I personally hate the heat. The problem in India is that the average temperature is much higher then US and Europe and therefore, it is very difficult to actually get accustomed to the heat. The problem is compounded due to the high amount of crowds. It is best to look into the average temperature before visiting places. Also, keep your sunscreen along with you when you going to India.
Well I do not have an upcoming trip, but I really wish that I did, but learning from my experiences the first time, I would definitely be a little weary of the heat. Of course it depends on where you go and at what time of year, but when we were there it was pretty brutal towards the end. The travel itself is also pretty arduous and long, which I never have been good at dealing with. Once you get there though, you tend to forget about all of these things.
Oh yeah it gets really hot really fast making the urban streets fester with different kinds of smells. That's what gets me as well the smell of people, spices, pollution etc. If your nose is as sensitive as mine then get ready for a sensory explosion. The 4 hour plane trip is nothing compared to the sensory overload of sights, sounds and smells.
The quality of roads is something that you should not consider if you want to travel around the world. Most roads worldwide are not in good condition mostly when you want to travel to game parks or other game reserves. I have also not seriously considered where to get medical support whenever I travel. I do hope that there are hospitals that I can in to whenever I fall sick. I have always been keen about what I should eat and where to get the food.
I had a lot of problems with mosquitoes. Bring a very good topical repellent and a long-sleeved, light shirt. My bites covered my feet, got infected, and gave me a nasty fever. Be sure to take note of where you can find hospitals and clinics. The area I went to didn't have a problem with malaria, but some areas might have problems with mosquito-borne infections. I would advise you to check on WHO's website for the area you are going to, just in case.