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.

The boom in GLP-1 drugs for diabetes and obesity management is not without its drawbacks. From vision loss to hair fall, researchers are increasingly assessing the side effects of popular weight loss medicines, which include semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound).

Recently, a new side effect among GLP-1 users was reported which entails detachment of the nails. Experts believe that using weight loss injections may cause the patient’s fingernails to fall off, raising fresh concerns about the short as well as long-term side effects of these medicines.

Risk Of Fingernails Falling Off In GLP-1 Users

Nail detachment, clinically known as onycholysis, is a condition in which nails separate from the skin underneath it.

A new study has found that the risk of fingernails falling off in people taking GLP-1 receptor agonists was almost four times more common than non-users. The findings were presented at the European Academy of Dermatology and Venereology (EADV) Congress 2026.

Researchers, led by Dr. Charles Taïeb, found that 39% of GLP-1 users reported nail detachment, compared to 9% of people in the comparison group. Overall, 66% of people taking GLP-1 drugs experienced at least one nail disorder.

Apart from nail falling off, nail discolouration was also seen frequently among users, affecting 46% compared to 17% of non-users.

Researchers described this as the first controlled study specifically examining the possible effects of GLP-1 receptor agonists on nail health.

Also read: New Experimental Drug May Preserve Muscle Mass During Weight Loss From Ozempic

Could Your Nails Be Affected By GLP-1 Weight Loss Drugs?

GLP-1 medicines like semaglutide and tirzepatide reduce appetite, which can lead people to eat way less than they normally do. Rapid or significant weight loss can sometimes affect the body's supply of protein and other nutrients needed for healthy hair and nail growth.

But the increased number of nail detachment cases seen among GLP-1 drug users could not be solely attributed to weight loss.

“Until now, nail changes associated with GLP-1 therapies had essentially been anecdotal,” said study author Dr Charles Taïeb. “Our findings show a clear association, but they also underline an important point: not everything that happens during GLP-1 treatment is necessarily caused by the treatment itself.”

The researchers stress that the study cannot establish that GLP-1 receptor agonists caused changes to the nails. Around half of users already had nail problems before the treatment began.

After adjusting dermatological conditions and nutritional deficiencies, the strength of some associations reduced. However, nail detachment and nail discolouration remained around two to three times more frequent among users after adjustment.

Dermatologists already recognise that GLP-1 treatment can cayuse brittle nails and slower nail growth, especially in people who lose substantial weight loss. The American Academy of Dermatology notes that these effects may occur alongside other changes to the skin and hair.

Also read: 2 Indians Charged In US Over Fake Ozempic Scheme: How To Spot Counterfeit GLP-1 Drugs

Hair Loss Was Also Reported By 50% Of GLP-1 Users

A companion study also identified unusual changes on the hair and scalp among GLP-1 users. Unusual hair loss was reported by 50% of GLP-1 users compared to 34% of controls.

The study also reported loss of hair volume or density affected 42% versus 19% among controls. Hair loss after the treatment was also more than twice as common among users, i.e. 26% among users compared to 12% in non-users. Redness of the scalp was also around three times more frequent.

Study author Dr Bruno Halioua explained, “This suggests that what is happening on the scalp may go beyond the classical shedding seen after rapid weight loss and involve an inflammatory component.”

The author added, “Scalp inflammation was the rule rather than the exception, which clinicians do not currently look for and which may be treatable. Taken together, our findings suggest that factors beyond weight loss alone may contribute to the hair, scalp and nail changes observed among GLP-1 users.”

He also said that these changes could be temporary and that one should not stop the treatment without discussing it with their doctor.

“These changes are frequent, usually benign, and are not a reason to stop an effective treatment on one’s own initiative,” he said. “Anyone who notices hair shedding, an itchy or red scalp or nail changes should mention it to their doctor rather than discontinue therapy.”

Chewing tobacco contributed to an estimated 251,000 deaths globally in 2023, according to a new study from the Institute for Health Metrics and Evaluation (IHME).

The analysis, part of the Global Burden of Disease Study 2023 (GBD 2023) and published in The Lancet Global Health, found that more than 90% of the health burden was concentrated in 10 countries, with India accounting for the largest share.

"Chewing tobacco is not a uniform public health problem, and our findings show that a relatively small number of countries bear an overwhelming share of its health burden," said Gabriela Gil, lead author and research scientist at IHME.

South Asia Bears 84% Of Global Deaths: India Leads

Also read: Trying For A Baby? Tobacco Smoking Hurting Male And Female Fertility, Warns WHO

South Asia accounted for an estimated 210,000 chewing tobacco-related deaths, or about 84% of the global total.

Nearly 15% of people aged 15 and older in the region used chewing tobacco in 2023.

The highest age-standardized prevalence was reported in:

• Palau: 24.4%
• Bangladesh: 23.4%
• Nepal: 17.5%

India recorded the highest number of chewing tobacco-related deaths among both males and females.

More than 90% of the male death and disability burden was concentrated in:

• India
• Bangladesh
• China
• Pakistan
• Myanmar
• US
• Nepal
• Sri Lanka
• Philippines
• Madagascar

Among females, the countries were:

• India
• Bangladesh
• Pakistan
• Indonesia
• Myanmar
• China
• Thailand
• Cambodia
• Vietnam
• Nepal

Chewing Tobacco Use Highest Among Elderly Females

Read More: Trying to Quit Tobacco? Yoga Could Improve Your Chances, Suggests Study

Globally, use was higher among males than females and increased with age before peaking at 60–64 years.

In South Asia:

• Nearly 1 in 5 males used chewing tobacco.
• Around 1 in 10 females used it.
• Male use peaked at 60–64 years.
• Female use peaked at 80 years and older.

Bangladesh showed a different pattern, with female use higher than male use across age groups older than 30.

"These findings show why chewing tobacco control cannot take a one-size-fits-all approach," said Dr. Emmanuela Gakidou, senior author and professor in the Department of Health Metrics Sciences at IHME.

"Prevention and cessation strategies need to reflect how patterns of use differ by country, age and sex, as well as the cultural and social factors that shape tobacco use in each setting," Dr Gakidou added.

Stroke, Oral Cancer Among Key Health Risks

Researchers assessed chewing tobacco-related burden across six outcomes:

• Stroke
• Lip and oral cavity cancer
• Esophageal cancer
• Other pharyngeal cancer
• Laryngeal cancer
• Nasopharyngeal cancer

Stroke accounted for the largest share of health loss, at 55.9 disability-adjusted life-years (DALYs) per 100,000 people, followed by lip and oral cavity cancer at 17.4 DALYs per 100,000.

Chewing tobacco accounted for 17.3% of lip and oral cavity cancer DALYs globally, rising to 30.5% in South Asia.

Global Burden More Than Doubled Since 1990

Chewing tobacco-related DALYs increased 116% between 1990 and 2023, reaching 6.48 million. Of this:

• 6.17 million years were lost to premature death.
• Total DALYs reached 6.48 million in 2023.

The researchers noted that chewing tobacco has received less attention than smoked tobacco in global tobacco-control efforts.

They said stronger prevention and cessation measures, tailored to age, sex, country and local patterns of use, are needed to reduce the burden.

Two Indian nationals have been held in the US over an alleged international scheme of smuggling and selling counterfeit Ozempic.

The US Food and Drug Administration (FDA) said Swapnadip Roy, 33, and Vicky Ramancha, 37, allegedly obtained counterfeit Ozempic from unauthorised sources in China and sold it to US distributors at deeply discounted prices between July 2023 and April 2024. Roy was extradited from Italy and has pleaded not guilty, while Ramancha remains at large.

This has raised fresh concerns about the risks of counterfeit GLP-1 medicines. The counterfeit products allegedly included fake packaging, package inserts, pen labels and needles, designed to make them appear like genuine Ozempic.

The alleged scheme continued even after the FDA seized some counterfeit products and issued a public warning in December 2023.

Risks Of Fake GLP-1 Drugs

Counterfeit medicines may not contain the primary drug they claim to contain. The FDA warns that fake drugs can contain the wrong ingredients, too much or too little of the active ingredient, no active ingredient at all, or harmful substances.

With injectable medicines like Ozempic, contaminated or counterfeit needles can also create an infection risk.

This is particularly concerning with GLP-1 drugs because medicines like semaglutide and tirzepatide are increasingly being used for diabetes and weight management. A person buying a fake injection may therefore have no reliable way of knowing what they are actually putting into their body.

Also read: 21% In 80 Weeks: Lancet Study Finds Lilly’s Retatrutide Delivers One Of The Biggest Weight Losses Ever

FDA Issued A Warning

Acting FDA Commissioner Kyle Diamantas said, "Infiltrating the American drug supply with counterfeit products isn’t just a crime — it’s also a direct threat to public health and patient safety."

He added, "The FDA will continue to trace illicit networks wherever they lead, across borders and through complex supply chains, to ensure that anyone who seeks to profit off counterfeit medicines face accountability — all in our mission to keep Americans safe."

The Justice Department has stressed that the charges are allegations and that the defendants are presumed innocent unless proven guilty.

Assistant Attorney General A. Tysen Duva of the US Justice Department said, “These defendants allegedly exploited people’s health to pay themselves. We will keep pursuing anyone who seeks to deceive American consumers with counterfeit drugs.”

Also read: From 365 Shots To 52: How Could Lilly’s Newly-Approved Weekly Insulin Injection Change Diabetes Care

How Can You Spot A Counterfeit GLP-1 Drug?

The FDA advises consumers to look for several warning signs.

1. Check The Packaging

Does the packaging look different from what you normally receive? Changes in fonts, spelling, labels, colours, printing quality or packaging can be warning signs of a counterfeit medicine.

2. Be Careful While Purchasing Online

The FDA specifically warns consumers to be cautious when buying GLP-1 medicines online. Unapproved or illegally marketed versions of semaglutide and tirzepatide may be counterfeit or contain harmful ingredients.

The agency recommends purchasing medicines only from state-licensed pharmacies.

3. Look At The Price

A dramatically lower price can be a red flag, particularly when an expensive prescription medicine is being offered through an unauthorised seller. In the alleged US scheme, counterfeit Ozempic was sold to distributors at deeply discounted prices.

4. Watch For Unexpected Side Effects

A new or unusual reaction after taking a medicine can also be a warning sign. The FDA lists unexpected side effects among possible indicators of counterfeit medicines.

What Should You Do If You Suspect You Have Bought A Fake Injection?

Contact your doctor or pharmacist and verify the product before taking a dose if you suspect your medicine is fake. Patients should also avoid buying GLP-1 medicines through social-media sellers, unverified websites or other unauthorised sources.