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!

If you think that injections of botulinum toxin -- commonly known as Botox -- are only used to make skin wrinkle-free, you may be mistaken.

A new study led by US researchers has shown that Botox injections can act as a “rescue therapy” to treat conditions such as finger ulcers, digital ischemia, and gangrene that are difficult to manage with standard therapies.

Finger ulcers (or digital ulcers) are painful open sores, while acute digital ischemia causes the fingers to become extremely painful, cold, and sometimes pale or bluish in color. Gangrene is the dangerous death of body tissue (necrosis), often turning skin black, green, or purple.

These debilitating complications, often associated with conditions like lupus, rheumatoid arthritis, systemic sclerosis, or bacterial infections, are caused by reduced blood flow to the fingers and heal poorly.

Botox injections, which work by reducing blood vessel constriction and improving circulation, may help achieve complete healing of lesions in more than 85 percent of such patients, according to a study recently published in JAMA Dermatology.

“These new findings are particularly important because therapeutic options remain limited for the cutaneous and vascular manifestations of systemic sclerosis and other autoimmune diseases,” said Dr. Netchiporouk, a scientist in the Infectious Diseases and Immunity in Global Health Program at the Research Institute of the McGill University Health Center.

Netchiporouk noted that the available vasodilator and immunosuppressive treatments are generally administered intravenously.

In contrast to Botox injections, these are also costly, minimally effective, and associated with significant adverse effects.

Also read: Botox Helped Her Burp: How Injectables Changed A 25-Year-Old's Life

The study also described the case of a 50-year-old man with a rare autoimmune disease that caused joint pain and digital necrosis (gangrene).

While traditional medications helped reduce his pain, he was forced to stop working, and the condition severely impacted his quality of life.

However, after receiving botulinum toxin injections, his pain was relieved, and sensation improved within 24 hours, and the necrosis began to improve within two weeks.

“This treatment has become an important tool, especially for patients with autoimmune vascular diseases that result in serious health consequences and for which there are few therapeutic options,” Netchiporouk said.

Also read: Why Regulatory Clarity Is Important for Safe Aesthetic Procedures in India

Botox: Safe, With Minimal Adverse Effects

The study, based on a systematic review and individual patient data meta-analysis of 30 published studies and one unpublished case involving 119 patients, found that only a few patients experienced adverse effects.

These were generally mild and short-lived, most commonly temporary muscle weakness or pain at the injection site.

“Our results show that botulinum toxin can improve blood circulation in the fingers and treat serious complications such as ulcers or gangrene, offering a safe and easy-to-administer alternative,” said Dr. Catherine Zhu, a dermatology resident at the McGill University Health Center.

Zhu added that the injections can be easily administered by rheumatologists and dermatologists in outpatient settings, reducing reliance on intravenous therapies that require hospitalization and increasing overall healthcare costs.

Importantly, in most cases, a single injection session was sufficient to achieve the desired response.

“Botulinum toxin can offer significant benefits with a favorable safety profile. It deserves further study to develop standardized protocols and optimize outcomes,” said Dr. Netchiporouk.

New Delhi: In a world where many are struggling with stress, work pressure, competition at school, and more, it does not come as a shocker that infertility has become too common. Couples often struggle to become parents, and that not only causes emotional stress but also takes a toll on relationships. But thanks to medical advancements, there are procedures like in vitro fertilisation (IVF) that make parenthood possible despite the many curveballs that infertility throws in the way. And with the precision that AI brings to the table, doctors have upped IVF success rates. But in some cases, even vitamin D deficiency can come in the way of a successful IVF treatment.

Read more: The Overlooked Role of Men in IVF: Why Their Silent Strength Is Key to Fertility Success

What is vitamin D deficiency?

Vitamin D, or the sunshine vitamin, is one of the most important nutrients that one needs for a healthy life. It influences mental health, bone and teeth strength, and, as it turns out, fertility as well. An extremely common occurrence in India, it is often seen in women of reproductive age. But can it also affect IVF success rates? Let's find out.

Dr. Kirti Singh, MBBS, MD, DNB (Obs & Gyn), Fellowship in Reproductive Medicine, Clinical Consultant, Aksigen IVF, interacted with Times Now Digital and explained how vitamin D affects women's health.

"Vitamin D is well known for maintaining calcium metabolism and bone health. Apart from that, emerging scientific evidence suggests that vitamin D may influence several pathways relevant to fertility, including ovarian function, endometrial receptivity, hormone regulation, and immune balance within the uterus. Vitamin D receptors (VDRs) are expressed in female reproductive tissues, including the ovaries, uterus, and placenta, hence having a significant impact on female fertility. Vitamin D supplementation has also been shown to have a positive effect on AMH expression. There are studies showing a positive correlation between follicular fluid (vitamin D levels) and fertilization rate. It is also known to regulate the expression of the HOXA10 gene, which helps in implantation," said Dr. Singh.

How does vitamin D deficiency affect fertility in women?

Dr. Nidhi Saluja, Centre Clinical Director, Indira IVF Hospital Limited, Gurugram, said, "Vitamin D deficiency is increasingly being recognised as an important consideration in female reproductive health, including in the context of assisted reproduction. Emerging clinical evidence suggests that low vitamin D is not merely an associated finding in infertility but a factor that may influence how ovaries function, how embryos implant, and how pregnancies progress. Since vitamin D receptors are present in reproductive tissues such as the ovaries, endometrium, and placenta, its role appears to extend beyond bone health into key aspects of fertility and reproductive support."

Read more: What Makes The IVF Journey So Hard On The Mind?

The expert went on to say that this becomes particularly relevant for women undergoing IVF, where factors such as ovarian function, embryo implantation, and endometrial receptivity are all important to treatment outcomes. Evidence suggests that women with sufficient vitamin D levels tend to show better implantation rates, improved embryo quality, and healthier endometrial receptivity. In clinical practice, low vitamin D is also often seen alongside diminished ovarian reserve and suboptimal ovarian response, especially in women already managing hormonal or metabolic challenges.

"Vitamin D status deserves greater attention as part of a comprehensive fertility assessment. While it should not be viewed as the sole determinant of IVF success, it may represent a potentially modifiable factor within broader fertility care. Identifying and addressing deficiency before conception or IVF can therefore help support a more informed and holistic treatment approach, particularly in women facing declining ovarian reserve or complex endocrine profiles," Dr. Saluja added.

What are the best sources of vitamin D?

Our main source of vitamin D, a fat-soluble steroid hormone, is sunlight. Only a small amount is obtained from our diet. In food, it is obtained from natural sources like eggs, fish, mushrooms, cod liver oil, green vegetables, yogurt, and milk. While vitamin D deficiency alone may not be the sole determinant of IVF success, studies increasingly indicate that correcting metabolic and nutritional imbalances can contribute to a healthier reproductive environment.

Even after being preventable and curable, tuberculosis (TB) retains its status as one of the deadliest infectious diseases more than 140 years after Robert Koch announced the discovery of Mycobacterium tuberculosis (Mtb) on March 24, 1882.

A major challenge is that millions of people carry it without knowing, and current tests often miss it. This is known as latent TB infection, where bacteria exist in an inactive state in the body.

While you do not feel sick, the infection can progress to active, contagious TB disease.

Ahead of World Tuberculosis Day, on March 24, scientists at the Indian Council of Medical Research-National Institute for Research in Tuberculosis (NIRT) in Chennai, reported developing an advanced blood test that can find TB even when it's hiding, and before it gets serious.

In the study, published in the Lancet journal eBioMedicine, the researchers explained about detecting circulating cell-free Mtb DNA in the plasma of individuals at high risk of developing TB disease via a dual target-based digital droplet PCR (ddPCR) assay.

The test was targeted at adults without a clear diagnosis of TB (asymptomatic or clinically diagnosed TB).

Using the test, the team led by Luke Elizabeth Hanna from NIRT's Department of Virology and Biotechnology, found TB in the blood up to 18 months before a person was diagnosed.

They identified eight out of 10 people at risk - all before they fell sick with the infectious disease.

“The new test performed better than all existing standard TB tests combined. This test could change how we fight TB - by finding it early, treating it faster, and stopping it from spreading,” said the team in the paper.

Tuberculosis: Advanced Blood Test

Detection of pathogen-derived cell-free DNA (cfDNA) has been gaining much attention in recent years for the diagnosis of several clinical conditions.

cfDNA is a liquid biopsy blood test that analyzes small, non-cellular DNA fragments circulating in the bloodstream.

The team found that the advanced blood test could find tiny traces of TB in the blood - even when a person feels completely healthy.

The test works by breaking a small blood sample into thousands of tiny droplets and searching each one for TB.

The study included 46 healthy household contacts of patients with pulmonary TB who developed TB within two years of follow-up, and 92 HHCs who did not progress to TB.

Plasma was obtained and subjected to testing using a ddPCR assay targeting two Mtb-specific insertion sequences, IS6110 and IS1081.

"Our findings support the diagnostic utility of ddPCR-based detection of circulating Mtb-derived cell-free DNA in plasma of individuals at high risk for progressing to active TB several months prior to clinical diagnosis," the ICMR-NIRT researchers said.

"These findings address important unmet diagnostic needs and indicate the potential of plasma-based Mtb ccfDNA detection to contribute to improved TB case detection and progress towards the WHO End TB goals," they added.

The WHO End TB Strategy

In 2024, an estimated 10.7 million people fell ill with TB worldwide, including 5.8 million men, 3.7 million women and 1.2 million children. TB is present in all countries and age groups, according to the World Health Organization (WHO).

The WHO aims to End TB by 2035, with a 95 percent reduction in deaths and a 90 percent reduction in incidence compared to 2015.