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.

Currently, there is a spike in cases of women being diagnosed with clotting factor deficiency, a condition where the blood does not clot properly. Many women aren’t aware of this and tend to dismiss it as routine menstrual concerns. While not always widely discussed, this condition can lead to serious health risks if not identified early. Hence, women should be more attentive and consult the doctor when they notice unusual bleeding patterns and improve their overall well-being.

What is Von Willebrand Disease?

One of the most common yet underdiagnosed conditions in women is von Willebrand disease. So, it is a genetic disorder that affects the blood’s ability to clot. Some women present as carriers of hemophilia or develop clotting issues due to liver disease, infections, hormonal imbalance, or nutritional deficiencies such as low vitamin K. Hence, women should pay utmost attention to their health.

What are the symptoms of VWD?

VWD is a common inherited bleeding disorder, and it occurs when there is a dysfunctional blood protein that does not let platelets clump together to form clots. Because it adversely affects the blood's ability to clot, it causes mucosal bleeding. In mild cases, the symptoms may not be there, but in other cases, the symptoms are the following:

1. Prolonged and frequent nosebleeds
2. Excessive bleeding after minor cuts
3. Easy bruising
4. Large and lumpy bruises
5. Spontaneous bleeding in the joints

What are the types of VWD?

VWD is classified in three categories based on the nature and severity of the defect:

1. Type 1: Mildest form with mild bleeding symptoms
2. Type 2: Mild to moderate bleeding
3. Type 3: Rare and severe, leading to serious bleeding problems

VWD is largely genetic, and the most extreme form—type 3—occurs when a faulty gene is inherited from both parents. For treatment, doctors recommend hormonal therapy like IUDs or birth control pills to manage heavy period bleeding.

“Clotting factor deficiency is seen when the body lacks certain proteins needed to stop bleeding. In women, this may be a genetic condition, such as hemophilia carriers or other inherited bleeding disorders. They can experience clotting factor deficiency because of liver problems, infections, hormonal imbalances, or nutritional deficiencies like low vitamin K levels. Women avoid the symptoms like bleeding gums, heavy period bleeding, and other issues, assuming that the symptoms with get better. However, prolonged bleeding is also reported by women, especially after gynaecological procedures like childbirth," Dr. Padma Srivastava, Senior Consultant Obstetrician & Gynaecologist, Motherhood Hospitals, Lullanagar, Pune, said in an interview with Health and Me.

Dr. Padma further added, “Around 2–3 women aged 50-60 are reporting every week. However, delayed recognition remains a major challenge, as many women tend to ignore symptoms or delay seeking medical advice. Management of this condition involves clotting factor replacement therapy, medications to control bleeding, and regular monitoring. With proper care, most women can lead healthy and active lives.”

Changing lifestyles, career priorities, financial planning, and personal choices are leading many couples to marry later than before. While late marriages are becoming increasingly common, fertility specialists are observing a parallel rise in delayed pregnancy planning and age-related fertility complications. Many couples now begin trying to conceive only after the age of 35, when fertility in both men and women naturally starts declining.

Currently, there is a growing trend of late marriages due to career priorities, financial stability goals, higher education, and changing lifestyle choices. Many couples are choosing to settle professionally and personally before planning a family. However, this delay can also lead to postponed pregnancy planning, often at a stage when fertility naturally starts declining. Increasing stress, underlying medical conditions, and lack of fertility awareness are further contributing to challenges in conception among couples in their mid to late thirties.

What are the complications that can occur in a pregnancy after turning 35?

“The increasing trend of late marriages (30–35+) is directly leading to delayed pregnancy planning. Most couples start trying to conceive after 35, when fertility has already begun to decline significantly. By the time many patients seek medical help between 36 and 39 years, several are diagnosed with low ovarian reserve (low AMH) or conditions such as oligoasthenoteratozoospermia (OAT) and azoospermia.

Lack of early fertility awareness often causes women to miss the window for timely intervention or fertility preservation options like egg freezing. Advanced maternal age pregnancies (40+) are steadily rising and are often associated with complex complications and lower treatment success rates. Currently, nearly 75% of fertility patients are above 35 years of age, while 25% are above 40. Only around 20% of patients are in their late 20s,” said Dr. Jyotshana Palgamkar, Fertility Specialist, Nova IVF Fertility, Virar.

Dr Jyotshna further added, “One of the biggest concerns linked to late pregnancy planning is reduced ovarian reserve in women. By the time many women seek medical help between the ages of 36 and 39, their anti-Müllerian hormone (AMH) levels, which indicate egg reserve, may already be low. This reduces the chances of natural conception and can also affect the success rates of fertility treatments. Male fertility is also being affected. A large number of men are diagnosed with oligoasthenoteratozoospermia (OAT), a condition in which sperm count, motility, and morphology are affected.

Consequences of delayed fertility evaluation

Delayed fertility evaluation often means that couples lose valuable time before beginning treatment or considering assisted reproductive options. Another major challenge is the lack of awareness about fertility preservation. Many women remain unaware that egg freezing at a younger age may help preserve fertility for the future. By the time they start exploring fertility options in their late thirties or forties, treatment becomes more complex and emotionally stressful. Advanced maternal age pregnancies, especially above 40, are also increasing. These pregnancies are often associated with lower conception rates, higher miscarriage risk, pregnancy complications, and reduced IVF success rates,” Dr Jyotshna explained.

Male fertility treatment options depend on the underlying cause of infertility and may include lifestyle changes, medications, hormonal therapy, or surgical procedures. “Conditions such as low sperm count, poor sperm motility, abnormal morphology, raised DNA fragmentation index (DFI) affecting sperm quality, varicocele, or azoospermia can often be managed with timely medical intervention. Assisted reproductive techniques like IUI, IVF, and ICSI are also commonly used to improve the chances of conception. Early diagnosis and proper fertility evaluation play an important role in selecting the most effective treatment option for men,” said Dr Palgamkar.

Understanding fertility timelines, seeking timely evaluation, and discussing preservation options early can help couples make informed decisions and improve their chances of successful parenthood in the future.

Back pain is generally considered a problem seen in old age, but of late, we are increasingly seeing younger adults suffering from back pain. Prolonged sitting hours, inadequate physical activity, smoking, and an unhealthy lifestyle have made back pain a common complaint even in people under 30 years of age.

What is a slipped disc?

In an interview with Health and Me, Dr Pramod Sudarshan, Spine Surgeon (ortho), Apollo Hospitals, Bangalore, said, “Most commonly, we attribute this pain to a slipped disc or other disc-related conditions. However, they are just one among many reasons causing back pain. A thorough understanding of the other conditions that can lead to back pain, and knowing the ‘red flags’ to help identify them, will assist in seeking early treatment and preventing further complications.”

Muscle strain is considered to be one of the most common reasons for developing back pain in younger individuals. Daily activities like travelling for long hours, lifting heavy weights without proper technique, and carrying heavy backpacks can lead to muscle strain. Often, the pain due to muscle strain comes down with the help of medications such as muscle relaxants and rest.

Poor posture and back pain

Working professionals and students spend many hours a day studying, gaming, and working on computers without maintaining proper posture, leading to excess strain on the back muscles and, in turn, prolonged back pain. Having a properly ergonomically designed workstation/study table setup can prevent back discomfort and stiffness.

What are the causes of back pain?

Lack of physical activity and associated conditions such as obesity weaken our core muscles, which are considered the main pillars supporting our spine. Weakened core muscles will not be able to perform the functions expected of them, leading to back pain. Regular exercise, weight management, a healthy diet, and guided weight training will help strengthen our core muscles and reduce the risk of back pain.

Other than muscles, the spine also contains small joints known as facet joints, irritation or inflammation of which can lead to back pain. A structure known as the pars interarticularis acts as a clamp in the spine, holding two adjacent vertebral bodies, and any defect, such as a congenital defect or fracture due to repetitive microtrauma, as seen in gymnasts, can lead to the slipping of one bone over the other, causing back pain.

Though mechanical back pain is most common, there are other conditions such as inflammatory arthropathy, tumours, and infections. Conditions such as ankylosing spondylitis, rheumatoid arthritis, and hyperuricemia/gout are some examples of inflammatory conditions in which an individual experiences early morning back pain associated with stiffness and may also present with pain in other joints.

Can tuberculosis lead to back pain?

Tuberculosis affecting the spine is considered the most common infection of the spine. Severe back pain, weight loss, loss of appetite, fever, and night sweats are some of the common symptoms. Other bacterial and fungal infections are also seen affecting the spine, most commonly in immunocompromised individuals.

Tumours, though rare in young individuals, warrant further investigation when symptoms such as severe weight loss, night pain, and prolonged back pain are present to rule out the possibility of tumours.

Other conditions such as scoliosis (congenital/adolescent idiopathic scoliosis), which is a three-dimensional deformity of the spine, can cause back pain. It requires further assessment in the form of radiological investigations to assess the degree of deformity and to plan any surgical intervention, if required, based on the severity of the curve.

What are the symptoms?

Identifying some of the red-flag signs, such as weakness in the legs, numbness around the groin, bladder or bowel dysfunction, fever, unexplained significant weight loss, or severe pain following major trauma, is essential. These symptoms may indicate serious underlying pathology requiring medical care.

Fortunately, back pain in young people is largely preventable. Basic lifestyle modifications such as regular exercise, maintaining proper posture, avoiding prolonged sitting, maintaining a healthy body weight, undertaking monitored weight-training programmes, following a healthy diet, and getting adequate sleep will help prevent as well as overcome existing back problems. Invest in your spinal health at the earliest opportunity to reap the benefits in the second half of life.