There's been nothing to indicate Ayaan has an illness, he could have one. However he could also be a divorcee, or he could have had an affair and kids while in America, he could also still be married.
I think it's got something to do with his time in America, because when his mum came with him to confirm the rishta they said he set up a business in America but now he will never go back there, he will stay in Pakistan. That seems weird to me. He has a business in America so it would be normal for him to travel there occasionally. I think there's a reason he doesn't want to return to America.
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