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.

The most frustrating skincare experience is breaking out a week after using a new product. Niacinamide serum is the most common one that people blame when it happens. But the real question is: does Niacinamide cause purging? The answer is no, but understanding what happens in your skin when you introduce it can help you.

A well-formulated Niacinamide Serum at the right concentration is very gentle on the skin.

And pairing it with a Niacinamide Moisturizer helps your skin adjust if you are using it for the first time.

What Is Skin Purging and How Is It Different from Breakouts

Skin purging is the result of an active ingredient accelerating your skin's natural cell turnover cycle. Your skin renews itself every 28 days. Retinol, AHAs, and BHAs speed up this process, which pushes microcomedones, trapped sebum, and dead cell buildup up to the surface faster.

Your skin may appear like it is experiencing a sudden flare-up of pimples, but it is your skin clearing all the buildup in one go. True purging:

• Happens only with ingredients that increase cell turnover
• Appears in the same areas you normally break out
• Resolves within four to six weeks
• Involves small whiteheads and blackheads rather than deep cysts

A regular breakout appears in new areas with any product and does not follow the same predictable timeline. Understanding this difference is important before you blame any ingredient.

Does Niacinamide Cause Purging?

Dermatologists say no, and the reason comes down to how niacinamide works at the biological level. Purging occurs only when an ingredient accelerates cellular turnover, forcing the skin to shed faster to clear hidden congestion.

Niacinamide is a form of Vitamin B3, and its action is fundamentally different. It works in the following manner:

• Regulates sebum production through the sebaceous glands
• Strengthens the skin barrier by supporting ceramide production
• Niacinamide reduces redness and inflammation caused by acne
• Stops the transfer of melanin so that pigmentation reduces

Why Niacinamide Is Less Likely to Trigger Purging

No Cell Turnover Acceleration

Can niacinamide cause purging? Purging occurs when the old skin cells are shed, and new ones form at a faster pace. Niacinamide has no effect on this process. It works on controlling oil and improving barrier function. It does not work on exfoliation or renewal rate. There is no mechanism through which Niacinamide could cause purging without accelerating cell turnover.

Regulates Sebum, Doesn't Exfoliate

Niacinamide signals the sebaceous glands to produce less oil over time, whereas salicylic acid dissolves the sebum inside pores, and AHAs dissolve the bonds between dead skin cells. It reduces the congestion that leads to breakouts. Niacinamide for pimples works by calming the conditions that create them.

Reduces Inflammation Instead

The anti-inflammatory action of Niacinamide calms the redness and swelling around active breakouts. So, does niacinamide cause pimples? Its inflammation-reducing properties make it the safest active for acne-prone skin, which you can introduce at any concentration between 5% and 12%.

What Could Actually Be Causing Your Purging

If you started a niacinamide product and broke out, here are the more likely reasons for it.

New Product Adjustment

Any new skincare product can cause a temporary adjustment period as your skin gets used to a new formula or ingredients. This is not purging, but your skin reacting to change. It settles within one to two weeks if the formula is compatible with your skin.

Reaction to Other Formula Ingredients

Many niacinamide serums contain additional actives, such as AHAs, BHAs, Retinol, or exfoliating enzymes, which increase cell turnover in your skin. If your Niacinamide serum contains these ingredients as well, the purging may result from them. So, always check the full ingredient list before blaming a reaction on any single ingredient.

Wrong Concentration for Your Skin

Using a 20% Niacinamide formula directly when your skin has never used actives before can cause irritation that looks like a breakout. It's your skin reacting to a concentration that it is not ready for. A safe way is to start between 5% and 10% and build up slowly to prevent flare-ups.

How to Add Niacinamide Properly to Your Skincare Routine

The chances of a reaction reduce a lot when you introduce Niacinamide correctly.

1. Patch test first: Take a small amount and apply it to your inner arm or jawline, and observe for any reaction in the next 24 hours before using it on your full face. Gentle ingredients can react differently on certain skin types, so you must do a patch test.

2. Start at a lower concentration: 5% to 10% is the best starting point if you are a beginner. Give your skin four weeks at this level before going with anything stronger.

3. Introduce one product at a time: If you add multiple new products all at once, you will never know which one is causing a reaction. Add Niacinamide on its own first and give it two to three weeks before introducing other active ingredients.

4. Apply after washing your face: Niacinamide works best when the skin is fresh. Apply it after your face wash and before your moisturizer so that it absorbs better into the skin.

5. Be consistent: The oil-regulating and pore-refining benefits of Niacinamide show only after four to eight weeks of daily use. So, you may not get the results if you stop using it abruptly because of an unrelated reaction.

Conclusion

If you are still wondering, does niacinamide cause purging? It does not. An increase in cell turnover results in purging, and Niacinamide does not work that way. The main reasons for breakouts can be your skin trying to adjust to a new product or another active ingredient in the formula. Higher concentrations can also be tough for your skin to tolerate, which may result in breakouts.

Researchers have found that up to 25 per cent more adults could be classified as obese, even if their body mass index (BMI) score falls under the normal category. As per the current rules, a BMI score of 18.5 to 25 is considered healthy, 25–29 is overweight, and 30 onwards is considered obese. Obesity can contribute to a long-term risk of serious illness, but according to an international team of experts, BMI may not be the most reliable measure for ascertaining obesity levels in an individual.

Why is BMI not a reliable parameter?

Researchers have found that adding the weight-to-height ratio and waist circumference could be a good way to ascertain unhealthy body fat levels. Fat, according to scientists, builds up in people who are not considered overweight or obese under the current rules, depending on where it is stored. Older bodies have a higher fat build-up around the waist, which, when combined with loss of muscle mass, means that there is no change in total weight. This means that the fat that accumulates, known as "skinny fat," does not always raise an alarm.

The new study from scientists at the University of Southern California analysed data from 5,642 adults in the US and discovered that a quarter of them had a normal BMI but actually met the obesity criteria. Furthermore, over 50 per cent of overweight people, according to their BMI, also met the updated obesity criteria. These findings, according to experts, suggest that millions of Americans with obesity-related health complications could be missing much-needed health interventions.

BMI is problematic because it does not evaluate body fat but reflects total body weight, including muscle and bone. Therefore, a muscular person is likely to have a high BMI but not much fat. However, a person with a normal BMI can have excess body fat, which can lead to complications later. The good news, experts say, is that these obesity-related issues can be addressed. Either lifestyle changes, medication, or both can be effective in reducing body fat levels and lowering the risk of future health problems. The sooner it is diagnosed, the better it is for long-term well-being.

Read more: Why 'Normal Weight' Doesn’t Always Mean Healthy

Does obesity risk increase with age?

Researchers estimate that 30 per cent of adults living in England aged 16 years and above are obese. This increases with age, with over 35 per cent of people aged 55 to 74 years living with obesity. Under the new rules, obesity would be defined as a BMI of 30 and above, or at least one elevated measure, such as a high waist circumference, a high waist-to-height ratio, or a BMI of 40 and above. Researchers have labelled these obesity subtypes as BMI-plus-anthropometric obesity.

What is an unhealthy waist circumference?

According to the NHS, an unhealthy waist circumference is 37 inches in men and 31.5 inches or above in women. An unhealthy waist-to-height ratio occurs when the waist circumference is half or more of a person's height. According to the British Heart Foundation, BMI is calculated by dividing weight by height squared. There are multiple BMI calculators available online. It is classified as follows:

1. Underweight – below 18.5
2. Healthy weight – 18.5 to 24.9
3. Overweight – 25 to 29.9
4. Obese – 30 and above

If BMI is in the overweight category, it is linked with a heightened risk of heart disease and incidents such as stroke or heart attack. If it falls within the obese category, the risks are higher. Underweight people are not exempt from risk, as they have a greater likelihood of developing long-term health problems.

Millions of Indians are increasingly turning to mental health apps to manage stress, anxiety, loneliness, and other emotional challenges. These digital platforms offer a range of services, from mood tracking and mindfulness exercises to AI-powered chatbots designed to provide conversational support that can feel similar to therapy.

The growing adoption of such apps comes amid a significant shortage of mental health professionals in India. Data from the National Mental Health Survey indicate that nearly one in ten Indian adults lives with a diagnosable mental health disorder, while more than 85 percent of people with depression do not receive adequate treatment. Other studies have also highlighted a large gap between the demand for mental healthcare services and the availability of trained psychiatrists, psychologists, and counselors, particularly in rural and underserved regions.

Against this backdrop, mental health apps position themselves as a convenient and relatively affordable way to access support anytime and from anywhere. However, researchers and mental health experts caution that the rapid rise of these platforms has also sparked concerns about data privacy, the clinical effectiveness of digital interventions, and the level of oversight and accountability surrounding AI-driven mental health tools. While some studies suggest that digital mental health programs can help reduce symptoms of anxiety and depression, experts emphasize that they should complement—not replace—professional care, especially for individuals with moderate to severe mental health conditions.

Also Read: India's Maternal Mortality Ratio Drops From 130 To 87 In Last 10 Years: Govt

How Mental Disorders Are Impacting Life Worldwide?

Mental disorders are on the rise worldwide, and nearly 1.2 billion lives are now affected by them. A recent study published in The Lancet has revealed this very crucial trend. The study was conducted by researchers at the Institute for Health Metrics and Evaluation (IHME) in collaboration with the University of Queensland.

This study shows that the number of people affected by the mental disorder has almost doubled since 1990. It also emphasizes the role of mental disorder in the case of disability, as the research suggests that it has crossed cardiovascular disease, cancer, and musculoskeletal conditions, leading to disability. Notably, the study has revealed that mental disorders affect people of different sexes and ages disproportionately.

The research was done on a massive scale from 1990 to 2023. The researchers studied the impact of mental disorder on both sexes, in 25 age groups, 21 regions, and 204 countries and territories.

Over the years, mental disorders have caused more and more mayhem in people's lives. Disability adjusted life years (DALYs) show the very impact of mental disorders on life. DALYs measure the health loss. It calculates the years lived with disability and years of life lost due to premature death.

According to this very measuring system, we can see that the mental disorder and its impact on overall life reached another zenith in 2023. That year, mental disorders alone caused 171 million disability adjusted life years (DALYs). This made mental disorder the fifth biggest contributor to total disease burden. Notably, in 2023, mental disorders had a 17 percent share of total life lost due to disability throughout the world.