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!

When John Cena started noticing blurry vision, he assumed it was simply part of getting older. But the worsening eyesight was also accompanied by redness, itchiness and crusting around his eyes.

“I had a lot of redness and itchiness, and every once in a while, waking up with eye crusties and stuff. At the same time, given my age — I'm 49 now — my vision was going a little bit, so I just figured it was par for the course. But because my vision was going, I needed to see if I needed glasses or prescriptions.”

Until then, Cena had delayed getting his eyes checked. He believed that the symptoms were caused by bright lights, excessive screen time or ageing.

However, an eye examination gave him a surprise. Cena learned that his symptoms were caused by Demodex blepharitis, a condition he says he had never heard of.

“Diagnosed with Demodex blepharitis, which I didn't even know existed.”

What Are Demodex Mites?

Also read: Study Decodes Why COVID Survivors Continue To Suffer Vision Problems

Demodex mites are tiny, eight-legged organisms that live naturally on human skin, particularly around hair follicles. Measuring just 0.15 to 0.4 millimeters, they are invisible to the naked eye but are present on the skin of almost every adult.

These microscopic mites feed on sebum (the skin's natural oil) and dead skin cells, helping remove accumulated debris under normal conditions.

How Do Demodex Mites Work?

Demodex mites are most active at night. They emerge from hair follicles after sunset because ultraviolet (UV) light is harmful to them. While people sleep, the mites feed, crawl and reproduce on the skin's surface.

They are also believed to be stimulated by melatonin, the hormone that helps regulate sleep, creating a unique relationship between humans and these naturally occurring organisms.

When Can Demodex Mites Become A Problem?

Although harmless in small numbers, Demodex mites can cause problems if they multiply excessively—a condition known as demodicosis.

According to Dr. Richard Locksley, professor of medicine at the University of California, San Francisco, an overgrowth of Demodex mites can contribute to:

• Rosacea
• Blepharitis (eyelid inflammation)
• Acne-like breakouts
• Itchy, inflamed skin

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People with weakened immune systems are particularly vulnerable because their bodies may be less able to control mite populations. In addition, inadequate sleep may increase oil production, providing more nourishment for the mites.

Should You Be Worried?

For most healthy people, Demodex mites are a normal part of the skin microbiome and are not considered harmful. Problems generally arise only when their numbers increase significantly.

To help reduce the risk of overgrowth:

• Wash your face every night with a gentle, non-comedogenic cleanser to remove excess oil and debris.
• Remove eye makeup and false eyelashes before bed, as these can encourage mite buildup.
• Get adequate sleep, since poor sleep may increase sebum production.
• Consult a dermatologist if you experience persistent redness, itching or inflammation around the eyes or skin.

Gone are the days when constipation was considered a problem only among older adults. Today, an increasing number of young professionals are experiencing irregular bowel movements, bloating, abdominal discomfort, and a constant feeling of incomplete evacuation. The fast-paced corporate lifestyle, long working hours, unhealthy eating habits, and chronic stress have made constipation a common digestive concern among people in their 20s and 30s.

One of the biggest contributors is a sedentary lifestyle. Many professionals spend eight to ten hours sitting at a desk, with little time for physical activity. Regular movement helps stimulate bowel function, and a lack of it can slow down digestion. Another common cause is poor dietary habits. Skipping breakfast, relying on processed or fast foods, and consuming inadequate amounts of fibre can significantly affect bowel health.

Hydration also plays a vital role. Busy schedules often lead people to consume more coffee or tea while neglecting water intake. Dehydration makes stools harder and more difficult to pass, increasing the risk of constipation. Stress is another major factor. Deadlines, work pressure, and poor sleep can disrupt the communication between the brain and the gut, affecting normal bowel movements. Ignoring the natural urge to pass stools due to meetings or travel can further worsen the condition over time.

The good news is that constipation can often be managed through simple lifestyle changes. A balanced diet rich in fibre from fruits, vegetables, whole grains, legumes, and nuts helps add bulk to stools and promotes regular bowel movements. Drinking at least two to three litres of water daily keeps stools soft and easier to pass.

Regular physical activity is equally important. Even a brisk 30-minute walk, stretching during work breaks, or choosing stairs over elevators can improve gut motility. Maintaining a consistent toilet routine, preferably after breakfast, and responding promptly to the body's natural urge can also help establish healthy bowel habits.

Stress management should not be overlooked. Practising yoga, meditation, deep breathing exercises, or simply ensuring adequate sleep can positively influence digestive health. Limiting excessive consumption of processed foods and caffeinated beverages can also reduce the risk of constipation.

While occasional constipation is usually not a cause for concern, persistent symptoms lasting more than three weeks, severe abdominal pain, blood in the stool, unexplained weight loss, or constipation alternating with diarrhoea should never be ignored. These could indicate an underlying medical condition that requires evaluation by a gastroenterologist.

Healthy digestion is closely linked to overall well-being and productivity. By adopting healthier daily habits and paying attention to digestive health, young professionals can prevent constipation, improve their quality of life, and maintain better physical and mental performance at work.

By Dr. Pradeepta Kumar Sethy, Director, Gastroenterology, Manipal Hospital, EM Bypass & Mukundupur

A stroke can happen suddenly and without warning, making every minute count. The first 60 minutes after the onset of stroke symptoms are crucial because timely medical treatment can help reduce brain damage and improve recovery.

What is a Stroke?

A stroke happens when the blood flow to an area of the brain is cut off due to either the blockage of a blood vessel supplying that area or the bursting of the said blood vessel. Without adequate blood flow, brain cells are deprived of oxygen and nutrients and begin to be damaged within minutes.

What Happens During the Golden Hour?

The first hour after a stroke is focused on rapid assessment and treatment. Once the patient reaches the hospital, doctors evaluate the symptoms, determine when they started, and perform an urgent brain scan, usually a CT scan, to identify the type of stroke.

This step is important because treatment depends on whether the stroke is caused by a blocked artery (ischemic stroke) or bleeding in the brain (hemorrhagic stroke). For eligible patients with an ischemic stroke, clot-dissolving medication or a procedure to remove the clot may be considered.

Although treatment windows may extend beyond the first hour for some patients, reaching the hospital as early as possible offers the greatest chance of saving brain tissue. In most patients, clot-dissolving medication is given within 4.5 hours of symptom onset, while selected patients may be eligible for treatment up to 9 hours. Mechanical clot removal is generally performed within 6 hours, although carefully selected patients may benefit from the procedure up to 24 hours after symptoms begin. However, earlier treatment is associated with better protection of brain tissue and improved outcomes.

Know the Warning Signs

Recognizing stroke symptoms early can help save valuable time. The BEFAST acronym is a simple way to remember the common warning signs:

B – Sudden loss of balance or coordination

E – Sudden vision loss or changes in one or both eyes

F – Face drooping

A – Arm weakness

S – Speech difficulty

T – Time to call emergency medical services

Other symptoms may include sudden loss of vision, dizziness, difficulty walking, numbness on one side of the body, confusion, or a sudden, severe headache.

Why Every Minute Matters

During a stroke, brain cells continue to be damaged as blood flow remains interrupted. Delays in reaching the hospital can limit treatment options and increase the risk of long-term disability. Seeking medical care as early as possible gives doctors the best chance to provide appropriate treatment.

What Should You Do?

If you notice stroke symptoms in yourself or someone else, do not ignore them or wait for them to improve. Call emergency medical services immediately and note the time the symptoms first appeared, as this information helps doctors decide the most suitable treatment.

The golden hour is a critical window during which timely action can significantly improve outcomes. Recognizing the signs of stroke and seeking immediate medical care can make a meaningful difference in recovery.