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!

Atrial fibrillation (AFib) is an irregular and often very rapid heart rhythm, also called an arrhythmia and can create blood clots in the heart, which can increase your risk of having a stroke by five times.

When a person has AFib, the normal beating in the upper chambers of the heart (the two atria) is irregular and blood doesn't flow as well as it should from the atria to the lower chambers of the heart (the two ventricles).

In this case, the risk of developing blood clots in your heart increases, which can not only cause a heart attack but also damage vital organs such as your brain. An AFib may happen in brief episodes, or it may be a permanent condition.

Common symptoms include palpitations (the feeling that your heart is racing, pounding, fluttering or like you have missed heartbeats), chest pain, finding it harder to exercise, tiredness, shortness of breath, dizziness or feeling faint.

READ MORE: You Can Stop A Heart Attack With This Medicine, Cardiologist Reveals Heart Attack 101

The death rate from AFib as the primary or a contributing cause of death has been rising for more than two decades.

Over 454,000 people with AFib are hospitalized in the US each year, out of which 158,000 die of the cause. It is estimated that 12.1 million people in the US will have AFib in the US will have AFib by 2050.

Who Is At Risk Of Having AFib?

• Advancing age.
• High blood pressure.
• Obesity.
• European ancestry.
• Diabetes.
• Heart failure.
• Ischemic heart disease.
• Hyperthyroidism.
• Chronic kidney disease.
• Moderate to heavy alcohol use.
• Smoking.
• Enlargement of the chambers on the left side of the heart.

Treatment for AFib includes medications to control the heart's rhythm and rate, therapy to shock the heart back to a regular rhythm and procedures to block faulty heart signals.

A person with atrial fibrillation also may have a related heart rhythm disorder called atrial flutter. The treatments for AFib and atrial flutter are similar.

How To Improve Your Heart Health

Experts recommend following the below to reduce yor risk of stroke or developing AFib and maintaining heart health:

• Don't smoke or use tobacco.
• Aim for at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity (or an equal combination of both) each week. Eat a heart-healthy diet.
• Stay at a healthy weight.
• Get quality sleep.
• Manage stress levels
• Get regular health screening tests.
• Eat a fiber, nuts and fish-rich diet
• Limit salt intake
• Reduce saturated fat intake

Changes in your voice, whether in tone, volume, speed or overall quality, can act as early warning signs for a wide range of medical conditions, experts say.

Your voice is produced by the coordinated effort of your respiratory system, vocal cords (also called vocal folds), and the resonating chambers of your throat, mouth, and nose. Even subtle shifts in hormone levels, hydration status or tissue health can noticeably affect how you sound.

Recent research shows that subtle changes in speech, for example, slurring or vocal cord tremors, may be signs of disease or illness like Parkinson’s disease, depression, cardiac and mental health problems, as speech requires coordination with the brain, muscles and respiratory system.

Which Conditions Can You Identify By A Change In Voice?

• Diabetes: High-pitched, raspy voices or vocal strain can be linked to diabetes, with AI studies showing up to 75% accuracy in prediction.
• Cardiovascular Disease: Voice analysis can detect high, fluttering voices associated with coronary artery disease, caused by stress or fluid changes in the vocal cords.
• Hypothyroidism: A deeper, softer, or huskier voice can indicate thyroid dysfunction.
• Respiratory Illnesses: Conditions like COVID-19 or COPD are often associated with a breathy voice, coughing, and short, interrupted sentences.
• Throat Cancer: Persistent hoarseness and raspy voice, especially lasting more than 2-3 weeks, can indicate laryngeal cancer.
• Parkinson’s Disease: Identified by a monotone voice, reduced volume, increased breathiness, and vocal cord tremors.
• Alzheimer’s Disease/Dementia: Characterized by slower speech rates, hesitation, frequent pauses, and simplified vocabulary/sentence structure.
• Stroke or Brain Injury: Indicated by slurred speech or difficulty finding words (global aphasia).
• Cerebellar Disorders (caused by damage to the nerves in the brain's cerebellum): Manifest as loud, staccato speech (bursts of broken sounds).
• Depression: Linked to a flatter, softer, and more monotone voice with a reduced pitch range.
• Anxiety/Stress: Often presents as a higher-pitched, faster, and more tremulous voice.
• Schizophrenia: Indicated by monotone, disorganized speech.

What Else Can Affect Your Voice?

Apart from serious medical conditions, voice changes may also be linked to aging and lifestyle factors. Fluctuations in testosterone, estrogen, progesterone, and thyroid hormone levels may also influence the structure and function of the vocal cords.

Dehydration is one of the most common causes of voice problems, as cords need adequate moisture to vibrate efficiently. Aim for at least 64 ounces of water daily, and more if you use your voice professionally or live in a dry climate.

Smoking irritates and inflames the vocal cords, causing chronic hoarseness and increasing the risk of vocal cord cancer. Even secondhand smoke and vaping can affect voice quality.

Diet also plays a role in vocal health. Caffeine and alcohol are diuretics that can dehydrate your vocal cords. Spicy foods and acidic beverages may trigger reflux, irritating the throat.

Dairy products can increase mucus production in some people, affecting voice clarity. Voice overuse or misuse, common in teachers, singers, and public speakers, can lead to vocal fatigue and damage. The following table compares how different lifestyle factors impact your voice.

How Can You Take Care Of Your Voice?

Whether the cause is hormonal changes, medical conditions, aging, or lifestyle factors, most voice problems can be improved with proper diagnosis and treatment. Here are some things you can do to take care:

• Stay hydrated by drinking water throughout the day and using a humidifier in dry environments
• Warm up your voice before extended speaking or singing with gentle humming or lip trills
• Avoid shouting or whispering, both of which strain the vocal cords
• Take voice breaks during prolonged speaking to prevent fatigue
• Manage stress through relaxation techniques, as tension affects voice quality
• Treat allergies and sinus problems promptly to reduce postnasal drip
• Maintain good posture to support optimal breathing and voice production

Living under constant psychosocial stress can significantly raise the risk of developing dementia and a stroke, a JAMA Network study suggests.

Psychosocial stress is a type of stress related to our relationships with others, usually arising from feeling judged, excluded, or not enough in others' eyes. It can also put a person in fight-or-flight mode, causing both mental and physical symptoms.

According to Chinese researchers, people who experience this form of stress in childhood as well as adulthood face more than a threefold higher risk of developing dementia compared with those in other groups.

Similarly, young people experiencing stressful situations in their adulthood had a significantly higher risk of stroke incidence that their counterparts.

Based on these results, the study highlights that early identification of psychosocial stressors, combined with effective mental health support and depression prevention, may reduce the long-term burden of neurodegenerative and cerebrovascular disease.

What Did The Study Find?

The scientists defined adverse childhood experiences (ACEs) as traumatic exposures occurring during childhood, typically grouped into 3 categories: household dysfunction, social dysfunction and family death or disability.

On the other hand, traumatic exposures occurring during adulthood were defined as adverse adult experiences (AAEs), which include events such as the death of a child, lifetime discrimination, ever being confined to bed, ever being hospitalized for a month or longer and ever leaving a job due to health conditions.

While analyzing the data they collected from the participants, the researchers also found that depression partly explained the links in all major relationships as it accounted for more than one-third of the connection between childhood adversity and dementia, and about one-fifth of the link between adulthood adversity and both dementia and stroke.

READ MORE: Avoid Doing These 3 Things Prevent Dementia, According To Neurologist

These findings suggest that long-term psychological stress may lead to brain and blood vessel diseases by causing ongoing emotional distress, unhealthy behaviours, and biological changes like inflammation and abnormal stress responses.

Psychosocial Stress: An Unseen Form Of Stress

Psychosocial stress can trigger physiological responses like increased heart rate, cortisol secretion, and inflammation, significantly increasing risks for hypertension, cardiovascular disease and mental health disorders.

This kind of stress can affect men, women, and people of all genders differently, but many of the symptoms are still the same. Common symptoms include:

• Sweating
• An increase in blood pressure
• Rapid heartbeat
• Dizziness
• Nausea and digestive problems
• Strong emotional reactions such as sadness or irritability
• Drug or alcohol abuse

These symptoms can be acute or chronic, meaning for some people they go away, and for others, they persist over a long period of time. Meeting with a therapist is often recommended for those living with chronic stress.

Experts typically suggest developing coping mechanisms include building support networks, utilizing relaxation techniques, and, in cases of severe mental impact, seeking professional support to help deal with psychosocial stress.