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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.
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.
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.
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.
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.
However, in case we do not get these technologically advanced toilets here, you can always pack a travel-friendly toilet kit!
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Changes in voice pitch, volume or clarity in older adults could be an early warning sign of cognitive decline, according to a new analysis.
The study, published in the Journal of Voice, found that older adults who experienced a decline in voice quality had a higher risk of cognitive impairment or dementia than those without a voice disorder.
The study tracked the health of more than 833,000 older Americans. Researchers found that people with a voice disorder had a 58% higher risk of cognitive impairment or dementia than those without voice problems.
The risk was even higher among people who had both a voice disorder and hearing loss, a well-recognized risk factor for Alzheimer’s disease.
A brief episode of hoarseness does not mean that a person is developing dementia.
However, persistent or noticeable changes in the voice, particularly when accompanied by hearing loss, may warrant a medical evaluation and, where appropriate, an assessment of cognitive health.
“We found the strongest link with dementia among patients experiencing a voice disorder and hearing loss,” said study author Dr. Robert Sataloff, a professor and chair at Drexel University’s College of Medicine.
“Importantly, we found that those with a voice disorder and no hearing loss were at greater risk than patients who experience hearing loss only. It may be valuable for many of these patients to talk with an otolaryngologist who can arrange a cognitive assessment to help patients develop an appropriate care plan.”
The researchers speculate that voice disorders may contribute to cognitive decline by limiting social interaction, which can also be affected by hearing loss.
People who have difficulty speaking or hearing may avoid social gatherings or group activities because they feel embarrassed or uncomfortable about their limitations. However, social engagement can help keep the ageing brain active by providing ongoing mental stimulation.
“If you have a voice disorder that impacts how your voice sounds or if it’s painful when you attempt to talk or sing, it’s only natural to participate less often in brain-supporting social or other engaging activities,” Dr. Sataloff said.
Speaking less may mean less social and cognitive stimulation, which could potentially contribute to dementia risk. However, the researchers also noted another possibility: changes in the brain associated with dementia could themselves contribute to voice problems. However, this has not been directly studied.
Most people with voice disorders will not go on to develop Alzheimer’s disease. Voice changes can have several other causes, including thyroid problems and cysts on the vocal cords, some of which can be treated effectively.
Speech therapists can also help people with impaired speech communicate more effectively and confidently.
Seeking medical attention for persistent voice changes can therefore help identify treatable causes and determine whether further evaluation, including a cognitive assessment, is needed.
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As the 2026-27 flu season begins in the US, doctors are reminding people that influenza can cause more than just cough, fever and a runny nose. Symptoms can come on suddenly and affect the entire body, with some patients also developing gastrointestinal symptoms.
During the 2025-2026 flu season, influenza caused at least 32 million illnesses, 390,000 hospitalizations and 24,000 deaths in the US, according to preliminary data from the Centers for Disease Control and Prevention (CDC).
According to the World Health Organization, from February through August 2026, influenza A(H1N1)pdm09, A(H3N2) and influenza B viruses circulated across regions. Influenza A viruses predominated in most regions, while influenza B dominated in Northern and Western Africa, North America and Eastern Asia.
While it is too early to know what the season ahead will look like, knowing the range of flu symptoms can help people recognize the infection. These include the classic symptoms of sudden fever, chills, body aches and extreme fatigue, as well as vomiting and diarrhea in some children.
Also read: WHO Sets 2027 Flu Vaccine Strains; US States Can Now Order Free COVID Shots For Kids
Influenza commonly affects the nose, throat and lungs, but its symptoms can be widespread.
The most common symptoms include:
Family physician Carlos Galindo at Texas Health Family Care said fever, chills and body aches are the classic flu combination. People may also develop a sore throat, runny nose and headache, according to the American Medical Association.
Unlike the gradual tiredness that can accompany a cold, flu-related fatigue can be intense.
Galindo described it as significant lethargy and malaise, with some patients feeling completely drained.
One of the key features doctors want people to recognize is how quickly influenza can make someone feel unwell.
Family physician Christopher Zipp of Atlantic Health in Morristown, New Jersey, said flu symptoms can develop over just a few hours, with fever, chills and body aches appearing suddenly.
However, flu symptoms can overlap with those of other respiratory infections, so symptoms alone cannot always confirm that someone has influenza.
Read More: Fall Vaccines 2026: US Doctors Issue COVID, Flu And RSV Jab Guidance
Flu symptoms can also differ between children and adults. While fever, chills, body aches and respiratory symptoms are common, children may also develop gastrointestinal symptoms such as vomiting and diarrhea.
These symptoms can occur alongside cough, sore throat or other signs of respiratory infection.
For most people, influenza is an unpleasant but temporary illness. However, it can sometimes lead to complications such as pneumonia and hospitalization, particularly in people with underlying health conditions.
Symptoms that become severe or worsen rather than improve warrant medical attention, especially among people at higher risk of complications.
In the US, many flu cases are seen between January and March, although influenza can circulate outside the peak season as well.
Doctors generally recommend flu vaccination around September or October to build protection before activity increases. It takes about two weeks for the body to develop protection after vaccination. Flu vaccination has been shown to reduce flu-related doctor visits by about 40% to 60%.
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A mammogram is routinely used to detect early signs of breast cancer, but the imaging test may also provide clues about a woman’s cardiovascular health.
Cardiovascular disease is a major cause of death among women. Yet, experts say heart disease in women can be overlooked because symptoms and risk factors may differ from the patterns traditionally associated with men.
Prof Rob Galloway of University Hospitals Sussex NHS Foundation Trust, writing in the Daily Mail, highlighted the need to identify cardiovascular disease in women earlier.
Citing a 2021 The Lancet study, he noted that women with cardiovascular disease remain “understudied, under-recognized, underdiagnosed, and undertreated.”
Galloway said he regularly sees women, particularly those in their 60s, arriving in emergency care with heart attacks after earlier symptoms were attributed to less serious causes.
“If that had been recognized, she could have been admitted, and if needed, had a stent (a mesh tube) inserted to open the artery before it was blocked,” he wrote.
“The truth is doctors are not as good as we should be at recognizing heart disease in women, or understanding their risk,” he added.
Also read: New Breast Cancer Guidelines Recommend Mammograms Every Two Years for Women
Women may experience heart attacks differently, with symptoms such as breathlessness, nausea, fatigue, or back, neck and jaw pain. Galloway also highlighted female-specific risk factors, which include:
He said these factors are not always routinely included when assessing a woman’s long-term cardiovascular risk.
Read More: World Heart Day: You Feel Healthy. But Plaque May Already Be Building In Your Arteries In Your 20s
Prof Galloway suggested that routine breast screening could potentially offer another opportunity to identify cardiovascular risk.
When blood vessels are damaged, calcium can accumulate in their walls. Mammograms can sometimes detect calcium deposits in the arteries of the breast, known as breast arterial calcification (BAC).
BAC is different from calcium buildup in the coronary arteries, but its presence has been associated with a higher risk of cardiovascular events such as heart attack and stroke. Some radiologists may therefore flag the finding to the treating doctor.
Prof Galloway also discussed the potential role of artificial intelligence in identifying and measuring breast arterial calcification.
A European Heart Journal study used AI to assess mammograms from over 123,500 US women. Compared with no calcification, mild breast arterial calcification was linked to a 30% higher cardiovascular event risk, moderate to 75–80% higher risk, and severe to roughly three times higher risk.
The association persisted even after researchers accounted for established cardiovascular risk factors such as obesity and smoking.
Prof Galloway said that the potential advantage is that the mammogram has already been performed for breast screening. If arterial calcification is identified, that information could potentially be included with the screening result and prompt a broader cardiovascular risk assessment.
Depending on the woman's overall risk, doctors could then consider measures such as more intensive management of blood pressure or cholesterol.
A coronary artery calcium scan is another way to assess calcium buildup in the arteries supplying the heart. It uses a CT scan to detect and measure coronary artery calcium and can help inform cardiovascular risk assessment in appropriate patients.
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