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!

Epilepsy is one of the most common neurological disorders and a leading cause of disability worldwide. Research has suggested that associated conditions, such as stigma, anxiety, and depression, can sometimes be more debilitating than the seizures themselves.

Stigma related to epilepsy can exist at both societal and individual levels, with many patients experiencing feelings of shame, fear, discrimination, and social isolation.

Now, research led by AIIMS New Delhi has suggested that yoga may help reduce epilepsy-related stigma while also improving seizure control. The 2023 study, published in Neurology, found that yoga-based interventions may offer benefits for both mental well-being and disease management.

“Yoga has been clinically proven to reduce the ‘felt stigma’ associated with epilepsy. By alleviating anxiety and improving both mindfulness and overall quality of life, mind-body interventions empower individuals to feel more in control and less socially isolated,” lead author Dr. Manjari Tripathi, Head of the Department of Neurology at AIIMS, told HealthandMe.

What Did the Study Find?

According to Dr. Manjari, the study identified three key benefits of yoga for people living with epilepsy:

• Stigma Reduction: Patients who participated in a six-month yoga and psychoeducation program reported a significant reduction in perceived stigma compared with the control group.

• Improved Seizure Control: The yoga intervention was associated with a higher rate of seizure reduction. "Participants were more than four times as likely to experience a greater than 50% reduction in seizures and were significantly more likely to achieve complete seizure remission," Dr. Manjari told HealthandMe.

• Better Mental Health: Yoga practice was linked to lower anxiety levels, improved emotional regulation, and reduced cognitive impairment.

Also read: Yoga's Increasing Role As Great Soft Power And Preventive Healthcare: Ayush Secretary

Dr. Rajesh Sagar, Professor of Psychiatry at AIIMS, told HealthandMe that yoga reduced the burden of epilepsy and improved the overall quality of life in epilepsy patients by reducing the perceived stigma. The overall quality of life was also improved in the yoga group.

How Was the Study Conducted?

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Researchers conducted a randomized clinical trial involving 160 adults with epilepsy who were followed for six months. Participants were assigned either a structured yoga program or a sham yoga intervention, while both groups also received epilepsy-related psychoeducation.

The yoga program included loosening exercises , breathing techniques, meditation, and positive affirmations.

While the impact on seizure frequency was reduced compared with the control group, the researchers cautioned that larger studies are needed to conclusively determine the effect of yoga on seizure control.

Yoga For Mental Health

Further, mood disturbances have been common among people with epilepsy and often remain inadequately addressed, particularly in developing countries.

According to the researchers, yoga may offer a scalable and accessible option for helping patients manage these challenges alongside conventional treatment.

Dr. Rajesh further told HealthandMe that yoga has well-established benefits for mental health.

“Yoga is important in mental health care, and it has been found that the three important things, which are pranayama, that is, breathing techniques, asanas, that is, physical posture, and dhyana, that is, meditation, have a positive effect on anxiety and even depression, and also improve sleep".

He added that yoga can help reduce stress, improve mood, lower anxiety levels, and enhance sleep quality.

“There is substantial evidence from around the world showing that yoga can benefit people living with certain mental health disorders,” he said.

Every morning, millions begin their day with a quick breakfast and blood pressure (BP) medication swallowed mechanically. But what happens when BP remains uncontrolled despite medicines? Uncontrolled hypertension is one of the most underestimated health threats. Often called the silent killer, it quietly damages the heart, brain, kidneys, and blood vessels.

The BP reading on the cuff captures only a visible measurement. BP that remains above goal over time despite treatment is concerning. Hypertension affects approximately 1.4 billion adults worldwide. Studies suggest that almost 54% of Indian patients have uncontrolled hypertension even while taking ≥2 medications. Thus, treatment does not necessarily mean control.

Why Does BP Control Matter?

Global organizations recommend stricter BP targets, aiming for readings below 130/80 mmHg or even 120 mmHg if tolerated. Studies show that each 10 mmHg reduction in systolic BP can decrease the risk of major cardiovascular events by 20%, stroke by 27%, heart failure by 28%, and death by 13%.

On the other hand, uncontrolled hypertension increases the risk of heart attacks, strokes, heart failure, end-stage kidney disease, type 2 diabetes, and death.

But What If The Numbers Don’t Change Despite Medication?

In persistently uncontrolled hypertension that other causes cannot explain, a hidden culprit called aldosterone is an under-recognized driver. Normally, aldosterone balances sodium and water to regulate BP.

However, in patients with uncontrolled hypertension, aldosterone production may remain abnormally high, causing sodium and fluid buildup, increasing BP.

Approximately 30% of patients with hypertension may have aldosterone dysregulation, and patients with resistant hypertension, obesity, type 2 diabetes, sleep apnea, and hypokalemia are at greater risk. Nearly 10–20% of patients with hypertension are treatment resistant, increasing their risk. In these patients, aldosterone dysregulation could be an important cause.

It is time to look beyond the cuff, as uncontrolled hypertension is a chronic, progressive, and often silent condition with serious consequences. Improving patient outcomes requires greater urgency, earlier intervention, better treatment optimization, and stronger awareness of underlying drivers such as aldosterone.

It is time to identify and treat the root causes of uncontrolled hypertension, so that patients can regain lasting BP control.

Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, affects millions of people worldwide. The lifelong condition commonly begins in adolescence or early adulthood and can require repeated hospital treatment, long-term immunosuppressive medication, and, in some cases, surgery.

Despite advances in treatment, many patients cycle through multiple therapies without achieving lasting disease control, impacting their lives and costing healthcare systems millions.

Now, a team of UK researchers from the Universities of Oxford, Newcastle, and Cambridge has identified an important driver of inflammatory bowel disease (IBD).

The findings, published in the New England Journal of Medicine, suggest that inflammatory bowel disease is not a single condition but a group of biologically distinct diseases driven by different underlying mechanisms.

"Understanding what drives the inflammation provides a clear explanation for disease in this group of people and opens the door to new treatments that target the autoantibodies themselves or cells that produce those autoantibodies," said Professor Holm Uhlig, a pediatric gastroenterologist and director of the Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford.

What Did the Study Find?

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The researchers analyzed more than 4,900 patients with IBD and discovered that:

• A substantial subset of patients shows autoimmune responses to one of the guardians of the immune system, interleukin-10 (IL-10), which leads to uncontrolled inflammation.
• This damaging immune response is the mechanism for one of the strongest known genetic risk factors for IBD.

Antibodies that block interleukin-10 (IL-10), a cell-to-cell messenger that normally acts as one of the body's key controls on inflammation, effectively remove the immune system's natural "brake" on inflammation, allowing inflammatory responses to continue unchecked.

The researchers found high levels of anti-IL-10 neutralizing autoantibodies in the blood of about 3.5% of IBD patients, including those with Crohn's disease and ulcerative colitis, but not in healthy individuals. This could equate to 15,000–20,000 people with IBD in the UK carrying these autoantibodies.

The Genetic Link

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The researchers also found that the presence of these antibodies was strongly linked to carriage of a particular genetic variant known as HLA-DRB1*01:03.

The link between HLA-DRB1*01:03 and a severe form of inflammatory bowel disease was first identified by Oxford researchers 30 years ago.

The new findings show that people carrying this variant are far more likely to develop antibodies that block IL-10, helping explain how the gene contributes to disease.

What Could This Mean for Patients?

The researchers say the findings support the development of a blood test to identify this subgroup of patients, helping clinicians move quickly toward more appropriate treatment.

What Is IBD?

As per the Centers for Disease Control and Prevention (CDC), IBD refers to a group of lifelong diseases that affect your intestines. The main types of IBD are ulcerative colitis and Crohn's disease.

Ulcerative colitis affects the large intestine, while Crohn’s disease can inflame any part of the digestive tract. Both are lifelong conditions of unknown cause that trigger abdominal pain, diarrhea and other complications, with no known cure.

What Are The Symptoms Of IBD That People Usually Ignore?

• Diarrhea or changes in bowel movements
• Stomach pain
• Fatigue
• Nausea
• Weight loss

• Dehydration
• Increased risk of colon and rectal cancers
• Low red blood cell count (anemia)
• Reduced bone density
• Joint pain
• Skin changes
• Eye irritation
• Delayed or impaired growth in some children.