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!

Many women do not consider persistent bloating to be a serious issue because they tend to correlate their symptoms with acidity, excessive gas, overeating, or other temporary issues caused by their digestive system. Many women tend to treat their symptoms on their own by changing their diet or taking over-the-counter medications without looking into what the underlying problem may be. Many women do this because their symptoms initially seem mild. However, it is important to pay attention to any persistent bloating, especially if the bloating occurs on a regular basis, has lasted for at least one month, or is associated with symptoms such as pelvic discomfort, loss of appetite, an increased feeling of fullness, or irregular bowel habits (diarrhoea, constipation, etc.).

Is persistent bloating a sign of ovarian cancer?

In an interaction with Health and Me, Dr Parnamita Bhattacharya, Gynaecologist at CK Birla Hospitals, CMRI, spoke about the concerns surrounding persistent bloating and whether it is associated with the risk of ovarian cancer.

One of the most significant concerns surrounding persistent bloating is that women can develop ovarian cancer, especially in the early stages, without knowing or having any obvious signs that they have the disease. Because there are no routine screening tests to detect ovarian cancer in the general population, it is critical for women to be on the lookout for any symptoms of persistent bloating and report them immediately to their doctor. Unfortunately, because women often ignore their symptoms and fail to seek medical attention, by the time they do see a doctor, ovarian cancer has progressed to a later stage of development.

How to know if it is digestion-related bloating?

Not all bloating is related to ovarian cancer. Other common contributing factors to bloating include irritable bowel syndrome, food intolerance, hormonal changes, and lifestyle factors. The significant difference between "normal" bloating and "abnormal" bloating is how long each type of bloating lasts and how quickly the symptoms progress. If your bloating continues despite dietary changes, or if it increases in frequency, you should not ignore the symptoms. You should have them evaluated by a medical professional.

It is important for women to understand the signals sent by their bodies. If you frequently experience bloating, this issue needs to be investigated and not just accepted as normal. If you seek timely evaluation, doctors can determine the source of your problem early on, which greatly increases your chances of a good outcome from a serious diagnosis such as ovarian cancer.

What are the symptoms of ovarian cancer?

Ovarian cancer symptoms can be vague and may develop as the disease progresses. Therefore, timely detection is a challenge. Some of the signs of ovarian cancer include:

1. Pain in the pelvic region
2. Swollen belly
3. Loss of appetite
4. Feeling full after small meals
5. Nausea
6. Diarrhoea
7. Constipation
8. Unexpected weight loss
9. Painful sex
10. Extreme fatigue
11. Abnormal vaginal bleeding between periods

Former New York City Mayor Rudy Giuliani has been discharged from the ICU but will remain in the hospital for “some time” as he recovers from pneumonia, according to his spokesperson.

In a post on social media platform X, spokesperson Ted Goodman said Giuliani, 81, was hospitalized earlier this week in critical but stable condition.

Giuliani, who served as New York City's mayor from 1994 to 2001, was previously diagnosed with restrictive airway disease following the infamous 9/11 terrorist incident, where he “took down the mafia, saved New York City, and ran toward the towers on September 11th".

However, the incident left Giuliani with lasting health complications, Goodman said, adding that the former NYC Mayor "is recovering from pneumonia”.

“The virus quickly overwhelmed his body, requiring mechanical ventilation to maintain adequate oxygen and stabilize his condition,” Goodman said.

Calling him the "same fighter he's always been, and he's winning this fight,” Goodman said that the "mayor and his family appreciate the outpouring of love and prayers sent his way”.

Notably, Giuliani is a longtime ally of President Donald Trump. In 2025, Trump also announced awarding Giuliani with the Presidential Medal of Freedom, the country's highest civilian honor.

What Is Pneumonia?

Pneumonia is an inflammatory condition of the lung tissue, most often caused by infections. It can affect one or both lungs and can range from mild to life-threatening, especially in vulnerable populations like the elderly, young children, or those with underlying health conditions.

There are several types of pneumonia, classified based on their causes—bacterial, viral, and fungal—and each has distinct patterns of transmission and severity.

What Causes Pneumonia?

Pneumonia is not a single disease but a syndrome resulting from various infectious agents:

Bacterial Pneumonia: This is the most common type, often developing as a secondary infection after a cold or flu. Streptococcus pneumoniae is the most frequent culprit.

Viral Pneumonia: Caused by viruses like influenza, respiratory syncytial virus (RSV), and SARS-CoV-2 (COVID-19), this type often starts in the upper respiratory tract and spreads to the lungs.

Fungal Pneumonia: This type is less common and usually affects individuals with weakened immune systems. It's typically contracted through environmental exposure, such as to soil or bird droppings.

Early Warning Signs You Shouldn’t Ignore

Pneumonia can be insidious. It often begins with symptoms that mimic the flu: headache, fatigue, and fever. But as the infection progresses, signs become more serious:

• Persistent cough with green, yellow, or even bloody mucus
• Shortness of breath
• Chest pain, especially when breathing or coughing
• High fever, chills, and night sweats
• Confusion, especially in the elderly
• Nausea or loss of appetite

In a shocking case, a 68-year-old woman in the US who took antibiotics for inflammation developed an alarming skin reaction, leaving her skin black and blue.

The unusual case, reported in the New England Journal of Medicine (NEJM), noted that the woman developed dark patches on her skin very quickly, within two weeks of starting the drug — a course of minocycline, an oral antibiotic.

Two weeks before the onset of the skin changes, she had started taking 100 mg daily of oral minocycline to treat rosacea, which causes chronic inflammation and redness of the face.

Over the course of six weeks, dark patches appeared on the woman's arms and legs. It ranged from a bruise-like dark blue and purple to jet-black.

Her doctors also noticed blue-gray "hyperpigmentation" on the woman's forearms and shins, as well as on the sides of her tongue. The woman noted that the patches had first appeared on her legs before cropping up elsewhere.

Rosacea is a common skin condition that leads to the formation of small, red bumps and pus-filled pimples on the skin, and evidence suggests that antibiotics like minocycline can help eliminate those bumps.

Writing in the paper, Aarti Maharaj, from the University of Florida, shared that hyperpigmentation is a well-established side effect of minocycline, in which patches of skin become darker than the skin surrounding them.

While the condition typically develops after months of treatment, it may rarely occur with shorter courses, the expert said.

In this case, the woman was diagnosed with type II minocycline-induced hyperpigmentation, which is "defined by blue-gray discoloration of normal skin on the extensor surfaces of the arms and legs," according to Maharaj.

Doctors advised the patient to stop taking minocycline and to avoid sun exposure, as ultraviolet light is thought to worsen hyperpigmentation in these cases. Six months later, the hyperpigmentation in her limbs had "abated somewhat" but was still visible.

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Minocycline And Hyperpigmentation

According to Mayo Clinic, minocycline belongs to the class of medicines known as tetracycline antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.

It causes hyperpigmentation:

• Type I shows up as blue-black discoloration on scarred or inflamed skin on the face, rather than on healthy skin on the limbs.
• Type II leads to blue-gray discoloration of normal skin on the extensor surfaces of the arms and legs.
• Type III appears as muddy-brown pigmentation on sun-exposed areas of the body.

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According to a frequently cited study, the side effect shows up in about 28 per cent of people in this population, although that research included only a small number of patients. The true incidence of the side effect is unclear, Live Science reported.

Once a person stops taking minocycline, the pigmentation can take months to years to dissipate, reports suggest. In type III cases, it sometimes never goes away.