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.

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.

A new botulism outbreak in the United States linked to the now-recalled Nara Organics Whole Milk Organic powdered infant formula has led to hospitalization of at least three infants in three states, according to a notice from the Centers for Disease Control and Prevention (CDC).

The affected infants, aged between 2 and 5 months, are from California, Pennsylvania, and Washington state. All three have been hospitalized and are receiving treatment for infection caused by the bacterium Clostridium botulinum.

The CDC noted that on June 13, Nara Organics recalled all Nara Organics Whole Milk Organic Infant Formula products, including all lot numbers and both can sizes. The products were sold online and at major retailers nationwide.

“Testing of opened cans of Nara Organics brand formula and unopened Nara Organics product samples is underway, and results are expected in the coming weeks,” the CDC said.

This is the second recent outbreak of infant botulism linked to powdered formula. Earlier this year, investigators from the California Department of Public Health, working with federal officials and other state health departments, identified 51 suspected or confirmed cases of infant botulism across 19 states between March 2022 and December 2025. Those infants had consumed ByHeart infant formula.

What Parents And Caregivers Should Do

Also read: Why Sleeping Pill Addiction Is Common Among Football Players

The CDC has urged parents and caregivers to immediately stop using any Nara Organics Whole Milk Organic Infant Formula.

If you have unopened cans of the recalled formula, throw them away or return them. Parents should also wash any items and surfaces that may have come into contact with the formula with hot, soapy water or in the dishwasher.

Seek immediate medical attention if your infant consumed the recalled formula and develops any of the following symptoms:

• Poor feeding
• Loss of head control
• Difficulty swallowing
• Decreased facial expression

Symptoms of infant botulism can take several weeks to appear. Parents whose infants consumed the recalled formula should monitor them for symptoms for up to one month after their last exposure.

What Is Botulism?

Read More: Introducing Eggs Before Age One May Lower Allergy Risk by 17%: Study

Botulism is a rare but serious illness caused by a toxin produced by the bacterium Clostridium botulinum. The toxin attacks the nervous system and can lead to life-threatening complications if not treated promptly.

Botulism is considered a medical emergency because it can cause paralysis and breathing difficulties.

Types of Botulism

There are several forms of botulism, including:

• Foodborne botulism
• Wound botulism
• Iatrogenic botulism
• Inhalation botulism
• Infant botulism

Infant botulism is the most common form in babies between 2 and 8 months old. It occurs when Clostridium botulinum spores grow in a baby's intestines and produce toxin. Honey and contaminated soil are known sources of exposure.

Symptoms of Infant Botulism

Symptoms typically begin 18 to 36 hours after exposure and may include:

• Constipation is often the first sign
• Weak or floppy movements
• Weak cry
• Drooling
• Drooping eyelids
• Difficulty feeding or sucking
• Progressive paralysis

Infant botulism often begins with constipation but is usually first recognized through feeding difficulties, a weak or altered cry, and poor head control.

If left untreated, the illness can progress to severe paralysis, breathing difficulties, and prolonged hospitalization.

Egg freezing, once perceived as a concept limited to celebrities or affluent urban populations, is gradually becoming an important part of reproductive planning among Indian women, according to fertility experts.

Dr. Tarang Yadav, Senior Consultant - IVF, Obstetrics and Gynecology, ShardaCare–Healthcity, told HealthandMe that India is witnessing a gradual shift in conversations surrounding reproductive health, with more women seeking fertility consultations proactively rather than after experiencing difficulty conceiving. As per the expert, this trend is particularly visible in metropolitan and tier-2 cities.

The reason? Increasing awareness regarding fertility, delayed parenthood, evolving lifestyles, and advancements in reproductive medicine have contributed to growing interest in fertility preservation across different age groups and professional backgrounds.

"Today, more women are prioritizing education, career growth, financial stability, and personal readiness before planning pregnancy," Dr. Tarang said.

According to the World Health Organization, around 17.5 per cent of the adult population globally, nearly 1 in 6 people, experience infertility at some point in their lives, highlighting the growing need for accessible fertility care and awareness.

Also read: High Prolactin Levels Behind 40% Surge In Female Infertility Cases, Warn Doctors

What Is Egg Freezing?

Dr. Tarang explained that egg freezing, medically known as oocyte cryopreservation, allows women to preserve healthier eggs at a younger reproductive age, potentially improving future reproductive opportunities. While it does not guarantee pregnancy later in life, it offers an additional reproductive option for women who may wish to delay childbearing for personal, social, or medical reasons.

According to current international fertility preservation guidelines, planned oocyte cryopreservation can be considered in appropriately counselled women, particularly when undertaken at a younger age and after proper fertility assessment.

Who May Benefit From Egg Freezing?

Dr. Tarang noted that egg freezing is increasingly being considered not only for social reasons but also for several medical indications.

Women who can benefit from fertility preservation include those:

• planning a delayed pregnancy due to career or personal circumstances, who have not yet found a suitable life partner,
• cancer patients undergoing chemotherapy or radiotherapy, women with severe endometriosis, patients undergoing ovarian surgeries,
• with diminished ovarian reserve
• with a family history of premature ovarian insufficiency

"In such situations, fertility preservation can provide psychological reassurance and reproductive flexibility before ovarian function declines further," Dr. Tarang said.

Read More: India Makes Significant Progress In Maternal Care, Nutrition And Child Immunization: NFHS-6

Why Timing Matters

Although egg freezing can be considered at different ages depending on individual ovarian reserve and reproductive goals, outcomes are generally better when eggs are frozen before the age of 35. Younger eggs tend to have better quality and chromosomal competence, which may improve future IVF outcomes.

The expert stressed the importance of early fertility counselling and ovarian reserve assessment. Tests such as Anti-Müllerian Hormone (AMH), ultrasound-based antral follicle count (AFC), and overall reproductive evaluation help determine whether a woman is an appropriate candidate for egg freezing.

Common Concerns About Egg Freezing

Addressing common concerns around the procedure, Dr. Shanujeet Kaur, Associate Director and Senior Gynecologist, Department of Fertility and Gynecology at Cloudnine Group of Hospitals, Chandigarh, told HealthandMe that some women may experience temporary mood swings due to hormonal medications used during ovarian stimulation.

Light to moderate exercise, including walking and stretching, is generally safe during treatment, though high-intensity workouts may be discouraged as the ovaries enlarge.

Current research suggests egg freezing is generally safe, with no strong evidence linking fertility medications used during the procedure to long-term health problems such as breast cancer, ovarian cancer, or infertility in most women.

Recovery after egg retrieval is typically quick, with most women able to resume normal activities within one to three days, though mild cramping, bloating, spotting, or fatigue may occur temporarily.

The expert also advised maintaining a balanced diet, staying hydrated, and following personalised medical guidance regarding birth control and lifestyle measures during treatment.