Laughter is the best medicine. It can relax muscles. It also gives exercise to body and helps relax joints.

It is possible to laugh on same joke many times but only very pure heart people can do it

Today's world, laughter is very unnatural. It is only to impress others. But real feeling laughter is missing. Only innocent people r able to laugh really.

#LaughterThread

It is not zaruri to create laughter by insulting others.

In early days people used to create laughter by situation. That is always more comedy than just Paxi type insulting laughter.

Laughter like a child helps to cure blood pressure, thyroid n liver issues. It also improve memory

#LaughterThread

I’m deeply saddened to learn that Dr Joseph Sonnabend, one of the most important figures in the history of AIDS, died yesterday. I spent time with him in 2018 for one of the last interviews he ever gave. Let me tell you about this man and what he did:

Sonnabend was one of the first doctors to raise the alarm. In 1979, while running a sexual health clinic in Greenwich Village, he wrote to the NY Health Dept to warn them of the symptoms he was seeing: low white blood cell counts, enlarged lymph nodes. He didn’t get a reply. 2/

So he kept speaking out. When a patient of his developed a very rare cancer – Kaposi’s Sarcoma – he linked up with a dermatologist at NYU who said that over a dozen gay men had it. Sonnabend knew there was something very wrong. He started working at the lab at NYU — for free. 3/

It was soon after this in 1981 that the New York Times famously reported “Rare Cancer Found In 41 Homosexuals”. The next decade would kill most of Sonnabend’s patients and friends — and all of his lovers. What Sonnabend did was to fight for every single of them. 4/

Want to know who was the first to publish advice to wear a condom? That was Sonnabend. In 1983 he co-authored the first safe sex leaflet to fight AIDS: “How To Have Sex In An Epidemic”. 5/

12 things you should look out for before buying health insurance

A thread 🧵

It’s a good idea to make sure your health is protected under an insurance policy so that you don’t shell out large sums of money for hospitalization and treatment. But buying an individual health insurance policy can be daunting in itself.

Websites and policy documents can be overwhelming. There’s a lot of loaded terms, there’s a whole bunch of things that your policy may or may not cover. It’s important to know and understand the details though, so you’re not surprised later.

In this thread, we'll talk about the things you absolutely need to watch out for when buying an individual health insurance policy for yourself or your family members :)

If you take an individual health insurance policy and the insurance company offers to pay up to ₹15 lakhs during the year whenever you’re diagnosed with a disease or meet an accident, that amount is the 'sum insured'.

We’ve done menstruation, let’s talk about the menopause! Because only women however they present can have the menopause although men who have had treatments for prostate cancer can have symptoms mimicking the menopause. There’s nothing scary about

the menopause. It’s a perfectly natural function of the body but it’s tied up with a thousand stereotypes of women, ageism and ‘old women are frightening’. True, old women are often very frightening to young men because look! A woman who doesn’t give a rat’s

arse what you think of her now all her mating hormones have gone and with it your charm as a potential mate. Now you’re just another annoying lad. That’s gotta hurt. Menopause means Wisdom, like it or not and it’s not always nice or cosy. Old women

are encouraged to refer to themselves as ‘young at heart’ and ‘as young as you feel’ and other such crap and told to ‘never give in to age’ which is ludicrous. Cosmetic surgery is now a thing but I can tell you what the surgeons and marketing

men won’t - it does not make you look young. You’re just an old woman who looks like at best, she’s had a great holiday and at worst like she was was trapped in a wind tunnel. Old is good. Old is meritorious. Old is survival. Old means you didn’t die young

During a normal pregnancy, oxidative stress enhances antioxidant mechanisms that are capable of reacting by way of enzyme activity and non-enzyme free radical deactivators. However, pregnancy is also a state in which this adaptation and balance may be easily disrupted.

There is strong evidence that a chronicin flammatory reaction combined with the presence of a local oxidizing environment may play a vital role in the etiology and development of complications during pregnancy.

In late pregnancy, damage to DNA (especially when it is caused by oxidative stress) is associated with pre-eclampsia(PE), intrauterine growth restriction (IUGR), and the death of mothers in developing countries; it largely determines pregnancy – related susceptibility to diseases

The referential values of ROS and NOS and their minimal and safe concentrations or physiologically beneficial concentrations are yet to be determined.

The measurement of oxidative stress in vivo is perceived as controversial,

as the sen-sitivity and specificity of various oxidative stress markers is unknown.. .

🧵 on Importance of correct indication of colonoscopic surveillance studies (English 🇺🇸🇬🇧)
@KM_Pawlak @KMonkemuller @drkeithsiau @JacquelineChuMD @PerelmansPearls @stevenbollipo @SWexner @DrBloodandGuts @ebtapper @DCharabaty @RashidLui @AdvaniRashmiMD @AtoosaRabiee @DrMohdZein

@GI_Guy @RodriguezParra_ @DrHarryThomas @TennysonMD @AustinChiangMD @KralJan @thomaskroner @alinkmd #GITwitter

1/ The implementation of screening and surveillance programs can reduce the incidence and mortality of

2 / But for these to be effective and to guarantee protection against CCR, they must meet a series of conditions. One of them is the correct indication for endoscopic studies for both screening and surveillance.

3 / According to a recent meta-analysis, the minority of patients who undergo colonoscopies have a correct indication, with less than 50% adherence to the surveillance intervals proposed by scientific

is ADHD a mental illness ?

a thread

ADHD is a neurodevelopmental disorder - people with it are born with it and it cannot be altered because it's part of their brain structure and is seen on brain scans. ADHD is also linked to premature births and hypothyroidism during pregnancy, among other things

from the WHO website: "neurodevelopmental disorders are disabilities in the functioning of the brain that can affect behaviour, memory and/or ability to learn."

neurodevelopmental disorders are not caused by external/environmental factors. you cannot *develop* these conditions

mental illness is a general term for a health problem that significantly affects how someone feels/thinks/behaves. mental illnesses cause suffering to those who experience them, as well as often their loved ones. ADHD does not directly cause suffering.

neurodevelopmental disorders are not mental illnesses. ADHD however, does make it more likely for a person to experience mental illness. ADHD can cause dysfunction and stress, but more often than not this comes from lack of accommodation rather than the symptoms themselves.

The #RELAx trial has been published today in @JAMA. It was coordinated by Anna Algera. This thread is to explain the rationale, what we did, the findings and the meaning.
The rationale of #RELAx is based on the following

First, there is NO adequate evidence on the level of PEEP in non-ARDS patients. Most of the studies are old, conducted in post-surgical patients (short-term ventilation), and were not powered to detect differences in patient-centered

Second, despite the absence of evidence, the levels of PEEP used in non-ARDS patients increased over years, from 5 to 7/8 cmH2O, probably as a reflection of studies and practice in ARDS

Third, one IPDM showed that higher levels of PEEP could benefit more severe ARDS patients. However, opposite trends (higher mortality and longer ventilation) were found in mild ARDS with higher PEEP (despite not powered to be statistically

Fourth, most of the weaning protocols include PEEP ≤ 5 cmH2O as a criterion for readiness to wean. Theoretically, a standardized liberal strategy of higher PEEP could delay weaning in some

ECTOPIC PREGNANCY

A woman just lost her life due to ectopic pregnancy!

It's a pregnancy in which the embryo attaches outside the womb. It can be life-threatening.

But we can save lives by helping educate women on our Timelines with this.

THREAD 🧵

In the human body, a fertilized egg hardly survives outside the womb. If allowed to grow, it may damage nearby organs & cause severe blood loss.

The bulk of ectopic pregnancies occur in/along the Fallopian tubes.

Some in the ovaries, cervix or a random location in the abdomen.

The usual symptoms of ectopic pregnancy a woman may experience esp. in early pregnancy are;

* Abdominal pain
* Vaginal bleeding, &
* Amenorrhea (missing your period)

Other pregnancy symptoms like breast fullness & occasional nausea may be there too.

But the common DANGER SIGNS of ectopic pregnancy that may signify rupture are;

🔴 Rigid abdomen

🔴 Severe abdominal pain

🔴 Shoulder tip pain, &

🔴 Signs of shock such as cold hands & feet.

With these signs, immediate medical attention is needed to save the woman's life!

Your chances of having an ectopic pregnancy are higher if you have;

1. Previous ectopic pregnancy

2. STI's like gonorrhea

3. Fertility treatments like IVF*

4. Fallopian tube surgeries

5. Pregnancy while using an Intrauterine Contraceptive Device

6. Smoking history! 🚭

DR CHRIS MACKIE (@Healthmac) is London’s Medical Officer of Health and a government advisor.

Yesterday, he said schools being open, “SLOWS the spread of COVID.”

For context, let’s look at 23 other times he misused data or gave a bad unsupported take.

🧵A THREAD🧵

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ADHD, a thread (1)
If you have #ADHD & are struggling please know you’re not alone. This week on @Overview, we're talking about living w/ ADHD & Anxiety during the pandemic & many the stigmas & misconceptions that making things worse.

I was diagnosed w/ ADHD when I was 7. And in so many ways it’s been a blessing. I love my energy, the hyper-focus, the calm I feel in chaos, the ability to & feel emotions so intensely. It’s allowed me to to see the world differently be in a constant state of wonder.(2)

But realizing all that has been a long, difficult journey so figured I’d share some of my own struggles as well as the resources from @HowtoADHD because Jessica's channel has been a game-changer for me.(3)

First off, #ADHD Attention Deficit Hyperactivity Disorder is a dumb description. It implies a deficit in attention & always hyper people. ADHD is a spectrum, & what we all have in common isn’t that we can’t pay attention. It’s that we have trouble controlling our attention.(4)

There are amazing analogies out there, like trying to watch 6 TV’s at once when someone else controls the remote. Or like driving a race car on city streets and spinning out whenever you try to turn.

After therapy sessions, it is occurring to me how my parents and maybe most desi parents don't really grow as parents. For example, a person would be a very different to a baby and to a teenager because the needs and vulnerabilities are so different.

But here, I feel that growth for parents stagnants sometime around when a child is 12-13. None of our parents really talk to us about puberty and growing up. None of us are taught or can talk about relationships because of moral reasons. So what do you have?

You have parents who are still parenting their adult children like kids, not apologising to us but asking us to eat, reminding us to wear jackets, locking up cars. They care. But they are coming from a care where the parent is always concerned about keeping the kid safe and alive

which imo really reduces the kind of parental advice and care one needs as an adult. Because adults know enough about the world to no longer be infantilized but we still have parents who expect us to be the same children because they're still the same kind of parents.

This is why so many of our parental relationships are strained or just based on civilities. We're forced to hide a lot from them because parents refuse to grow as parents and acknowledge us as adults. How many of us are still lectured, have curfews, other restrictions?

it seems to me that not many know that navalny is an avowed nationalist & racist and not just a blonde guy who likes to gently kiss his blonde wife before going to jail and watches “rick & morty”. so here’s a little thread and some of it is pretty personal.

here is navalny’s 2007 video. “a tooth without a root is called “dead”. a nationalist is someone who doesn’t want the russian root to be removed from the word “russia”. we have the right to be russian in russia, and we will defend it.”

i downloaded it to make sure it won’t disappear but it is still shared by navalny’s official youtube channel. btw, in this video, navalny is introduced in the caption as a “certified nationalist”.

here is another video navalny is not keen to share anymore, in which he compares muslims to cockroaches and flies and recommends shooting them with guns if swatters and shoes

here is a 2011 interview with navalny where he explains why he goes to the so-called “russian march”, a yearly nationalist gathering, and why he thinks it’s ok to collaborate with

In medicine, reckoning with racism includes reappraising the very syntax we use every day. Proud to add my voice w/ @J_Ikeme and @RWGrantMD in this @JAMAInternMed pub addressing:

Does race/ethnicity belong in the first line of the patient

Some background: I’ve struggled with this question since early in medical school

Medical syntax is designed to communicate information in a predictable sequence with key elements prioritized to facilitate efficient communication and formation of an assessment and plan

2/

From preclinical lectures to Qbank questions to clerkship rotations, race/ethnicity was often prioritized in the same sentence as age + gender.

I grew accustomed to reading/hearing: a 70-year-old Black man w/ history of x, a 50-year-old Hispanic woman presented w/ y.

3/

However, when it came time for me to use race/ethnicity, there was always tension. Race/ethnicity are self/socially-ascribed identities that in clinical practice are almost always assumed by providers based on appearance. I was also concerned about the potential for bias

4/

I wondered how my own care would be impacted or not impacted by my ethnicity (Hispanic) – I have light skin so I’m not sure if my doctors would even identify me as such – but how would my care be different if I was presented as a 30-year-old Hispanic male?

5/

So many people don’t realize that they have OCD because actual obsessive compulsive disorder is rarely talked about openly. So here are the basics: 🧵(thread)

I think that a lot of people forget that OCD is a mental illness, emphasis on the MENTAL. When it’s portrayed on TV, it’s always shown as a very behavioral disorder. And while it’s true that overt behavioral compulsions are part of OCD, they don’t begin to tell the whole story

OCD stands for obsessive compulsive disorder. That’s obsessive thoughts and compulsive behaviors. The OCD cycle is the cycle of obsessions that lead to compulsions that lead to more obsessions that lead to more compulsions etc etc etc.

People with OCD experience intrusive thoughts (which become obsessions.) Intrusive thoughts are unwanted and invasive, and they’re generally REALLY disturbing. It’s a common misconception that people with OCD are exclusively concerned with tidiness and cleanliness. This is false

TW/ OCD subtypes

Intrusive thoughts can be about anything, but there are a few common “subtypes” of obsessions. These include harm OCD, self harm OCD, sexual OCD, pedophelia OCD, relationship OCD, contamination OCD, religious OCD, moral OCD, health OCD and “just right”