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!

Endometriosis is a chronic disease affecting about 1 in 10 women worldwide. Diagnosis and treatment remain challenging, particularly for women with severe pain and other complications.

Now, US researchers have developed a targeted nanotherapy that showed promising results against endometriosis in early testing.

Scientists at Washington State University found that the treatment reduced endometriosis lesions, symptoms and pain sensitivity after a single dose in mice.

The findings were published in Advanced Healthcare Materials. Researchers hope to eventually test the treatment in humans.

How Does The Drug Work?

Also read: Endometriosis Can Take Years To Diagnose But This AI Tool Can Identify Its Signs In 18 Milliseconds

The drug, niclosamide, was previously used to treat intestinal tapeworm infections in humans and is still used in animals.

Earlier research found that niclosamide could reduce endometriosis lesions and inflammation. However, it is not suitable for long-term use, limiting its potential as a treatment for a chronic condition.

To overcome this, researchers developed a nanotherapy that delivers niclosamide directly to cells associated with endometriosis.

“We found the disease-specific immune cell, and then we had a drug, but we couldn’t target the cell with the drug alone,” said Kanako Hayashi, professor at WSU’s School of Molecular Biosciences.

“So we used this nanocarrier that delivers the drug specifically to the disease site,” Hayashi said.

Single Dose Reduced Lesions In Mice

The team used a nanosized molecule called a dendrimer to bind with niclosamide and deliver it in a more soluble form.

In mice, a single injection reduced the size and number of lesions and lowered pain sensitivity.

“Although we still need to clear multiple phases, this study is telling us the efficacy is strong, and this nanocarrier is stable, so far, for two weeks—and we think we can go longer,” Hayashi said.

If the treatment remains stable for longer periods, researchers believe it could potentially be given less frequently. Hayashi said a monthly injection could be possible in the future, but this would depend on further testing.

READ: Endometriosis Taught Me To Always Listen To My Body, Says Model Padma Lakshmi

Can It Be Used In Humans?

Not yet. The treatment has only been tested in mice and must undergo further safety and efficacy testing before human trials.

Researchers also do not yet know whether it would ultimately be given as an injection or IV infusion.

What Is Endometriosis?

Endometriosis affects an estimated 190 million women worldwide. It occurs when tissue similar to the lining of the uterus grows outside the uterus.

It can cause severe pelvic pain, painful periods, pain during sex and infertility. Symptoms are sometimes dismissed as a “bad period,” contributing to delays in diagnosis.

There is currently no cure, although treatments can help manage symptoms.

How Is Endometriosis Treated?

Treatment depends on symptoms, disease severity and fertility goals.

Hormonal medicines can help control pain and disease activity but may cause side effects and can affect fertility while being used.

Painkillers, including non-steroidal anti-inflammatory drugs, may help manage discomfort.

Laparoscopic surgery can remove lesions and endometriotic cysts and may help restore pelvic anatomy. It can also improve fertility in some women, although the disease can recur.

Lifestyle measures such as regular exercise, stress management and dietary changes may also support symptom management.

Lung development of the fetus depends on the physical and genetic health of the parents.

At birth, breathing begins with air from the environment, containing oxygen and other gases, and is influenced by known and unknown forces of nature. The air then passes through well-developed nostrils, which regulate the air temperature and prevent foreign bodies from entering the body and help protect against diseases.

Breath travels through the nasal passages, sinuses, pharynx (throat), larynx (voice box), trachea (breathing tubes), bronchi, small airways, air sacs, interstitial membrane, into thin-walled blood vessels that transport oxygen and collect gases and other substances to be expelled from the body.

The diaphragm, the muscle that separates the lungs from the abdomen, is the most powerful breathing apparatus.

The lungs in the early stages of life undergo dramatic changes from newborn→ infancy→ childhood→ puberty→ teenage→ adults→ middle age→ seniors. Factors influencing lung health risks keep changing with age, depending on genetics, environment & external factors.

• Genetics or abnormalities – disorders at birth, transmitted from parents. Stress, environment, nutritional deficits, and accidents play an important role in lung and airway development. Also, anatomical abnormalities of the airways since birth, whether corrected or correctable or left alone.

• Allergy—genetic or acquired is lifelong unless well managed

• Chronic health conditions – Asthma can occur during childhood, pregnancy, post-pregnancy, or later in life and is generally manageable. Diabetes can develop during childhood, in young adulthood, or later in life, but it can be managed effectively. Hypertension, including pulmonary hypertension, can occur at any age and may be caused by blood clots, underlying diseases, primary conditions, or genetic factors.

• Environmental factors and unhealthy habits – smoking, pollution, gases, drugs, near-drowning. Recreational drugs, or side effects of medications used for diseases of the body, can have a telling effect on the lungs and airways.

• Nutrition – inadequate nutrition of mother and child can cause damage till old age

• Occupational lung disease – at any stage – workplace, smoking, birds, pets, pollution, construction activity, dusty atmospheres and travel, which may cause difficulty in breathing till later in life, leading to chronic obstructive lung disease that may cause morbidity.

• Infections – Can occur during childhood or throughout life, affecting both healthy individuals and those with reduced immune function, which may be due to co-existing diseases, medications that suppress the immune system to prevent rejection of transplanted organs, congenital immune deficiencies, or acquired immune deficiencies resulting from medications, external factors, or underlying diseases.

• Prophylactic medication, vaccines, and early treatment of airway diseases help in later life.

• Autoimmune diseases–arthritis, thyroid, etc.- where the body's defense mechanism has become rogue and fights itself, can develop from childhood till late in life.

• Accidents – happen at any age, damaging the breathing apparatus and requiring emergency treatment

• Cancer in any part of the body, including radiation, may affect the lungs at any age

• Body’s failure of in-built Immunity (innate) or acquired immunity mechanism; sunlight is nature’s gift to mankind; it improves lung resistance at all ages

• Snoring as an indicator for suspected obstructive sleep apnea

For Better Lung Health

• Exercise – yoga, sports, walking, physical and breathing exercises help to improve the performance of the respiratory tract throughout life

• Education – helps in understanding the causes, prevention, and timely treatment. It helps in averting damage to the airways in the future.

• Availability of health care facilities in urban & rural areas – can make a difference in the development, prevention, and treatment of respiratory disorders.

• Breastfeeding of the baby is important as it helps in the development and growth of the lungs, immunity, and fighting against damaging forces in nature, in the form of bacteria, viruses, fungi, prions, and a horde of known and unknown mechanisms which harm airways. Cough and sneeze reflexes begin to develop, which are powerful forces used to throw out unwanted particles and organisms from the airways.

The lungs and airways perform non-respiratory functions of protecting the body against harmful insults, both from within and external threats, and it also protects against insults received from other organs of the body. The lungs have a powerful defense mechanism protecting the body and also have hormonal, physical, and immunological defense mechanisms.

A small lump in the neck is easy to overlook, especially when there is no pain. In many cases, it has a simple explanation, such as an infection or a swollen lymph node. Thyroid nodules are also common, and most of them are not cancerous.

The thyroid is a small gland at the front of the neck. When cancer develops in the thyroid, a lump or swelling may sometimes be the first noticeable change. It may remain painless, which is one reason people tend to wait before getting it checked.

What changes are worth noticing?

The way a lump changes over time can provide an important clue. A swelling that suddenly becomes larger, feels harder, remains in place for several weeks deserves attention.

Other changes can include persistent hoarseness, difficulty swallowing, a feeling of pressure in the neck or, less commonly, difficulty breathing. Swollen lymph nodes on the side of the neck can also occur. These symptoms are not specific to thyroid cancer and may be related to other causes, but they should not be dismissed if they persist.

Also read: Thyroid Medicine Recall Gets US FDA’s Highest Risk Rating: What To Know

How is the lump checked?

A doctor will first examine the neck and assess the size and location of the swelling. An ultrasound is often used to look more closely at the thyroid and any nodules present.

If a nodule has features that call for further investigation, a fine-needle aspiration may be advised. A small sample of cells is taken with a thin needle and examined to determine whether further treatment or monitoring is required.

When is it time to see a doctor?

A painless lump does not automatically mean cancer, and discovering a thyroid nodule is not a reason to panic. At the same time, a swelling that stays for over three weeks, grows or is accompanied by changes in swallowing or voice should be evaluated.

Early assessment can help identify whether the lump is related to the thyroid, an infection or another condition, and whether any follow-up is needed.

By Dr Akshat Malik, Senior Consultant, Head & Neck Oncology, Indraprastha Apollo Hospital, Delhi