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!

For many long-term cannabis users, the usual jokes about the munchies feel far removed from reality. Over recent years, emergency rooms have reported a steady rise in regular smokers arriving with sudden bouts of severe stomach distress that leave them curled up and unable to function. What makes it more troubling is that these episodes return several times a year, often leaving both patients and clinicians unsure of what is going on.

Scromiting: What is Cannabis Hyperemesis Syndrome (CHS)?

The source of the problem is cannabis hyperemesis syndrome (CHS), a difficult condition marked by unrelenting nausea, strong abdominal cramps and repeated vomiting that can occur four or five times an hour, according to the Cleveland Clinic.

What Is Scromiting?

Symptoms usually appear within a day of cannabis use and can linger for several days. These episodes can be so overwhelming that emergency staff have adopted the term “scromiting,” a blend of screaming and vomiting that captures how distressing it can be.

Although cases have become more common, many healthcare workers are still relatively unfamiliar with CHS because it was only identified in recent years. This makes it easy to confuse with other illnesses such as foodborne infections or stomach bugs.

“A person often will have multiple emergency visits before the condition is correctly identified, which can be very costly,” said Dr. Beatriz Carlini, a research associate professor at the University of Washington School of Medicine who studies the health risks linked to cannabis. Once a diagnosis is made, managing the condition can still be a challenge.

There are no approved treatments at present, and many standard nausea medications fail to bring relief, explained Dr. Chris Buresh, an emergency medicine physician with UW Medicine and Seattle Children’s Hospital.

This often pushes doctors to try less common options, including Haldol, a drug usually used to manage psychosis. Some people experience temporary improvement from applying capsaicin cream to the abdomen, as the warming sensation can help lessen discomfort for short periods.

Hot baths and showers are another frequent source of relief. Many patients report staying in the bathroom for long stretches to calm their symptoms.

“That is often something that helps confirm the diagnosis for me,” Buresh said. “People say a hot shower is the only thing that brings any comfort, and they end up using all the hot water in the home.”

Scromiting Recovery Challenges

Once the worst phase passes, long-term improvement is not always straightforward. Because CHS comes and goes, some cannabis users assume an episode was caused by something else and continue smoking, only to fall ill again, according to UW researchers.

Even for those who accept the diagnosis, quitting cannabis can be difficult due to dependence, which prolongs the cycle of nausea and vomiting, Carlini said. The only known cure is to stop cannabis use entirely.

Researchers still do not know the exact biological cause of CHS. The leading idea is that years of heavy cannabis use overstimulates receptors within the endocannabinoid system, which may disrupt the body’s usual control over nausea and vomiting, as outlined by the Cleveland Clinic.

Why this affects certain users and not others remains unclear. “We do not yet know if it is tied to wider access to cannabis, higher THC levels, or something else entirely,” Buresh said.

“There seems to be a point at which people become vulnerable to this condition, and that point varies from person to person,” he added. “Even small amounts of cannabis can trigger vomiting once someone crosses that threshold.”

A study released earlier this year by George Washington University researchers examined 1,052 people with CHS to learn more about potential risk patterns.

The findings showed that those who began using cannabis at younger ages were more likely to return to the ER with hyperemesis episodes. Many reported daily use and long-term consumption, with 44 percent using cannabis regularly for more than five years before symptoms began.

CHS is not limited to adults. Data shows that emergency visits among American adolescents have increased more than tenfold between 2016 and 2023. While overall rates tend to be higher in states where recreational cannabis is legal, the sharpest year-to-year rise in adolescent CHS cases has been recorded in states where recreational use is still against the law.

People who rely on a commonly prescribed medicine may face a kidney-related side effect that needs medical attention. This drug is routinely used for high blood pressure and heart failure, and doctors often prescribe it after a heart attack. In 2024 alone, it was issued 34.8 million times. Beyond lowering the risk of future heart attacks, strokes, and kidney problems, it also improves survival when taken for heart failure or after a cardiac event. But which medicine raises this concern?

NHS ‘Kidney’ Warning For People Taking Ramipril

Ramipril (sold under names such as Altace, Vostally, Tritace, Cardace) belongs to a group of medicines called ACE inhibitors. Doctors use it to treat a range of heart and blood vessel problems because it relaxes and widens the arteries, easing pressure on the heart and reducing blood pressure. It is usually taken as a tablet, capsule, or liquid. Although ramipril is helpful for many people managing long-term blood pressure or heart issues, it can occasionally trigger side effects. Some reactions may be strong enough to require urgent medical help.

Is Ramipril a Beta Blocker?

Ramipril is not a beta blocker. It belongs to a group of medicines called ACE inhibitors. Both ACE inhibitors and beta blockers are used for blood pressure and heart problems, but they do not work the same way.

How Ramipril Works (ACE Inhibitor)?

Ramipril stops the body from making a certain enzyme known as ACE. When this enzyme is blocked, the body produces less angiotensin II, a hormone that normally tightens the blood vessels. With less of this hormone active, the blood vessels stay more open, which lowers blood pressure and helps blood move through the body more easily.

Ramipril Side Effects

Not everyone who takes ramipril will feel unwell, yet it can cause problems for certain users. NHS advice notes that long-term use may reduce how well the kidneys work. For that reason, anyone on ramipril may need routine blood tests so that their doctor can keep an eye on kidney function.

More common side effects, which may affect more than one in a hundred people, include:

• A light skin rash
• Blurred eyesight
• A dry or tickly cough
• Diarrhoea
• Vomiting
• Headaches
• Feeling faint or dizzy

Ramipril can also lead to more serious issues, though these are rare. These include:

• Kidney concerns shown by blood in urine, little or no urination, or puffy ankles
• Possible bone marrow problems such as unusual tiredness, frequent bruising, dizziness, or fever
• Yellowing of the skin or eyes, which can suggest a liver problem
• Severe pain in the stomach

In rare situations, ramipril can cause a serious allergic reaction known as anaphylaxis. The NHS advises seeking emergency help if this happens. Signs include:

• Swelling of the lips, throat, or tongue
• A tight throat or trouble swallowing
• Sudden confusion
• Fainting and not waking up normally
• Blue, grey, or pale skin, lips, or tongue
• Very rapid breathing or difficulty breathing

More information about ramipril is available on the NHS website. Always speak with your doctor before beginning or stopping any prescribed medicine.

Every year on December 1, World AIDS Day reminds us that HIV continues to be a global concern, and in 2025 the focus is on "Overcoming disruption, transforming the AIDS response. Early testing and treatment are key to making that transformation real. The sooner HIV is detected and treated, the better the long-term health outcomes. India has made notable progress.

According to 2023 estimates, adult HIV prevalence is around 0.2%, and prevention and treatment programmes using medication continue to expand. Still, challenges remain: gaps in testing, delayed diagnoses, and interruptions in care persist—issues World AIDS Day 2025 urges us to address.

World AIDS Day 2025: Why HIV Diagnosis Is Important

HIV is still a very real health concern today. It can affect anyone, students, professionals, or those in stable relationships—especially if needles or syringes are shared or protection is not used.

Once HIV enters the body, it gradually weakens the immune system. If left undetected and untreated, it can progress to AIDS, leaving even minor infections dangerous. The good news is that this progression can be prevented. With early testing and proper treatment, people living with HIV can lead full, healthy, and normal lives.

Dr. R K Gattani, Senior Consultant Physician at Kailash Hospital & Heart Institute, Noida, says, "Early testing is an important form of self-care. Choosing to get tested shows you are taking responsibility for your health—it doesn’t mean something is wrong."

Meanwhile, Dr. Vaibhav Gupta, Senior Consultant in Internal Medicine, Critical Care, and Diabetology at Regency Health Kanpur, adds, "Detecting HIV early allows doctors to begin Antiretroviral Therapy (ART) straight away, keeping the immune system strong, preventing AIDS, and reducing transmission risk almost to zero. In a world where millions are diagnosed each year, early recognition is one of the strongest tools young Indians have to protect themselves and their partners."

What Is Modern Antiretroviral Therapy?

Today’s ART enables people diagnosed early to live long, healthy, and productive lives. It keeps the virus under control, safeguards the immune system, and dramatically lowers the chance of passing HIV to others. Early diagnosis also gives young people the knowledge to make safer lifestyle choices.

Dr. Aabid Amin Bhat, Medical Director at Ujala Cygnus Group of Hospitals, explains, "Encouraging open discussions, expanding access to youth-friendly testing, and fighting stigma are essential steps. When HIV is found early, it’s not the end; it’s the start of informed care, timely treatment, and a healthier future."

The challenge is that early HIV symptoms often look like common illnesses like fever, fatigue, sore throat, swollen lymph nodes, and rashes—which can be easily ignored. Without prompt testing, the virus may advance silently, making treatment more complex. Early testing also opens doors to preventive options like post-exposure prophylaxis (PEP), which can prevent infection if taken within 72 hours of potential exposure. Recognizing early signs and seeking confidential, judgment-free testing allows young Indians to stop HIV before it develops into AIDS, turning a potentially life-altering diagnosis into a manageable condition.

HIV prevention is simpler than many think. Basic precautions like using protection during intimate contact, avoiding sharing needles or items that could contact blood, and staying informed about your health—make a huge difference. Anyone who may have been exposed should immediately consult a healthcare professional for guidance. Above all, don’t hesitate to get tested, ask questions, or seek help. Taking care of your health is the most responsible and empowering way to protect your future. People living with HIV, when on proper treatment and taking necessary precautions, should not automatically be seen as a risk to others.

Education and awareness remain key. Safe practices, timely diagnosis, and access to treatment can transform HIV from a feared disease into a manageable condition, giving young Indians control over their health and future.