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!

Cardiac arrest is considered one of the most urgent medical situations. It can occur unpredictably, at home, at work, while traveling, or anywhere. It is characterized by a blockage in the heart's arteries, and it differs from a heart attack, which is a situation when the heart stops pumping blood into the body. After a few minutes, oxygen deficiency happens and affects the brain and other organs. Therefore, it is important to know how to perform cardiopulmonary resuscitation (CPR).

CPR is an emergency lifesaving technique that uses chest compressions and, in some situations, blowing mouth-to-mouth air into the person who has suffered a cardiac arrest, to help maintain blood circulation and oxygen delivery to vital organs when a person's heart has stopped beating effectively. It does not restart the heart by itself, but it can keep blood flowing until an automated external defibrillator (AED) is available or emergency medical professionals arrive.

Importantly, CPR is not a skill limited to doctors or healthcare professionals. It can be administered by ordinary people for whom learning the basic CPR techniques is easy.

The Importance of Rapid and Efficient Actions in Case of Cardiac Arrest

If someone faces cardiac arrest, rapid actions may save this person's life. If CPR is performed directly and immediately after a cardiac arrest, it will be possible to keep the flow of blood to the brain and other organs before the arrival of medical experts. The use of CPR can improve the chances of survival for patients who have experienced cardiac arrest.

Besides, in combination with early defibrillation through an AED, it can be even more effective. AED is a portable medical device that checks the heart rhythm of the person experiencing cardiac arrest and delivers an electric shock to restart a normal heartbeat.

However, sometimes people prefer to do nothing for fear of mistakes. But it is much more dangerous not to act at all.

Recognizing Cardiac Arrest

It begins with identifying the presence of a possible cardiac arrest in the patient. The patient will generally fall, become unconscious, and will not breathe properly. They can occasionally breathe abnormally with strange sounds, which should not be considered breathing properly.

If you see anyone fall and become unresponsive, check whether they respond to your questions and breathe normally. Tell any passerby to call the emergency services and bring an AED device, if one is present. If the patient is not breathing normally, initiate CPR on them.

What To Do?

If the patient is an adult, hands-only CPR can be done easily by everyone. For this, you need to keep the heel of one of your hands in the center of the person’s chest, keep your other hand over it, and press down with a rapid rhythm. The compression must be continued at a pace of around 100-120 beats per minute.

Also, you can use the AED device if one is available. Turn on the AED and follow the steps according to the voice prompts from it. The AED device will analyze the rhythm of the heart and give a shock.

CPR is a Practical Skill, not Just Medical Knowledge

Another reason for reluctance to administer CPR is the notion that it should be administered only by doctors, nurses, and other professionals. However, even basic CPR can be taught to regular citizens using special courses. It takes only a couple of hours of practice for someone to gain enough confidence to use CPR in emergencies.

CPR training should be more accessible in schools, offices, and residential communities, as it would help people know what to do in those critical first few minutes.

Cardiac arrest will not wait for doctors to show up. When cardiac arrest occurs, the first person on the scene might be either a relative, co-worker, friend, or a total stranger. Knowing CPR will prepare you for these moments of life or death. A simple skill learned today may help save someone’s life tomorrow.

(Dr. Lalit Kapoor, Senior Consultant - Cardiac Surgery and Robotic Surgery – Narayana RN Tagore Hospital, Mukundapur, Kolkata)

Worried about your graying hair? It may reflect a natural cellular response to DNA damage, according to a study by Japanese researchers.

Hair color comes from melanocyte stem cells (McSCs), which live inside hair follicles and produce melanin, the pigment responsible for hair and skin color. These cells are especially sensitive to DNA damage from environmental and internal factors.

While DNA damage is linked to both aging and cancer, researchers at the University of Tokyo found that McSCs can take different paths after being damaged — including one that leads to hair graying and another associated with melanoma, a type of skin cancer.

How Does Gray Hair Act As A Defense?

When McSCs suffer certain types of DNA damage, they can undergo a process called senescence-coupled differentiation, or seno-differentiation. The damaged stem cells permanently differentiate and are eventually lost, leading to hair graying.

This response is driven by the p53–p21 pathway and may help eliminate damaged cells before they can become cancerous.

Also read: Unusually High Cancer-Fighting Immune Cells Could Explain Why Some People Live Beyond 100: Study

What Did The Study Find?

Published in Nature Cell Biology, the study examined how McSCs respond to different types of DNA damage.

Professor Emi Nishimura and Assistant Professor Yasuaki Mohri used long-term in vivo lineage tracing and gene-expression profiling in mice to study the fate of these stem cells.

The researchers found that DNA double-strand breaks triggered seno-differentiation. In this process, damaged McSCs irreversibly differentiate and are lost, resulting in hair graying.

However, the response was different when the cells were exposed to certain carcinogens, including 7,12-dimethylbenz(a)anthracene, or ultraviolet B. In these situations, McSCs could bypass the protective differentiation process, retain their ability to self-renew and expand clonally.

This process was supported by KIT ligand signals from the surrounding tissue and epidermis, which suppressed seno-differentiation and pushed the cells toward a tumor-prone state.

“These findings reveal that the same stem cell population can follow antagonistic fates—exhaustion or expansion—depending on the type of stress and microenvironmental signals,” Nishimura said.

“It reframes hair graying and melanoma not as unrelated events, but as divergent outcomes of stem cell stress responses,” she added.

Does Gray Hair Prevent Cancer?

Read More: Ferritin Face: Can Pale Skin Signal Iron Deficiency?

Not necessarily. The study does not show that people with gray hair have a lower risk of cancer.

Instead, the findings suggest that hair graying can be the result of a protective cellular response in which damaged stem cells are eliminated. When that response is bypassed, damaged McSCs may persist and contribute to melanoma development.

The researchers say the findings offer a framework for understanding how the same stem-cell population can contribute to either tissue aging or cancer depending on the type of damage and signals from the surrounding environment.

Can You Prevent Premature Graying?

Genetics plays a major role in when hair turns gray. There are also some lifestyle changes that can prevent graying, support hair and overall health. These include:

• Managing stress
• Eating a nutrient-rich diet
• Protecting your hair and scalp from excessive UV exposure
• Avoiding excessive heat and harsh chemical treatments
• Avoiding smoking.

An Alzheimer’s patient may vividly remember their wedding day from 40 years ago, remember the house they grew up in or sing a song they learned in childhood, but still struggle to remember what they ate for breakfast or a question they were asked just an hour ago.

So if Alzheimer’s is a memory loss disease, why do some old memories appear to remain intact while recent ones disappear so quickly?

According to leading experts, the answer lies in the way different memories are formed, stored and retrieved in the brain. It is also in the fact that Alzheimer’s does not damage every memory system at the same speed. This means that the ability to form and retain new memories can become impaired before older memories are affected.

“In Alzheimer’s, memory loss does not always happen evenly. The brain regions responsible for forming and storing new memories, particularly the hippocampus and surrounding areas, are often affected early,” Dr K K Jindal, Director, Neurology, CK Birla Hospital, Delhi, told HealthandMe.

Recent Memories Disappear First

A person with Alzheimer's disease may remember a marriage, childhood home or an event from 40 years ago, but not remember a meal or conversation from an hour earlier. To understand this, it helps to look at what happens when a new memory is formed.

Dr Praveen Gupta, Chairman, Marengo Asia International Institute for Neuro and Spine, Marengo Asia Hospitals, Gurugram, told HealthandMe, “The memories that Alzheimer’s erodes do not deteriorate at equal rates. One of the first brain functions to be compromised is the creation of new memories. This is because the older memories have enough time to spread their representations in the brain while the newer memories rely on memory circuitry that is very vulnerable.”

Dr Saurav Aggarwal, Consultant, Neurology, Fortis Hospital, Ludhiana, explained the process to HealthandMe through the concept of memory consolidation. He said when a person experiences something new, the memory initially depends heavily on the hippocampal network.

Dr Aggarwal said, “Old memories go through consolidation, where the brain spreads a memory across the cortex, its outer layer, including the temporal and frontal lobes. Years of retelling strengthen those links.”

By contrast, new memories remain heavily dependent on the hippocampal network. “Alzheimer's damages the hippocampus first, so the brain fails to consolidate new information, such as a memory from the morning or a few hours ago, causing it to fade” Dr Aggarwal says.

Older memories have therefore had years, sometimes decades, to become more represented and strengthened through repetition and recall. New memories do not have that advantage.

Also read: Donald Trump Wants Childhood Vaccines Split Into 5 Shots To Prevent Autism: But Is There Evidence?

The Hippocampus Is More Than The Brain's Memory Bank

The hippocampus is not just a storage box for memories. It plays a crucial role in organising and absorbing new experiences. Dr Aggarwal describes it as a “sorting desk”.

He says, “The hippocampus works like a sorting desk. It takes in new experiences, a step called encoding, and passes them to the cortex for storage, meaning that proper memories cannot be formed if the hippocampus is damaged.”

The hippocampus is particularly vulnerable in Alzheimer’s disease. According to Dr Aggarwal, two abnormal proteins are central to the disease process.

“Two abnormal proteins drive this damage. Amyloid forms plaques between neurons, and tau twists into tangles inside them,” Dr Aggarwal says. “Tangles appear first in the entorhinal cortex, the hippocampus's gateway. They spread inward and, with amyloid plaques, damage the connections between neurons (synapses).”

Dr Steve Paul Manjaly, Geriatric Medicine, Apollo Hospitals, Bangalore, told HealthandMe that the hippocampus has a high level of synaptic transmission, which makes it particularly vulnerable to toxic processes linked with Alzheimer’s disease.

He explains, “The hippocampus is the seat of memory and has high synaptic transmissions, making it prone to toxicity,” he says. “Also the pathology is such that the affect the networking pathways that affect the hippocampus majorly.”

Also read: World Patient Safety Day: With 2800% Margin, Costly Hospital Consumables Can Threaten Patient Safety; Here’s How

All Memories Are Different

One important misconception about Alzheimer’s is that there is one single type of memory that simply gets weaker over time. In reality, the brain uses several memory systems, and they can be affected at different stages.

“There is no single memory system; the three different types of memory systems are episodic memory, semantic memory, and procedural memory,” says Dr Gupta.

Episodic memory refers to personal experiences. For example, what happened yesterday, where a person went, or what they discussed during a particular conversation. This is affected earlier.

Semantic memory involves facts, information, words and their meanings. “Semantic memory is about names. E.g Delhi is the capital of India. This is affected much later in Alz,” Dr Manjaly explains.

Procedural memory is the memory of how to perform learned skills. “Procedural memory is about how something was learned. E. G driving a cycle etc. This is affected later in the disease,” he says. This is why someone with Alzheimer’s may forget what they had for lunch but still be able to tie their shoelaces or perform a familiar skill.

Also read: Scientists Grow Human Brain Tissue Inside Mice: Could This Help Cerebral Palsy, Epilepsy & Autism Research?

Why Can A Patient Sing An Old Song But Forget A Person's Name?

One of the most striking and fascinating examples of preserved memory in Alzheimer’s is music. Families of people with dementia often notice that a loved one who struggles to remember names or recent conversations may still be able to sing an old song almost perfectly.

Songs are encoded through more than their words. Rhythm, melody, repetition, emotion and long-established associations all contribute to how they are represented in the brain.

“The various types of memories involve different neural networks,” says Dr Gupta. “Songs we know are not just about words; songs have associations with rhythm, emotions, repetition, and neural links that have been created since ages.”

Dr Aggarwal notes that procedural skills involve structures such as the basal ganglia and cerebellum, which tend to be affected later in Alzheimer’s disease.

Musical processing also involves several networks beyond the hippocampus, some of which may remain relatively preserved. This helps explain why familiar routines, songs and well-practised skills can sometimes survive long after the ability to form new memories has deteriorated.

Also read: 1 In 4 Doctors Near Retirement Age By 2036: WHO Warns Of Global Health Workforce Crisis

When Is Forgetfulness More Than Normal Ageing?

Forgetting sometimes is not, by itself, evidence of Alzheimer’s disease. With normal ageing, people may take longer to retrieve a name, need more time to learn something new or occasionally forget something, and remember it later. The more important warning signs are progression, frequency and impact on everyday functioning.

Dr. Gupta explains, “What matters most is not that they are forgetting but the frequency with which it occurs, that it is becoming progressively more problematic, and that it starts to interfere with daily functioning.”

According to the experts, warning signs may include:

• Repeatedly asking the same question within a short period
• Forgetting conversations or events that happened recently
• Getting disoriented in familiar places
• Misplacing objects and not being able to retrace one's steps
• Struggling with familiar recipes
• Having difficulty managing finances or medications
• Developing problems with words or understanding conversations
• Showing poorer judgement or decision-making
• Becoming increasingly dependent on family members for tasks previously handled independently

How Do Doctors Determine Whether Memory Loss Is Due To Alzheimer’s?

According to the doctors, Alzheimer’s diagnosis begins with a detailed history, including when the symptoms started, how they have progressed and how they affect daily functioning.

Information from family members can be particularly important because a person experiencing memory impairment may not recognise the extent of the changes.

“Now, the diagnosis of Alzheimer's is not just about memory tests,” says Dr Gupta. “We utilize a comprehensive assessment along with high-tech investigation methods like serum markers and PET scanning to find out the presence of biological markers of Alzheimer's disease.”

Besides memory loss, several medical conditions can produce symptoms that resemble dementia. Vitamin B12 deficiency and thyroid disorders can contribute to cognitive problems and need to be considered.

Experts say that blood tests can help identify such reversible contributors, while an MRI can look for strokes and patterns of brain shrinkage.

“MRI scans and pet scans can help narrow it down further and help sometimes in ruling out other causes of cognitive impairment,” Dr Manjaly says. “Thyroid and vitamin b12 deficiencies are also conditions that may mimic dementia.”

Modern diagnosis can also go beyond symptoms and structural imaging. Dr Aggarwal says amyloid PET imaging and cerebrospinal fluid testing can provide additional evidence of Alzheimer’s pathology by detecting abnormal protein changes associated with the disease. The exact combination of tests depends on the individual patient and overall clinical situation.