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

1/23 We haven't had a lot to celebrate during this pandemic. But achieving the milestone of offering vaccine to the over 70s, health and care workers and the most clinically vulnerable just before target date is a huge cause for celebration, given the scale of the achievement.

2/23 When Margaret Keenan got her first jab in Coventry on December 8th last year, who’d have thought that, by Valentine’s Day, we’d have vaccinated over fourteen million people across the UK in just ten short weeks? Amazing, extraordinary and truly, really, world class!

3/23 I’ve been struck by how much joy and relief has been brought to those doing the vaccinations and those receiving them. A GP told me yesterday that nothing had given him greater pleasure in his long career. And that the patient's relief was sometimes overwhelming.

4/23 It's vital to recognise the extraordinary contribution of the staff and volunteers who have made this happen. One of my close family had their jab yesterday and was in awe of the volunteer standing outside in the freezing cold for a four hour shift meeting and greeting.

5/23 What I wanted to share in this thread was the slightly untold story of some of the extraordinary challenges the NHS has had to overcome to deliver this target. Requiring superhuman effort from NHS leaders and staff, way beyond the call of duty. Five challenges set out below.

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”

THIS IS A CATCHY & ATTENTION-GRABBING TITLE

Today, the Province will likely announce what zone of the reopening framework we'll shift into as of Tuesday. Whatever is announced, though, doesn't change what we need to do. Why?

Kindly read these 14 tweets & we'll tell you. (1/14)

Fun fact: COVID-19 does not follow us on Twitter. COVID doesn't know, or particularly care, if we're in the Red or Orange zone.

The behaviours of the virus do not depend on the current ‘zone’ of public health restrictions. And, to be perfectly candid, neither should ours. (2/14)

Once upon a time we used to say #WeAreInThisTogether in our messaging. Here's the thing: we are, but we aren't. Not everyone is experiencing this pandemic the same.

Nurses, doctors, paramedics & healthcare workers have experienced things much differently than most of us. (3/14)

Some people have been home & isolated for months, while others haven't been able to stop working.

Business owners & hospitality workers have been on a rollercoaster of openings & closures.

Students, parents, teachers & school staff have had to adapt to going from online (4/14)

to in-person learning (and back again) numerous times.
And this virus has disproportionately affected some groups more than others.

But there's the thing: while our experiences of this pandemic haven't been shared, we do have a shared goal.

And we can reach it together. (5/14)

Ashtangha Yoga or the eight limbs of Yoga-

Many people think Yoga is just an Indian physical exercise but that's wrong. Yoga is a way to connect with the Supreme in Hinduism and attain Moksha(liberation).
The proper yoga as described in Hindu scriptures consists of 8 limbs:

1) Yamas- They are the 5 ethical rules of Hinduism. The 5 Yamas are:
i) Ahimsa: Nonviolence (this also includes not eating meat)
ii) Satya: truthfulness
iii) Asteya: non-stealing
iv) Brahmacharya: chastity, sexual restraint
v) Aparigraha: non-avarice, non-possessiveness

2) Niyamas- They are the 5 "do's". The five Niyamas are:
i) Shaucha: purity of mind, speech and body
ii) Santosha: contentment
iii) Tapas: austerity, self-discipline
iv) Svadhyaya: study of Vedas(Holy books of Hindus)
v) Ishvarapranidhana: contemplation of the Ishvara (God)

3) Aasana or the physical yoga-
Asana is a posture that one can hold for a period of time, staying relaxed, steady, comfortable and motionless. The aasana postures are believed to have been given by Mahadeva (Hindu God) himself. Hatha Yoga Pradipika mentions 84 aasanas.

[Thread]: Old school "medicine" ads obviously created by aliens.

Let's begin with cocaine toothache drops, for only 15 cents.

Dr. Batty’s asthma cigarettes were not recommended for "children under 6.”

Best prescription for malaria, chills and fever: Grove's tasteless Chill Tonic, obviously.

"It is simply iron and Quinine in a tasteless form".

The cheapest specific for the relief of cough: heroin.

There's also Dr Williams' Pink Pills for Pale People.

@br0oklynzo0 @KatyMontgomerie @ElPolloDiabloX @AbigailShrier @chadfelixg Okay, so you haven't read the study in the British Journal of Sports Medicine, you've read a Guardian story about it.

I have now read the study, and I teach critical appraisal as part of my job, so let's dive into it a bit.

@KatyMontgomerie @ElPolloDiabloX @AbigailShrier @chadfelixg First things first, the sample size in this study is tiny. 46 people. Plus, the point of comparison was "all women and men under the age of 30 in the Air Force between 2004 and 2014" rather than a longitudinal group.

@KatyMontgomerie @ElPolloDiabloX @AbigailShrier @chadfelixg So no matching for age, background, or physical condition. The result of these is that you're going to get a lot of statistical artefacts.

@KatyMontgomerie @ElPolloDiabloX @AbigailShrier @chadfelixg Second of all, there were three points of comparison here and you're ignoring two of them. The researchers measured for push-ups and sit-ups as well, both of which showed physical advantage removed entirely by hormones. Which means you're cherrypicking.

@KatyMontgomerie @ElPolloDiabloX @AbigailShrier @chadfelixg So what do you get when you have a tiny sample size and cherrypicked results? That's right, you get noise in the data. Take a look at the results graph from this paper you haven't read.

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?

@73inlancs @janethooton_ @ErinInTheMorn @fifi_EY 1/ The 🏴󠁧󠁢󠁥󠁮󠁧󠁿 government decided pediatric gender care in England would be a monopoly contract (a Labour minister, in 2008), despite all other NHS patients officially being entitled to a choice of providers, & second opinions on diagnoses & treatment, & gave it to GIDS, which has…

@janethooton_ @ErinInTheMorn @fifi_EY 2/…always advocated that trans minors & their families must have no alternative source of care, & subsequent Tory ministers have personally put their signature on renewals of it, and even personally rejected proposals for improvement that have been put forward by NHS England…

@janethooton_ @ErinInTheMorn @fifi_EY 3/…as a result of wider & public consultation. They & their civil servants listen only to GIDS on trans minors - it was GIDS advised against <18s being allowed #GenderRecognition in 2004, & since, on the basis that no one under 18 can be certain of their gender identity, just…

@janethooton_ @ErinInTheMorn @fifi_EY 4/…as many other staff at their trust wrote⬇️ to the press in 2002 (when the first instigator of this case, psychoanalyst Susan Evans was on staff too) that no trans people should be allowed that recognition but needed

@janethooton_ @ErinInTheMorn @fifi_EY 5/…to "cure" us instead. Yet GIDS proved incapable of defending its super-conservative protocol in court - no doubt because GIDS has always expected challenges to be from patients seeking care more like that elsewhere, arrogantly ignoring that services in countries where the…

A staple of anti-lockdown conspiracism in yoga/wellness is that public health measures are oppressive, authoritarian, and stifling what it means to be human. Masks suppress identity and speech. Vaccines assault the sovereign body. Influencers must rise up against tyranny! /1

Ironically, pandemic management in economies where yoga/wellness is lucrative has been a neoliberal, choose-your-own-adventure mess in which centre-right governments barter with public health to enact a patchwork of half-measures that punish the poor and marginalized. /2

The goal is not universal health rights, or protecting medical systems, or saving as many lives as possible. The goal is to return to business-as-usual, using public health as a pit stop on a productivity race off a cliff. The ice caps aren’t melting fast enough, I guess. /3

Right-leaning governments, like influencers, have assessed the COVID threat with the magical bias of limitless optimism. Then they work to normalize COVID casualties as a new cost of doing business. *This* is what alt-healthers and Qamoms call “socialist”, or “communist”. /4

Centre-right governments and wellness influencers share a goal: get back to the optimism of making productivity heroic and consumption virtuous, without any reflection on structural issues of injustice, or what universal health care funding and standards would look like. /5

Masks. A short thread. In June last year my GP advised me that wearing a mask even for a short space of time would be harmful for me on two fronts. One - I have painful rosacea on my face. It’s a horrible condition and it’s lifelong. I can at times look scary!

Putting on a mask simply makes it worse. Two - I have hypertension. Manageable and controlled. GP also advises that mask wearing even for short periods can raise cortisol levels and make them dangerous to me.

On that basis and given the dreadful treatment us non-maskers have to suffer and to appease the abusers I have three times asked my GP to issue me with a letter relating to my conditions.

On each occasion she has said that there is no need. Whilst she won’t admit it straight up, all conversations suggest she’s been told not to. I happen to agree that no-one should need to reveal their medical history to anyone other than medical professionals responsible for me.

I’ve researched mask wearing in relation to what they are supposed to be used for ref *Covid* - I’m no thicko - I prepare risk assessments (and I’m qualified to do so) every day (or did) - and the evidence *for* is weak. Very weak.

I entered this conversation thinking that I already knew the story, in a way. Dr Wodarg had succeeded in preventing the WHO from creating a fake pandemic in 2009. He thought the world wasn't silly enough to be fooled twice, but he'd been wrong. 1/9

He'd previously had ready access to mainstream media and found this suddenly cut off when he opened his mouth to voice his concern about the hysterical mania of Covid. The comically corrupt whom he'd vanquished all those years ago had been waiting for him. 2/9

All sorts of web entries about his courageous and humane career in public health and politics had morphed into caricatures that painted him as a freak; a "denier", as the post-modern parlance goes, with no means of redress. 3/9

This much I knew before I even started asking questions. What I hadn't expected was to find political correspondence with him, & we found that all of a sudden towards the end of the interview. He calls himself a socialist, I call myself scale dependent, & stop there. But ... 4/9

... it turned out we'd kindled the same central concept—subsidiarity. Subsidiarity is a principle in social organisation holding that functions which are performed effectively by local organisations belong more properly to them than to a dominant central one. 5/9

“Should I give them more fluid?”

Extremely common question during AKI referrals from junior docs.

⛔️ Fluid management is tricky, often misunderstood, & can cause huge iatrogenic harm ⛔️

We try to convey important principles in THREAD 👇

#tipsfornewdocs #medtwitter #tweetorial

Currently too often patients with high creatinine are given too much IV fluid, driven by an AKI ➡️ fluid reflex

We’ve seen 7 litres be given in one shift.

Medics & surgeons, juniors & seniors, it seems everyone loves to reach for extra IV fluid (especially if urine output poor)

Why does huge volume IV fluid ‘resuscitation’ consistently occur?

Lots of reasons, including FALSE beliefs:
🛑 IV fluid always “treats AKI”
🛑 Hypotension = hypovolaemia
🛑 Lactate >2 means fluid deficiency
🛑 Septic patients are very hypovolaemic

The rule with IV fluids and AKI is to remember this 5 word phrase:

💥 💥 Aim for euvolaemia, then stop💥 💥

Fluid status is like Goldilocks - hypovolaemia is bad for the kidneys BUT excess volume is also harmful for renal function and will cause other complications too.

It is easy to say “target euvolaemia” - but we agree it is more difficult to do!

Fluid status assessment is certainly made harder by a belief that we must only rely on a snapshot assessment of examination features which are NOT specific / sensitive / reliable to elicit like.…

Fun fact: the standard advice for if a dog, cat, or human bites your hand, is to feed the bite. Push your hand further into their mouth, forcing the jaw open.

Nurses, EMTs, veterinarians, etc are taught to respond this

The advice for a human biting you is to jam your hand or arm deeper into their mouth, and rub the spot under their nose back and forth.

If you attempt to remove your hand, or forearm, the teeth do what they're supposed to and gouge out a chunk.

This vicious wolf attack illustrates proper technique.

So: every EMT and nurse who gets bitten by a human, is trained to jam their hand or forearm deeper into the mouth, feeding the bite so the jaw widens enough to remove the limb

Also, every redneck learns this along with the advice of "never run from an angry dog"

APL Apollo conducted their earnings con-call today at 2:00 pm

"Vision of capacity of 4 Million Tone till 2025"

@hiddengemsindia @gvkreddi

Here are the key highlights 😀👇

Business Updates:

• Net Working Capital Remains under 10 days which is best in the building material
• Continue expanding rural region.
• Added 15 new distributors.
• Value added products contributed 50-60% of the topline.

Revenue breakup

• EBIDTA Margin Improvement: This was mainly because of cost structarize and better operational

• Working Capital Cycle as per mgmt should remain sustainable

• Blue Ocean: Company owns 100% subsidiary which contributes nothing but own property where corporate office is there

Improvement in Net Selling Realization:
• With expanding capacities at 2.6Million Tones and utlization of 75%, scalability has been affected.
• While the prices of steel has gone by by around 35%, due to shortage of steel.

• Apl Apollo being the dominant player past connection with steel companies worked well.
• Steel tubes supply from China is shrinking.
• Hence the discounting factor while selling the products has went away.

Controversial 3D. Probably none of you knows about Leber congenital amaurosis type 10, congenital blindness that affects 3 out of 100,000 children, condemning them to blindness for life. The only possible treatment is through gene therapy. 1/n

Thanks to Crispr-CAS9 technology we MODIFY the defective gene inside the patient eye ( they directly inject the treatment into the eye). Before CRISPR the treatment was based on Adenovirus carrying the correct form of the gene

In both cases, we MODIFY the patient DNA and that's the only way (today) to treat this disease. LCA10 is not the only genetic disease affecting kids unfortunately the list is long and the variety of diseases is terrifying.

Now think about a parent with a kid with a genetic disease, he/she would try and do anything to save him/her. ANYTHING and they would take some RISKS, gene therapy was a risk at the beginning, and any new experimental treatment shares a percentage of risk. 4/n

Now we come to #COVID19 and #vaccines. The new RNA vaccines are a HUGE scientific breakthrough, that may open new amazing therapeutic paths. And like ANY other human activity share a risk.