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!

Infections accounted for an estimated 2.3 million new cancer cases worldwide in 2024, or about 12% of all cancers diagnosed that year, according to a September 2026 study published in The Lancet Oncology. Among these, Helicobacter pylori (H. pylori), a bacterium that infects the stomach, was associated with an estimated 760,000 cancer cases.

A 2025 study by the International Agency for Research on Cancer (IARC), part of the World Health Organization (WHO), estimated that 76% of the 15.6 million stomach cancer cases expected over the lifetimes of people born between 2008 and 2017 could be attributable to H. pylori infection if prevention efforts do not improve.

Although infections can contribute to cancer development, they are not the only cause. Genetics, age and non-infectious factors also play a role, Dr. Vivek Kaul, Professor of Medicine in the Gastroenterology & Hepatology Division at the University of Rochester Medical Center, told HealthandMe in an exclusive interview.

“I think, generally speaking, I think H. pylori is a well-known carcinogen, mostly responsible for the development of gastric cancer,” Kaul said.

Is Cancer Increasingly Linked To Infections?

The findings highlight the contribution of infectious agents to the global cancer burden. However, Kaul cautioned against concluding that cancer is increasingly being driven by infections.

“But I don't think it's fair to say that, you know, we are moving towards a more infectious etiology for cancer,” he said.

“Cancer is a multifactorial disease state that develops, most commonly develops from genetic and from non-infectious causes,” Kaul added.

He explained that cancer development also depends on the ability of cells to defend themselves against external threats and genetic mutations.

“In many cases, cancer development comes primarily from genetic and age-related issues and boils down to the individual cell's ability, you know, to fight external attacks, such as from H. pylori type of agents or from genetic mutations,” he said.

Kaul also noted that other infectious agents have been implicated in cancer development.

How Does H. pylori Raise Stomach Cancer Risk?

H. pylori is a bacterium that infects the stomach lining and can persist for years. The infection can cause chronic inflammation and damage to stomach tissue, increasing the risk of gastric cancer.

According to scientists at the International Agency for Research on Cancer (IARC), part of the World Health Organization (WHO), H. pylori infection is responsible for an estimated 76% of stomach cancer cases worldwide. The infection often causes no noticeable symptoms, although some people may experience digestive complaints.

The bacterium can spread through contaminated food or water and close contact with infected individuals. In some cases, the infection can cause stomach ulcers. Because many infected people have no symptoms, testing may be needed to identify it.

Can H. pylori Infection Be Prevented From Progressing To Cancer?

The World Gastroenterology Organisation's global guidelines state that eradicating H. pylori before precancerous changes develop can help prevent gastric cancer. This evidence supports test-and-treat screening programmes for young adults in countries with a high disease burden and sufficient resources.

Testing can involve blood, breath or stool tests, depending on the clinical context. People diagnosed with the infection can receive treatment to eradicate the bacterium. Follow-up testing can then confirm whether treatment has worked.

Nobel laureate and gastroenterologist Dr Barry Marshall has also highlighted the potential for early treatment to reduce cancer risk.

“H. pylori is much more than an ulcer organism. If the infection persists for many years, it can cause chronic inflammation in the stomach and increase the risk of gastric cancer. That gives us an opportunity because this is a potentially preventable cause of cancer,” Marshall told PTI.

He stressed the need for wider testing, appropriate treatment and follow-up to ensure the infection has been cleared.

Other Digestive Cancers Are Also A Growing Concern

Beyond infection-associated cancers, Kaul highlighted the rising incidence of several digestive cancers.

“We know that esophageal squamous cancer is another example where we will be close to a million cases by 2035,” he said, pointing to the burden in East Asia, sub-Saharan Africa and South America, including India.

Kaul also identified liver cancer as a growing concern and noted the rise in colorectal cancer among younger people in Western countries. The increase in colorectal cancer among younger adults in the US contributed to recommendations to begin average-risk screening at age 45 rather than 50.

These trends underline the need to address infectious causes of cancer alongside other risk factors, while improving access to prevention, early detection and appropriate care.

With the increasing use of smartphones, laptops and other digital devices, neck pain and back discomfort are becoming common concerns among people of different age groups. Long working hours, improper sitting positions and excessive screen time are putting additional pressure on the spine. What may begin as mild stiffness in the neck or shoulders can gradually develop into persistent discomfort if ignored.

Poor posture and prolonged screen use are among the common lifestyle factors contributing to neck and back pain.

Many people complain of neck stiffness or back pain despite not being involved in physically demanding activities. On examining their daily routine, we often find that they spend several hours working on computers or looking at their mobile phones without taking adequate breaks. Maintaining the same posture for extended periods can put unnecessary stress on the spine.

The spine is a complex structure made up of vertebrae, intervertebral discs, joints, ligaments and muscles. It supports the body, helps maintain balance and allows movement. However, prolonged sitting and incorrect posture can affect the normal functioning of these structures.

One of the growing concerns associated with digital device usage is ‘text neck’, a term commonly used to describe neck pain and discomfort linked to repeatedly looking down at smartphones and tablets. When the head moves forward from its natural position, the muscles of the neck and shoulders have to work harder to support it. Over time, this may lead to stiffness, muscle fatigue and recurring pain.

Children and teenagers are also vulnerable to posture-related problems because of extended screen time, online learning and gaming. Encouraging them to take regular breaks and participate in outdoor activities can help promote better musculoskeletal health.

The effects of an inactive lifestyle extend beyond the spine. Reduced physical activity can contribute to weight gain, poor muscle strength and an increased risk of metabolic and cardiovascular health problems. Regular movement is therefore important not only for spinal health but also for overall well-being.

Simple Lifestyle Changes Can Make a Difference

Preventing posture-related pain does not necessarily require complicated exercise routines. Small changes in everyday habits can help reduce strain on the neck and back.

Taking short breaks during working hours instead of remaining seated continuously. Standing up, walking around or performing gentle stretches every 30 minutes can help reduce prolonged static loading on the spine.

Workstation ergonomics also plays an important role. People should keep their feet comfortably supported on the floor, maintain a relaxed shoulder position and avoid bending their neck forward for extended periods. The computer screen should be positioned at a comfortable viewing height, while laptop users can consider an external keyboard and mouse to improve their working posture.

Regular physical activity can further support spinal health. Exercises such as bridges, planks and bird dogs can help strengthen the muscles that support the spine when performed correctly. Walking, swimming and cycling are also useful ways to remain active. The World Health Organization recommends that adults undertake at least 150 minutes of moderate-intensity physical activity each week.

People with obesity, diabetes or a family history of spinal disorders should pay particular attention to their daily activity levels and seek medical advice when necessary. Parents should also encourage children to balance screen time with physical activity and healthy movement habits.

When Should You Consult a Specialist?

Occasional discomfort that improves with movement or a change in posture may not necessarily indicate a serious problem. However, persistent or worsening pain should not be ignored.

Consulting a doctor if neck or back pain continues for several weeks, radiates into the arms or legs, or is accompanied by tingling, numbness or muscle weakness. Pain associated with fever or unexplained weight loss also requires prompt medical evaluation.

Do not rely on painkillers for prolonged periods without professional guidance. Pain relief alone may not address the underlying cause, making an appropriate assessment important when symptoms persist.

Most cases of neck and back pain do not require surgery. Many can improve with appropriate treatment, physical activity and changes in daily habits. The important thing is to identify the cause of the pain and avoid ignoring recurring symptoms

As digital devices become an essential part of modern life, protecting spinal health requires greater awareness of posture, regular movement and healthy screen habits. Simple preventive measures adopted today can help people maintain better mobility and comfort in the long run.

(By Dr. Lalit Kumar, Director Consultant, Orthopaedics, Joint Replacement and Spine Surgeon at Shalby International Hospitals, Gurugram)

Beyond weight loss and diabetes control, GLP-1 drugs may offer mental health benefits by reducing the need for psychiatric hospital care among people with schizophrenia and type 2 diabetes (T2D), according to a new study published in The Lancet Psychiatry.

The findings showed that treatment with glucagon-like peptide-1 receptor agonists (GLP-1s) was associated with lower risks of psychiatric hospitalization and emergency department visits among people with both conditions.

What Did the Study Find?

Also read: Exclusive: GLP-1 Drugs Are The ‘New Statins’, Says University Hospital Birmingham Professor

Researchers from Deakin University and the University of Queensland in Australia analyzed US health records of more than 70,000 adults with schizophrenia and T2D who received treatment between January 2018 and October 2026.

The researchers found that people taking GLP-1 drugs were:

• 24% less likely to require psychiatric hospitalization than those not taking any of the compared diabetes medications.
• 18% less likely to require psychiatric hospitalization than those taking DPP-4 inhibitors.
• 17% less likely to require psychiatric hospitalization than those taking SGLT2 inhibitors.

GLP-1 use was also associated with fewer psychiatric emergency department visits. Compared with the same groups, users were:

• 29% less likely to require emergency care than those not taking any of the compared diabetes medications.
• 13% less likely than those taking DPP-4 inhibitors.
• 20% less likely than those taking SGLT2 inhibitors.

Further, when the researchers analyzed individual drugs, the association was observed with semaglutide, liraglutide, and tirzepatide, but not dulaglutide.

GLP-1 Drugs Not Primary Treatment for Schizophrenia

Read More: Ozempic Baby: Can GLP-1 Drugs Help Women With PMOS Conceive?

The researchers cautioned that the observational study cannot establish that GLP-1 drugs directly reduce the need for acute psychiatric care.

They said the medications should not be considered primary psychiatric treatments or prescribed solely to reduce psychiatric hospitalizations and emergency visits.

Instead, the findings point to a potential additional benefit when GLP-1 drugs are prescribed for appropriate metabolic indications as part of integrated cardiometabolic and mental health care.

“The findings suggest that lower psychiatric acute-care use could be a favourable secondary benefit when GLP-1-based therapies are clinically indicated for metabolic management,” the researchers said.

They added that randomized clinical trials and mechanistic studies are needed to determine whether the drugs have a direct effect on psychiatric outcomes. Further research should also investigate their potential benefits in people with schizophrenia who do not have T2D.

Why Is Type 2 Diabetes More Common in People With Schizophrenia?

Schizophrenia is a serious psychiatric disorder associated with disability, other health conditions, and premature mortality. Cardiometabolic diseases, including T2D, contribute substantially to this burden.

Studies suggest that diabetes may be up to five times more common among people with schizophrenia than among those without the condition. Approximately one in five people with schizophrenia may also have diabetes.

Several factors may contribute to this increased risk, including:

• Obesity
• High cholesterol and other abnormal blood lipid levels
• Elevated blood sugar
• Smoking
• Unhealthy diet
• Physical inactivity
• Poor sleep
• Stress

Could GLP-1 Drugs Help Address Both Conditions?

GLP-1 receptor agonists are an established class of medications used to manage T2D and, in some cases, obesity. Their potential role in people with schizophrenia is of growing interest because of the high burden of metabolic disease in this population.

However, whether these medications directly improve psychiatric outcomes remains uncertain.

The latest findings suggest that GLP-1 treatment may be associated with reduced use of acute psychiatric care among people with schizophrenia and T2D. Further clinical trials are needed before any direct mental health benefit can be established.