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.

Delhi has issued a public health advisory amid a sharp rise in H1N1, commonly known as swine flu, cases. Health authorities urging residents to follow respiratory hygiene, avoid crowded places and seek medical advice if flu-like symptoms develop.

The national capital has reported more than 1,777 H1N1 cases so far this year, including 114 new infections recorded on August 20 alone, according to the latest health department data. Overall, Delhi has reported more than 2,300 Influenza-A cases in 2026.

The sudden surge has prompted the Centre and Delhi authorities to step up surveillance and hospital preparedness. Health officials have also stressed that people should not panic but take necessary precautions to avoid getting sick.

Delhi Sees A Sharp Rise In H1N1 Cases

According to health department, Delhi had recorded 2,392 Influenza-A cases by August 21, of which 1,777 were H1N1. The tally also included H1 and H3 infections and other Influenza-A strains.

The current number is significantly higher than the corresponding period last year. Public health experts have also described some of the H1N1 cases being seen this season as relatively severe.

Dr Chandrakant Lahariya, a public health expert, said H1N1 is not a new subtype and has been known for years, but the current surge needs to be taken seriously.

Also read: Delhi H1N1 Cases Rise To 1,777: Patients Reporting Diarrhea, Muscle Pain, Drop In Oxygen Levels, Say Doctors

Humid Weather Could Be A Major Factor

Doctors have linked the increase to the seasonal pattern of respiratory infections during the monsoon, when humidity, changing temperatures and increased indoor contact can facilitate the spread of respiratory viruses.

Dr Neetu Jain, senior consultant in pulmonary, critical care and sleep medicine at PSRI Hospital, told PTI, “H1N1 cases are particularly high in Delhi-NCR this year.”

She also said the number of cases was reported to be around six times higher than previous years and noted that high temperatures and humidity may contribute to the increase in flu and other viral infections.

Common Symptoms

H1N1 infection can mimic other viral respiratory illnesses. Common symptoms include:

• Fever
• Cough
• Sore throat
• Runny or blocked nose
• Headache
• Body aches
• Chills
• Fatigue and weakness

Some people recover without complications, but influenza can become serious, particularly in young children, older adults, pregnant women and people with weak immune systems.

Difficulty in breathing, chest pain, drowsiness, low blood pressure, bluish discolouration or worsening of an existing medical condition are among warning signs that need urgent medical attention.

Also read: Human H1N2v Swine Flu Case Detected In China: Should You Worry?

Doctors Advise Against Self-Medication

With flu cases rising, doctors are also urging people not to assume that every fever or cough is H1N1 and start medicines without medical advice.

Dr Jain described H1N1 as a “fairly treatable illness”, while noting that it can become serious in vulnerable people. Antiviral medicines may be prescribed in appropriate cases, along with supportive treatment.

The Delhi government's advisory recommends several basic measures to reduce transmission. People are being urged to wear masks in crowded places, cover their mouth and nose while coughing or sneezing, wash their hands frequently and avoid close contact with people showing respiratory symptoms.

Residents have also been advised not to touch their eyes, nose or mouth unnecessarily and to avoid spitting in public places.

People who develop flu-like symptoms should stay away from others where possible and seek medical advice, particularly if symptoms become severe.

Strenghtening Healthcare System

Authorities have also increased monitoring across the healthcare system. Thirty-five hospitals are under special surveillance, while referral laboratories at AIIMS and the National Centre for Disease Control (NCDC) are available for testing and confirmation.

Hospitals and district health authorities have been asked to strengthen monitoring of influenza-like illness, severe respiratory infections and COVID-19.

Union Health Minister JP Nadda has also reviewed Delhi's preparedness amid the rise in H1N1 cases, with authorities instructed to focus on surveillance, early detection and timely treatment.

Chronic kidney disease is a disease whereby the patient's kidneys progressively lose their capacity to filter wastes and excessive fluids from the blood stream.

Since kidney damage develops slowly, many individuals might not experience any signs in the early stages of the disease. It is therefore critical for individuals to know about the stages of CKD in order to appreciate the significance of kidney monitoring and timely medical intervention.

Stage 1: Mild Kidney Damage

At stage 1, patients' kidney functions will be relatively normal (eGFR level of 90 or more). However, there will be some indication of kidney damage for example presence of protein in urine. Individuals usually show no symptoms. Controlling diseases like diabetes and high blood pressure can delay progression of CKD.

Stage 2: Mild Loss of Function

This CKD stage is indicated by an eGFR level of 60 – 89 as well as kidney damage. There will probably be no symptoms or very mild symptoms at this stage.

Also read: US CDC Says COVID ‘Growing’ In Nearly Every State: What You Should Know

Stage 3: Moderate Loss of Kidney Function

This stage reflects the moderate loss of kidney function and features an eGFR ranging from 30-59. It normally involves two sub-stages that can be either 3a or 3b. Some of the symptoms of kidney failure can be fatigue, swelling of legs or ankles, changes in urination, or hypertension.

Stage 4: Loss of Kidney Function Is Severe

The fourth stage means that there is a severe loss of kidney functionality, which can be measured by eGFR of 15-29. It normally entails such symptoms as vomiting, swelling, tiredness, or changes in appetite. Health specialists discuss the possibilities of treatment of end-stage kidney disease with their clients and prepare them for getting a new kidney.

Also read: US Woman Paralyzed After Potassium Mistakenly Given During Knee Replacement Surgery

Stage 5: Kidney Failure

Stage 5 is indicated by eGFR being below 15 or the inability of kidneys to perform their functions properly. Waste products and extra fluids can accumulate in the blood and cause life-threatening conditions. Depending on the condition of a patient, the treatments may include dialysis, kidney transplantation, or supportive therapy.

Maintaining Good Kidney Function

The progression of CKD may not always be swift and early detection can make all the difference. The management of blood pressure and sugar, heeding medical advice, living a healthy lifestyle and regular medical check-ups can help preserve kidney functions. If anyone experiences consistent swelling, alteration in urinary habits or feels unusually tired among other symptoms, they should visit a Nephrologist.

Obstructive hypertrophic cardiomyopathy (oHCM) remains one of the most misunderstood cardiac conditions, despite being the most common inherited cardiomyopathy. Misconceptions around the disease often lead to fear, delayed diagnosis, and hesitation in seeking appropriate medical care.

While oHCM has historically been associated with sudden cardiac death, particularly in young athletes, advances in diagnosis and treatment have significantly transformed its management. Today, with early diagnosis and appropriate treatment, many patients can lead active and fulfilling lives.

Understanding the facts is essential, not only for patients living with the condition, but also for families, caregivers, and the wider community. Separating myths from medical evidence can help ensure timely diagnosis, informed treatment decisions, and better long-term outcomes.

Understanding oHCM

Obstructive hypertrophic cardiomyopathy (oHCM) is a form of hypertrophic cardiomyopathy (HCM)—an inherited heart muscle disorder caused by genetic mutations that affect heart muscle structure and function. These changes cause the heart muscle to become abnormally thick, most commonly affecting the wall (septum) between the two lower chambers of the heart.

In nearly two-thirds of patients with hypertrophic cardiomyopathy, the thickened heart muscle can block the flow of blood leaving the heart—a condition known as obstructive HCM (oHCM). As a result, the heart must work harder to pump blood throughout the body, often leading to symptoms such as breathlessness, chest pain, fatigue, dizziness, palpitations, or fainting during physical activity.

Myth: A diagnosis of oHCM inevitably leads to sudden death.

Fact: While oHCM was once primarily recognised for its association with sudden cardiac death, advances in medical science have significantly improved patient outcomes.

With timely diagnosis, appropriate medical care, and ongoing monitoring, many people with oHCM can lead active lives with a good quality of life and a near-normal life expectancy. Regular follow-up helps assess disease progression and guides individualized care over time.

Myth: People with oHCM need to avoid physical activities

Fact: Complete avoidance of physical activity is no longer recommended for most patients.

Although high-intensity competitive sports may not be suitable for everyone with oHCM, mild-to-moderate exercise is generally encouraged and offers important cardiovascular benefits. Exercise recommendations should always be individualised after a comprehensive assessment by a cardiologist, taking into account symptoms, severity of obstruction, and overall risk profile.

Myth: Diet and lifestyle are the primary causes of oHCM.

Fact: oHCM is a genetic condition. It is not a lifestyle disease.

Unlike heart conditions caused by high blood pressure, diabetes, or high cholesterol, oHCM develops because of inherited genetic mutations affecting heart muscle proteins. Healthy lifestyle choices remain important for overall cardiovascular health, but they do not cause or prevent the condition itself. Because the disease often runs in families, screening of close relatives may also be recommended.

Myth: Every patient with oHCM will require surgical treatment.

Fact: Surgery is only one of several available treatment options. Care is individualized, and the most appropriate approach depends on each patient's symptoms and clinical condition.

Myth: oHCM cannot go unnoticed.

Fact: The condition can remain silent for years. Some individuals carrying the genetic mutation never develop symptoms, while others experience mild or intermittent symptoms that may be attributed to more common conditions. Typical symptoms include:

• Shortness of breath
• Chest pain
• Fatigue
• Palpitations
• Dizziness or light-headedness
• Fainting, particularly during or after exercise

Given this variability, individuals with persistent symptoms or a family history of cardiomyopathy or sudden cardiac death should undergo appropriate cardiac evaluation.

Myth: Medication can cure the disease

Fact: Advances in treatment have significantly improved disease management, helping many patients lead healthier and more active lives. While current therapies focus on controlling symptoms and reducing complications, ongoing research continues to expand treatment possibilities.

Treatment aims to reduce symptoms, improve blood flow, minimize obstruction, and lower the risk of complications such as abnormal heart rhythms and heart failure. Long-term follow-up remains an important part of care, allowing treatment to be adjusted as the condition evolves.

Myth: There's no benefit to diagnosing oHCM early

Fact: Early diagnosis can make a significant difference. Because oHCM symptoms often resemble those of other conditions, timely testing is important—especially for those with a family history of the disease. Early detection can help patients access appropriate treatment, manage symptoms effectively, and reduce the risk of complications.

Why Awareness Matters

The understanding and management of obstructive hypertrophic cardiomyopathy have evolved considerably over the past decade. Although it remains a lifelong condition, it is no longer viewed through the lens of fear alone. Advances in medical therapies, improved diagnostic tools, and personalized treatment strategies have changed the outlook for many patients.

By challenging common myths and promoting awareness, more individuals can be diagnosed earlier, receive appropriate treatment, and live healthier, more active lives with confidence.

(Dr. Daljeet Kaur, Cardiac Electrophysiologist at AIG Hospital, Hyderabad)