Every year, World Toilet Day is observed to raise awareness about the global sanitation crisis and encourage action to solve it. The goal set by the United Nation is to achieve safe toilets for all by 2023, as a part of their Sustainable Development Goals.

The UN also states that 3.5 billion people live without proper sanitation and many children also lose their lives due to poor sanitation and unsafe water. This is why World Toilet Day is observed to raise awareness on this issue.

Theme

This year, the theme for World Toilet Day 2024 is "Toilets - A Place for Peace'. This focuses on the growing threat to sanitation that is caused by conflict, climate change, disaster and neglect. When there is a threat to using toilets, it can lead to many health risks.

Not using toilets for too long may lead to Urinary Tract Infection or UTI. For many who do not have access to clean toilets do not drink enough liquid or hold pee for too long. Doctors suggest that holding in pee for too long can cause bacteria to multiply and lead to UTI. By not drinking enough water, your bladder fails to tell the body to pee often, and can cause the bacteria to spread through the urinary tract, which can lead to infection.

Symptoms of UTI:

• Burning or stinging feeling while urinating
• Pain in pelvis or lower abdomen
• Constant urge to empty the bladder
• Strong or foul smelling urine
• Consistently dark urine
• Blood in urine

Holding in pee for too long can also cause your bladder to stretch, making it difficult or even impossible for the bladder to contract and release pee normally. It can also damage your pelvic floor muscles or could lead to kidney stones.

World Toilet Day History And Significance

To prevent such conditions, it is important that everyone has access to clean and safe toilets. In terms of history, the day was established in 2001, by the World Toilet Organization (WTO), which was founded by Jack Sim. However, it was officially recognised by the UN in 2013. The Government of Singapore worked with WTO to create the first UN resolution called Sanitation for All.

India too promotes safe and hygiene toilet through its Swachh Bharat Yojna.

The International Agency for Research on Cancer (IARC), the World Health Organization's (WHO) cancer research agency, has classified three widely used medicines—hydrochlorothiazide, voriconazole, and tacrolimus—as Group 1 carcinogens, meaning they are "carcinogenic to humans."

All three medicines are included on the WHO Model List of Essential Medicines and are prescribed to millions of people worldwide for treating hypertension, serious fungal infections, and preventing organ transplant rejection.

A Group 1 classification means there is sufficient scientific evidence that an agent can cause cancer in humans under certain circumstances. However, it does not indicate how likely a person is to develop cancer while taking the medicine as prescribed. The actual risk depends on factors such as the dose, duration of use, individual health, and other risk factors.

Which Medicines Have Been Classified as Carcinogenic?

Hydrochlorothiazide: It is a thiazide diuretic commonly prescribed to treat essential hypertension. Although newer blood pressure medications are increasingly used, it remains a widely prescribed treatment because of the global burden of hypertension.

Voriconazole: It is a broad-spectrum triazole antifungal medicine used to treat invasive aspergillosis and other serious fungal infections, particularly among transplant recipients and other immunocompromised patients.

Tacrolimus: It is an immunosuppressive medicine used to reduce the risk of organ rejection in adult and pediatric transplant recipients and to prevent graft-versus-host disease following stem cell transplantation. Topical tacrolimus is also used as a second-line treatment for atopic dermatitis and vitiligo when topical corticosteroids are unsuitable.

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Why Did IARC Classify Them as Carcinogenic?

"The IARC Monographs Working Group reviewed evidence from epidemiological studies, cancer bioassays in experimental animals, and mechanistic studies to assess the carcinogenic hazard to humans of exposure to these agents and concluded that hydrochlorothiazide, tacrolimus, and voriconazole are all carcinogenic to humans (Group 1)," the IARC said.

• Hydrochlorothiazide has been linked to squamous cell skin cancer and lip cancer because it increases the skin's sensitivity to sunlight.
• Voriconazole is associated with squamous cell carcinoma of the skin through the phototoxic effects of one of its metabolites.
• Tacrolimus has been linked to non-Hodgkin lymphoma and post-transplant lymphoproliferative disorders, largely due to its immune-suppressing effects.

What Does This Mean for Patients?

Dr. Shyam Aggarwal, Chairman, Medical Oncology, Sir Ganga Ram Hospital, told HealthandMe that the classification identifies a cancer hazard, not the level of cancer risk associated with normal therapeutic use.

"The IARC underlines that this Group 1 listing identifies a cancer hazard—the potential of an agent to cause malignancy rather than measuring how great the actual risk is when the medicines are taken at normal therapeutic doses. All three remain listed as essential medicines by WHO, reflecting their critical role in treating serious illness," he said.

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Dr. Aggarwal stressed that patients should not stop taking these medicines without consulting their doctor.

"Abruptly stopping any of these agents can result in dangerous rises in blood pressure, uncontrolled infection, or transplant failure. The recommended course is to speak with the treating physician, adopt rigorous sun-protection habits if taking hydrochlorothiazide or voriconazole, and maintain regular surveillance for those receiving tacrolimus after transplantation," he added.

No Need to Panic

Dr. Tushar Tayal, Associate Director – Internal Medicine, CK Birla Hospital, Gurugram, told HealthandMe the reclassification should not be a cause for alarm.

According to him, the concern relates to long-term cumulative exposure rather than a single dose. Stopping treatment abruptly could pose a much greater immediate risk, including uncontrolled hypertension, severe infection, or transplant rejection.

What Should Patients Do?

• Do not stop or change your medication on your own.
• Consult your treating physician before making any changes to your treatment.
• Discuss whether regular skin examinations or an alternative treatment plan may be appropriate based on your individual risk.
• Use sun protection if you are taking hydrochlorothiazide or voriconazole, as advised by your doctor.
• Attend regular follow-up appointments, especially if you are taking tacrolimus after an organ transplant.

A UK-based surgeon from Egypt has been permanently barred from practising medicine after a medical tribunal found that he made a catastrophic blunder during an emergency bowel surgery.

Dr Yasser Adly Abdel Rahman, who was working as a locum surgeon at Royal Oldham Hospital in Greater Manchester, mistakenly connected the wrong parts of a patient’s digestive system, a procedure experts described as “not known to man.”

Here's What Happened

Dr Rahman carried out the operation on a young man in August 2020. Instead of restoring the patient’s bowel, the surgery created a “closed loop” that caused contents of the bowel to flow back into the stomach.

The error left the patient in unimaginable pain and in a condition deemed “not compatible with life.”

According to findings by the Medical Practitioners Tribunal Service (MPTS), the patient was left feeling severe pain, vomiting and an inability to pass stool after the surgery.

A second surgeon later performed emergency corrective surgery, creating a stoma and saved the patient’s life.

The tribunal heard that Dr Rahman failed to realise the seriousness of the patient’s deteriorating condition and did not adequately respond to concerns raised by the patient’s family and medical colleagues.

An expert from the General Medical Council (GMC) described the erroneous procedure as “as bad as it gets” and said the surgical connection was “not known to man.”

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The Surgeon Was Struck Off From The UK Medical Register

The tribunal ruled that Dr Rahman’s actions amounted to serious professional misconduct.

It also found that, in 2021, after restrictions were placed on his medical practice, he breached them by taking up a locum job in Affidea Express Care Clinic in Ireland in 2022.

Dr Rahman was absent at the misconduct hearing and instead maintained that he was a victim of a witch hint and had been made a “scapegoat.”

But, the tribunal concluded that his incompetence, failure to accept responsibility and repeated breaches of regulatory conditions meant he posed an ongoing risk to patients. He has now been permanently removed from the UK medical register.

Also read: World Plastic Surgery Day: Hidden Risks To Know If You’re Travelling Abroad For Affordable Cosmetic Procedures

What Is A “Closed Loop” Bowel Obstruction?

A closed loop bowel obstruction occurs when a section of the intestine is blocked at two points, restricting its contents. This can fatally cut off blood supply to the bowel, causing tissue death, perforation, infection and sepsis if not treated urgently.

In this case, the incorrect surgical connections diverted bowel contents back into the patient’s stomach instead of allowing them to pass normally through the digestive tract, creating a life-threatening emergency that required immediate corrective surgery.

While surgical complications can occur even in experienced hands, medical experts told the tribunal this error was far from acceptable.

The case has also drawn attention because the surgeon allegedly ignored warning signs after the operation. He later breached restrictions placed on his medical licence by taking up a job elsewhere. These factors ultimately contributed to the decision to strike him off from the UK register permanently.

Also read: UK Woman Becomes World-First To Receive Experimental Cell Therapy For Ovarian Cancer

About Dr. Yasser Adly Abdel Rahman

Dr Rahman qualified in 1993 from Ain Shams University in Cairo, Egypt. He trained as a general and colorectal surgeon.

He later worked in the UK as a locum consultant, meaning he was employed on temporary contracts rather than in a permanent consultant position.

At the time of the incident in August 2020, he had only been working at Royal Oldham Hospital in Greater Manchester for a few days before performing the emergency bowel surgery.

After several months of a statewide crackdown on food adulteration, Maharashtra has now banned the manufacture and sale of non-dairy paneer, commonly known as analogue paneer or analogue cottage cheese.

The move follows multiple raids on fake paneer manufacturing units and the seizure of large quantities of spurious dairy products.

Earlier this week, the Chhattisgarh government also banned the sale and use of analogue paneer across the state. The Health Department announced that the product will no longer be permitted in markets, hotels, restaurants or roadside eateries. Maharashtra has now become the second Indian state to impose such a ban.

Ban on Manufacture and Sale of Analogue Paneer

The order, issued by Food Safety Commissioner Tukaram Mundhe in Maharashtra, prohibits the manufacture, processing, packing, storage, transportation, wholesale and retail sale, distribution, and offering for sale of analogue or non-dairy paneer across the state.

Violations can attract up to six months' imprisonment and a fine of Rs 1 lakh under the Food Safety and Standards Act, 2006.

In cases where the consumption of unsafe food results in death, the law provides for life imprisonment and a minimum fine of Rs 10 lakh.

As per the Maharashtra Maharashtra Food and Drug Administration (FDA), strict legal action will also be taken against individuals or establishments selling analogue paneer as genuine dairy paneer for misleading consumers.

Why Was the Ban Imposed?

The decision follows findings from the Maharashtra FDA's year-long enforcement and surveillance drive.

According to the regulator, routine inspections, food sampling and awareness campaigns failed to curb the sale of analogue paneer.

"The proportion of non-conforming samples remained persistently high at 35.4 per cent of the samples analysed," the FDA order stated. Between April 1, 2025, and March 31, 2026, the FDA collected paneer and analogue paneer samples from across the state.

Further, the FDA stated that its year-long inspections found that hotels, restaurants, caterers and other food establishments were routinely using analogue paneer instead of genuine paneer without informing customers through menus, invoices or display boards.

Authorities also found that analogue paneer was often transported and sold without original packaging, mandatory labels, invoices, batch identification or traceability documents, making it difficult to identify its source and increasing risks to public health.

Analogue vs Diary Paneer

Traditional paneer is a fresh, soft, non-melting cheese commonly used in Indian cuisine. It is made by curdling milk with acidic ingredients such as lemon juice, vinegar, or citric acid, separating the curd from the whey. The curds are then drained and pressed to remove excess water.

On the other hand, analogue paneer is made using vegetable fats or oils, starches and other non-dairy ingredients instead of milk fat.

As per the Food Safety and Standards Authority of India (FSSAI) regulations:

• Paneer must be made from milk.
• It should not contain added starch, non-dairy fats, or synthetic ingredients.
• Analogue paneer can be sold only if it is clearly labelled as "analogue" or "imitation" and not marketed as genuine paneer.

How to Identify Fake Paneer

FSSAI and experts recommend these simple checks:

• Check the texture: Genuine paneer is firm with a fresh milky smell. Fake paneer tends to crumble or melt quickly when heated.
• Read the label: Products made with non-dairy substitutes must be labelled as "analogue" or "imitation".
• Iodine test: Boil a piece of paneer, add a few drops of iodine tincture. If it turns blue, it may indicate the presence of starch.
• Toor dal test: Boil the paneer, cool it in water, add some toor dal and leave it for 10 minutes. If the water turns light red, it may indicate adulteration.

What Are the Health Risks?

Health experts warn that adulterated paneer can pose serious health risks, especially if manufactured using unsafe ingredients.

Possible risks include:

• Food poisoning
• Vomiting and diarrhea
• Allergic reactions
• Kidney damage from nephrotoxic compounds
• Liver damage due to toxin accumulation
• Exposure to chemicals such as formalin, detergents or industrial stabilizers, if used in illicit preparations