A report by Swachh Bharat Mission says that 74.5 per cent of public places are equipped with toilets. Another report by the Ministry of Jal Shakti states that there are 2.23 lakh Community Sanitary Complexes built across all States and UTs under the Swachh Bharat Mission (SBM) since October 2014. Over 92 lakh toilets have been constructed since the launch of SBM Gramin (SBM (G)) in April 2020.

While toilets are there, are they accessible? This is the question one should ask. The National Family Health Survey (NFHS) focuses on 131 health indicators, but not until the NFHS 5 survey did they include the question of accessibility of toilets in the survey. This happened after the inputs from the Department of Drinking Water and Sanitation (DDWS) and the Ministry of Health & Family Welfare questioned the accessibility.

One might ask, why is the question of accessibility so important? The answer is quite simple. Access to water, sanitation and hygiene is the most basic human need and is also included under the Sustainable Development Goals by the UN.

Are These Numbers Real?

This thought crossed my mind because back in 2021, I went on a solo trip, on a bus to Udaipur from Delhi. There, the bus made two stoppages. This was done so people could get a quick dinner and freshen up, relieve themselves and be prepared for the rest of the journey. This was a nightmare. The bus only stopped for 10 minutes. While some men used the washroom, others went to the bushes.

For the women, there were three cubicles. One of them was broken, and the other one did not have a light bulb, which meant only one was usable. There was a long queue for that cubicle, and time was short. There was no point in trying to find an isolated corner, because it was past midnight, in an unknown area.

I waited anxiously. When finally, my turn came, I saw an overused, dirty washroom. The toilet seat is in a horrible condition. I wanted to touch nothing there. But I had to pee. So, I used my mask to cover my nose from the odour, folded my pants so they did not touch the floor and squatted. It was quite a task to balance.

On my way back to Delhi, I made sure to not drink any water for over a 13-hour bus journey. I dehydrated myself so I did not have to use the washroom. When I did reach, I was severely dehydrated and was sick for three days.

I shared my experience with my friends only to realise that many women have faced the same. There are no washrooms for women.

A friend of mine told me that it is because these roads and dhabas are mainly designed to serve men. They are the ones who travel at night or are on the roads most of the time. As a result, the few women who do travel or are on the road suffer.

Health Risks Women Are Prone To

Well, it is true, but partially. While holding your pee for too long can lead to health risks, peeing on a dirty toilet seat cannot lead to infections unless your urethra is in contact with the bacteria present on that toilet seat. However, nobody wants to sit on a dirty toilet seat, even if you do not get an infection. A safe and hygienic toilet is a basic need.

One of the regular saleswomen, Usha, who visits my house shared her experience with me. “Being on the road constantly means I must use the dirty public washrooms. But I do not want to use them. So, sometimes I ask my regular customers to let me use their washrooms. Some say yes, and some say no. I understand they are also concerned about their safety and privacy,” she says. As a result, Usha spends most of her day not drinking enough water and holding her pee when she is at work. Due to this, she also suffered from a Urinary Tract Infection (UTI).

Her friend, Halima too faced similar problems and due to increased levels of uric acid in her body, she suffered from Hyperuricemia.

Other health risks are kidney stones and other kidney problems, headaches, dull skin, xerostomia or dry mouth, fatigue, and urinary incontinence, which means losing control over your pelvic floor muscles leading to uncontrolled leakage of urine, seizures and weakness.

What Can You Do?

Wear comfortable clothes and capris. Capri pants are comfortable and are short in length, which means this won’t touch the toilet floor when you squat or sit.

Carry Essentials

Even though you cannot get a UTI alone from sitting on a toilet seat, it is always safe to carry a toilet seat sanitiser. If nothing, it can help you get rid of the bad odour so you can use your stand and pee device inside the toilet. You can also use disposable toilet seat covers if your knees are weak, and you cannot squat. Always flush with your seat down.

Always keep disposable gloves, a portable bidet (fill it with water before use), a pocket liquid handwash, wet wipes, tissues and sanitiser handy. Do not forget to keep extra sanitary pads. It might sound a lot, but I promise that it all fits in one pouch. Use this travel-friendly pouch every time you are on the road, or using a public washroom.

What Can We Learn From Others?

However, in case we do not get these technologically advanced toilets here, you can always pack a travel-friendly toilet kit!

World Asthma Day is observed globally every year on the first Tuesday of May to raise awareness about the most common chronic non-communicable disease in the world.

The condition affects over 260 million people. It is also responsible for over 450,000 deaths each year worldwide. However, most of these deaths are preventable.

As per the Global Burden of Disease Report (GBDR) 2019, India has the highest and growing burden of asthma in the world in terms of deaths and disability-adjusted life years, and over 3.4 crores of people in India have asthma, despite accounting for only 13 per cent of the world's asthma population, and 42 per cent of global asthma mortality.

World Asthma Day: History

World Asthma Day began in 1998 during the first World Asthma Meeting in Barcelona, Spain.

Coordinated by the Global Initiative for Asthma (GINA), with over 35 countries initially participating, it has grown into a global awareness event held annually on the first Tuesday of May.

GINA is a World Health Organization collaborative organization founded in 1993.

World Asthma Day: Theme

This year, the theme is: “Access to anti-inflammatory inhalers for everyone with asthma – still an urgent need”.

The theme reinforces that every person with asthma, including most pre-school children with asthma, should receive inhaled corticosteroids.

These inhalers reduce the person’s risk of asthma attacks and preventable asthma deaths.

GINA continues to emphasize the need to ensure that all people with asthma can access inhaled medications that are essential for controlling the underlying disease and treating attacks.

Preferably, the inhaler should be a combination 2‑in‑1 inhaler containing both an inhaled corticosteroid and a quick-acting reliever. Together, they treat the asthma symptoms, prevent asthma attacks, and reduce hospital admissions.

Also read: Exposure To Traffic Emissions Before Birth May Delay Speech Development In Children: Study

What is Asthma? Signs and Symptoms

Asthma attacks are mainly caused by the obstruction of the air passages in the lungs, which reduces the ability of the person to inhale life-sustaining oxygen into the body.

The airway obstruction is caused by spasm and tightening of the airway muscles, and inflammation, which causes both swelling of the walls of the air passages and mucus or phlegm blocking the airways.

Common symptoms include

• shortness of breath,
• wheezing (a whistling sound on exhaling),
• chest tightness or pain,
• coughing—often worse at night, early morning, or during triggers like colds, exercise, allergens, or smoke.

How To Treat Asthma

According to GINA, inhaled corticosteroids are essential for treating and controlling asthma.

The short-acting bronchodilator relievers (salbutamol, albuterol, terbutaline, SABAs) only relieve the spasm and tightening of the muscles in the air passages, but inhaled corticosteroid-containing medications prevent asthma attacks by treating the underlying inflammation that causes asthma.

The inhaled corticosteroid-containing medication should be prescribed in addition to, or in combination with, reliever medication, to prevent the continuing avoidable morbidity and mortality from asthma.

In low-middle-income countries, lack of availability or high cost of inhaled medicines, especially inhaled corticosteroid-containing inhalers, are major contributors to the fact that many attacks and 96 per cent of global asthma deaths occur in these countries.

How To Prevent Asthma

Asthma can be prevented by:

• Avoiding exposure to environmental triggers such as air pollution, cold air, fragrances, etc.
• Avoiding contact with allergens.
• Avoiding smoke from cigarettes, candles, incense, and fireworks. Staying away from sick people (cold or the flu)
• Keeping the surroundings dust-free
• Taking vaccinations on time to prevent pneumonia, diphtheria, tetanus, the zoster vaccine, and whooping cough
• Adhering to asthma medications.

If you speak to doctors today, one pattern is becoming very common—women in their 30s are often being diagnosed with both thyroid problems and PCOS together. Earlier, these conditions were seen separately. Now, they frequently show up side by side.

At first, this can feel confusing. The thyroid is a gland in your neck that controls how your body uses energy, while PCOS affects the ovaries, periods, and hormones. They seem unrelated—but inside the body, they are more connected than we think.

Hormonal Imbalance

A big reason behind this overlap is hormonal imbalance. PCOS already disturbs the balance of female hormones and can lead to irregular periods. If the thyroid is underactive, it slows the body’s metabolism and also interferes with hormone levels. When both happen together, symptoms tend to become more noticeable and sometimes more difficult to manage.

Insulin resistance

Another important link is insulin resistance. Many women with PCOS have it, even if they are not diabetic. This means the body struggles to use sugar properly, leading to higher insulin levels. Over time, this doesn’t just affect weight—it also impacts hormones and can indirectly influence thyroid function. That’s why the two conditions often overlap.

Lifestyle

Lifestyle plays a bigger role than we usually admit. In your 30s, life tends to get busy—work pressure, family responsibilities, irregular sleep, and constant stress. Meals are often rushed or skipped, exercise takes a backseat, and screen time goes up. All of this affects the body’s internal balance. Stress hormones, in particular, can disrupt both thyroid function and reproductive hormones.

Weight Gain

Weight gain is another common thread. Many women notice gradual weight gain that doesn’t seem to respond easily to diet or exercise. Thyroid problems can slow metabolism, while PCOS can increase fat storage, especially around the abdomen. This, in turn, worsens insulin resistance—creating a loop that’s hard to break without proper guidance.

It’s also worth noting that we are simply diagnosing more cases now. Women today are more aware of their health and are more likely to seek help for symptoms like irregular periods, fatigue, hair fall, or acne. Earlier, these were often ignored or brushed off as “normal.”

When both thyroid issues and PCOS are present, you may notice:

• Periods are becoming irregular or stopping altogether
• Constant tiredness, even after rest
• Hair thinning or excessive hair fall
• Acne that doesn’t settle easily
• Unexplained weight gain
• Difficulty getting pregnant

How To Manage

The encouraging part is that both conditions can be managed well. The approach is not just about medicines—it’s about small, consistent lifestyle changes. Eating balanced meals, staying physically active, managing stress, and getting proper sleep can make a real difference over time.

The key is to listen to your body. If something feels off and continues for months, don’t ignore it. Getting checked early can save a lot of trouble later.

In the end, this rise in combined thyroid and PCOS cases isn’t random. It reflects how modern lifestyles are affecting women’s health. The good news is—with the right care and awareness, it’s absolutely possible to manage both and stay healthy.

The concept of self-medication in the case of a trivial ailment such as a headache or a small cut is generally considered responsible self-care. Nevertheless, it becomes a matter of public health concern when the process goes through two particular stages. The first of these stages is the “masking of chronic disease." When one uses over-the-counter (OTC) drugs to cover up symptoms of fatigue, acidity, or thirst, he or she ends up masking the symptoms of underlying chronic diseases, which could be type 2 diabetes or high blood pressure, for instance. By the time these symptoms are diagnosed, the condition may have caused irreparable damage to organs. Another health problem created due to self-medication is antimicrobial resistance, which poses a danger not only to the individual but also to society as a whole.

What are the risks of making a self-diagnosis?

Dr Vimal Pahuja, MD, Associate Director, Internal Medicine & Metabolic Physician, Diabetes & Weight Management Clinic, Dr LH Hiranandani Hospital, Powai, Mumbai, said, “The most serious complications include those that have no immediate effects and do not trigger pain signals. DILI is a growing concern in India and is a consequence of the persistent abuse of painkillers (NSAIDs) or even some of the herbal supplements available in the market. In the same way, ‘kidney compromise’ results from prolonged consumption of analgesics. Looking at things from the viewpoint of the endocrine system, the frequent consumption of over-the-counter steroids, which are also included in some ‘miracle’ skin creams and supplements, can affect hormones and lead to the development of secondary diabetes.”

Does it help to ‘Google’ symptoms?

Internet searches usually generate confirmation bias, where patients only seek answers that align with what they want to hear. Health-related social media sites and influencers tend to oversimplify medical issues by encouraging bio-hacking. This results in unsafe practices, such as people prescribing themselves advanced metabolic and hormonal treatments without being aware of the contraindications or the need for clinical testing.

Dr Kirti Sabnis, Infectious Diseases Specialist, Fortis Hospital, Mulund & Kalyan, Mumbai, said, “With the growing emphasis on early and accessible diagnosis, more individuals are becoming proactive about understanding their symptoms and lab reports. This has led to a noticeable rise in what clinicians often refer to as ‘Google diagnosis,' where patients arrive with self-researched conclusions based on online information or AI-enabled report analyses.”

Why is accurate diagnosis important?

The expert went on to say that interpreting symptoms and investigations is rarely straightforward. Fever, for instance, is merely a symptom and can stem from a wide range of causes, from infections to non-infectious conditions such as thyroid disorders. While digital tools and AI platforms can analyse reports and suggest possible conditions, they typically rely on common algorithm-based differentials. In some cases, this may lead to alarming or misleading possibilities such as tuberculosis or even cancer, when the underlying issue could be far less serious.

Accurate diagnosis requires more than data interpretation; it demands clinical expertise, physical examination, and years of medical experience to connect symptoms, history, and test results. Over-reliance on online searches can sometimes lead to unnecessary anxiety, delayed diagnosis, or even self-medication, which may complicate the condition further.

The importance of taking time to explain the reasoning behind prescribed medication is essential, especially when informing a patient that an antibiotic cannot cure their flu.