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.

Influenza strain H1N1, formerly known as swine flu, is rising significantly in India, with deaths also being reported in some states.

H1N1 is a subtype of Influenza A and can cause sudden fever, cough, sore throat, headache, body aches and fatigue. These symptoms can overlap with those of other seasonal influenza strains, COVID-19 and respiratory syncytial virus (RSV), making it difficult to identify the infection based on symptoms alone.

H1N1 Cases and Deaths Reported in States

Delhi: According to official data, Delhi has reported 1,349 confirmed H1N1 infections. No official deaths have been reported.

Kerala: A total of 2,468 influenza cases were recorded in the state in July, with 24 deaths reported during the month. The total number of cases recorded in the state this year stands at 5,519, with 60 deaths reported.

Maharashtra: The state has reported 25 laboratory-confirmed H1N1 cases, including a major spike of 15 cases in July. One confirmed death was officially verified by the Nagpur Municipal Corporation (NMC) Death Audit Committee.

Gujarat: H1N1 activity is also being reported, with Ahmedabad currently seeing a rise in cases.

Although H1N1 influenza primarily affects the respiratory tract, the infection can also put additional strain on the heart in some people, particularly those with a chronic history of cardiovascular disease, experts told HealthandMe.

How H1N1 Can Strain the Heart

Fever, dehydration, increased levels of carbon dioxide in the body, decreased oxygen levels and the body’s inflammatory response can increase the workload on the heart during an H1N1 infection.

This added strain may be more concerning for people who already have cardiovascular disease, said Dr. Praveen Raman Mishra, Associate Consultant, Institute of Cardiac Sciences at ShardaCare – Healthcity.

Heart Problems Linked to H1N1

Some H1N1 influenza patients may experience cardiovascular complications, including:

• Inflammation of the heart
• Abnormal heartbeats
• Worsening of heart failure

Dr. Saurabh Gupta, Associate Director, Internal Medicine, Yashoda Medicity, added that H1N1 infection may cause fluctuations in heart rhythm or inflammation associated with the heart.

“In some circumstances when suffering from the H1N1 virus, although the initial symptoms of the virus may be those shared with the normal flu, such as temperature, aches and cough, those with pre-existing heart conditions should be more vigilant whilst they’re recuperating,” he told HealthandMe.

“As the infection puts more work on the body, you can find that previous heart problems are more noticeable,” he added.

Warning Signs to Watch For After H1N1

The experts noted that people recovering from H1N1 should seek medical attention if they develop symptoms such as:

• Severe chest pain
• Shortness of breath
• A high or fluttering pulse
• Sudden faintness
• Severe weakness

Who Should Be Particularly Careful?

People with a chronic history of cardiovascular disease may face greater strain on the heart during H1N1 infection.

Monitoring symptoms during recovery and seeking medical attention when concerning symptoms develop can help identify cardiovascular problems early.

For many women, menopause can bring a string of uncomfortable symptoms like hot flashes, sleep problems, changing body composition and weight gain.

Now, researchers are looking at whether combining GLP-1-based weight-loss medicines with menopausal hormone therapy (MHT) could offer greater benefits, particularly for women struggling with obesity after menopause.

A recent Mayo Clinic study, published in The Lancet Obstetrics, Gynaecology & Women's Health, found that postmenopausal women taking tirzepatide along with hormone therapy lost about 35% more weight than those taking tirzepatide alone.

What Are The Study's Findings?

Researchers studied 120 postmenopausal women with overweight or obesity who had been taking tirzepatide for at least 12 months. Forty women were also using MHT, while 80 were not.

Women taking both treatments lost around 17-19% of their body weight, compared with about 14% among those taking tirzepatide alone. About 45% of women on the combination achieved at least 20% weight loss, compared with 18% in the tirzepatide-only group.

“This study provides important insights for developing more effective and personalized strategies for managing cardiometabolic risk in postmenopausal women,” said Dr Regina Castaneda, first author and Mayo Clinic researcher.

However, this was just an observation in the study, not a randomized clinical trial. Therefore, it cannot prove that hormone therapy itself caused the additional weight loss.

“It is possible that women using hormone therapy were already engaged in healthier behaviors, or that menopause symptom relief improved sleep and quality of life,” said Dr Maria Daniela Hurtado Andrade, senior author of the study.

Also read: Postmenopausal Women May Face More Severe Dry Eye Disease; How Do Hormones Contribute?

Could The Combination Work?

During menopause, declining oestrogen levels can change fat distribution, appetite, metabolism and muscle mass. GLP-1 medicines, meanwhile, reduce appetite and slow stomach emptying, helping with weight management.

Researchers believe there could also be a biological interaction between oestrogen and GLP-1 signalling. “Preclinical data suggest a potential synergy, with estrogen appearing to enhance the appetite-suppressing effects of GLP-1,” Castaneda said.

Earlier research has also suggested greater weight loss among postmenopausal women using semaglutide alongside hormone therapy.

A 2026 review similarly concluded that GLP-1 medicines may help reduce weight and abdominal fat in menopausal women, but larger studies are needed.

Also read: Experimental Menopause Drug Shows Promise Mid-Stage Trial, Reduces Hot Flashes By 83%

Are There Any Side Effects Of Combining These Drugs?

GLP-1 medicines may cause nausea, vomiting, diarrhoea, constipation, abdominal pain and reduced appetite. These effects often surface when the dose is increased.

Hormone therapy has its own side-effects and it is also not suitable for everyone. Depending on the patient's medical history, MHT can increase the risk of complications like blood clots and stroke.

Hormone therapy should not be started simply to fuel weight loss from a GLP-1 drug. It is primarily used to treat certain menopause symptoms and should be prescribed after considering a woman's age, symptoms, medical history and individual risks.

As Hurtado Andrade noted, researchers now want to determine whether the combination offers benefits beyond weight loss, including improvements in cardiometabolic health.

It can be confusing and sometimes alarming to receive different thyroid test results from two different laboratories, especially when both tests are done on the same day. A slight difference in values does not necessarily mean that your thyroid function has suddenly changed. In many cases, the variation is due to differences in how the tests are performed rather than a change in your health.

The Laboratory Can Make A Difference

One of the biggest reasons for varying results is the laboratory itself. Accredited laboratories, such as NABL-certified labs, follow stringent quality-control measures, use standardised testing protocols and have trained personnel to handle samples correctly. Laboratories with less rigorous quality standards may produce results that are less consistent.

Different Equipment Can Produce Different Results

The equipment and testing methods used can also differ from one laboratory to another. Different analysers, calibration techniques and testing kits can produce slightly different values for thyroid hormones such as TSH, T3, T4, Free T3 and Free T4.

Even the reference ranges printed on reports may not be identical because each laboratory establishes its own normal range based on the equipment used and the population it serves.

Also read: UK Approves Eli Lilly’s Foundayo: Is the GLP-1 Pill Better Than Wegovy, Mounjaro?

The Time Of Your Test Matters

The timing of the test is another important factor. Thyroid-stimulating hormone (TSH) naturally fluctuates throughout the day. It is generally higher during the early hours of the morning and gradually falls as the day progresses.

As a result, a blood sample collected in the afternoon may show a lower TSH level than one collected early in the morning.

Stress, Sleep And Medication Can Affect Results

Lifestyle and biological factors can also influence thyroid hormone levels. Stress, poor sleep, recent illness, medications and even eating before the test may affect the results.

For people taking thyroid medication, blood samples should ideally be collected in the morning on an empty stomach and before taking the daily dose. Testing after medication may temporarily alter hormone levels and make interpretation more difficult.

Also read: Why Women Want Hormonal Health Care, Not Just Pregnancy Care

Biotin And Other Medicines Can Interfere With Thyroid Tests

Certain supplements and medications can interfere with thyroid tests as well. Biotin, commonly found in hair and nail supplements, can falsely lower TSH levels while increasing Free T3 and Free T4 values.

Medications such as amiodarone, glucocorticoids, dopamine and heparin may also affect thyroid hormone measurements. During pregnancy, hormonal changes, particularly increased levels of human chorionic gonadotropin (hCG), can naturally alter TSH values.

Even Sample Handling Can Affect The Report

Laboratory handling also plays a role. Delays in processing, improper storage temperatures, differences in centrifugation timing or sample-handling errors can influence the final result.

In some individuals, thyroid autoantibodies may interfere with laboratory assays, potentially leading to inaccurate Free T3 and Free T4 measurements.

Also read: Silent Neck Swellings: Why An Unusual Lump Should Never Be Ignored

Should You Repeat A Thyroid Test?

Because of these variables, experts recommend getting thyroid tests done at the same accredited laboratory whenever possible. This allows doctors to compare results more reliably over time.

If a thyroid value is only mildly abnormal or falls within a borderline range, it may often be advisable to repeat the test before making a diagnosis or starting lifelong medication.

Ultimately, thyroid test reports should never be interpreted in isolation. Doctors consider the patient's symptoms, medical history, physical examination and repeat test results before deciding on treatment.

Consistency in where and how the test is performed can help avoid unnecessary anxiety and support more accurate clinical decisions.

By Dr Shaheen Guy, General Physician, Saifee Hospital, Mumbai