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!

On most clinic days, I meet patients who are doing what they believe is “everything right” for their diabetes—avoiding sweets, switching to brown rice, walking regularly. Yet their blood sugar remains stubbornly high, and complications quietly advance. When we look closer, the problem is often not just what they are cutting out, but what they are missing.

This is where the story changes. In the larger conversation on diabetes, protein rarely takes center stage. But it should.

India’s Diabetes Burden: Looking Beyond Sugar

India continues to carry one of the world’s largest burdens of Type 2 diabetes. Urban lifestyles, reduced physical activity, and easy access to refined carbohydrates have all played their role. Public messaging has, understandably, focused on reducing sugar intake.

But diets are not built on sugar alone. In countless Indian homes, especially those of vegetarians and people with limited means, the bulk of the diet revolves around cereals. Rice, wheat, or millets dominate the plate.

Protein, on the other hand, tends to be an afterthought. This creates a subtle but important imbalance: a high intake of carbohydrates coupled with insufficient protein. It's a problem that seldom gets much attention, yet it has a profound impact on metabolic health.

Understanding the Real Culprit: Insulin Spikes

To grasp the significance, let's break down the post-meal process. Eating foods high in carbohydrates, particularly those that are refined, causes a swift influx of glucose into the bloodstream. The body's response is to release insulin, a hormone that facilitates the transport of glucose into cells. While occasional spikes are perfectly normal, frequent and repeated ones put a strain on the system.

As the years pass, our cells start to ignore insulin's signals. This phenomenon, insulin resistance, is the primary problem in Type 2 diabetes. In response, the pancreas kicks into overdrive, cranking out extra insulin to try to keep up. However, this increased demand takes its toll. This slow decline in pancreatic function is what fuels the disease's advancement and opens the door to further health issues.

Also read: Diabetes Diet Plan: South Indian Breads That Are Better Than Roti

Protein: The Quiet Regulator

Now, where does protein fit into this? Protein does not cause sharp rises in blood sugar. In fact, when included in meals, it acts as a natural regulator. It slows down how quickly the stomach empties, meaning glucose enters the bloodstream more gradually. It also promotes a sense of fullness, reducing the tendency to overeat.

More importantly, protein helps maintain muscle mass—and muscle is one of the body’s largest sites for glucose utilization. Simply put, healthier muscles mean better sugar control.

A meal that includes adequate protein alongside carbohydrates behaves very differently from one that is carb-heavy and protein-poor.

The Invisible Problem: Hidden Protein Deficiency

Protein deficiency is not always obvious. Many individuals appear well-fed, even overweight, yet lack adequate protein at a cellular level. This is often referred to as “hidden malnutrition.”

In people living with diabetes, this becomes particularly concerning.

Low protein intake contributes to gradual muscle loss, especially with ageing. This loss—known as sarcopenia—reduces metabolic efficiency and worsens insulin resistance. Recovery from illness slows down. Wound healing becomes less effective. The body, in a sense, loses its resilience.

Also read: Shift to Plant-Based Proteins, Low-Fat Dairy To Boost Heart Health: American Heart Association

When Deficiency Meets Disease: A Compounding Risk

Diabetes is not just about blood sugar numbers; it is about long-term impact.

When protein intake is inadequate, the risks multiply. Nerve damage becomes more likely. Kidney health may deteriorate faster. Physical strength declines, increasing frailty and reducing quality of life.

There is also a vicious cycle at play. Reduced muscle mass leads to poorer glucose control, which in turn accelerates further muscle breakdown. Breaking this cycle requires more than medication—it requires nutritional correction.

Also read: 1 In 4 Diabetic Patients in India Suffer from Liver Fibrosis, Finds Lancet Study

How Much Protein Do We Really Need?

For most healthy adults, daily protein needs are modest but essential—roughly 0.8 grams per kilogram of body weight.

In individuals with diabetes, requirements are often slightly higher, around 1.0 to 1.2 grams per kilogram per day. However, this must always be individualized, especially in those with kidney disease or other medical conditions.

The key message is not excess, but adequacy—and consistency.

Making It Practical: The Indian Plate Reimagined

The good news is that improving protein intake does not require expensive supplements or drastic dietary changes.

For vegetarians, traditional foods offer excellent options: dals, chickpeas, kidney beans, paneer, curd, soy products, nuts, and seeds. For those who consume non-vegetarian foods, eggs, fish, and lean meats provide high-quality protein.

The simplest strategy is also the most effective: ensure that every meal contains a meaningful source of protein.

A bowl of dal with lunch, a serving of curd with dinner, or an egg at breakfast—these small additions can create a measurable difference over time.

Also read: What Is The Viral ‘Boy Kibble’ Trend?

Beyond Diet: Completing the Picture

Nutrition does not work in isolation. Regular physical activity—particularly resistance exercises—helps preserve and build muscle mass, enhancing insulin sensitivity. Adequate sleep supports hormonal balance. Stress management prevents metabolic disruptions that worsen glycemic control.

Diabetes care is not a single intervention; it is a continuum of daily choices.

Conclusion: Rethinking What We Prioritize

For too long, diabetes management has been framed as a battle against sugar alone. While reducing excess carbohydrates remains important, it is only half the story.

The other half lies in restoring balance. Addressing the protein gap offers a simple, accessible, and powerful tool to stabilize blood sugar, protect muscle health, and reduce long-term complications.

Protein is not just another nutrient on the plate. In the context of diabetes, it is part of the treatment itself.

In today’s digital age, screens have become almost inseparable from daily life—even for very young children. While technology offers convenience and learning opportunities, increasing clinical observations have raised concerns about a phenomenon often referred to as “virtual autism." In an interview with Health and Me, Dr Aarti Javeri Manek, Paediatric Neurologist at Sir HN Reliance Foundation Hospital, explained what virtual autism is and the impact of screen time on children's brain health.

What is “virtual autism”?

Virtual autism is not a formally recognised medical diagnosis but rather a descriptive term used for children—typically toddlers—who exhibit autism-like features in the context of excessive screen exposure, particularly during critical periods of brain development. These children may show reduced eye contact, delayed speech, poor social interaction, and limited responsiveness to their environment.

Also Read: Cancer Is The 10th Leading Cause Of Death In Indian Children: Study

However, it is crucial to distinguish this entity from clinical Autism Spectrum Disorder (ASD). ASD is a neurodevelopmental condition, often with a strong underlying genetic and biological basis, present in addition to exogenous influences. External stimulus exposure may not even be apparent. In contrast, children with virtual autism often demonstrate significant improvement when screen time is reduced and replaced with real-world, interactive experiences. This reversibility is a key differentiating factor.

Read more: Is My Child Shy Or Autistic? Psychiatrist Shares Tips To Help Parents Spot Early Signs

What early signs should parents watch for?

From a neurological perspective, early childhood is a period of rapid synaptic growth, heavily influenced by sensory and social input. When screens replace human interaction, this can impact language acquisition, attention, and social interaction.

Some red flags that may suggest screen-related developmental delays include:

1. Limited or absent eye contact
2. Reduced response to name
3. Delayed speech or loss of previously acquired words
4. Preference for screens over people
5. Decreased or limited gestures (not pointing, showing, or sharing interest)
6. Repetitive behaviours such as watching the same videos excessively or viewing the same rhyme persistently
7. Irritability or meltdowns when screens are removed

While these signs overlap with autism, the context is important. A history of prolonged, unsupervised screen exposure, often exceeding 3–4 hours per day in toddlers, should prompt consideration of environmental impact.

Read more: Can Cell Therapy Be The Future Of Autism Treatment?

Are toddlers at greater risk compared to older children?

Yes, significantly so. The first three years of life are critical for brain development, particularly for language, social bonding, and emotional regulation. During this period, the brain relies heavily on serve-and-return interactions—a child babbles, a caregiver responds; a child points, and a parent names the object. These exchanges build neural circuits essential for communication and cognition.

Screens, even educational ones, are inherently passive. They do not adapt in real time to a child’s cues in the same way a human does. Excessive exposure during this sensitive window can therefore displace meaningful interactions, leading to significant developmental delays.

Older children, while not immune, are generally more resilient, as they have already established foundational social and language skills. However, excessive screen time in this group may still contribute to attention difficulties, behavioural issues, and reduced social engagement.

What can parents do?

The encouraging aspect of virtual autism is its potential reversibility if it is identified early. Reducing screen exposure, especially in children under 2 years, and reintroducing interactive play, storytelling, and face-to-face communication may lead to noticeable improvements. Ultimately, screens are tools and not substitutes for relationships. In early childhood, it is these relationships that shape the developing brain most profoundly.

For some people, getting inked is more than a passion—it is a form of self-expression. And tattoos are nothing short of an addiction; it is not easy to stop at one. Despite being a painful procedure that requires a great deal of caution—using fresh needles and safe ink, for instance—several incidents come to light where getting a tattoo goes wrong in irreversible ways. In a recent case, a man developed a weeping, black ulcer of dead flesh on his neck months after getting a tattoo. In this case, doctors blamed this reaction on the colour of the tattoo ink—it may have triggered inflammation that caused the skin to blacken and die.

A reaction from the tattoo ink

A 20-year-old man had a red cross tattoo on the base of his neck. After three months, it faded away spontaneously and was replaced by scars and bumps on either side of the neck, accompanied by a necrotic ulcer. In this case, when the tissue blackens and dies, it results in a painful wound. The unnamed man was hospitalised five months after getting his first tattoo. Doctors examining the patient found that the lymph nodes, which help fight infections, were swollen and hard. Doctors also examined a large crusted ulcer, which had spread across the base of the neck and had seeped into deeper layers of skin.

Read more: Tattoos May Increase Cancer Risk, Study Suggests

Doctors also performed an MRI and found large lumps around the ulcer that measured up to 5 cm. There were two blood clots in the jugular vein as well. Two biopsies were taken of the necrotic ulcer, but they did not reveal what may have triggered the necrosis. The team was then concerned about the scan results and how fast the patient's condition was progressing. He was then rushed into surgery, where doctors removed the ulcer along with masses on the neck. His neck was then reconstructed using fat from the thighs. The patient was then diagnosed with necrotising granulomatous lymphadenitis.

What is necrotising granulomatous lymphadenitis?

Necrotising granulomatous lymphadenitis is an inflammatory condition wherein the lymph node tissues die and form clumps of immune cells known as granulomas. This can develop in response to an injury, and in this case, doctors said that the tattoo was to blame.

Doctors said that heavy metals like cadmium and mercury in organic tattoo ink can result in an immune response. From surgery to recovery, the patient's case is published in the journal JAMA Otolaryngology. Experts say that this is only the second known case of necrosis after a tattoo.

What are the riskiest spots for a tattoo?

Getting a tattoo can be painful, but for some people, the pain is worth it. However, according to experts, there are some spots that are not ideal for getting a tattoo. These are:

1. Eyes—can lead to partial or complete blindness
2. Genitals – heightened risk of contracting sexually transmitted diseases and infections
3. Spine – a tattoo on the spine is extremely painful, and if it goes wrong, there could be irreversible repercussions