Imagine this. A young teenager, 17, years old, who is fully developed. Now imagine this, the same teenager has a fully developed extra set of limbs and a pelvis. That extra set of pair is attached with chest artery. But, how can this happen?

While it is extremely rare, and has a chance of less than one case occurring per 100,000 births. Such things do happen. This is called parasitic twin.

What Is A Parasitic Twin?

It is an extremely rare type of cojoined twin where a baby is born with an underdeveloped twin attached to its body. This condition is also known as vestigial twins. The condition is very closely related to conjoined twins, where babies are connected at birth and share organs. However, the main difference is that in conjoined twins, there are two developed babies, whereas in parasitic twins, only one is fully developed, other one is underdeveloped and non functional.

In such a case, the twin who is developed is medically known as the autositic or the dominant twin. The dominant twin is healthy in most aspect but may have extra tissue, organs, or limbs from the parasitic twin.

The parasitic twin may be attached with the dominant twin through several places. The common joints are at the head, torso, chest, pelvis, buttocks, or back. In these cases, the parasitic twin is not alive and they die either in the womb or during the childbirth.

Doctors Remove Parasitic Twin

Now, let's go back to the case we referred to, where a young teenager had an extra pair of limbs attached to chest. The teenager who has not been named is from Uttar Pradesh's Unnao neighbourhood, and was treated in AIIMS, Delhi. The team of doctors successfully removed the extra set of limbs from his body.

Dr Asuri Krishna, who led the team of specialist who surgically removed the extra limbs told the BBC that only 40 to 50 cases of parasitic twins have been documented in world medical literature, and in those cases, the surgery had been attempted on children. The doctor said that without much medical literature to guide them, the team of doctors depended on "intuition, skill and knowledge".

The doctor shared that the child had two fully formed legs, buttocks and external genitalia, which weighed around 15kg "protruding from his abdomen".

How Was The Surgery Performed?

The doctor shared that first they identified how interconnected the parasitic and host twins were. The doctors took scans and found that parasitic twin was attached to the teen's breastbone. The blood was being supplied from a vessel in his chest. However, "there wasn't much connection with other main organs like the liver or kidneys," said Dr Krishna. The team also found a large cyst in the teen's abdomen.

Then the surgery was performed in two stages. In the first stage, the parasitic twin was removed. Then the cystic mass was extracted from the surrounded area. The entire surgery was completed in two and a half hours and the team of doctors included radiologists, anaesthetists, and plastic surgeons.

The biggest challenge was when the teen's blood pressure dropped as 30 to 40% of his blood flowed to the parasitic twin, however, the doctors were prepared for it and they stabilized him.

Metabolism-Associated Fatty Liver Disease (MAFLD) — also termed Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) — is defined by excess hepatic fat accumulation (>5 per cent of liver weight) in the presence of metabolic dysfunction, independent of alcohol intake. It encompasses a spectrum from simple steatosis to steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma.

MAFLD: Epidemiology In India

A Lancet Regional Health study found that approximately 39 per cent of Indian adults screened had fatty liver disease, making it one of the most prevalent chronic liver conditions in the country. Within India, prevalence shows regional variation driven by genetic, dietary, and socioeconomic factors.

A particularly important feature is the “lean MAFLD” phenotype — South Asians often develop fatty liver at a lower BMI due to disproportionately high visceral fat, which complicates detection based on conventional BMI screening. Currently, MASLD is the commonest cause of liver cirrhosis and hepatocellular carcinoma (HCC).

MAFLD: Causes And Risk Factors

The core drivers are components of metabolic syndrome: type 2 diabetes mellitus, obesity (particularly central adiposity), dyslipidemia, hypertension, and insulin resistance. MASLD is strongly linked to obesity, sedentary lifestyles, and metabolic syndrome.

Genetic susceptibility also plays a role — variants in genes such as PNPLA3 are associated with increased liver fat accumulation, particularly in certain Indian populations. Rapid dietary transition towards ultra-processed, high-calorie foods compounds the risk.

MAFLD: Investigations

Routine liver function tests may appear normal in early stages, and an ultrasound detects only moderate-to-severe fat accumulation. A structured approach includes:

• Blood tests: LFTs, fasting glucose, HbA1c, lipid profile, insulin resistance indices
• Ultrasound abdomen: First-line imaging for steatosis
• FibroScan (Transient Elastography): Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) are standardized non-invasive tools for assessing fibrosis and steatosis.
• Liver biopsy: Gold standard for staging steatohepatitis and fibrosis when non-invasive tests are inconclusive.

MAFLD: Treatment

No approved pharmacotherapy exists exclusively for MAFLD; management is lifestyle-centred:

• Weight loss: 7–10 per cent body weight reduction significantly reduces hepatic steatosis and inflammation
• Diet: Mediterranean-style diet; restrict refined carbohydrates and saturated fats
• Exercise: Both aerobic and resistance training improve insulin sensitivity and liver fat
• Metabolic comorbidity control: Optimise glycaemia (GLP-1 agonists show hepatic benefit), manage dyslipidaemia and hypertension
• Emerging therapies: Resmetirom (thyroid hormone receptor-β agonist) has shown promise in MASH with fibrosis.

Once known to affect only people over 60, Parkinson’s Disease is now increasingly being seen in young adults, especially at the age of 40, said health experts on World Parkinson’s Day today.

World Parkinson’s Day is observed every year on April 11 to raise awareness about the brain condition that causes tremors, slowness of movement, and trouble walking.

Parkinson’s is a progressive and neurodegenerative movement disorder caused by the loss of dopamine-producing brain cells.

Progressive decline in mobility is a key issue among Parkinson's patients, impacting their independence and quality of life. Other problems include slow movement, tremor, imbalance, cognitive impairment, mental health disorders, sleep disorders, and pain.

Also read: World Parkinson's Day 2026: Origin, Theme And Global Burden

Young-onset Parkinson’s Disease

According to the American Parkinson's Disease Association, a diagnosis of Parkinson’s between the ages of 21 and 50 is referred to as early-onset Parkinson’s disease, or young-onset Parkinson’s disease (YOPD).

Exposure to environmental toxins and lifestyle changes are major reasons for the rise in Parkinson's in this group.

While the symptoms of the disease are mostly the same at whatever age it develops, younger people will experience the disease differently due to their unique life circumstances. Managing the disease can be particularly challenging for a younger person and their family from a medical, psychological, and social standpoint.

"There is a perceived increase in younger-onset Parkinson’s in India. Possible reasons include better awareness and diagnosis (more neurologists, improved access to care), environmental exposures (pesticides, heavy metals), and air/water pollution. Lifestyle (sedentary habits) and urbanization-related factors may also contribute," Dr Sudhir Kumar, Neurologist at Apollo Hospitals Hyderabad, told HealthandMe.

A 2022 study, published in NPJ Parkinson's Disease, showed that the incidence of Parkinson’s disease, or the number of new cases diagnosed per year, is 50 per cent higher than previously estimated.

Instead of past estimates of 60,000 new cases of Parkinson’s disease diagnosed per year, the study determined that there are approximately 90,000 new cases of Parkinson's disease diagnosed in the US per year.

"Young-onset Parkinson’s disease (YOPD) is on the rise, mainly in the middle socio-demographic index. These countries include India, China, and some Southeast Asian countries," Dr Paresh Doshi, Director of Neurosurgery and Stereotactic & Functional Neurosurgery at Jaslok Hospital and Research Centre.

"According to one research paper, the age-standardized incidence rate has been rising at an alarming rate of 1.4 per cent per annum. To put it in perspective, if the incidence was 100/10,00,000 in 1995, it would be 153/10,00,000 in 2026," he added.

The experts noted that, along with the rising disability burden, mortality is reducing. The compound effect of all these is a larger number of YOPD patients suffering longer. Surgeries like deep-brain stimulation can help reduce these disabilities significantly.

Checklist for Parkinson’s: Signs You Should Not Ignore

Early recognition is critical, as many symptoms precede motor features by years.

Common early signs include:

• Reduced sense of smell (anosmia)
• Slowness of movement (bradykinesia)
• Reduced arm swing while walking
• Resting tremor
• Masked facies (reduced facial expression)
• Change in handwriting (micrographia)

Other important symptoms, which are often overlooked:

• Constipation
• Sleep disturbances (especially REM sleep Behavior disorder)
• Depression or anxiety.

Parkinson’s Disease is traditionally characterized by motor symptoms such as tremor and dyskinesia, although non-motor symptoms, in particular gastrointestinal (GI) symptoms such as constipation and incomplete emptying, are often the first markers of the disease and may precede the motor symptoms by years.

GI dysfunction is reported in approximately 70-80 per cent of Parkinson’s patients, mediated in large part through the gut-brain axis (GBA).

Speaking to HealthandMe, Dr Paresh Doshi, Director of Neurosurgery and Stereotactic and Functional Neurosurgery at Jaslok Hospital and Research Center, GBA, is an established two-way network that links the GI tract and the central nervous system (CNS). The connection is multifaceted, involving the vagus nerve, the enteric nervous system (ENS), the immune system, and a vast number of microbial metabolites and neuroendocrine signals.

“Constipation is seen in 66 per cent of Parkinson’s patients, attributed to disordered central and peripheral parasympathetic disruption, and can lead to alteration of the gut microbiome, which in turn worsens constipation, starting a feedback loop,” the doctor explained.

What Parkinson’s Patients Must Eat

Dr Sudhir Kumar, Neurologist at Apollo Hospitals Hyderabad, told HealthandMe that changes in the gut microbiome may influence inflammation, α-synuclein aggregation, and symptom progression.

Practical dietary principles for Parkinson’s patients include:

• Prefer fiber-rich, plant-based foods (vegetables, fruits, whole grains), which support gut microbiota
• Include fermented foods (curd, buttermilk), which may improve microbial diversity
• Reduce ultra-processed and pro-inflammatory foods
• Ensure adequate hydration (helps reduce the risk of constipation, a common non-motor symptom)
• Protein timing matters: Levodopa competes with amino acids for absorption.

These gut-targeted interventions are promising adjuncts to conventional Parkinson's therapy, and improving patient quality of life.

Parkinson’s Treatment With Dance, Art

Beyond gut-brain axis, research has proven that unconventional therapy, like dance and art, can improve Parkinson’s treatment.

A 2024 study published in the Scientific Reports found that tango, particularly Argentine tango, improved Parkinson's symptoms like thinking problems or balance issues. It also led to a significant improvement in recognizing emotions on people's faces.

Dr Kumar said dance therapy improves balance, gait, and coordination; provides rhythmic cueing, which enhances motor performance, and improves mood and motivation (dopamine-related pathways).

Similarly, art therapy has been shown to improve overall visual-cognitive skills and visual exploration strategies as well as general motor function in patients with Parkinson’s. The changes in brain connectivity highlight a functional reorganization of visual networks, as revealed by a study published in Parkinsonism & Related Disorders.

Dr Kumar said art and creative therapies are also helpful in enhancing cognitive engagement. It may help with executive function and emotional well-being and provide a non-verbal outlet for expression. However, these therapies work best as adjuncts, not replacements, to standard treatment, the expert noted.

World Parkinson’s Day 2026

World Parkinson's Day is observed annually on April 11 to raise global awareness of Parkinson’s disease, the world's fastest-growing neurodegenerative disorder.

It highlights the need for early diagnosis, research, and support for the nearly 10 million people living with the condition. The day marks the birthday of Dr. James Parkinson, who first described the disease in 1817.

The theme of World Parkinson's Day 2026 is "Bridge the Care Gap." It reflects a critical challenge that persists despite advances in medical research: many people living with Parkinson's still lack consistent access to specialist care, affordable treatment, and integrated support systems.

Parkinson's disease affected 11.9 million people in 2021 and will affect 25.2 million people globally by 2050, representing an alarming 112 per cent rise.