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 suspected plague situation in Russia has reportedly claimed another life, fueling fears of a potential outbreak. However, Russia has not confirmed that either death was caused by plague, and investigations into the cases are ongoing.

India, which has witnessed plague outbreaks in the past, including the 1994 Surat outbreak and a pneumonic plague outbreak in Himachal Pradesh in 2002, also has rodent populations that can serve as reservoirs for plague. But does the situation in Russia pose a risk to India if plague is eventually confirmed?

To understand the potential risk to India, HealthandMe spoke to two experts with experience investigating plague outbreaks in India.

Plague From Test-Tube Exposure?

Also read: Russia Plague Scare: Is Pneumonic Plague Deadlier Than Bubonic & Septicemic Plague?

The death of a 28-year-old laboratory worker in Russia’s Irkutsk region has raised concerns about possible plague exposure. Reports said she may have accidentally broken a test tube containing Yersinia pestis, the bacterium causing plague, while collecting samples. However, Russian authorities have not confirmed plague and said she died of pneumonia of unknown cause.

Dr NK Ganguly, former Director General of the Indian Council of Medical Research (ICMR) told HealthandMe that the case has not been established as plague and questioned whether a test-tube exposure could explain plague pneumonia.

“Actually, the case in Russia has not been proven to be plague. It has been reported as a case of unknown cause and undiagnosed pneumonia. They have been investigating plague among about 2,000 people in the vicinity, as well as among people in the laboratory. So, they have not confirmed it as a plague case. And from a test tube exposure, it is difficult to have plague pneumonia.”

Unconfirmed reports have also claimed another death linked to the same laboratory, but this has not been independently verified.

Dr Ganguly was one of the people who investigated the 1994 plague outbreak in Maharashtra’s Beed district.

Should India Be Concerned?

There is currently no indication that the situation in Russia poses a significant pandemic risk to India.

Dr Ganguly said there is no reason for India to be very concerned about the Russian situation, particularly because plague has not been confirmed.

“So from the Russian plague, there is no, we need not be very worried. Firstly, they have not reported it as plague. It might be plague, but they have not reported it as plague.”

The WHO has also assessed the risk to the wider population as low. WHO spokesperson Christian Lindmeier said the initial assessment based on available information put the risk at moderate to low for Irkutsk, low for Russia as a whole and very low for the WHO European Region.

How Does Plague Spread?

Plague is caused by the bacterium Yersinia pestis and is primarily associated with rodents and their fleas. It can occur in different forms, including bubonic, septicemic and pneumonic plague. Russia is suspected to have pneumonic plague.

Dr Amitabh Banerjee, who investigated the Himachal Pradesh plague outbreak in 2002, said plague does not typically spread rapidly from person to person.

“So it's not a very quick transmission, particularly person to person. But plague is a disease which cannot be eradicated because it is in wildlife, it is in rodents and all. So the only thing is hygiene and, with modern antibiotics, there should not be any panic,” he told HealthandMe.

Banerjee also noted that pneumonic plague can be severe, while bubonic plague does not typically spread easily from person to person.

“So pneumonic plague can be very deadly particularly pneumonic plague and that will be localized pandemic it is not possible because those persons will be very sick, they cannot move out or not and bubonic plague will not transmit very easily from person to person and both are treatable…”

How Should India Prepare?

While Dr Ganguly said there is no immediate reason for India to be worried about the Russian situation, he stressed the importance of continued surveillance of rodents and other animals, particularly where wildlife and human habitation overlap.

“So the main thing is that go on doing surveillance in the rats and other, in the vicinity of where the forest and the human habitat march. And whenever you find any activity, then take preventive precaution.”

Leaving Delhi for a city with cleaner air could be a health-smart decision as it can reduce your exposure to harmful pollutants. But just because you are away from the smog, it does not mean the health effects from years of inhaling polluted air will recover overnight.

That brings us to an important question. How long do lungs take to recover after living in an excessively polluted environment?

Air pollution, particularly fine particulate matter known as PM2.5, triggers inflammation and oxidative stress throughout the body. This can directly impact the lungs, heart, blood vessels and even the brain.

The World Health Organization says long-term exposure to air pollution increases the risk of serious disorders like heart disease, stroke, chronic obstructive pulmonary disease (COPD) and lung cancer. That is why relocating could be beneficial without necessarily being a complete reset for the body.

Exposure Stops But Not Effects

Also read: Delhi Air Pollution Is Back: What Days Of Poor AQI Can Do to Your Lungs

The key difference to note here is between ongoing exposure and the damage that exposure may have contributed to. Once someone moves to a place with cleaner air, they are no longer receiving the same daily dose of pollutants. This can alleviate the ongoing inflammatory burden due to toxic air significantly.

But if years of exposure have contributed to changes in lung function, blood vessels or cardiovascular health, those effects may take much longer to recover, and some chronic disease may not even be completely reversible.

A recent study examining Delhi’s pollution between 2019 and 2023 found that PM2.5 levels exceeded India’s national daily standard on roughly 60% of measurements and the WHO daily guideline on almost all days.

Researchers also found that particles deposited deep in the lungs can be cleared much more slowly than larger particles, sometimes over weeks to years.

Lungs May Be Impacted For A Long Time After Moving

Also read: Children, Adults & Seniors: How Lung Health Risks Change Across Life Stages

PM2.5 particles are small enough to travel deep into the respiratory system. Some particles can reach the alveolar regions of the lungs, where clearance and recovery are slower. Constant exposure can also keep irritating the airways, worsening conditions like asthma and contributing to long-term respiratory disease.

WHO notes that short-term exposure can aggravate asthma and increase respiratory infections, while chronic exposure is associated with diseases such as COPD and lung cancer.

The consequences of air pollution on health are not just limited to breathing. PM2.5 can contribute to inflammation and oxidative stress, while some particles can enter into the bloodstream. This can affect blood vessels and the cardiovascular system.

Long-term exposure has also been associated with atherosclerosis, heart attacks and stroke, among other cardiovascular outcomes. The US Environmental Protection Agency says evidence links both short and long-term PM2.5 exposure with changes in heart and blood-vessel function and with cardiovascular disease.

Recovery After Moving Away

Reducing exposure could be an excellent health intervention to start the recovery process. Once a person is no longer repeatedly exposed to high concentrations of PM2.5 and other pollutants, the body is no longer subjected to its active effects.

But recovery also depends on what has happened during the years of exposure. Temporary inflammation or irritation may improve after exposure falls, while structural changes or chronic diseases may persist for quite a while even after moving away.

It is therefore more accurate to think of relocation as reducing future exposure rather than expecting to escape pollution health effects scot-free.

Delhi’s pollution crisis is not confined to a few extremely bad winter days. Research analysed five years of AQI data and found persistently high PM2.5 and PM10 concentrations. It also found that pollution generally worsened during post-monsoon and winter months. Evening commuting periods also produced higher particulate deposition than morning periods.

In my 13 years of working with clients as a trauma-informed consulting psychologist, I have often noticed that people recognise nervous-system overload only after their body forces them to slow down.

Until then, they may describe themselves as “too sensitive”, “lazy” or “unable to cope”. In reality, these reactions are often the nervous system’s attempt to protect us.

Fight, Flight, Freeze Or Shutdown

Our nervous system continually assesses whether we are safe. When stress feels persistent or overwhelming, the body may move into fight or flight.

We might become irritable, restless, anxious or unusually controlling. The heart may race, muscles tighten and sleep become disturbed. At other times, the system may shift towards freeze or shutdown, showing up as exhaustion, emotional numbness, procrastination, forgetfulness or a strong desire to withdraw.

Also read: LSD-Based Treatment Clears Second Phase 3 Trial: Could It Be The First New GAD Drug In 2 Decades?

When Everyday Reactions May Signal Overload

For example, someone who becomes disproportionately angry over a minor delay may not simply have an “anger problem”; their system may already be carrying days or months of accumulated stress. Another person may sit before a simple email for hours, unable to respond.

What looks like avoidance may actually be a freeze response. Some people remain highly productive while feeling disconnected from their bodies, until headaches, digestive difficulties or fatigue begin demanding attention.

These signs do not automatically indicate trauma or a mental health condition. They are invitations to become curious: What has my system been carrying? When did I last feel rested, supported or genuinely safe?

Small Ways To Help The Body Feel Safer

If you notice these patterns, begin gently. Reduce unnecessary stimulation, eat regularly, protect your sleep and spend time with people around whom you do not have to perform. Slow breathing—particularly allowing the exhale to be longer—may help signal safety. You can also look around the room, notice your feet on the floor and name what you can see and hear. Small, repeated experiences of safety are often more helpful than forcing yourself to “calm down”.

If symptoms persist, interfere with daily life or feel difficult to manage alone, speaking with a trauma-informed therapist can help you understand the patterns beneath them. Therapy is not only for moments of crisis; it can offer a safe space to listen to what the nervous system has been communicating all along.

The body is rarely working against us. Often, it is asking for care in the only language it knows.

By Ms Arouba Kabir, Psychologist & Therapist, Founder - Enso Wellness