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!

Blood cancers are among the most challenging, but advances in treatments, such as targeted therapies, advanced transplantation techniques, and increasingly customized approaches, are offering a new ray of hope for patients. Among these innovations, Chimeric Antigen Receptor T-cell therapy, commonly known as CAR-T cell therapy, represents one of the most important breakthroughs in modern cancer care in recent times.

Unlike conventional treatments that directly target cancer cells, CAR-T cell therapy harnesses the patient's immune system to identify and attack cancer. It is a powerful example of how medicine is moving towards personalized treatment strategies that are designed around an individual's disease biology.

How CAR-T Cell Therapy Works

To understand CAR-T therapy, it is important to understand the role of T-cells. These are specialized immune cells responsible for recognizing and eliminating abnormal cells in the body. In some blood cancers, cancer cells develop mechanisms that allow them to evade immune surveillance. CAR-T therapy addresses this challenge by genetically modifying a patient's T-cells in a laboratory to recognize specific proteins present on cancer cells.

The process begins with the collection of T-cells from the patient's blood through leukapheresis. These cells are then engineered to express specialized receptors, called chimeric antigen receptors (CARs), which enable them to recognize cancer cells more effectively. Once modified and multiplied, the cells are infused back into the patient's bloodstream, where they seek out and destroy cancer cells.

Potential of CAR-T

Currently, CAR-T cell therapy has shown encouraging results in several blood cancers, including certain forms of acute lymphoblastic leukemia, diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma, follicular lymphoma, and multiple myeloma. For some patients whose disease has relapsed after multiple lines of treatment or failed to respond to conventional therapies, CAR-T therapy has offered a valuable new treatment option.

One of the most promising aspects of CAR-T therapy is its potential for durable responses. In selected patients, the engineered immune cells can continue to remain active within the body, providing ongoing surveillance against cancer recurrence. While every patient may not experience the same outcome, the ability to achieve long-lasting remission in heavily pre-treated cancers has generated significant optimism within the oncology community.

CAR-T therapy: The Challenges And Side Effects

All that being said, CAR-T therapy is a highly specialized treatment that requires careful patient selection and close monitoring. Some patients may also experience side effects such as cytokine release syndrome (CRS), neurological complications, or temporary suppression of normal blood cell production. Fortunately, advances in supportive care and growing clinical experience have substantially improved the management of these complications.

The Future of Blood Cancer Care

Researchers across the world are working on next-generation CAR-T platforms designed to improve effectiveness, reduce toxicity and expand treatment eligibility. Investigational approaches include "off-the-shelf" CAR-T products derived from healthy donors, dual-target CAR-T cells capable of recognizing multiple cancer markers, and therapies aimed at overcoming treatment resistance.

Scientists have also been exploring the potential of CAR-T therapy in other blood cancers and even selected solid tumors. While significant challenges remain, ongoing research continues to push the boundaries of what immune-based therapies can achieve. As research advances and access continues to improve, CAR-T cell therapy is expected to play a very important role in the future of blood cancer care. For patients, families, and clinicians alike, it represents a powerful reminder that innovation continues to redefine what is possible in the fight against cancer.

(By Dr. Dinesh Bhurani, Director – Hemato-Oncology & Bone Marrow Transplant, Rajiv Gandhi Cancer Institute & Research Centre (RGCIRC))

Keeping your cholesterol levels in a healthy range is one of the best things you can do for your heart. High cholesterol is a major risk factor for heart disease, but the good news is that what you eat can make a significant difference. While some people may need medication, research shows that certain foods can naturally help lower LDL cholesterol and support overall cardiovascular health.

One of the easiest places to start is with oats. Oats are packed with a soluble fiber called beta-glucan, which helps reduce the amount of cholesterol absorbed into your bloodstream. A review published in Nutrients found that regularly eating oat beta-glucan can lead to meaningful reductions in LDL cholesterol, especially when combined with an overall heart-healthy diet.

Legumes such as beans, lentils, and chickpeas are another powerful addition to your plate. They're rich in fiber and plant-based protein, making them an excellent alternative to processed meats and other foods high in saturated fat. Research has consistently linked regular legume consumption with lower LDL cholesterol levels and better heart health.

Nuts also deserve a place in a cholesterol-friendly diet. Almonds, walnuts, and other tree nuts provide healthy unsaturated fats, fiber, and antioxidants. According to studies published in the American Journal of Clinical Nutrition, moderate nut consumption can help improve cholesterol levels and support cardiovascular health.

Fatty fish like salmon, sardines, and mackerel are well known for their heart-protective benefits. These fish are rich in omega-3 fatty acids, which can help lower triglycerides and support healthy blood vessels. The American Heart Association recommends eating fatty fish at least twice a week as part of a balanced diet.

Fruits and vegetables remain some of the most important foods for maintaining healthy cholesterol levels. Apples, berries, oranges, leafy greens, and broccoli provide fiber, vitamins, antioxidants, and plant compounds that help protect the heart. Numerous studies have shown that diets rich in fruits and vegetables are associated with a lower risk of cardiovascular disease.

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Avocados are another heart-smart choice. They contain monounsaturated fats and fiber, both of which can help improve cholesterol levels when used in place of foods high in saturated fat. A clinical study published in the Journal of the American Heart Association found that people who ate one avocado daily experienced greater reductions in LDL cholesterol than those following similar diets without avocado.

The bottom line is that controlling cholesterol doesn't require a drastic diet overhaul. Small, consistent changes—such as eating more whole grains, legumes, nuts, fruits, vegetables, fatty fish, and healthy fats—can have a lasting impact on heart health. Combined with regular exercise and other healthy lifestyle habits, these foods can help keep your cholesterol in check and support long-term well-being.

Sleep is one of the most important factors for overall health and well-being, influencing both physical and mental health. Yet, how much sleep a person actually needs remains a common topic of debate.

Dr Sudhir Kumar, a neurologist at Apollo Hospitals, addressed several misconceptions and shared evidence-based insights about sleep that everyone should know.

In a detailed post on social media platform X, Dr Sudhir said that most adults need 7–9 hours of sleep per night.

While some may function well with slightly less or more sleep, he noted that "regularly sleeping less than six hours or more than 9–10 hours is associated with adverse health outcomes."

Sleep Consistency Matters Too

While sleep duration is important, sleep consistency is equally important.

"Going to bed and waking up at roughly the same time every day helps regulate your circadian rhythm," he said.

Irregular sleep schedules, on the other hand, are associated with poorer metabolic health, mood disturbances, and daytime sleepiness.

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Monophasic vs Biphasic Sleep

Dr Sudhir said that most modern adults follow a monophasic pattern, with one main sleep period at night.

However, "a biphasic pattern (night sleep plus a short afternoon nap) can also be healthy if total sleep duration is adequate and the nap does not interfere with nighttime sleep."

Does Everyone Need an Afternoon Nap?

Not necessarily, said Dr Sudhir, popularly known as Hyderabaddoc on X, adding that many healthy adults do perfectly well without naps.

However, naps may be particularly useful for:

• Shift workers

• People with sleep debt

• Older adults with increased daytime sleepiness

• Those performing safety-critical tasks requiring sustained alertness

Further, he said that a 10–30-minute nap, also known as a power nap, is usually best, and may help:

• Improve alertness

• Improve concentration

• Reduce fatigue

• Enhance performance

However, naps lasting more than an hour may cause "sleep inertia" (grogginess) and disrupt nighttime sleep in some individuals.

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Night Shift Work And Health Impacts

"Night shift work is not biologically normal," Dr Sudhir said.

Humans are programmed to be awake during the day and asleep at night. Long-term night shift work has been associated with increased risks of:

• Obesity

• Type 2 diabetes

• Cardiovascular disease

• Mood disorders

• Workplace accidents

Sleep During Weekends

Dr Sudhir also addressed the common belief that people can make up for lost sleep during weekends.

While "partial recovery is possible," he said weekend catch-up sleep does not fully reverse the effects of chronic sleep deprivation.

Large shifts in sleep timing during weekends, often referred to as "social jet lag," can disrupt circadian rhythms.

He advised keeping wake-up and bedtime within about one to two hours of the weekday schedule.

He also warned against relying on multiple alarms every morning, which according to him "suggests insufficient sleep, poor sleep quality, and circadian misalignment."

How Inadequate Sleep Can Affect You

Dr Sudhir said regularly sleeping more than 9–10 hours may be associated with higher risks of cardiovascular disease, depression, frailty, and mortality.

At the same time, the neurologist noted that "even one night of inadequate sleep can impair performance".

Short-term sleep deprivation can lead to:

• Reduced attention

• Slower reaction time

• Poor decision-making

• Mood changes

• Increased accident risk

Chronic insufficient sleep is associated with:

• Hypertension

• Type 2 diabetes

• Obesity

• Cardiovascular disease

• Depression and anxiety

• Cognitive decline

• Reduced quality of life

"Sleep is a fundamental biological requirement, just like nutrition and exercise," Dr Sudhir said.