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!

Back pain is generally considered a problem seen in old age, but of late, we are increasingly seeing younger adults suffering from back pain. Prolonged sitting hours, inadequate physical activity, smoking, and an unhealthy lifestyle have made back pain a common complaint even in people under 30 years of age.

What is a slipped disc?

In an interview with Health and Me, Dr Satish Satyanarayana, neurosurgeon, Apollo Hospitals, Bengaluru, said, “Most commonly, we attribute this pain to a slipped disc or other disc-related conditions. However, they are just one among many reasons causing back pain. A thorough understanding of the other conditions that can lead to back pain, and knowing the ‘red flags’ to help identify them, will assist in seeking early treatment and preventing further complications.”

Muscle strain is considered to be one of the most common reasons for developing back pain in younger individuals. Daily activities like travelling for long hours, lifting heavy weights without proper technique, and carrying heavy backpacks can lead to muscle strain. Often, the pain due to muscle strain comes down with the help of medications such as muscle relaxants and rest.

Poor posture and back pain

Working professionals and students spend many hours a day studying, gaming, and working on computers without maintaining proper posture, leading to excess strain on the back muscles and, in turn, prolonged back pain. Having a properly ergonomically designed workstation/study table setup can prevent back discomfort and stiffness.

What are the causes of back pain?

Lack of physical activity and associated conditions such as obesity weaken our core muscles, which are considered the main pillars supporting our spine. Weakened core muscles will not be able to perform the functions expected of them, leading to back pain. Regular exercise, weight management, a healthy diet, and guided weight training will help strengthen our core muscles and reduce the risk of back pain.

Other than muscles, the spine also contains small joints known as facet joints, irritation or inflammation of which can lead to back pain. A structure known as the pars interarticularis acts as a clamp in the spine, holding two adjacent vertebral bodies, and any defect, such as a congenital defect or fracture due to repetitive microtrauma, as seen in gymnasts, can lead to the slipping of one bone over the other, causing back pain.

Though mechanical back pain is most common, there are other conditions such as inflammatory arthropathy, tumours, and infections. Conditions such as ankylosing spondylitis, rheumatoid arthritis, and hyperuricemia/gout are some examples of inflammatory conditions in which an individual experiences early morning back pain associated with stiffness and may also present with pain in other joints.

Can tuberculosis lead to back pain?

Tuberculosis affecting the spine is considered the most common infection of the spine. Severe back pain, weight loss, loss of appetite, fever, and night sweats are some of the common symptoms. Other bacterial and fungal infections are also seen affecting the spine, most commonly in immunocompromised individuals.

Tumours, though rare in young individuals, warrant further investigation when symptoms such as severe weight loss, night pain, and prolonged back pain are present to rule out the possibility of tumours.

Other conditions such as scoliosis (congenital/adolescent idiopathic scoliosis), which is a three-dimensional deformity of the spine, can cause back pain. It requires further assessment in the form of radiological investigations to assess the degree of deformity and to plan any surgical intervention, if required, based on the severity of the curve.

What are the symptoms?

Identifying some of the red-flag signs, such as weakness in the legs, numbness around the groin, bladder or bowel dysfunction, fever, unexplained significant weight loss, or severe pain following major trauma, is essential. These symptoms may indicate serious underlying pathology requiring medical care.

Fortunately, back pain in young people is largely preventable. Basic lifestyle modifications such as regular exercise, maintaining proper posture, avoiding prolonged sitting, maintaining a healthy body weight, undertaking monitored weight-training programmes, following a healthy diet, and getting adequate sleep will help prevent as well as overcome existing back problems. Invest in your spinal health at the earliest opportunity to reap the benefits in the second half of life.

Every year, millions of people undergo routine health check-ups that include a lipid profile. Yet for many, the numbers on the report—Low-Density Lipoprotein (LDL), High-Density Lipoprotein (HDL), triglycerides, and increasingly ApoB—remain confusing.

Most people know that cholesterol is linked to heart disease and that "good" cholesterol can be beneficial, while high levels of "bad" cholesterol may increase cardiovascular risk. However, understanding what the different lipid profile numbers mean—and which ones matter most—can make a significant difference to long-term heart health.

Taking to the social media platform X, noted neurologist Dr. Sudhir Kumar said, "This is mainly meant for people who have NOT suffered a heart attack or stroke and are NOT already taking statins."

How Often Should You Get Tested?

Dr. Sudhir, Senior Consultant Neurologist at the Institute of Neurosciences, Apollo Hospitals, Hyderabad, shared that for most healthy adults, a lipid profile every two to three years is generally sufficient.

However, more frequent testing may be necessary for people with:

• Diabetes
• High blood pressure
• Obesity
• A history of smoking
• A family history of premature heart disease
• Previously abnormal cholesterol levels

LDL: Why This Cholesterol Matters

Also read: AHA’s New Dyslipidemia Guidelines Stress Early Screening, Lifestyle Management

LDL cholesterol, commonly known as LDL-C, is often referred to as "bad cholesterol." The expert explained its key role in the development of heart disease.

"Excess LDL can enter artery walls and contribute to plaque formation. Over time, these plaques may narrow blood vessels or rupture, increasing the risk of heart attacks and strokes," Dr. Sudhir said.

For most healthy adults, LDL levels below 100 mg/dL are considered desirable. Levels above this range gradually increase cardiovascular risk, particularly when elevated over many years.

The lower the LDL, the lower the long-term risk of heart attack and stroke. On the other hand, persistently high LDL can increase the lifetime risk of:

• Heart attack
• Stroke
• Peripheral artery disease

Triglycerides: A Marker Of Metabolic Health

Triglycerides are another type of fat found in the bloodstream. High levels of triglycerides are often a marker of poor metabolic health, Dr. Sudhir said.

He added that high triglycerides can indicate:

• Insulin resistance
• Obesity
• Prediabetes
• Diabetes
• Physical inactivity
• Excessive alcohol consumption
• Diets rich in refined carbohydrates and sugary beverages

What About HDL?

High-density lipoprotein, or HDL, has long been known as "good cholesterol." Traditionally, higher HDL levels have been associated with lower cardiovascular risk.

However, recent research has challenged the idea that simply raising HDL improves heart health. Several medications designed to increase HDL levels failed to reduce heart attack risk, prompting a shift in focus toward lowering harmful cholesterol particles rather than boosting HDL alone.

As a result, the expert cautioned against judging cardiovascular health based solely on HDL levels.

ApoB: The Emerging Risk Marker

Read More: Cardiovascular Diseases Lead As India’s Top Killer: US Cardiologist Points Out Risk Factors

One of the most important developments in cardiovascular prevention is the growing recognition of Apolipoprotein B, or ApoB. Dr. Sudhir stated that ApoB is a protein found on potentially harmful cholesterol-carrying particles such as LDL and VLDL (Very Low-Density Lipoprotein, a type of "bad" cholesterol).

"Think of ApoB as a count of the particles capable of entering artery walls and causing plaque. One ApoB is equal to one potentially harmful particle," the expert said.

ApoB is important because two people may have the same LDL level, but only one may have many more cholesterol-carrying particles. That person will often have a higher ApoB level and potentially higher cardiovascular risk. ApoB often provides a more accurate assessment of risk than LDL alone, the neurologist explained.

He suggested that ApoB testing should be considered by people with diabetes, prediabetes, metabolic syndrome, obesity, elevated triglycerides, or a strong family history of heart disease.

How To Improve Lipid Profile Naturally?

• Exercising regularly
• Maintaining a healthy body weight
• Avoiding smoking
• Limiting sugary drinks
• Reducing ultra-processed foods
• Eating more vegetables, fruits, and legumes
• Choosing healthier sources of fat
• Prioritizing good sleep.

A recent research published in the Nature Medicine journal reveals that a new drug can help people on obesity shots to avoid unwanted muscle loss linked to flat bums or "Ozempic butt". The US research suggests that about a third of the weight loss from GLP-1 obesity jabs like Wegovy and Mounjaro can come from muscle rather than fat. The medication is apitegromab.

The trial with 102 adults, mostly women, who took apitegromab with their obesity medication, maintained more muscle while still losing fat, body scans showed.

But How Does Ozempic Function?

The first thing to remember here is that Ozempic is a brand-name medicine that contains semaglutide as its active ingredient. Semglutide is the synthetic version of GLP-1, a natural hormone produced in the intestines that regulates blood sugar, appetite, and digestion. Now, every time you eat, your body produces various hormones, including GLP-1. These are called post-nutrition hormones, and they help you absorb the energy you just consumed.

Also Read: Salmonella Outbreak: Instant Noodles Sicken Over 80 In The UK, Europe

GLP-1 travels to your pancreas, prompting it to produce insulin. It also travels to the hypothalamus in your brain, which gives you the feeling of being full or satiated. Ozempic imitates this hormone, thereby silencing the food chatter in the brain. Interestingly, for some people, this food chatter is really quiet ( people with low appetite), and for others it is an outburst (people who generally binge eat). So with Ozempic, silencing this self-talk in the brain, people tend to lose their appetite and eventually weight.

However, it is important to note that losing weight includes not just fat but muscle as well. Losing too much muscle can lead to reduced strength and a shorter life span. Notably, records show that most people who start taking them stop them at 12 weeks; therefore, it is important for some but not for others.

Also Read: Ebola Outbreak Escalates: Uganda Rushes Medics To Congo Border Regions

What Are The Side Effects?

Ozempic is a drug that is tasked to help diabetic patients manage their blood sugar levels and weight. However, recent research has shown its effectiveness in mitigating various addictions like alcohol and drugs by inhibiting hormones. But what people ignore are its side effects, which include:

• Nausea is a frequent side effect, especially when starting Ozempic or increasing the dose, and vomiting may occur along with nausea.
• Diarrhoea and abdominal discomfort also show up in people using Ozempic, but they generally resolve as your body adjusts.
• Ozempic can reduce appetite but may also lead to unintended weight loss or reduced food intake, causing discomfort for some people.
• There are certain less common, but serious side effects, like Pancreatitis, or inflammation of the pancreas.
• This drug may also cause severe kidney issues, particularly if dehydration occurs from side effects like vomiting or diarrhoea.