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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.
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.
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".
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.
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COVID-19 vaccines were rolled out during the pandemic, so questions about their safety, how long they protect against infection and whether mRNA technology was tested for long enough continue to dominate public debate.
Dr Paul Offit, paediatrician and director of the Vaccine Education Center at Children’s Hospital of Philadelphia and former member of the CDC’s Advisory Committee on Immunization Practices, says many concerns overlook the the evidence collected before and after the vaccines were introduced.
In an interview with HealthandMe, Offit discussed how long COVID vaccine protection lasts, what scientists have learnt about rare side effects and why the technology behind mRNA vaccines was not as new as many people thought.
“I think it is probably the best studied vaccine in human history,” Offit said. He pointed to the large number of people who received them and the safety-monitoring systems used to look for adverse effects.
The circulation of SARS-CoV-2, the virus that causes COVID-19, is sometimes used to argue that the vaccines do not work. Offit said this misunderstands the type of infection the virus causes and the protection vaccination offers.
“It’s a short incubation period mucosal infection,” he said. “So, vaccination or natural infection will protect you for about four to six months from mild to moderate disease, should protect you for longer against severe disease.”
He compared the future of COVID to influenza, saying that infections will continue even as vaccines help protect against serious illness.
“Even if everybody in the world were vaccinated every year, that virus would still circulate,” he said. “This virus is now with us forever.”
Offit said the goal of COVID vaccination is not necessarily to prevent every infection. It is to reduce the risk of hospitalisation and death, particularly among people most likely to develop severe disease.
“The goal of the vaccine is to keep you out of the hospital and to keep you from dying,” he said.
He said that people over 75, those with chronic heart or lung disease, pregnant women and people with weakened immune systems are at higher risk of developing severe complications from COVID. He said these groups should receive a vaccine every year.
Also read: American COVID Drives Cases And Deaths In UK: Unusual XFG Symptoms To Watch For
When COVID vaccines were first authorised in December 2020, the clinical trials involved approximately 35,000 participants across the Pfizer-BioNTech and Moderna studies, Offit said. Some rare side effects of the vaccine became apparent only after the vaccines were administered to much larger populations.
One such side effect was myocarditis, an inflammation of the heart muscle, and, less commonly, pericarditis, which affects the lining around the heart.
“Very quickly, it was found to be a rare cause, roughly 1 in 50,000 myocarditis,” Offit said, referring to mRNA COVID vaccines. He said cases were seen primarily in males aged 16 to 29 and were generally short-lived.
Current evidence confirms that myocarditis and pericarditis are rare but recognised risks associated with mRNA COVID vaccines. The risk has been observed most often in adolescent and young adult males, particularly within seven days after a second dose.
In June 2025, the US Food and Drug Administration required updated safety warnings for the Pfizer-BioNTech and Moderna vaccines. The FDA also noted that some patients in follow-up studies continued to show signs of heart muscle injury on MRI scans, with improvement in some cases. The long-term significance of these findings remains under investigation.
Offit also cited the example of Johnson & Johnson COVID vaccine, which was associated with a rare but serious condition involving blood clots and low platelet counts. The vaccine was no longer available in the US by May 2023.
“You're always looking and trying to find any rare side effect that's associated with the vaccine,” he said.
He added that concerns about stillbirths and pregnancy outcomes had circulated despite research examining vaccination during pregnancy.
Offit said there was “no evidence of congenital malformations, no evidence of premature birth or spontaneous abortion” in the studies he was referring to.
Another common concern is that mRNA COVID vaccines were developed too quickly and that the technology had not been studied for long enough. Offit disagreed, saying that the technology was not entirely new.
“I think it was studied for a long time,” he said. He pointed to research into mRNA as a vaccine platform that began decades before the COVID-19 pandemic.
“Drew Weissman and Katie Carrico met in 1997 and started working on mRNA as a vaccine platform, for which they won the 2023 Nobel Prize in Medicine,” Offit said.
He also referred to efforts to develop mRNA vaccines against SARS, the coronavirus that caused an outbreak in 2002 and 2003.
“But we really had, really since 1997, information about this vaccine, so like more than 20 years of studies of that vaccine,” he said. “People think it was a new vaccine, but it really wasn't that new.”
The technology had been studied before COVID-19, although the pandemic vaccines themselves still required clinical trials to establish their safety and effectiveness. After their introduction, researchers continued monitoring them to identify rare adverse events.
Offit said the decision to vaccinate should take into account both the risk of side effects and the risk posed by COVID itself. “I'm an older person, so I'm going to get a COVID vaccine every year because I think that the benefits clearly outweigh the risks,” he said.
He argued that COVID continues to cause hospitalisations and deaths, making protection against severe disease an important consideration.
He said that the benefits outweigh the risks, particularly for people at higher risk of serious illness. Individual decisions should also take account of age, underlying health conditions, previous vaccination and current medical guidance.
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One of the most common contributing factors in lung cancer is smoking but a recent report suggests an alarming pattern in which cases among non-smokers are on the rise.
Pope Leo XIV was recently diagnosed with lung adenocarcinoma, a type of aggressive cancer that develops in the cells lining the lungs. He had no history of smoking. The 71-year-old pontiff underwent surgery to have part of his right lung lobe removed. According to reports, he is out of the hospital and recovering well.
Another case is of Stanford physician Bryant Lin whose stubborn cough led him to seek medical attention. After six weeks, he underwent an X-ray. The diagnosis stated that he had stage 4 lung cancer. Lin was less than a month away from turning 50, and he had never smoked a cigarette in his entire life.
“Definitely a shock,” Lin recalled according to The Washington Post. By the time doctors identified the cancer in spring 2024, it had spread to his liver, bones and brain.
According to the US Centers for Disease Control and Prevention (CDC), around 10% to 20% of lung cancers in the United States are reported in people who have never smoked or have smoked fewer than 100 cigarettes in their lifetime. That amounts to an estimated 20,000 to 40,000 cases annually.
For these patients, their no-smoking history can delay diagnosis and treatment. Hence, researchers are now looking into how environmental exposures, genetic causes and the biology of tumours may contribute to lung cancer in non-smokers.
Smoking remains the leading risk factor for lung cancer. But other reasons like exposure to radon, secondhand smoke, air pollution and asbestos can also increase risk. Family history plays a role, especially when a first-degree relative has cancer before age 50.
Researchers are also examining genetic differences that may help explain why some people develop lung cancer despite never smoking.
A study published in September identified a rare genetic mutation concentrated in the southeastern United States that was associated with a 60-fold higher risk of lung cancer among non-smokers. The finding focuses on a possible role for inherited susceptibility, but it does not explain most cases in this group.
Lung cancer also has a different demographic profile among people who have never smoked. Women who have never smoked are more than twice as likely as their male counterparts to develop lung cancer.
“Two-thirds of nonsmoking-related lung cancer happens in women, so there’s certainly an association with female sex,” said Jaclyn LoPiccolo, a medical oncologist at Dana-Farber Cancer Institute who co-authored the mutation study.
She added, “Nonsmoking-related lung cancer is also more common in people of East Asian descent, but whether that’s a genetic or environmental association, we don’t yet know.”
People who have never smoked may not recognise a persistent cough or other respiratory symptoms as signs of lung cancer. Doctors may initially consider more common explanations if the patient has no smoking history.
Never-smokers are often diagnosed late at more advanced stages of the disease because their doctors initially consider lung cancer to be less likely.
Haiying Cheng, a medical oncologist at Montefiore Einstein Medical Center in New York, said the stigma surrounding the disease can compound the problem. “A cancer diagnosis should never become a judgment about a patient,” Cheng said.
She added that clinicians need to consider assumptions beyond smoking when it comes to lung cancer and focus on the patient’s risk profile and tumour biology.
Lin is receiving antibody therapy targeting a cancer-driving mutation. He had a positive response to treatment.
“The treatment has done wonders for me,” he said. “When I was a medical student or resident, I would have never thought a Stage 4 lung cancer patient could be very productive and have a high quality of life almost two-and-a-half years after diagnosis.”
In the United States, the US Preventive Services Task Force recommends annual low-dose CT screening for adults aged 50 to 80 who have a smoking history. People who have never smoked are not included in these recommendations.
As researchers dig deeper into lung cancer chances in non-smokers, there is growing interest in different screening recommendations. Taiwan, for example, has a national early-detection programme offering low-dose CT scans to non-smokers with a family history of lung cancer.
Lin has urged his own sons to consider screening at a younger age. “I’ve got two sons, and I told them, ‘When you hit 45 or even 40, think about getting screened,’” he said.
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Many women in their forties come to my clinic with joint pain they have lived with for months, assuming it is part of getting older. World Arthritis Day is a good time to look at what changes in a woman's joints after 40 and why it pays to act early.
The biggest shift is hormonal. Oestrogen helps regulate inflammation and protects cartilage, bone and muscle. As levels fluctuate during perimenopause and fall after menopause, the joints lose part of that protection. A 2024 review in the journal Climacteric named this pattern the musculoskeletal syndrome of menopause, estimating that more than 70% of women experience joint or muscle symptoms during the transition and about one in four find them disabling.
Lower oestrogen also speeds up the loss of muscle and bone. When the thigh muscles weaken, the knee absorbs more shock with every step, which is one reason knee osteoarthritis becomes more common in women at this stage. Osteoarthritis, the gradual wear of the cartilage cushioning the bones, commonly affects the knees, hips, hands and spine. Old injuries, excess weight, and family history increase the risk.
Women are also two to three times more likely than men to develop rheumatoid arthritis, an autoimmune condition in which the immune system attacks the joint lining. It most often begins between the ages of 30 and 60.
One simple check is how long your joints stay stiff in the morning. Stiffness and pain that increases with movement is typical of osteoarthritis. Stiffness even with rest, especially with swelling in the small joints of both hands or wrists, suggests inflammatory arthritis and needs prompt assessment. Other signs include pain while climbing stairs or getting up from the floor, a grating feeling in the knee, firm bony swellings on the finger joints and tiredness out of proportion to your activity.
Not every ache after 40 is arthritis. Menopause-related pain, for instance, tends to move around the body. An examination, an X-ray, and simple blood tests can tell these conditions apart, so avoid self-diagnosis.
Consult an orthopaedic specialist if joint pain or stiffness lasts beyond a few weeks or affects daily tasks. In rheumatoid arthritis, early treatment can slow the disease and prevent permanent joint damage. A suddenly hot, red, swollen joint with fever needs same-day attention, as it may signal infection.
Arthritis does not have to come with turning 40. Women who notice the early signs, keep their muscles strong, and see a doctor in time can stay active and independent well into later life.
By Dr Saurabh Bansal, Consultant Orthopaedic Surgeon, PB Health
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