Credits: Unsplash
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!
Credits: Canva
On No Smoking Day, we drive our focus to science-backed methods that can help one leave smoking. Smoking is one of the leading causes of preventable deaths worldwide. It also contributed to severe health problems, including cancer, cardiovascular diseases, and respiratory diseases. Even though many people are aware of this harmful consequences, many struggle to quit smoking. Mostly because it is a habit often associated to enjoying a break. Even when someone does not need it, their brain tricks them into believing that smoke is important for the break they are meant to enjoy.
However, there are several studies that have explored science-backed methods that could help one to quit smoke.
A study published in the journal Addiction, emphasizes three primary methods proven effective for quitting smoking: behavioral support, prescription medications, and nicotine replacement therapy (NRT). These strategies have shown varying levels of success in aiding smokers to quit permanently. In addition, alternative methods like e-cigarettes and mindfulness-based techniques have gained traction in helping reduce smoking addiction.
Quitting smoking is more than just a decision; it’s a commitment to significantly improving your health and well-being. Smoking has been directly linked to various cancers, lung diseases, and heart conditions. In the long term, stopping smoking can lower your risk of these life-threatening conditions.
According to the study, individuals looking to quit smoking should consider using Varenicline (sold as Chantix/Champix), Cytisine (a plant-based supplement available in Europe and Canada), or nicotine e-cigarettes.
“Quitting smoking is difficult, and some people find it harder to quit than others, but tobacco is uniquely deadly among legal consumer products, so it’s important to seek help quitting,” said lead investigator Jonathan Livingstone-Banks, a lecturer and researcher in evidence-based health care with the University of Oxford in the U.K.
Read: Does Smoking Affect Women Differently Than Men?
Quitting smoking isn’t just about resisting cravings. Often, behavioral support through counseling or therapy is crucial for tackling the psychological aspects of addiction. Behavioral therapy involves working with a trained professional to identify triggers, develop coping strategies, and create a tailored quit plan. Research shows that combining counseling with other quit methods can significantly increase success rates.
Some medications, such as varenicline (Chantix) and bupropion (Zyban), have been shown to help people quit smoking by reducing cravings and withdrawal symptoms. Experts suggest that varenicline works by blocking the effects of nicotine in the brain, while bupropion is an antidepressant that helps manage withdrawal symptoms. Both medications are generally more effective when combined with behavioral therapy.
Nicotine replacement products, such as nicotine patches, gums, lozenges, and nasal sprays, deliver controlled amounts of nicotine to ease withdrawal symptoms. According to experts at Harvard Health, NRT can double the chances of quitting by alleviating physical cravings while the person works on overcoming the psychological addiction.
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously called fatty liver disease, is becoming extremely common in people with type 2 diabetes in India.
Studies suggest that 50–70 percent of Indians with type 2 diabetes may have fatty liver, and a significant proportion can progress to inflammation, liver fibrosis, cirrhosis, or even liver cancer if the condition is not detected early. Because India already has one of the world’s largest populations with diabetes, MASLD is emerging as a major but under-recognized public health problem.
The recently published consensus guidelines developed by Indian experts aim to provide practical, India-specific recommendations for diagnosing and managing MASLD in people with type 2 diabetes.
In fact, these are the first global guidelines for MASLD and type 2 diabetes, albeit restricted to India. This matters because most existing international guidance—including from organizations such as the American Diabetes Association—is largely based on evidence and healthcare systems in high-income Western countries. These recommendations often assume easy access to expensive diagnostic tests and medications, which may not always be feasible in India.
In India, healthcare costs are frequently paid out-of-pocket by patients. Advanced imaging tests or newer medications can therefore be unaffordable for many people.
The Indian consensus addresses this reality by recommending step-wise and cost-effective screening strategies, beginning with simple clinical risk assessment and basic laboratory tests, followed by non-invasive fibrosis scoring tools and ultrasound when appropriate. This approach helps identify high-risk individuals without overburdening patients or the healthcare system.
Another important reason these guidelines matter is that Asian Indians have a unique metabolic profile. Compared with Western populations, Indians often develop diabetes and fatty liver at younger ages and lower body weight, partly because of higher abdominal fat and insulin resistance. Therefore, early screening for liver disease in people with diabetes becomes particularly important in India.
Dietary recommendations are also adapted to local eating patterns. Instead of focusing on Western dietary models, the guidelines emphasize reducing refined carbohydrates, excess sugars, and unhealthy fats common in Indian diets while promoting traditional, healthier foods, whole grains, legumes, and increased physical activity.
In simple terms, these India-specific guidelines aim to ensure that more patients with diabetes are screened early, treated appropriately, and protected from severe liver complications, using strategies that are practical, affordable, and suited to the realities of the Indian healthcare system.
Guidelines for MASLD developed in Western countries provide important scientific guidance, but they are often designed for healthcare systems with greater resources and different patient characteristics. The Indian consensus recommendations differ in several key ways to make them more suitable for local populations and healthcare settings.
First, screening strategies are more pragmatic and cost-conscious. Western guidelines often recommend advanced imaging tests or specialized biomarkers to assess liver fat and fibrosis. However, these tests can be expensive and not widely available in many parts of India.
The Indian recommendations emphasize simple, widely available tools—such as routine blood tests and non-invasive fibrosis scoring systems—before considering more advanced imaging. This stepwise approach ensures that patients who are most at risk are identified while keeping costs manageable.
Second, the guidelines recognize the unique metabolic risk profile of Asian Indians. Compared with Western populations, Indians tend to develop metabolic diseases such as type 2 diabetes and fatty liver at younger ages and lower body mass index (BMI). Abdominal obesity and insulin resistance are particularly common.
Therefore, the Indian recommendations stress earlier and more vigilant screening for MASLD in people with diabetes, even if they are not severely obese.
Third, treatment priorities differ because of affordability and access to medications. Western guidelines may emphasize newer and often expensive drugs that show benefits for fatty liver disease. While these therapies can be effective, they may not be accessible to many patients in low- and middle-income countries.
The Indian consensus places stronger emphasis on lifestyle interventions, weight reduction, improved diet, and physical activity as the foundation of treatment, while suggesting pharmacotherapy selectively based on evidence, availability, and cost.
Fourth, perhaps the most important difference, dietary advice is culturally tailored. Western guidelines typically discuss Mediterranean-style diets.
In contrast, the Indian recommendations translate healthy eating principles into Indian dietary patterns, focusing on reducing refined carbohydrates, sugar-sweetened foods, and excess saturated fats while promoting whole grains, pulses, vegetables, and traditional balanced meals.
Finally, the Indian document highlights the need for public health awareness and primary care involvement, since a large proportion of patients with diabetes are managed outside specialized centers.
Overall, the key difference is that while Western guidelines provide strong scientific foundations, the Indian recommendations adapt those principles to local realities.
Credits: Wikimedia Commons and Instagram
Bristol Palin, an American real estate agent, who was a former public speaker and reality television personality started experiencing facial paralysis over a tear ago. On March 9, her 35-year-old daughter Sarah Palin posted a video on her Instagram Stories that shared an update on her ongoing health struggles. The story revealed that she is now considering plastic surgery to fix her paralysis.
"I am going to have a consultation today with a plastic surgeon in Austin," she said. "I have read that she specializes in facial paralysis type stuff so we will see what she says."
She also said, "Prayers because maybe she can help mostly with this eye," while pointing to her left eye. "When I smile or when I am expressive, it closes. I don't really care about my crooked mouth but my eye...so embarrassing to me. I feel like I should wear an eyepatch or something."
She went on to say, "It looks crazy and I just feel like I cannot even smile because it just closes. So maybe she can do some Botox or maybe there is some options with surgery. So we will see. Maybe she ca help with this eye or just the overall symmetry."
She also said that she had just returned from Alaska, where she visited another specialist who does her facial nerve blocks to help her paralysis. She also posted another update on her Instagram Stories and said that her consultation went well and that she will be sharing the information with her followers soon.
It was in January 2025, when she revealed her facial paralysis on Instagram. "I woke up nine days ago with a little weird sensation in my face. My mouth was pulling this way and it just felt a little off. So I went, looked in the mirror. I'm like 'Wow. This is looking a little weird. I feel like everything is pulling to the left."
She said that hours later her condition got worse and the left side of her face was having a "delayed" reaction.
Read: Why Does Your BBL Smell? Doctor Explains 4 Reasons That Could Cause It
As per a 2020 study published in the Indian Journal of Plastic Surgery, botulinum toxin (Botox) injections are helpful and are minimally invasive technique to restore facial symmetry. However, the study noted that a "surprisingly small minority of aesthetic injectors treat this condition."

The study also gives a case study of a patient with longstanding facial nerve paralysis after resection of an osteogenic sarcoma, before and after two weeks after first treatment with botulinum toxin. The improvements could be seen in mentalis synkinesis, more symmetrical smile, and improved eye apertures on animation.
It is an FDA-approved, injectable neurotoxin derived from Clostridium botulinum bacteria. It temporarily relaxes muscles by blocking nerve signals, commonly used to smooth dynamic wrinkles and treat medical conditions like chronic migraines, excessive sweating, and muscle spasms. Its effects last from three to four months.
Botox prevents the release of a neurotransmitter that signals muscles to contract, causing them to relax and soften wrinkles. Results typically appear in 3 to 14 days.
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