm triggers the release of melatonin at night and halts it when morning light appears. People who are completely blind often struggle with sleep because their brains can’t register these light cues properly, as per the John Hopkins Study.

The sleep drive works much like hunger. The longer you stay awake, the stronger your urge to sleep becomes. Unlike hunger, though, your body can override your willpower, if exhaustion sets in, it can force sleep to happen, even during daily activities or while driving. In extreme fatigue, brief “microsleep” moments lasting just a few seconds can occur without a person realizing it. However, taking long naps later in the day can reduce this natural sleep pressure, making it harder to fall asleep at night.

Why Sleep Matters For Your Brain

Anyone who has felt mentally sluggish after a sleepless night knows how strongly rest affects the brain. Adequate sleep is key to brain plasticity—the ability to learn, adapt, and form memories. Without it, the brain struggles to retain new information and perform cognitive tasks. Scientists also believe that deep sleep allows the brain to clear out toxins that build up during waking hours, improving long-term brain health.

Sleep impacts far more than the mind. Poor sleep can worsen conditions like depression, high blood pressure, migraines, and even seizures. It weakens the immune system, leaving the body more vulnerable to infection. Metabolism also suffers, as just one night without enough rest can temporarily throw the body into a prediabetic state.

As Dr. Wu explains, “There are countless ways sleep supports health.” From mental clarity to physical repair, the hours we spend asleep are some of the most important for keeping the body and brain functioning at their best.

When COVID-19 first emerged, it was largely seen as a respiratory illness. Over time, doctors discovered that the virus can affect nearly every major organ, including the heart, kidneys, liver, and skin. While cough, fever, and fatigue remain common signs, some people also develop unusual skin reactions. So, can COVID-19 actually lead to rashes? Here’s what experts have found.

Can COVID-19 Really Cause Rashes?

When COVID-19 first emerged, it was largely seen as a respiratory illness. Over time, doctors discovered that the virus can affect nearly every major organ, including the heart, kidneys, liver, and skin. While cough, fever, and fatigue remain common signs, some people also develop unusual skin reactions. So, can COVID-19 actually lead to rashes? Here’s what experts have found.

What Do COVID-19 Rashes Look Like?

Skin changes linked to COVID-19 are not among the most common symptoms, but they do occur. These rashes may appear on the neck, mouth, or toes and are often caused by inflammation in the body, as per Health website. They can look like flat or raised patches, small round spots, or itchy bumps. In some people, these rashes appear while they’re infected; in others, they show up weeks later.

Why Do These Rashes Occur?

Researchers believe COVID-related rashes are connected to how the virus interacts with the body’s ACE2 receptors, which are found in the skin. When the virus attaches to these receptors, it can trigger the release of inflammatory proteins called cytokines. This inflammation may lead to skin irritation, itchiness, or lesions.

Common Types of COVID-19 Rashes

1. COVID Toes

One of the most recognized skin signs of the virus, “COVID toes,” resembles chilblains, which are cold-weather sores. They appear as pink, red, or purple patches, sometimes with swelling or blistering. This condition is seen more often in younger people and may occur even after other symptoms fade.

2. Hives (Urticaria)

Hives tend to appear suddenly and can spread across any part of the body. They’re itchy, raised, and may come and go within hours or days.

3. Neck Eczema

Some people develop eczema-like rashes on the neck, chest, or trunk during or after COVID-19. The patches can be itchy and vary in color depending on skin tone—pink on lighter skin and brown, gray, or purple on darker skin.

4. Oral Rash

COVID can also cause soreness or peeling inside the mouth or on the lips. The area may feel dry, irritated, or scaly as it heals.

5. Vesicular and Papular Rash

These small, itchy bumps can be filled with fluid (vesicular) or solid (papular). They may appear anywhere on the body and are often linked with ongoing inflammation.

6. Pityriasis Rosea

This condition begins with a single large patch on the chest, back, or abdomen, followed by smaller spots that form a tree-like pattern. Though harmless, it can take several weeks or months to fade.

7. Purpuric or Vasculitic Rash

These rashes appear as dark, bruise-like spots caused by small blood vessel damage under the skin. The color may range from red and purple to brown or black, depending on skin tone.

How Long Do COVID Rashes Last?

The duration depends on the type of rash and the person’s immune response. Most clear up within 2 to 12 days, but some, especially in long COVID cases, may persist for weeks.

How Are COVID Rashes Treated?

Many rashes resolve without any special treatment. To relieve itching or pain, applying mild hydrocortisone cream can help. For more severe or persistent cases, doctors may recommend:

• Antihistamines to reduce itching
• Corticosteroids to lower inflammation
• Blood thinners if the rash is linked to blood vessel irritation

Your doctor will determine the safest treatment depending on the type of rash and overall health.

Disclaimer: This article is for general informational purposes only and should not be considered medical advice. Always consult a qualified healthcare professional before starting, stopping, or changing any medication, or if you experience any unusual symptoms or side effects.

It is a common theme for people to feel down and sad in winter. However, why do shorter, colder days often bring on feelings of loneliness and gloom? There is a biological reason behind it. As the days get shorter, many people feel a dip in energy or mood, but for millions, this signals Seasonal Affective Disorder (SAD), which is a serious form of depression that shouldn't be ignored. Experts from West Virginia University (WVU) caution that SAD symptoms are very similar to major depressive disorder and must be taken seriously.

What Causes SAD?

SAD is much more than just feeling down when it gets dark. It's a genuine type of depression most often seen during the winter months, especially in places far north where daylight is scarce. The basic problem is simple: less natural light hits your eyes. This drop in sunlight confuses your brain's chemistry.

It messes with two vital brain chemicals: serotonin, which helps stabilize your mood, and melatonin, which controls when you sleep and wake up. This lack of light also throws off your body's internal clock, called the circadian rhythm. When all these elements get disrupted, it triggers feelings of low energy and depression.

What Are The Symptoms Of SAD?

SAD involves a cluster of symptoms that persist and significantly interfere with your daily life. The pattern is usually predictable: symptoms begin in the fall, peak in the winter, and disappear by spring. Symptoms often include:

• Feelings of hopelessness.
• Loss of interest in activities you once enjoyed.
• Significant changes in sleep (often sleeping more, or having disrupted sleep).
• Changes in appetite or increased food cravings.
• Difficulty concentrating and persistent fatigue.

The risk of SAD is higher among younger people, women, and those with a family history of mood disorders.

Can You Treat/Prevent Seasonal Affective Disorder?

Because Seasonal Affective Disorder is highly predictable, experts advise starting preventative treatments early in the fall. Seeing a healthcare provider is essential to determine the best plan and timing for treatment, rather than waiting for severe symptoms to appear later in winter.

Light Therapy

This involves sitting daily before a special light box emitting 10,000 lux of bright white light. Doing this for 30 to 60 minutes each morning is the most common and effective treatment for SAD, as it helps correct the imbalance caused by reduced sunlight exposure.

Cognitive-Behavioral Therapy (CBT)

This form of talk therapy teaches you practical skills to manage negative thinking patterns and behaviors linked to depression. CBT helps individuals reframe their outlook on winter and build effective coping mechanisms to reduce the impact of SAD symptoms.

Medication

In certain situations, a healthcare provider may prescribe antidepressant medication to help regulate mood-affecting brain chemicals like serotonin. This is often considered alongside light therapy or counseling, especially if symptoms of depression are severe or persistent.

Lifestyle Changes

Simple daily habits are powerful tools. Regular exercise boosts mood and energy, while maintaining a consistent sleep schedule keeps your body's internal clock stable. These practical steps offer significant support alongside clinical treatments.