Eight-month-old twins from Hayward Heath, West Sussex, recently met the surgeon who saved their lives even before they were born. The BBC reports how their mother, Katerina Ahouansou, at six months pregnant, during a routine scan, uncovered a serious issue with their development and blood supply.

Doctors diagnosed the twins with twin-to-twin transfusion syndrome or TTTS. It is a condition where one twin received more blood and nourishment than the other due to uneven blood vessel distribution in the placenta. In case there is no medical intervention, it could be fatal for both the twins.

A Specialist Steps In

This is when Ahouansou was referred to Professor Kypros Nicolaides at King’s College Hospital in London. Professor Nicolaides is a pioneer in fetal medicine and he specializes in a laser procedure that redistributes blood supply between twins in cases of TTTS.

When Ahouansou was scanned, Nicolaides observed that one of the twins were significantly smaller than the other. "There was a very high chance that if we did not intervene, both twins could die," he recalled.

An Operation No Less Than A Miracle

The life-saving laser surgery was performed and within a week the doctors saw an improvement with the twin who was smaller in size. When the twins were born, they weighed 1.5kg and 1.7kg. To recognize the efforts by the surgeon, Ahouansou named them Kai Kypros and Asher Nicolas after Professor Kypros Nicolaides.

Ahouansou also expressed deep gratitude for the professor's expertise and called him "proof that miracles can be performed by people who are devotees to their profession."

Professor Kypros Nicolaides has been at King’s College Hospital since 1980 and is widely regarded as a leader in fetal medicine. His groundbreaking research and development of screening and surgical techniques have saved countless lives.

Through his dedication, Professor Nicolaides has given many families hope, demonstrating how medical advancements continue to improve survival rates for complex fetal conditions like TTTS.

More about Twin-to-twin Transfusion Syndrome

As per the John Hopkins Medicine, TTTS is a rare pregnancy condition that affects identical twins or other multiples. It happens in pregnancies where twins share one placenta and a network of blood vessels that supply oxygen and nutrients essential for development in the womb. These pregnancies are known as monochorionic.

Sometimes, the blood vessels in the placenta are unevenly distributed, causing an imbalance in blood flow between the twins. The donor twin loses more blood than it receives, leading to malnutrition and potential organ failure. Meanwhile, the recipient twin gets an excess of blood, putting strain on the heart and increasing the risk of cardiac complications.

Impact on the Donor Twin

The donor twin loses blood volume (hypovolemia), reducing kidney function and urine production. This leads to low amniotic fluid levels (oligohydramnios) or, in severe cases, a complete absence (anhydramnios). Without proper blood circulation, the donor twin faces cardiovascular issues, increasing the risk of death.

Impact on the Recipient Twin

The recipient twin experiences excess blood volume (hypervolemia), causing increased urination and excessive amniotic fluid (polyhydramnios). The overworked heart struggles to handle the surplus blood, leading to cardiovascular dysfunction, heart failure, and, in extreme cases, death.

As oncologists, we often meet patients at some of the most difficult moments of their lives. Yet there are times where a patient's journey reminds of the extraordinary resilience that people can show while facing the challenges that cancer presents

I recently treated a 38-year-old woman whose story has stayed with me.

Having just welcomed her baby into the world, her demanding yet joyful routine revolved around feeding schedules and sleepless nights. It was during this period that she noticed a hard lump in her breast.

Breast Lumps Can Cause Aggressive Breast Cancer

A sonomammography revealed a suspicious BIRADS 4A lesion. A biopsy confirmed Triple-Negative Breast Cancer (TNBC), which is one of the more aggressive forms of breast cancer. It was classified as a Stage III disease after evaluation through PET-CT which showed involvement of the axillary lymph nodes. The tumor also had a high Ki-67 index, indicating that it was growing rapidly.

Facing Cancer While Caring for A Newborn

The untimely diagnosis found the mother facing difficult questions about cancer treatment, her future and her ability to care for her child. One of the immediate challenges was that she had to stop breastfeeding.

Under the guidance of her pediatrician, her baby was transitioned to bottle feeds. This can be an emotionally challenging process for mothers as the feeling of guilt tends to seep in when breastfeeding plans are disrupted by illness.

A Modern Treatment Approach

After detailed and prolonged discussions with the patient and her family, we initiated treatment with neoadjuvant immunotherapy using pembrolizumab in combination with chemotherapy. This approach has emerged as one of the more prominent advances in the treatment of high-risk Triple-Negative Breast Cancer, having significantly improved outcomes for many patients.

Motherhood is a physically and emotionally taxing experience but the patient showed incredible strength during her cancer therapy, driven by her child and the unwavering support of her family.

Following completion of neoadjuvant therapy, repeat PET-CT imaging showed a near-complete response. She subsequently underwent surgery, and the final pathology report revealed a pathological complete response, meaning no residual invasive cancer had been detected.

This was the desired outcome for the treating team as well as the patient. She later completed the remaining course of immunotherapy, bringing her total treatment duration to one year. Today, both mother and child are doing well.

Breast Cancer Can Occur During Pregnancy

This tremendous journey highlights an important message. The fact that breast cancer can occur during pregnancy and the postpartum period deserves wider attention. Any breast lump that persists or feels unusual should be evaluated by a healthcare professional, as early diagnosis remains one of the most important factors in achieving positive outcomes.

The process is reflective of the advances in cancer treatment that are changing the outlook for patients with aggressive cancers. These advances are done through the integration of immunotherapy into treatment protocols which is helping more patients achieve improved long-term outcomes. The mother’s story is a reminder that cancer and motherhood are not mutually exclusive journeys.

Her ability to navigate this path is due to her timely diagnosis, access to appropriate treatment, family support and personal resilience. What began as a frightening diagnosis soon after childbirth ultimately became a story of hope, courage and survival. This is a powerful reminder to every new mother who might discover an unusual breast lump, that listening to your body and seeking medical advice early can make all the difference.

Pregnancy should not be regarded as a physical journey since it is a very emotional and deeply transformative phase in any woman's life. As the body changes itself to support new life, expecting mothers usually experience pain in the back, fatigue, and breathing-related discomfort. When practised under proper medical guidance, prenatal yoga can be very safe and highly supportive throughout pregnancy.

Supports Better Flexibility and Body Balance

As pregnancy progresses, the center of gravity of the body is shifted by the growing uterus. This can even impact posture and overall movement of the body. Prenatal Yoga normally includes gentle stretches and a controlled level of movement, which helps to improve the flexibility and stability without even placing unnecessary strain on the mother's and baby's bodies.

Yoga helps in:

• Reducing pregnancy-related back pain: Pain in the lower back is one of the most common discomforts that is mainly experienced during pregnancy. Gentle Yoga also assists in strengthening the back and provides better support to the spine.

• Improving breathing and oxygen flow: Mindful breathing also assists expectant mothers in managing breathlessness and calming the nervous system. Breathing-related awareness can assist women in remaining composed during the birth of a child.

• Reducing stress and anxiety: Pregnancy also causes emotional problems due to changes in hormones and physical discomfort during the birth of a child. Prenatal yoga integrates movement, exercises related to breathing, and relaxation techniques, which help reduce stress and mental fatigue. A good, calm mother is more likely to experience emotional well-being throughout the journey of pregnancy.

• Promoting better sleep: Most of the pregnant women also struggle with sleep-related patterns, due to body aches, frequent urination, which may help women to feel more confident and well prepared for the birth of a child.

• Preparing the body for labor: Prenatal yoga also plays a good role in building strength and controlled breathing, which can support the body during labor. Gentle hip opening movements and all relaxation techniques also help women to feel more confident and well prepared for the birth of a child.

• Encourages mother-baby connection: Prenatal yoga also provides expecting mothers with dedicated time to connect well with their baby. All these practices can also enhance the existing bond between mother and child, making the journey of pregnancy feel more positive.

India’s Union Ministry of Health and Family Welfare has issued a notification ending the over-the-counter (OTC) sale of all syrups, including cough syrups.

Under the new rules, a doctor's prescription will now be required to purchase cough syrups across the country.

“Consequently, the sale and dispensing of cough syrups in smaller villages will now be required to take place only through duly licensed pharmacies in accordance with the provisions of the Drugs and Cosmetics Act, 1940 and the Rules framed thereunder,” the notification said.

Why Are the Rules Being Amended?

The amendment comes months after contaminated cough syrups were linked to the deaths of 22 children in Madhya Pradesh and Rajasthan, raising fresh concerns over the safety and regulation of commonly used liquid medicines.

Following the incident last year, health authorities in India had banned three cough syrups Coldrif, Respifresh TR and ReLife after traces of diethylene glycol (DEG) were detected in the products. The Coldrif contamination was linked to the deaths of 22 children in the country.

“The amendment has been undertaken to strengthen regulatory oversight of syrup formulations and to align the exemption framework with contemporary public health and safety requirements,” the notification said.

“The measure is expected to promote responsible distribution and sale of cough syrups while ensuring greater compliance with regulatory standards across the country,” it added.

Also read: Introducing Eggs Before Age One May Lower Allergy Risk by 17%, Says Study

Experts Welcome Move To Restrict Cough Syrup Sales

Dr Kuldeep Kumar Grover, Associate Director, Pulmonology and Critical Care, CK Birla Hospital, Gurugram called it a

"a good initiative to include all syrup varieties, cough syrups included, under prescription medicines".

Cough syrups have substances that might lead to drowsiness, addiction, or drug interaction in patients who do not seek medical advice before taking the medicines.

"It is important to note that a cough could be a symptom of other serious conditions like infections, asthma, and allergies. Prescription-based access encourages proper evaluation, accurate treatment, and safer medication use," Grover said.

Dr. (Prof.) Mohsin Wali, former Physician to the President of India, said cough syrups and similar formulations often contain suppressants such as codeine and dextromethorphan (DXM), along with other solvents.

Dr. Wali, Senior Consultant and Head of Preventive Cardiology at Pacific One Health, recalled previous incidents in which contaminated Indian-made cough syrups were linked to deaths in Gambia and other African countries.

"Industrial-grade solvents were detected in some of these products, leading to kidney failure, severe metabolic acidosis, and, in some cases, death," he said.

According to Dr. Wali, the new notification will help curb the overuse, misuse, and addictive use of cough syrups while improving patient safety.

What Did The Notification Say?

The Ministry notified an amendment to the Drugs Rules, 1945, through Gazette Notification G.S.R. 927(E) dated December 29, 2025, published in the Gazette of India Extraordinary, Part II, Section 3, Sub-section (i), dated December 30, 2025.

The amendment omits the word “Syrup” from Schedule K, Serial No. 13, Entry 7 under the heading “Class of Drugs.”

Schedule K of the Drugs Rules, 1945, provides exemptions from certain provisions of the Drugs and Cosmetics Act, 1940, and the rules framed under it for specified classes of drugs.

Before this amendment, Entry No. 13 of Schedule K permitted the sale of cough syrups in villages with a population of less than 1,000 without requiring compliance with certain retail sale licensing provisions.

With the omission of the word “Syrup” from the entry, this exemption will no longer apply to cough syrups.

Manufacturers, distributors, and retailers dealing with cough syrups have been advised to ensure strict compliance with the applicable licensing and regulatory requirements under the Drugs and Cosmetics Act, 1940, and the Drugs Rules, 1945.

Ban On Pediatric Cough Syrups

Last year, India formally prohibited the use of certain commonly available OTC cough and cold medicines in children below the age of four.

The policy move, notified through a gazette notification, banned a fixed-dose combination (FDC) of Chlorpheniramine Maleate and Phenylephrine Hydrochloride—two ingredients commonly found in pediatric cough syrups.

The decision followed growing global concerns over the safety of these medicines in very young children, with India joining several countries that have introduced stricter regulations.

Countries including the United States, Canada, and the United Kingdom had previously issued guidelines or warnings regarding the use of OTC cough and cold medicines in young children.