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!

Anemia remains one of the least talked about threats to a safe pregnancy in India. The National Family Health Survey-5 data shows that 52.2% of pregnant women in India were anemic. This translates to at least one in two expectant mothers entering pregnancy with insufficient hemoglobin to meet her own and her baby’s needs.

Pregnant women with iron-deficiency anemia may feel unusually tired, weak or short of breath. Some women may suffer from dizziness, headaches, palpitations or reduced ability to concentrate. However, symptoms can be subtle and this is why routine antenatal screening is important even if the woman feels well.

Left unaddressed, it raises the risk of preterm birth, low birth weight, postpartum haemorrhage, and maternal fatigue severe enough to affect daily functioning and recovery after delivery.

Severe anaemia can also reduce a woman's ability to tolerate blood loss during delivery, making even an otherwise uncomplicated birth potentially more challenging.

Why pregnancy makes it worse? Well, blood volume expands by nearly 50% during pregnancy, and the growing fetus draws heavily on maternal iron stores, especially in the second and third trimesters. Most Indian women begin pregnancy with iron stores already depleted by poor dietary intake, frequent pregnancies, or heavy menstrual blood loss. So, the added demand tips many into overt anaemia.

Do's:

1. Start Antenatal Care early. You should get a baseline haemoglobin test at your first antenatal visit, and repeat this each trimester or more if needed.

2. Iron and folic acid tablets must be taken in accordance with the prescription given. It is best to start with them before conceiving or as soon as possible in the pregnancy process, preferably in discussion. The dietary consumption may not always be sufficient to cater to the increased demands during pregnancy.

3. Pair iron-rich foods with vitamin C. A squeeze of lemon with dal or leafy greens meaningfully improves absorption. Indian gooseberry (amla), guava, oranges and tomatoes improve absorption of non-heme iron from plant based foods.

4. Include iron-dense foods regularly like leafy greens, jaggery, dates, legumes, eggs. If non-vegetarian, eat lean meat or fish, meat or poultry.

5. Treat underlying causes. Get heavy periods, worm infestations or unexplained fatigue evaluated before conception if possible.

6. Ask about your ferritin level, not just haemoglobin, since ferritin reveals depleted iron stores earlier.

Anaemia is not always caused by iron deficiency. B12 or folic acid deficiency, problems with haemoglobin production, infections, and many other medical conditions can also be contributing factors.

Also read: 'My Periods Are Painful' Is Not Always Normal: When Could It Be A Sign of Endometriosis?

Don'ts:

1. Do not stop iron supplements simply because you feel better. Treatment usually needs to continue for the recommended period to replenish iron stores.

2. Don't take iron tablets with tea, coffee or milk. These block absorption. Space them at least an hour apart.

3. Do not skip supplements because of nausea or constipation. Ask your doctor for alternate formulations instead of foregoing the supplements.

4. Don't assume fatigue is ‘normal pregnancy tiredness’ without a haemoglobin check. Persistent breathlessness, dizziness or a racing heart need evaluation.

5. Don't self-medicate with over-the-counter iron doses. Both too little and too much iron can cause harm.

6. Don't ignore mild anaemia on the assumption that it will ‘sort itself out’. It typically worsens as pregnancy progresses and has to be actively treated.

Anemia in women is mostly preventable and treatable early. Regular antenatal check ups, proper supplementation, balanced diet and timely treatment can go a long way in reducing its impact on the mother and baby. The key message is simple, really. Screen early, do not wait for symptoms, treat appropriately and maintain adequate iron stores throughout pregnancy.

Blood tests are often a source of dread for people in our society. While many people dread the needle stick, most are scared of what the results may show. Even before consulting a physician, most people nowadays would consult an AI-powered platform to verify and interpret the values of their blood tests. However, such online searches most often give rise to more uncertainties and confusion rather than answering the basic queries. Thus, this article is an attempt to shed some light on the basics of common blood test results.

LIPID PROFILE

Lipid profile is one test that everyone should do, at least occasionally, after the age of 40. This is a silent epidemic, and without blood tests, no clinical symptoms can reliably identify raised lipid parameters. There are multiple parameters printed in the report, but the main values we are looking for are total Cholesterol, triglycerides, LDL, and HDL. There are many others, but the interpretation of those is best left to your physician. Total Cholesterol should be less than 200, triglycerides less than 150, and the “bad” cholesterol, or LDL, should be below 100. On the other hand, HDL, the “good” cholesterol, should be above 40 for men and above 50 for women. So, for HDL, we want the values to be higher! However, whether deranged lipid parameters warrant treatment and, if so, for how long, will be the clinical decision of your doctor.

CBC

CBC means complete blood count. This is the most basic test done for every patient. In this test, we check for levels of haemoglobin, total leukocyte count, differential white cell count, platelet count, and ESR. Besides, there are numerous other parameters printed in your report, like MCV, MCH, MCHC, RDW, and PDW. But let’s first look at the basic parameters. Haemoglobin is perhaps the most important parameter to look at. It shows how much oxygen your blood can carry. Low hemoglobin is called anemia. If you have anaemia, you need to get treatment ASAP. The standard normal values of hemoglobin depend on age and gender and also physical states like pregnancy. The normal hemoglobin of an adult male will be different from that of an adolescent girl. There are many different causes of anaemia in our society, like iron deficiency, worm infestation, thalassemia, and kidney disease. Your doctor will do further tests to elucidate the cause.

The next most important parameter is total leukocyte count. This gives an indication of whether you have any infection or inflammation. Conversely, in some conditions like Typhoid, the counts may be low despite fulminant infection. Platelet count is also important in infections like dengue, where it may get dangerously low. We need to check platelet count repeatedly, sometimes even twice or thrice the same day, in dengue infection. Platelet count may be low in some forms of blood cancer too.

The other parameters like MCV and RDW are too complex to be discussed in this short article. Suffice it to say, they are deranged in conditions like Thalassemia, sickle cell disease, vitamin B12 deficiency, and hereditary Red cell membrane disorders.

Also Read: BTS’ V Opens Up About 2-Year Battle With Hearing Loss

And finally, the ESR is a very non-specific parameter. It can be raised in multiple conditions, ranging from cancer to inflammation. It is usually interpreted in unison with other necessary tests.

Dr Rudrajit Paul, Consultant Physician, Manipal Hospital, Kolkata

“All That” star Christy Knowings has died after reportedly suffering an asthma attack that led to cardiac arrest and brain damage.

The 46-year-old actress was hospitalized on August 7 after the attack and placed on life support, TMZ reported.

According to TMZ, citing family sources, Knowings suffered cardiac arrest following the asthma attack. Her family decided to take her off life support on August 11.

Knowings, who was born on February 25, 1980, in the Bronx, is the second former All That cast member to die this year, following the fatal hit-and-run death of Kianna Underwood in January in Brooklyn.

In a Facebook post, Knowings’ aunt wrote that her niece was an “outstanding actress, comedian, twin sister” and an “amazing daughter.”

Knowings’ reported death after complications from an asthma attack is a reminder that while asthma can often be managed, it should not be taken lightly, health experts told HealthandMe.

What Is Asthma? How Severe Can It Turn?

Dr. Abhijit Ahuja, Consultant Pulmonologist, Saifee Hospital, Mumbai, explained that asthma is a condition that makes it difficult to breathe because the airways become inflamed and narrow.

Many people with asthma can control their symptoms with medication. However, an asthma attack can sometimes become severe and life-threatening.

During an asthma attack, symptoms suddenly worsen and usual medication may not provide enough relief. A person may experience difficulty breathing, wheezing, chest tightness, severe coughing or trouble speaking.

“If you use your inhaler but still have trouble breathing, you need to go to the hospital right away,” Dr Ahuja said.

When the airways become so narrowed that the body does not receive enough oxygen, the asthma attack can turn severe. The lungs may also be unable to remove carbon dioxide properly.

“If this keeps happening, it can hurt parts of the body like the brain and the heart,” Dr Ahuja said.

A severe asthma attack can lead to difficulty breathing, loss of consciousness, brain injury and cardiac arrest.

When Can an Asthma Attack Be Deadly?

Dr. Taniya Mehta, Consultant Respiratory Medicine, Sterling Hospitals, Gujarat, told HealthandMe that while most asthma attacks can be treated, a very severe attack can become deadly when the airways become so tight that the lungs cannot get enough oxygen.

“If treatment isn't given quickly, low oxygen levels can cause the lungs to stop working, damage the brain, cause the heart to stop and lead to death,” she said.

Signs That an Asthma Attack Is an Emergency

Seek emergency medical help if a person has:

• Breathing difficulty or wheezing that is rapidly getting worse.
• Trouble speaking more than a few words because of breathing difficulty.
• No improvement after using a quick-relief inhaler.
• Blue, grey or very pale lips, fingernails or skin, which may indicate low oxygen.
• Severe confusion or loss of consciousness.

Who Is More Likely to Have a Severe Asthma Attack?

People may be at greater risk if they:

• Have had a severe or life-threatening asthma attack before.
• Need to use their quick-relief inhaler frequently.
• Do not use their asthma medicines as prescribed.
• Do not have their asthma under control.
• Cannot recognise when their symptoms are getting worse.

Do Not Wait Out a Severe Asthma Attack

Deadly asthma attacks are uncommon, but they can happen quickly, the doctors warned.

Taking asthma medication as prescribed, knowing how to use inhalers correctly, attending follow-up appointments and undergoing lung tests when needed can help keep asthma under control.