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!

When the heart stops functioning, time doesn’t stop with it. In cases of cardiac arrest, time serves as one of the most decisive factors between survival and irreversible loss. Within a couple of seconds, the body starts losing its oxygen supply. In a few minutes, the brain starts to suffer damage. And with each passing minute without intervention, the chances of survival reduce significantly.

This severe reality is at the centre of what Dr Ankit Desai, Paediatric Anaesthetist and Founder & Director of Children’s Anaesthesia Services, explains as “a race against biological shutdown — one where the bystander is the only lifeline”.

The silent collapse: what happens in cardiac arrest

Several people have the misconception that cardiac arrest is similar to a heart attack, but they are very different. A heart attack is a circulatory issue where the heart might still be beating. However, in cases of cardiac arrest, there is an electrical failure, and the heart suddenly stops pumping blood effectively.

Whenever this occurs, blood flow to the brain and other vital organs ceases immediately. The oxygen reserves in the brain are extremely limited and typically last for about 4 to 6 minutes before any permanent injury occurs.

This is where the concept of time sensitivity becomes more important. For every passing minute without CPR or defibrillation, the chances of survival drop by approximately 7–10%. By the time 10 minutes have elapsed without intervention, survival is extremely unlikely in most cases.

“The tragedy is not just the cardiac arrest itself,” explains Dr Desai, “but the silence that follows — when no one knows what to do or hesitates too long to act.”

The brain’s narrow window of survival

The brain is the first organ to be affected during cardiac arrest. Neurons are highly sensitive to oxygen deprivation. Brain cells start to malfunction within 3 minutes. By 5 minutes, the damage starts becoming increasingly severe. Beyond 10 minutes, the chances of meaningful recovery drastically reduce. This is why immediate CPR is not just a supportive measure but a bridge that keeps oxygen flowing artificially until a normal rhythm can be restored.

Chest compressions manually pump blood to the brain and heart, delaying cell death.

Why bystander action matters more than ambulance time

Emergency medical services, even in well-equipped systems, often take several minutes to reach a patient. In urban areas, response times may be shorter, but they are rarely instantaneous. In cardiac arrest, those minutes matter more than any hospital intervention.

Dr Desai emphasises that “the first responder is almost always not a doctor — it is a family member, a colleague, or a nearby stranger”.

This makes bystander CPR the most critical determinant of survival. Studies consistently show that when CPR is initiated immediately, survival rates can double or even triple compared to cases where no bystander action is taken.

Yet fear, hesitation, and lack of training remain major barriers. Many people worry about performing CPR incorrectly, causing harm, or being held legally responsible. In reality, doing nothing is far more dangerous than taking imperfect action.

The Chain of Survival: breaking down the timeline

Medical professionals often refer to this situation as the “Chain of Survival”, which includes early detection of cardiac arrest, immediate CPR, rapid defibrillation (AED use), advanced medical care, and post-resuscitation support. Every link in this chain is highly time-sensitive. Any delay in one step weakens the entire outcome. The strongest determinant, however, remains the second step — early CPR.

Automated External Defibrillators (AEDs), if available, can help restore a normal heart rhythm if used quickly. But again, their effectiveness decreases sharply with delay. The combination of CPR and early defibrillation within the first few minutes offers the best chance of survival.

Why awareness changes everything

The key difference between life and death is less about complexity and more about readiness.

Awareness training helps transform bystanders into responders. A person who knows how to identify cardiac arrest — unresponsiveness, absence of breathing, sudden collapse — is far more likely to act immediately rather than wait.

Dr Desai highlights a critical cultural gap: “We often associate medical emergencies with hospitals. But cardiac arrest begins in living rooms, offices, gyms, and streets. The response must begin there, too.”

Basic CPR training takes less than an hour to learn, but can influence outcomes for decades. Schools, workplaces, and community programmes play a vital role in normalising this skill.

Overcoming hesitation: the psychological barrier

One aspect of cardiac arrest that often gets overlooked is human hesitation. Bystanders often freeze due to shock and uncertainty. Some assume that someone else will step in. Others underestimate the severity of the situation.

Public awareness campaigns help highlight the simplicity of CPR, which helps overcome this barrier. Hands-only CPR focuses on continuous chest compressions without mouth-to-mouth breathing, making intervention much easier and more accessible. The message is simple: push hard, push fast, and don’t stop until help arrives.

A shift from reaction to preparedness

Cardiac arrest survival is not just a medical issue, but also one of public preparedness. The Chain of Survival starts long before the emergency happens. It starts with education, confidence, and awareness.

Dr Desai states that “if more people understood how little time they truly have, more lives would be saved not by hospitals, but by ordinary people doing extraordinary things in the first five minutes”.

Conclusion: time is the real patient

In cardiac arrest, the patient is not just the person who collapses — it is time itself. Every second lost reduces the chance of recovery. Every trained bystander becomes a potential lifesaver. The science is clear, the timeline is unforgiving, and the solution is remarkably simple: act immediately, compress the chest, and keep blood flowing until professional help arrives.

For years, PCOS was often diagnosed through the most visible disruptions: irregular periods, acne, facial hair, weight gain, or difficulty conceiving. That made many patients enter the healthcare system through gynecology, usually when menstrual, reproductive, or visible hormonal symptoms became hard to ignore.

The shift from Polycystic Ovary Syndrome to Polyendocrine Metabolic Ovarian Syndrome encourages clinicians to look earlier, wider, and more systematically at the condition.

A Wider Starting Point

The old name placed the ovary at the center of the condition. PMOS keeps ovarian function in the picture, but it widens the diagnostic lens to include the hormone and metabolic systems that are often involved from the start. This distinction matters because the condition is not defined by harmful ovarian cysts. In fact, ovarian cysts are not required for diagnosis, and some women with PCOS may not show polycystic ovaries on ultrasound at all. The newer name, therefore, helps move diagnosis beyond a scan-based or ovary-only understanding, and closer to how the condition actually presents and manifests itself in the body.

From Period Problem To Whole-body Assessment

With PMOS, diagnosis should become less dependent on ultrasound and more attentive to the full clinical pattern. Doctors will still look at irregular or absent periods and signs of high androgen levels, such as acne, excess facial or body hair, hair thinning, and raised testosterone levels, where tested. But the newer framing should also make metabolic screening routine, especially for insulin resistance, type 2 diabetes risk, blood pressure, cholesterol, obesity, sleep apnea, and fatty liver-related concerns. WHO describes PCOS as a chronic metabolic condition that can persist beyond the reproductive years, with symptoms and risks varying from person to person.

PMOS: Why This Change Could Reduce Missed Diagnosis

The scale of underdiagnosis is large. It is estimated that PCOS affects 10–13% of reproductive-aged women, while up to 70% of affected women worldwide may not know they have the condition. A name that leads with “polyendocrine” and “metabolic” may help clinicians connect symptoms that were previously treated separately: a dermatologist sees acne, a gynecologist sees irregular periods, an endocrinologist sees insulin resistance, and a mental-health professional sees anxiety or poor quality of life.

What Needs To Change Now

The diagnosis is not changing into a different disease. The condition remains the same, but the way it is understood may become broader and more accurate. The real opportunity lies in better recognition: fewer patients being told their symptoms are only about cysts, weight, periods or fertility, and more patients being assessed for the long-term hormonal and metabolic risks that can come with the condition.

For this shift to matter, awareness must grow across the medical fraternity and among patients, so PMOS is approached as a multi-system condition; symptoms are recognized earlier, and care becomes more connected from the beginning.

(Written by Dr. Rashmi Dharaskar, Sr. Consultant Obstetrics and Gynaecologist at Surya Mother & Child Super Specialty Hospital).

When Indian summers touch 48 degrees, it’s no longer just uncomfortably hot—it’s a serious public health challenge. Extreme heat affects everything from hydration levels in the body to digestion, the health of your skin, heart, and even mental well-being. Surviving (and staying healthy) through such brutal temperatures requires 360-degree body care, not just an extra glass of water or switching on the AC.

Dr P. Venkata Krishnan, Senior Consultant & Director—Internal Medicine, Narayana Hospital, Gurugram, in an interview with Health and Me, shared a complete and practical survival plan to help your body cope with the extreme Indian summer—inside and out.

Hydration: Go Beyond Plain Water

In intense heat conditions, your body loses water and electrolytes very quickly through sweat. Electrolytes help carry water to the blood and tissues. Hence, drinking only plain water in summer may not suffice. Try sipping water consistently at regular intervals instead of gulping large quantities at once. Electrolyte-rich fluids like coconut water, lemon water with a pinch of salt, or buttermilk are healthy, affordable options to soothe parched throats. Avoid excess caffeine, colas, and alcohol, as they increase dehydration; if you must indulge, have a glass of water before your coffee or alcoholic drink.

Pro tip: Check your urine colour—dark yellow is a warning sign of dehydration.

Eat Light, Cool, and Smart

Our digestive systems are also tired in extreme summers. Spicy, heavy, and oily foods generate more internal heat, which puts an additional burden on digestion. Opt for seasonal fruits like watermelon, muskmelon, papaya, and berries instead of chips and snacks.

To ease digestion, add items like curd, rice, cucumber, and bottle gourd to your meals. Avoid red meat and fried foods during peak summer days. Smaller, lighter meals are easier for the body to process in extreme heat. Find ways to increase hydration through fruits and vegetables in your food too, apart from water intake.

Protect Your Skin from Heat Damage

Heat doesn’t just tan your skin—it accelerates ageing, causes pigmentation, and triggers rashes. Incorporating a summer skincare regimen can help prevent damage to your skin.

1. Use a broad-spectrum sunscreen daily, even if you’re indoors.
2. Wear loose, breathable cotton or linen clothing.
3. Take cool (not ice-cold) showers to soothe overheated skin.
4. Seek medical advice for prickly heat, fungal infections, or sudden rashes—they thrive in sweaty conditions.

Mind Your Heart and Blood Pressure

Extreme temperatures put additional stress on the cardiovascular system, especially in people with hypertension, diabetes, or heart conditions. There are just a few things to bear in mind. When the temperature outside sizzles, avoid stepping outdoors for prolonged periods, especially between 12 pm and 4 pm, when the sun beats down mercilessly.

Take all prescribed medications exactly as advised—don’t skip doses even if you experience heat-induced nausea. If you feel dizzy or experience palpitations or severe fatigue, consult your doctor as soon as possible. Heat exhaustion can silently progress to heatstroke, which is a medical emergency.

Smart Cooling at Home and Work

Air conditioning is helpful, but overexposure can lead to dry skin, headaches, and respiratory discomfort. However, since the emphasis is more on cooler environments in summer, there are a few ways to avoid overexposure to AC.

Once every two or three hours, step away from your desk for a few minutes. Walk or stand, and sip some water. Open windows, if possible, to avoid thermal shock. Set AC temperatures between 24 and 26 degrees, despite the urge to cool the surroundings further. Use fans and cross-ventilation whenever possible, relying a little less on air conditioning in the process. Never move directly from extreme heat into freezing AC environments, or vice versa, as it can impact your body suddenly.

Sleep & Mental Well-being Do Matter

Poor sleep due to heat can increase irritability, anxiety, and fatigue. Include some calming activity before bedtime. Put away screens, as they radiate heat too. Some tips to help you sleep better:

1. A lukewarm shower before bed.
2. Well-ventilated bedrooms.
3. No heavy dinners or eating late at night; ideally, finish dinner before 9 pm, leaving a gap of a couple of hours afterwards before going to sleep.
4. Mindful slow breathing or short meditation helps control heat-related restlessness.

Special Care for Vulnerable Groups

Children, elderly individuals, pregnant women, and outdoor workers are at higher risk of heat-related health concerns. They should particularly ensure that they hydrate more frequently.

1. Watch for signs like dry mouth, lethargy, confusion, or reduced urination. Seek a doctor’s advice if needed.
2. Include cooling foods to prevent dehydration and encourage lighter, frequent meals instead of full, heavy meals.
3. Never leave children or pets inside parked vehicles or in spaces without ventilation—even for a few minutes.

A holistic approach covering hydration, nutrition, skincare, heart health, and mental well-being can help your body adapt and stay resilient. Extreme heat is not “just a bad summer." Treat it seriously, listen to your body, and make smart daily choices, because protecting yourself from the heat today prevents long-term health problems tomorrow.