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!

Air conditioners feel great when the weather turns hot and sticky. Most of us spend hours under one, at home, at work, or even on long drives, and it barely crosses our minds. But sitting in cold air for too long can quietly leave your neck and back feeling tight and sore. AC isn't going to cause a serious spine problem on its own, but it can tighten up your muscles and make existing pain worse.

Why Does This Happen?

Muscles function optimally when they are relaxed and warm. As soon as the cold air comes into contact with them, the body automatically starts tightening them as it seeks to retain its warmth. When this occurs in places such as the neck, shoulders, and lower back regions, there is a chance that these muscles will get sore and stiff. This condition worsens even more if the cold air continues to blow in the same spot for hours, especially while sleeping or sitting at a workstation.

What It Does To Your Neck And Back

Your neck and back rely on several muscles to keep you upright and moving properly all day. Cold air can slow blood flow to these muscles, which makes them tense up more easily. That's why people often wake up with a stiff neck after sleeping under an AC vent or feel upper back pain after a day in a freezing office. If you already deal with something like cervical spondylitis or chronic back pain, cold air can make those symptoms flare up even more.

It's Not Just The AC

Cold air rarely works alone. Bad posture, sitting too long, skipping exercise, and not stretching enough all add to the problem. Picture sitting at a computer for hours in a chilly office: that's tense muscles and poor posture combining at the same time, which makes stiffness and pain even more likely.

Simple Ways To Avoid It

A few small changes can make a real difference: keep the airflow away from your neck and back, set the temperature to something comfortable rather than freezing, get up and stretch every so often, drink enough water, and keep a light sweater or shawl nearby if it gets too cold.

AC keeps us comfortable when it's hot outside, but too much cold air for too long can leave your neck and back stiff and achy. A little attention to airflow, posture, and movement throughout the day can help you stay comfortable without paying for it later.

(By Dr. Aanchal Sharma, Pain Physician, Principal Consultant and Head of Department, Department of Pain Medicine at BLK MAX Hospital, New Delhi)

Vitiligo is an autoimmune condition that causes pigment loss in patches of skin. It is highly treatable and does not spread from person to person. However, stress, poor sleep, diet, and overall immune health may influence how active the condition becomes, experts said today on World Vitiligo Day.

Awareness around vitiligo remains low and is often clouded by misconceptions. Observed annually on June 25, World Vitiligo Day aims to raise awareness and challenge the stigma associated with the condition.

HealthandMe spoke to experts to understand the disease and the factors that may affect it.

Dr. Rashmi Ranjan, Consultant – Dermatology, Yatharth Super Speciality Hospital, Noida, said the biggest misconception is that vitiligo is contagious.

"It cannot spread from one person to another through touch, sharing food, or close contact."

Dr. Rashmi told HealthandMe that many people also incorrectly believe vitiligo is caused by poor hygiene or specific foods, claims that are not supported by scientific evidence.

Also read: Sleeping Too Little or Too Much? Neurologist Explains Health Risks

What Is Vitiligo?

Vitiligo occurs when the body's immune system attacks melanocytes, the cells responsible for producing skin pigment. While the condition is not life-threatening, it can have a significant emotional and psychological impact.

“As a chronic autoimmune disorder, vitiligo develops when the body's immune system mistakenly attacks melanocytes—the cells responsible for producing skin pigment. The result is the appearance of white patches that can develop anywhere on the body and may gradually increase in size or number over time,” Dr Hetanshu Parekh, Consultant Plastic Reconstructive & Cosmetic Surgeon, Bhailal Amin General Hospital, told HealthandMe.

The Emotional Impact of Vitiligo

The theme of World Vitiligo Day 2026 is "From Stigma to Strength".

According to Dr. Rashmi, visible skin changes often attract unwanted attention, questions and social judgment. Some people may avoid social gatherings or experience challenges in relationships and employment because of persistent misconceptions.

Children may face bullying, while adults can struggle with anxiety and low self-esteem. Emotional support from family, friends and healthcare professionals is therefore crucial.

A recent study also highlighted a strong link between vitiligo and mental health in India. Nearly 89% of patients reported moderate to severe depression, while close to 60% said they covered their patches, underscoring the continuing impact of stigma.

Read More: Did Donald Trump Take Eli Lilly's Weight Loss Drug? What Did White House Say

Vitiligo and the Role of Lifestyle Factors

Dr Hetanshu said vitiligo is often viewed as a skin condition alone, but the disease is far more complex. He explained that

Stress

• Stress can disrupt immune balance and increase inflammation, potentially worsening vitiligo.
• New or expanding patches are often observed after major life events such as exams, work pressure, illness, financial difficulties or bereavement.

Sleep

• Quality sleep is essential for immune regulation and overall health.
• Chronic sleep deprivation, irregular sleep schedules or less than six hours of sleep may worsen autoimmune conditions, including vitiligo.

Diet

• There is no specific "vitiligo diet" and no food can cure the condition.
• Deficiencies in Vitamin B12, Vitamin D, folate and copper may affect immune and skin health.
• Experts recommend an anti-inflammatory diet rich in fruits, vegetables, whole grains, nuts, seeds and omega-3 fatty acids.
• Smoking and excessive alcohol consumption should be avoided.

Skin Protection

• Repeated friction, cuts, burns and excessive sun exposure may trigger vitiligo patches (Koebner phenomenon).
• Use sunscreen regularly, wear protective clothing and avoid unnecessary skin trauma from tight straps, jewellery or repetitive rubbing.

Is Vitiligo Treatable?

Advances in targeted topical medications, phototherapy and immune-modulating therapies have expanded treatment options and enabled more personalized care, said Dr. Rashmi told HealthandMe.

Dr Hetanshu stressed that lifestyle measures should complement, not replace, medical treatment. Treatment measures include:

• For small, stable patches, doctors commonly prescribe corticosteroid creams and tacrolimus ointment.
• More extensive or rapidly spreading vitiligo may require narrowband UVB phototherapy, excimer laser therapy, oral corticosteroids or newer JAK inhibitors such as tofacitinib and ritlecitinib.
• Patients with stable disease for six to twelve months may be candidates for surgical procedures such as skin grafting and melanocyte transplantation.
• Medical tattooing and camouflage techniques can help in difficult-to-treat areas.

Blood cancers are among the most challenging, but advances in treatments, such as targeted therapies, advanced transplantation techniques, and increasingly customized approaches, are offering a new ray of hope for patients. Among these innovations, Chimeric Antigen Receptor T-cell therapy, commonly known as CAR-T cell therapy, represents one of the most important breakthroughs in modern cancer care in recent times.

Unlike conventional treatments that directly target cancer cells, CAR-T cell therapy harnesses the patient's immune system to identify and attack cancer. It is a powerful example of how medicine is moving towards personalized treatment strategies that are designed around an individual's disease biology.

How CAR-T Cell Therapy Works

To understand CAR-T therapy, it is important to understand the role of T-cells. These are specialized immune cells responsible for recognizing and eliminating abnormal cells in the body. In some blood cancers, cancer cells develop mechanisms that allow them to evade immune surveillance. CAR-T therapy addresses this challenge by genetically modifying a patient's T-cells in a laboratory to recognize specific proteins present on cancer cells.

The process begins with the collection of T-cells from the patient's blood through leukapheresis. These cells are then engineered to express specialized receptors, called chimeric antigen receptors (CARs), which enable them to recognize cancer cells more effectively. Once modified and multiplied, the cells are infused back into the patient's bloodstream, where they seek out and destroy cancer cells.

Potential of CAR-T

Currently, CAR-T cell therapy has shown encouraging results in several blood cancers, including certain forms of acute lymphoblastic leukemia, diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma, follicular lymphoma, and multiple myeloma. For some patients whose disease has relapsed after multiple lines of treatment or failed to respond to conventional therapies, CAR-T therapy has offered a valuable new treatment option.

One of the most promising aspects of CAR-T therapy is its potential for durable responses. In selected patients, the engineered immune cells can continue to remain active within the body, providing ongoing surveillance against cancer recurrence. While every patient may not experience the same outcome, the ability to achieve long-lasting remission in heavily pre-treated cancers has generated significant optimism within the oncology community.

CAR-T therapy: The Challenges And Side Effects

All that being said, CAR-T therapy is a highly specialized treatment that requires careful patient selection and close monitoring. Some patients may also experience side effects such as cytokine release syndrome (CRS), neurological complications, or temporary suppression of normal blood cell production. Fortunately, advances in supportive care and growing clinical experience have substantially improved the management of these complications.

The Future of Blood Cancer Care

Researchers across the world are working on next-generation CAR-T platforms designed to improve effectiveness, reduce toxicity and expand treatment eligibility. Investigational approaches include "off-the-shelf" CAR-T products derived from healthy donors, dual-target CAR-T cells capable of recognizing multiple cancer markers, and therapies aimed at overcoming treatment resistance.

Scientists have also been exploring the potential of CAR-T therapy in other blood cancers and even selected solid tumors. While significant challenges remain, ongoing research continues to push the boundaries of what immune-based therapies can achieve. As research advances and access continues to improve, CAR-T cell therapy is expected to play a very important role in the future of blood cancer care. For patients, families, and clinicians alike, it represents a powerful reminder that innovation continues to redefine what is possible in the fight against cancer.

(By Dr. Dinesh Bhurani, Director – Hemato-Oncology & Bone Marrow Transplant, Rajiv Gandhi Cancer Institute & Research Centre (RGCIRC))