Singer Jesy Nelson recently shared an emotional update regarding the complications she is experiencing in her pregnancy with twin babies. Former Little Mix singer Jesy, who is having twins with partner Zion Foster, announced that she has been diagnosed with pre-twin-to-twin transfusion syndrome (pre-TTTS). The condition, which is present in pregnancies involving twins with a shared placenta, has serious risks involved and needs intense medical supervision. As Nelson embarks on this difficult journey, her story enlightens us about a rare but dangerous condition many expectant parents may not know much about.

Twin-to-twin transfusion syndrome is a rare but dangerous condition that arises in monochorionic twin pregnancies, in which identical twins share a single placenta. The placenta supplies the developing babies with oxygen, nutrients, and blood flow, but in TTTS, there is an imbalance of blood vessels that interconnect the twins, and thus the vital resources are not evenly distributed. One twin, or the donor twin, shares excess blood with the other, referred to as the recipient twin. This leads to one baby becoming malnourished and possibly anemic, and the other in danger of heart problems due to too much blood.

Nelson described her diagnosis in a heartfelt Instagram video, explaining that she is currently in the pre-stage of TTTS and undergoing frequent monitoring. "I am being scanned twice a week, and each time, things have gotten a little worse," she shared, expressing her fears and hopes for the health of her babies.

Potential Risks of TTTS

If left untreated, TTTS can have devastating consequences. Medical research indicates that:

• 90% of the cases of untreated TTTS lead to loss of one or both twins.
• Despite treatment, only a 70% survival rate for both twins is assured.
• Severe forms can result in preterm labor, cardiac failure in the recipient twin, and organ failure in the donor twin.
• Complications in long-term survivors include neurological damage and developmental delay in surviving infants.

TTTS usually advances in stages, beginning with minimal changes in fluid levels and worsening as one twin continues to get an unequal share of blood. In extreme cases, fetal laser surgery, referred to as the Solomon technique, can be employed to divide the blood vessels and balance the twins.

Why Identical Twin Pregnancies Are More Complicated

Identical twins may develop differently, and their own unique form of placental sharing can have a dramatic effect on pregnancy risk. Jesy Nelson's twins are considered monochorionic diamniotic (mono/di), which means they share a placenta but have two amniotic sacs. This is the type of pregnancy in about 70% of identical twin pregnancies and carries an increased risk of complications like TTTS, umbilical cord entanglement, and growth restriction.

Conversely, dichorionic diamniotic (di/di) twins both have a separate placenta and amniotic sac, which greatly diminishes the threat of TTTS. Twin pregnancy type is normally identified by early ultrasound, with physicians being able to track future complications from inception.

Other Twin Pregnancy Health Risks

Twin pregnancies, even without the presence of TTTS, entail a variety of health risks to the mother as well as infants:

1. Premature Birth

Over 60% of twin pregnancies end in premature delivery, with birth usually taking place before 37 weeks. Premature infants can have immature organs and need neonatal intensive care (NICU) assistance to assist with breathing, feeding, and infection fighting.

2. Gestational Hypertension and Preeclampsia

Pregnant women with multiples are at increased risk of having high blood pressure during pregnancy. This, if left untreated, can result in preeclampsia, a serious complication of pregnancy that can result in damage to organs, preterm labor, and in some cases, maternal or fetal death.

3. Anemia

Pregnant women carrying multiples are twice as likely to experience anemia, a condition where the body does not produce enough healthy red blood cells. This can lead to fatigue, dizziness, and complications during delivery.

4. Birth Defects

According to John Hopkins Medicine, multiple birth babies are twice as likely to have congenital abnormalities compared to single births. These can include heart defects, neural tube defects, and gastrointestinal issues.

5. Amniotic Fluid Imbalances

When twins have to share a placenta, they are more likely to have polyhydramnios (excess amniotic fluid) or oligohydramnios (not enough amniotic fluid). Both result in distress to the babies during fetal development and can result in premature labor.

6. Postpartum Hemorrhage

Twins are at increased risk of excessive postpartum hemorrhage because their uterus is larger and there are greater blood supply needs.

Jesy Nelson's openness about her challenging experience is raising awareness for TTTS, a condition that few individuals—let alone expectant mothers and fathers—might be aware of. Through her tearful video, Nelson stressed the significance of knowing about twin pregnancies aside from the thrill of having multiples. "We had no idea that this type of thing occurs when you're having twins. We just desperately want to make people aware of this because there are so many people who aren't aware."

Her case reminds us of the intricacies involved in twin pregnancy and the significance of early identification and medical management. For mothers carrying twins, frequent ultrasounds and vigilance can become a life-and-death issue for early detection and better outcomes of both babies.

Through constant medical attention and care, she and her partner Zion Foster remain positive and get ready for their babies to be born. In other parents whose situations are no different, the story of Nelson highlights awareness, medical progress, and emotional encouragement in handling complicated pregnancies.

The expecting parents of twin siblings are advised to discuss TTTS screening and possible interventions with their physicians to give their babies the best chance.

More than a quarter of Americans (28%) misrepresented symptoms to obtain antibiotics for themselves, while 27% did so to get antibiotics for a child in their care, according to an alarming survey.

The nationwide survey of nearly 1,000 people, published in JAMA Network Open, found that common reasons included feeling very sick, believing antibiotics were the only effective treatment and needing to recover quickly to return to work or school.

The findings highlight the need for better communication between doctors and patients so that concerns are heard and symptoms are appropriately treated, whether or not antibiotics are needed.

“Now that we have a clearer picture of how common these behaviors are and the reasons behind them, the next step is to look at strategies that help patients express their preferences and communicate what they’re feeling to their provider, and for their provider to hear them, understand their concerns, and reassure them,” said Alistair Thorpe, research assistant professor of population health sciences at the University of Utah Health and one of the study's first authors.

What Did The Survey Reveal?

Among respondents, 28% said they had deliberately exaggerated or fabricated symptoms to obtain antibiotics for themselves, while 27% had done so for a child in their care.

The most common reason was feeling that they or their child were very sick and believing antibiotics were the only treatment that could help.

“It is a tough situation,” Thorpe said. “People are experiencing unpleasant symptoms, and they can have this strong feeling that antibiotics are the only thing that can help them feel better. Being told to just rest and wait is a hard thing to do, and if you think there’s something that could make you feel better, it’s a very hard impulse to override.”

Other reasons included needing to recover quickly to return to work or school and wanting greater control over treatment decisions.

Why Is Taking Unnecessary Antibiotics Dangerous?

Antibiotics treat bacterial infections but do not work against viral infections, which commonly cause cold- and flu-like symptoms. They can also cause side effects.

“These medications are not totally benign for the patient,” explained Andrea Levy, Professor of social sciences at Connecticut State Community College Middlesex and one of the study's first authors. “And antibiotic use contributes to increasing antimicrobial resistance, which is a broader public health concern.”

Unnecessary antibiotic use contributes to antimicrobial resistance (AMR), making bacterial infections harder to treat.

Accurate symptom reporting is therefore important. Doctors need a clear picture of a patient's symptoms to determine whether antibiotics are necessary and avoid prescribing them when they are unlikely to help.

Why Are Children At High Risk With Antibiotic Misuse?

Children commonly receive antibiotics for infections such as ear infections and respiratory illnesses. However, many childhood infections are caused by viruses, against which antibiotics are ineffective.

Unnecessary antibiotic exposure can cause side effects, including diarrhoea, nausea and allergic reactions. It can also contribute to antimicrobial resistance, making future bacterial infections harder to treat.

Repeated antibiotic use may also disrupt the developing gut microbiome, which plays a role in digestion and immune function.

Why Do Patients Misrepresent Symptoms And How Can It Be Prevented?

The researchers emphasise that the findings are not intended to blame patients or caregivers.

“There are very understandable reasons that we can sympathize with about why patients might feel the need to misrepresent symptoms, or why caregivers might do so on behalf of their children,” Levy said. “We’re simply saying: perhaps there’s a better way.”

Past experiences with healthcare providers may influence these decisions. People were more likely to exaggerate symptoms if a doctor had previously dismissed or downplayed their concerns.

Another factor is the mistaken belief that antibiotics helped someone recover from an earlier viral infection. Since viral infections usually resolve on their own, patients may incorrectly attribute their recovery to antibiotics rather than the body's natural healing process, Thorpe explained.

The findings highlight the need for better communication between doctors and patients.

Healthcare providers need to reassure patients that their symptoms are being heard and taken seriously, even when antibiotics are not appropriate.

The Union Ministry of Health and Family Welfare has proposed three separate amendments to the Drugs Rules, 1945, to strengthen pharmaceutical quality control, manufacturing accountability and patient safety.

The proposals include immediate suspension of manufacturing licences for drugs failing specified critical quality tests, stricter microbial monitoring in sterile manufacturing areas, and mandatory authorisation of qualified personnel for batch release.

The announcements aim to strengthen India's drug regulatory framework and align manufacturing standards with international guidelines.

Immediate Suspension Of Licences For Drugs Failing Critical Quality Tests

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In a significant move to enable faster action against substandard medicines, the Ministry has proposed immediate suspension of manufacturing licences for drugs declared Not of Standard Quality (NSQ) on specified critical parameters.

Under the existing provisions, suspension or cancellation of a manufacturing licence involves a prescribed regulatory process, including the issuance of a show-cause notice. This can create a time gap between the identification of a quality failure and regulatory action, during which the drug may remain in circulation.

To address this, the proposed amendment would allow the Central Licensing Approving Authority or the State Licensing Authority, as applicable, to immediately suspend the manufacturing licence upon receiving a Government Analyst's report declaring a drug NSQ on any of the following parameters:

• Assay
• Dissolution
• Related substances
• Impurities
• Sterility

These parameters are critical to determining the quality and safety of medicines. The proposed provision seeks to enable prompt intervention and minimise potential risks to patients.

Stricter Microbial Monitoring In Sterile Drug Manufacturing

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The Ministry has proposed amendments to Schedule M of the Drugs Rules, 1945, to revise microbial contamination limits in Grade A clean areas in line with the World Health Organization's (WHO) Good Manufacturing Practices (GMP) guidelines for sterile pharmaceutical products.

Grade A areas are critical zones in sterile pharmaceutical manufacturing, where exposed products, containers and sterilised components are handled. Maintaining strict microbial controls in these areas is essential to preventing contamination and ensuring product safety.

The proposed revision addresses differences between the existing Schedule M requirements and WHO guidelines. It also provides for any microbial growth detected in Grade A areas to trigger an investigation, in accordance with WHO guidance.

The amendment aims to strengthen contamination monitoring and bring India's sterile manufacturing standards in line with internationally recognised benchmarks.

The development comes in the backdrop of an episode involving India’s biggest drug maker Sun Pharma, which was recently ordered to halt production at its manufacturing plant in Assam after reports of contamination in some of the eye drops made there.

Mandatory Authorization For Drug Batch Release

In another proposal, the Ministry has sought to make it mandatory for drug manufacturers to formally designate a suitably qualified and experienced person responsible for batch release.

Although manufacturers are currently required to provide details of competent technical staff responsible for manufacturing and testing while applying for licences, the rules do not specifically require them to identify the person authorised to release drug batches.

Under the proposed framework, manufacturers applying for licences under the relevant provisions of the Drugs Rules, 1945, would have to:

• Designate a qualified and experienced person responsible for batch release.
• Maintain prescribed records for every batch manufactured.
• Follow a prescribed format for the Batch Release Certificate.

Batch release is a critical stage in pharmaceutical manufacturing. It involves reviewing quality parameters and relevant documentation before a batch is cleared for distribution.

The proposed requirements seek to establish clear accountability for batch-release decisions, improve traceability and strengthen quality assurance.

The World Health Organization (WHO) has reported significant global progress against neglected tropical diseases (NTDs), with fewer people requiring treatment. However, the rising burden of dengue remains a major concern.

The Global Report on Neglected Tropical Diseases 2026 found that 63 countries had eliminated at least one NTD by June 2026, up from 42 at the end of 2020.

“Elimination of neglected tropical diseases is one of the standout success stories of global health,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

However, he warned that these gains could be lost without increased domestic financing, sustained external support and the integration of NTD services into primary healthcare.

Global Progress Against NTDs

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The number of people requiring interventions for NTDs fell to 1.41 billion in 2024, a 36% decline since 2010 and a 19% decline since 2020.

Cases of sleeping sickness have dropped by 98% since 1999, while Guinea worm disease recorded just 10 human cases in 2025, its lowest number yet.

Between 2021 and 2025, 31 countries eliminated at least one NTD. Of these, 16 received WHO recognition for the first time. Between January and June 2026, five more countries received recognition: Algeria, Australia, Libya and Tunisia for trachoma, and Chile for leprosy.

By June 2026, 42 countries had eliminated one disease each, 16 had eliminated two, four had eliminated three and one country, Togo, had eliminated four.

India has eliminated three NTDs: Guinea worm disease in 2000, yaws in 2016 and trachoma in 2024.

Why Dengue Remains A Concern

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Despite progress against several NTDs, the report highlights uneven progress, with these diseases continuing to disproportionately affect the world's poorest and most vulnerable communities.

Dengue remains a major concern. Cases of the mosquito-borne disease reached a record 15.1 million in 2024, up from 2.74 million in 2020.

Locally acquired cases were reported across all six WHO regions. The organisation also classified dengue as a Grade 3 emergency, its highest emergency level, in 2024.

The Region of the Americas accounted for most reported cases, with Brazil contributing the largest share of the regional burden.

WHO said climate and environmental change, rapid and often unplanned urbanisation, population movement and the geographical expansion of Aedes mosquitoes are contributing to the spread of dengue.

WHO also warned that the geographical expansion of dengue into previously unaffected populations increases the risk of severe disease from secondary infections, making health system preparedness and the management of severe cases increasingly important.

In 2024, 12,554 deaths were reported across dengue, visceral leishmaniasis and chikungunya, against the 2030 target of 1,291 or fewer annual deaths.

Dengue accounted for 11,827 of these deaths, followed by visceral leishmaniasis (482) and chikungunya (245). Compared with the 2016 baseline of 5,163 deaths, reported deaths from these three diseases increased by 143.2%.

Other NTD Targets Remain Off Track

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The report also identified several challenges to achieving the 2030 targets. Deaths from vector-borne NTDs have increased, while progress towards yaws eradication remains off track. Only three disease-specific indicators achieved their 2025 milestones.

The WHO's 2021–2030 road map aims to:

• Reduce by 90% the number of people requiring NTD interventions

• Reduce NTD-related disability and premature deaths by 75%.

• Enable 100 countries to eliminate at least one NTD

• Eradicate Guinea worm disease and yaws

With five years remaining to meet these targets, WHO called for accelerated action, increased domestic financing and the integration of NTD interventions into universal health coverage to protect progress and address persistent gaps.