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!

Amanda Peet, the Hollywood actress known for roles in Something’s Gotta Give, The Whole Nine Yards, and Jack & Jill, recently opened up about her breast cancer diagnosis and how informing her kids about her health became the toughest part for her.

In a New Yorker essay published March 21, the 54-year-old actress announced how a routine scan in August 2025 showed an unusual ultrasound result. Later, a biopsy detected a tumor that “appeared” small.

The Dirty John star found to be in stage 1 of lobular cancer that is “hormone-receptor-positive” and “HER2-negative,” making her “happier than the pre-diagnosis” stage.

It is because Hormone-receptor-positive and HER2-negative cancer is less aggressive and often easier to treat than more aggressive forms of breast cancer.

However, informing her children, Frances, 19, Molly, 15, and Henry, 11, about the cancer was the toughest part for her, and she had to be in the right mindset before sharing the news with them.

“They've been great,” Peet told E! News.

“I definitely had to get myself together before including them. The hard part was realizing that nothing is certain and there was going to be no perfect time to tell them,” she added.

Peet stated that between her diagnosis, she had also been navigating a series of family health crises — with both of her parents' final months in hospice care.

The Your Friends & Neighbors actress, in her essay, also noted that she would “only need a lumpectomy and radiation,” not a double mastectomy.

Also read: Jane Fallon Diagnosed With Breast Cancer, This Is How She Caught It Early

What is Lobular Cancer?

Invasive Lobular Carcinoma (ILC) the second most common form of breast cancer, representing 5 to 15 percent of breast cancer cases.

Rather than a distinct lump, it can appear as a thickening or "fullness" rather than a tumor.

It is often difficult to detect on mammograms, thus MRI or ultrasound are more effective for detection

It is usually hormone receptor-positive.

Also read: Olivia Munn’s Mom Diagnosed With Breast Cancer After Actor Urges Her To Take Risk Test; What Should You Do If Cancer Runs In Your Family?

What Is Hormone receptor-positive (HR+) and HER2-negative (HER2−) Breast Cancer

HR+ and HER2− breast cancer is the most common subtype and is seen among 60–75 per cent of cases.

It is not two different cancers, but rather specific, defining characteristics of the same cancer type (breast cancer). It grows:

• due to hormones estrogen/progesterone,
• lacks excess HER2 protein,
• it can occur in either or both breasts
• has a better prognosis
• slower growth rate
• often treated with hormone therapy and sometimes chemotherapy.

Why Early Diagnosis Matters for Breast Cancer

According to the Centers for Disease Control and Prevention (CDC), breast cancer screening is a proactive checkup used to find cancer before any physical signs or symptoms appear. While screening doesn’t prevent cancer, its goal is early detection, making the disease much easier to treat.

Since every person’s body and history are different, you and your doctor should engage in informed and shared decision-making. This means discussing the pros and cons to decide together if, and when, screening is right for you.

The US Preventive Services Task Force (a group of national medical experts) provides guidelines based on the latest research:

Average Risk

Women aged 40 to 74 should generally get a mammogram every two years.

High Risk

If you have a family history or other risk factors, your doctor may recommend a different schedule or additional tests.

GLP-1 receptor agonists are a modern class of medicines that have changed the treatment of type 2 diabetes and obesity. In simple terms, they help the body respond to food more smartly. After eating, the intestine naturally sends signals that help regulate sugar and appetite levels.

GLP-1 RA medicines imitate this signal. As a result, blood sugar rises less after meals, appetite becomes more controlled, and many people feel full with smaller amounts of food. This is why these medicines are used not only for diabetes, but also for weight reduction in selected people.

GLP-1 Drugs: Not A Miracle Injection

These medicines are important because their benefits can go beyond sugar control alone. Studies and current diabetes guidelines show that some GLP-1 RAs can reduce body weight, improve long-term sugar levels, and lower the risk of major heart-related problems in people who have type 2 diabetes and high cardiovascular risk.

Recent guidance also supports their use in some people with chronic kidney disease when cardiovascular risk reduction is an important goal. This does not mean every drug in the group is identical, but it means the class has become medically important for more than just lowering sugar.

For the general public, one important point is that these are not “miracle injections.”

They work best when combined with better food choices, regular walking or exercise, good sleep, and medical follow-up. They are usually started slowly because the commonest side effects are stomach-related, such as nausea, vomiting, constipation, loose motions, or a feeling of fullness.

Not everyone is suitable for them, and the decision depends on a person’s diabetes status, weight, heart or kidney disease, other medicines, and cost. Used properly, GLP-1 RAs are powerful tools that can improve health, but they should always be taken under medical supervision.

GLP-1 Drugs: Urgent Need to Curb Misuse

So Indian Medical Association (IMA) is planning to seek a mandate restricting prescriptions of GLP-1 drugs to certified endocrinologists/diabetologists or MD general medicine practitioners to curb indiscriminate use and safeguard patient safety as access expands, many media report in August last year about rampant misuse of GLP1 weight loss drugs by cosmetologists, physiotherapists, dermatologists, general MBBS clinicians, and even ayurveda, and other non-modern medicine practitioners.

Many MBBS, physiotherapists, and non-modern medicine practitioners are prescribing GLP1 drugs to people who neither have diabetes nor any comorbidity or acute obesity, but purely for cosmetic reasons to lose some weight that can be otherwise easily done with some lifestyle changes like exercise and diet.

It is a duty of the government to take care of it because there is a lot of misuse and misprescription that needs to be curbed immediately, because these medicines also have side effects.

We will write to the government to take necessary action to stop the misuse of the drug. We will discuss it in our meeting in the first week of April 2026.

One in four or 25 percent of adults with type-2 diabetes in India also suffer from liver fibrosis, according to an alarming study published in The Lancet Regional Health Southeast Asia journal today.

With data from more than 9,000 patients across the country, it is the largest ever real-world survey of liver fibrosis in type 2 diabetes from any low- or middle-income country.

While fatty liver disease has been touted as the most common liver condition among diabetes patients, the new study established liver fibrosis as the real danger among people with high blood sugar.

“Type 2 diabetes is closely linked to fatty liver disease (also known as MASLD). But how common is liver Fibrosis — the real danger — in Indian diabetics? Our answer: 1 in 4 has clinically significant liver fibrosis. One in 20 already has probable cirrhosis. Most had no symptoms. We propose liver fibrosis as the ‘4th major complication’ of diabetes,” said Ashish Kumar, from Ganga Ram Postgraduate Institute of Medical Education and Research (GRIPMER), from Sir Ganga Ram Hospital, in a post on social media platform X.

Also read: About 84% IT Employees Are Suffering With Fatty Liver Disease - Why Screenings Are Necessary For Corporate Workers

What Did The Study Find?

Fatty liver is typically the first and reversible stage of liver disease, where excess fat builds up in liver cells. Left untreated, it progresses to liver fibrosis, which is the excessive accumulation of scar tissue (collagen) in the liver resulting from chronic inflammation. The condition then progresses to the third and late stage, irreversible scarring (fibrosis) of the liver. The final stage is liver cancer.

The DiaFib-Liver Study included a total of 9,202 adults with type-2 diabetes patients who underwent FibroScan (VCTE) to assess liver fibrosis in routine diabetes care.

Of these:

• 26 percent had clinically significant fibrosis,
• 14 percent had advanced fibrosis,
• 5 percent had probable cirrhosis
• 65 percent had fatty liver disease.

• obesity
• dyslipidaemia
• kidney problems
• diabetes duration ≥10 years.

Fibrosis: The Screening Target

The study suggested the urgent need to integrate fibrosis screening into national diabetes programs.

“One in four adults with type 2 diabetes in India has clinically significant liver fibrosis and one in twenty already has probable cirrhosis, establishing advanced liver disease as a 'fourth major complication' of diabetes,” said the researchers.

“The DiaFibLiver Study calls for: Fibrosis — not steatosis — as the screening target. FibroScan integration into routine diabetes care. Moving beyond ultrasound-based referral,” Jha said.

“We hope this data from India adds to the global conversation on diabetes and liver disease,” he added.

Also read: The Silent Rise of Fatty Liver Disease: How India-Specific Guidelines Can Help

The findings highlight the urgent need to:

• move beyond steatosis
• systematically integrate fibrosis assessment into routine diabetes care,
• deploy non-invasive tools such as vibration-controlled transient elastography (VCTE) in community practice
• define screening strategies,
• evaluate therapeutic interventions.

Everyday Habits That Harm the Liver

Certain lifestyle choices can accelerate liver damage, such as:

Overeating processed or fried foods

High sugar intake (soft drinks, sweets, desserts)

Physical inactivity or prolonged sitting

Ignoring health issues like diabetes or hypertension

Crash dieting or taking unprescribed supplements.

How To Improve Liver Health?

Early screening and detection are key to prevent irreversible stages. Yet liver disease can be prevented with lifestyle changes such as:

• Eating a balanced diet with vegetables, fruits, whole grains, and lean protein
• Engaging in at least 30 minutes of exercise daily
• Staying hydrated to help the liver flush out toxins
• Avoiding alcohol and smoking
• Avoiding self-medication and unnecessary pills
• Getting routine health screenings.