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.

Fatty liver and liver damage are not identical. While fatty liver refers to a buildup of excess fat inside the liver cells, liver damage describes harm caused to the liver due to inflammation, scarring, toxins, infections, or any long-term disease.

What Is Fatty Liver?

The liver turns fatty, when the body stores too much fat in the liver. This can be caused due to obesity, insulin resistance, type 2 diabetes, high cholesterol- referred to as MASLD (Metabolic dysfunction associated Liver Disease). High consumption of alcohol or chronic hepatitis infection can also lead to fatty liver.

In many cases, fatty liver causes no obvious symptoms, especially in the early stages. Some people may feel tired or notice discomfort in the upper right side of the abdomen, but many often know about it incidentally- either during blood tests or through an ultrasound scan.

What Is Liver Damage?

Liver damage, on the other hand, can range from mild irritation to severe and permanent injury. The damage may be caused by viral hepatitis, alcohol misuse, certain types of medicines, autoimmune diseases, inherited conditions, or fatty liver that has turned serious.

Liver damage may be referred to inflammation, liver-cell injury, fibrosis, cirrhosis, or a reduction in the function of the liver. In short, fatty liver is one condition, while liver damage points to a wider range of liver diseases.

Also read: Healthcare In India No Longer A Privilege, Becoming A Right: PM Modi

How Are They Related?

The relationship between the two is important. Fatty liver does not always mean that the liver is badly damaged. Certain people have a simple fatty liver, where fat is present but there are little or no inflammation or scarring in the liver. This stage often improve with weight loss, a healthy diet, exercise, and a reduction in alcohol intake, if alcohol is a factor. However, in some people, fatty liver can progress.

When this fat buildup causes liver swelling and cell damage, it is called MASH (Metabolic Dysfunction-Associated Steatohepatitis) which can lead to an injury and the formation of scar tissue in the liver. Over a period of time, this can progress to fibrosis and, in advanced cases, cirrhosis. At this stage, the liver is damaged and may not be in a position to function properly.

Symptoms and Warning Signs

Symptoms also differ. Early fatty liver is often silent. More serious liver damage may cause jaundice, swelling in the legs or abdomen, easy bruising, severe fatigue, confusion, itching, or dark urine. These symptoms suggest the liver is under undue stress and needs proper medical management.

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Diagnosis

Doctors diagnose these conditions by taking note of the medical history, getting blood tests done, scans, and sometimes specialized tests or even a liver biopsy. Blood tests will show any signs of liver inflammation or liver dysfunction, whereas scans will reveal the presence of fat or scars on the liver.

Key Takeaway

The key message is this: fatty liver is not always severe liver damage, but it can damage the liver if left ignored. The earlier it is diagnosed, the better is the chance of stopping or reversing the problem. Healthy weight management, regular exercise, balanced nutrition, control of diabetes and cholesterol, and abstinence of alcohol are the important protective steps.

When to Seek Medical Advice

If someone has ongoing fatigue, yellowing of the skin, abdominal swelling, or abnormal liver tests, they consult a doctor at the earliest. Early attention can make a major difference in protecting long-term liver health.

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The process of becoming parents is one of hopes, anxieties, and numerous waits for many couples. Infertility does not only refer to a medical problem but is a psychological and sociological problem that can influence relationships, confidence, and overall psychological state of an individual. The World Health Organization states that about one out of six individuals experience infertility at some point in life.

Infertility Needs Couple-Based Evaluation

Infertility cannot be considered a problem for women only from the perspective of obstetrics and gynaecology. Infertility problems in women can be associated with ovulatory disorders, PCOS, endometriosis, blocked fallopian tubes, fibroids, decreased ovarian reserve, or declining quality of eggs due to the advanced age of the woman.

In men, infertility may relate to low sperm count, impaired sperm mobility or morphology. Correct diagnosis is the key point of developing the appropriate treatment program.

Also read: 'You Are Just Tired': When Postpartum Depression Goes Unnoticed At Home

IVF: A Scientific Pathway to Parenthood

With the emergence of in-vitro fertilization, known as IVF, people can now have children even if they do not possess the ability to conceive through natural means.

This technique is achieved through stimulation of ovaries, egg collection, fertilizing collected eggs using sperm in laboratory conditions, and implantation of a healthy embryo into the womb. Nonetheless, this method is not a simple one-time process but rather a medically guided journey. Every treatment is based on individual factors of the woman.

Embryology: The Silent Backbone of IVF

Embryology in the modern age has revolutionized the results of IVF procedures. Embryo selection can be done through procedures like ICSI, blastocyst culture, grading of embryos, cryopreservation and, in some cases, genetic screening to select healthier embryos.

ICSI is especially helpful in the case of male infertility, in which a single sperm is introduced into an egg.

Also read: Miles Apart, But Planning A Family Together: The Fertility Reality Of Long-Distance Marriages In India

Safer Pregnancy, Not Just Positive Pregnancy

The purpose of IVF is not just conception but the creation of a successful and safe pregnancy. In the past, many embryos were used to increase the chances of conception, but that caused complications with either twins or triplets. But now, because of better screening, fewer embryos can be transferred where appropriate, thus decreasing pregnancy risk. According to CDC figures, 37.5% of ART cycles ended in live-birth delivery.

The advances in IVF and embryology have revolutionized fertility treatments into an arena of hope and possibilities. With proper counselling, couples can embark upon their fertility journey with certainty. Being parents was once the dream of many people; however, with the advancements in the scientific field, science is now enabling many couples to fulfill this dream.

By Dr. Nisha Mangal, Senior Consultant - Obstetrics & Gynaecology, Cocoon Hospital, Jaipur

For most people, the arrival of monsoon brings welcome relief from the scorching summer heat. For physicians, however, it also signals the beginning of a season when managing chronic lifestyle diseases becomes significantly more challenging.

High humidity, fluctuating temperatures and a sharp rise in seasonal infections create conditions that can quietly destabilise diabetes, hypertension and heart disease, even in people whose conditions are otherwise well controlled.

Lifestyle diseases are often thought of as long-term conditions that progress gradually. Yet they are also highly sensitive to environmental changes. During the monsoon, the body works harder to regulate temperature and maintain normal circulation. High humidity reduces the body'sability to cool itself efficiently, increasing the workload on the heart. At the same time, sudden shifts between hot outdoor conditions and cold indoor environments can influence blood vessel function, leading to fluctuations in blood pressure. These physiological changes may seem subtle, but for individuals living with chronic illnesses, they can increase the likelihood of complications.

The season also brings a surge in viral, bacterial and mosquito-borne illnesses. Infections such as influenza, gastroenteritis, dengue, and fungal diseases are becoming more common, placing additional stress on the body. For people living with diabetes, even a relatively minor infection can upset blood sugar control. The body's response to illness triggers the release of stress hormones that increase blood glucose levels. In contrast, changes in appetite and food intake during illness may increase the risk of both hyperglycaemia and hypoglycaemia if medications or insulin are not adjusted appropriately under medical supervision.

Beyond infections, the monsoon often disrupts everyday routines that are essential for effective diabetes management. Reduced physical activity due to persistent rainfall, missed walks, and a greater tendency to indulge in fried, calorie-dense comfort foods can contribute to poor glycaemic control. Prolonged exposure to damp conditions, particularly from wearing wet or closed footwear for extended periods, also increases the risk of fungal infections and delayed wound healing—complications that people with diabetes are already more susceptible to. While these changes may appear routine, together they can make diabetes significantly more difficult to manage during the rainy season.

Seasonal changes equally influence hypertension, although the effects are often less obvious. Variations in temperature and atmospheric pressure can cause blood vessels to constrict or relax, leading to fluctuations in blood pressure. Dietary habits also tend to shift during the rainy season, with increased consumption of salty snacks, pickles, and processed foods, which contribute to sodium overload and fluid retention. Because hypertension frequently remains symptomless, many people assume they are doing well despite missing medicines or delaying routine blood pressure checks. Unfortunately, uncontrolled blood pressure often comes to light only after a serious complication such as a stroke, heart attack, or acute cardiac event.

By Dr. Manjeeta Nath Das, Associate Director – Internal Medicine, PB Health