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.

In a significant step forward in the fight against malaria, the World Health Organization (WHO) has prequalified the first treatment for newborns and young infants weighing between two and five kilograms.

The newly prequalified treatment—artemether-lumefantrine — is the first antimalarial formulation designed specifically for the youngest malaria patients.

So far, infants with malaria have been treated with formulations intended for older children. This increased the risk of dosing errors, side effects, as well as toxicity.

"For centuries, malaria has stolen children from their parents, and health, wealth, and hope from communities," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

"But today, the story is changing. New vaccines, diagnostic tests, next-generation mosquito nets, and effective medicines, including those adapted for the youngest, are helping to turn the tide," he added.

Malaria is a life-threatening disease spread to humans through the bites of some infected anopheles mosquitoes. However, they are preventable and curable.

While the initial symptoms may be mild, similar to many febrile illnesses, and difficult to recognize as malaria. Left untreated, malaria can progress to severe illness and death within 24 hours.

What Does WHO Prequalification mean?

The WHO defines prequalified medicine as that which meets international standards of quality, safety, and efficacy, and will help to expand access to quality-assured treatment for one of the most underserved patient groups.

WHO prequalification will enable public sector procurement, contributing to closing a long-standing treatment gap for some 30 million babies born each year in malaria-endemic areas of Africa.

Malaria: New Prequalified Tests

Earlier this month, on April 14, the WHO also prequalified three new rapid diagnostic tests (RDTs) designed to address emerging diagnostic challenges for malaria.

The most common malaria RDTs for the P. falciparum parasite work by detecting the protein, known as HRP2. But some strains of the malaria parasite have lost the gene that makes this protein – so they become "invisible" to HRP2-based RDTs, leading to false-negative results.

The new tests address this issue by targeting a different parasite protein (pf-LDH) that the malaria parasite cannot easily shed. They provide a reliable, quality-assured alternative where HRP2-based tests are failing.

WHO now recommends that countries switch to these alternative RDTs when more than 5 per cent of cases are missed due to pf-hrp2 deletions. This ensures accurate diagnosis, appropriate treatment, and protects hard-won malaria control gains – especially for the most vulnerable communities.

World Malaria Day 2026

The theme this year is "Driven to End Malaria: Now We Can. Now We Must". It underlines that ending malaria is a real possibility with science advancing faster than ever, with new vaccines, treatments, malaria control tools, and pioneering technologies.

According to the World Malaria Report 2025, there were an estimated 282 million cases and 610,000 deaths in 2024 – an increase from 2023. While 47 countries have been certified malaria-free and 37 countries reported fewer than 1000 cases in 2024, progress at the global level is stalling.

Read: World Malaria Day 2026: Theme, History, And Significance

Twenty-five countries are now rolling out malaria vaccines, protecting millions of children, and next-generation mosquito nets make up 84 per cent of all new nets distributed. These advances demonstrate what is possible when all partners work together to innovate and deliver on the promises towards ending malaria for all.

The most common malaria symptoms include:

• fever
• chills
• weakness
• other flu-like symptoms

Even as the Indian Meteorological Department (IMD) continues to predict rising temperatures and heatwaves in most parts of India, especially in Delhi, doctors flag a quiet but terrible effect that can alter the demographics of the country.

Heatwave conditions are likely to persist in Delhi-NCR from April 23 to 25, with maximum temperatures expected to climb by 1-2°C and remain above normal for at least five days, according to the latest weather bulletin by the India Meteorological Department. The mercury has already been hovering between 40°C and 42°C.

Some parts of the national capital on Friday recorded the season’s first heat wave, even as the India Meteorological Department issued a yellow alert, warning that similar conditions may continue on Saturday.

Beyond Delhi, heatwave conditions are likely to continue over the plains of northwest and central India, including parts of Punjab, Haryana, Rajasthan, Madhya Pradesh, and Uttar Pradesh.

India is already seeing a drop in fertility rates, reaching the replacement level of 2.0 as per the National Family Health Survey

-5 (2019-21) and continuing to decline to 1.9 by 2023 in the Sample Registration System report.

But with rising heat, both male and female reproductive health could be at risk.

Emerging research suggests that extreme heat can disrupt hormonal balance, reduce fertility in both men and women, and even affect pregnancy outcomes. From lowering sperm quality to interfering with ovulation, scorching temperatures may have deeper biological consequences than many realize.

Heatwave And Women’s Reproductive Health

Dr Archana Dhawan Bajaj, a gynaecologist and IVF expert at Nurture IVF Clinic, noted that heat stress can directly affect hormonal balance.

“During extreme heat conditions, we see women coming in with complaints of irregular menstrual cycles, delayed periods, and worsening symptoms of conditions like PCOS."

"The body’s hormonal system is extremely sensitive to environmental stress, and prolonged heat exposure can disrupt normal functioning in ways that are often overlooked,” she said.

Working in extreme heat can double the risk of stillbirth and miscarriage for pregnant women, according to 2024 research from India published in the BJOG: An International Journal of Obstetrics and Gynaecology.

A 2025 study led by researchers from the Arizona State University in the US showed that thermal stress reduces sperm quality and increases miscarriage risk.

Heat stress could disproportionately impact vulnerable populations, especially in low-income countries. Heat and air pollution could synergistically worsen reproductive health outcomes.

Heatwave: The Impact On IVF Outcomes

Dr. Hrishikesh Pai, Consultant Gynaecologist & IVF Specialist, Lilavati Hospital, Mumbai, highlighted that the rising temperatures are not only hurting natural pregnancy but also affecting outcomes of fertility treatments like IVF.

"We are seeing extreme heat during the summer months for the last couple of years. This is making pregnancy more challenging for some women due to poor egg quality and implantation difficulties," he said.

Dr Pai noted that as a result, women with reduced chances of natural conception are moving to "assisted reproductive techniques like IVF, but environmental and lifestyle factors are increasingly playing a role in treatment outcomes."

Heatwave: Impact on Sperm

Further, men’s health is also being impacted, particularly when it comes to fertility.

A 2024 study by Argentine researchers, published in the journal Science of the Total Environment, showed that semen from men exposed to heat waves had lower sperm number and abnormal morphology.

The differences were 4–5 times higher in peak heatwave years (2013, 2023). Heat wave length was negatively associated with semen quality.

“Rising temperatures are a serious but often overlooked risk factor for male infertility. The testicles need a cooler environment compared to the body to function properly in producing sperm. Any slight increase can affect their numbers and quality," said Dr Vineet Malhotra, Head of Urology and Director, VNA Hospital.

"When exposed to hot temperatures over an extended period of time, especially in urban areas, there is an increase in low-quality sperm, genetic mutations, and infertility in men,” he added.

How To Prevent?

The experts urged both men and women planning pregnancy to

• Avoid prolonged periods in the heat.
• Take regular shade breaks if working outdoors on hot days.
• Avoid exercising or sunbathing for long periods in the hottest part of the day.
• Wearing light clothing,
• Maintain proper hydration.

Even as the Indian Meteorological Department (IMD) issued a yellow alert for heatwave and rising temperature in Delhi, the state government issued guidelines for all schools, focusing on hydration and safety measures.

The IMD has forecast heatwave conditions at isolated places in Delhi from today, with maximum temperatures expected to climb between 41 °C and 44 °C through April 24.

Also Read: US CDC Study Showcasing COVID Vaccine Benefits Blocked From Publication

The guidelines issued by the Directorate of Education (National Capital Territory of Delhi) are applied to all government-aided and private unaided recognized schools. The guidelines call for:

Outdoor Assemblies: Outdoor assemblies are to be curtailed or conducted in shaded/indoor areas with minimal duration. No open-air classes are to be conducted.

Water Bell Initiative: Schools shall implement a "Water Bell" system, whereby a bell is rung at regular intervals (every 45-60 minutes), reminding students to drink water to prevent dehydration.

Display of IEC Material: IEC (Information, Education and Communication) material issued by the Health Department, Government of NCT of Delhi, on heat wave precautions shall be prominently displayed at visible locations in schools, including notice boards, corridors, and classrooms.

Awareness Sessions: Schools shall conduct short awareness sessions/briefings for students during class hours/assembly to educate them about preventive measures, the importance of hydration, and the identification of symptoms of heat-related illnesses. Immediate first aid and medical attention must be ensured wherever required.

Buddy System: Establishing a buddy system wherein each student may be paired up with another student during school hours to monitor and take care of each other's physical well-being.

Outdoor Activities: It must be ensured that students avoid outdoor physical activities.

Regular Advisory Updates: Class teachers shall share advisories of the India Meteorological Department (IMD) with parents through their respective class-specific WhatsApp groups, ensuring regular guidance and awareness regarding heat safety measures. Schools shall share daily heat wave forecasts and alerts with students through prayer time/assembly and notice boards to ensure timely awareness and necessary precautions.

Appropriate Clothing and Personal Hygiene: Parents are advised to ensure that their wards come to school dressed in light, breathable cotton clothing. They should also reinforce the importance of personal hygiene, including daily bathing, to help children stay fresh and reduce the impact of heat.

The DoE also directed each school to designate nodal officers who will be responsible for the implementation of monitoring the water bell initiative, awareness sessions, and display of IEC materials.

Heat-Related Illnesses: Symptoms And First Aid Measures

The DoE noted that the symptoms of heat-related illnesses include:

• Nausea and increased sweating
• Vomiting
• Acts or talks confused
• Muscle cramps
• Fainting,
• Weakness,
• Dizziness
• Body temperature rises to 40.5°C (105°F) or higher

First aid measures to follow if you feel dizzy or uneasy

• Drink water to rehydrate
• Move to a cooler place immediately
• Loosen clothes if possible
• Sponge with water
• If unconscious, do not force-feed or give water
• If symptoms persist, immediately visit the nearest health centre or call an ambulance.

Heatwave In India: Which States Are On Alert?

Beyond Delhi, a heatwave alert has been issued for:

• East Uttar Pradesh from April 21 to 25.
• Madhya Pradesh, Chhattisgarh, and West Uttar Pradesh from April 22 to 25,
• Odisha and Rajasthan between April 23 and 25.
• Gangetic West Bengal and Bihar for April 21 and 22,
• Vidarbha from April 24 to 26.