It's useful to keep reminding oneself.
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Joydeep Grover
@JoydeepGrover
Consultant Emergency Physician, Bristol.
Alumnus AFMC, Pune.
Photography, Music, Training, Systems, Medicolegal.
EnglandJoined August 2010
Joydeep Grover’s Tweets
In 1917, US microbiologist Alice Catherine Evans reported her findings that Bacillus abortus in milk caused the disease brucellosis. Disbelieved because she was a woman and had no PhD, it was not until 1930 that milk in the US was routinely pasteurised. en.wikipedia.org/wiki/Alice_Cat
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Excellent analysis of Bicarbonate.
It remains an intervention with few indications and it's use comes with consequences.
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You've probably heard that Bicarbonate has to turn into CO2 to raise the pH. “Don’t give bicarb if you can’t increase ventilation.”
But how much CO2 is there in an amp of sodium bicarbonate?
A bicarb 
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21% MACE surprises me! Prof any thoughts with your troponin hat on?
- do you want to know about these or screen for this?
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There is an entity called MINS (myocardial injury after non-cardiac surgery). It is essentially evidence of cellular damage w/o ECG changes. The new european cardiology guidelines recommend screening for it post-op...
But does it impact outcomes?
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What a wonderful story, of a young man and his violin, in a time of war and turmoil. Of hope and kindness in the midst of cruelty and intolerance.
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Last year, a coworker randomly asked me to hand-deliver an antique violin across the country. I said yes, because why not. I had no idea what I was getting into, and now I need your help. A
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Why do hibernating bears, despite prolonged immobility, not get venous thromboembolism?
In a new study, scientists prioritize HSP47 down-regulation.
I am most impressed with the team for sticking needles in hibernating brown bears!! 
science.org/doi/10.1126/sc @ScienceMagazine
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Please let the bees out!
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Queen #Bees - HELP THEM OUT!
Another important thread concerning #bumblebee queens at this time of year!
Please #retweet/#share as every queen bee that survives gets to establish a nest that otherwise would not happen. This has knock on effects going forward. Let me explain.
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📢 Second strike - Junior Doctors Industrial Action (JDIA)
⚠️ 96-hour full walkout
🕛 6:59 AM: 11 April 2023 to 6:59 AM: 15 April 2023
📖 Read our guidance on JDIA here:
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#HelpUsHelpYou during the busy bank holiday and strike action next week by choosing the right service for your needs.
▶️Visit 111.nhs.uk if you need medical help or advice
▶️Please only dial 999 or visit our Emergency Department if it's a life-threatening emergency
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Many people asking us about #bumblebees at the moment - why they’re seeing them on the ground - so here’s a quick thread to explain what they’re up to. Please #retweet as every #queen that survives means a new colony that gets to exist & produce new queen #bees for next year! 1/8
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Really intriguing take on social economics and priorities.
Worth a read, particularly as we seem to have a poverty of thought in our political ambition.
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Here's a little look at German cost of living vs British cost of living, which goes a long way to explain why British people are suffering- despite the UK being ome of the richest countries in the world
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How biased are we? Good to have a sense check often!
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Psychologists have posited hundreds of cognitive biases over the years. A new paper argues that they all boil down to one of a handful of fundamental beliefs coupled with confirmation bias. doi.org/10.1177/174569
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And why do cigarettes lead to the release of neutrophils from the bone marrow?
Cigarette smoke contains >4,500 components and 5 x 10¹⁴ radicals are inhaled with each puff of smoke.
These molecules lead to INFLAMMATION.
ehp.niehs.nih.gov/doi/pdf/10.128
pubmed.ncbi.nlm.nih.gov/19330016/
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If you know, you know :-)
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Hey I very much doubt that you would've cancelled had he taken a complicit view. It follows that you are not acting neutrally. Please don't hide behind impartiality clauses as you haven't been impartial. Let both views be aired.
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My @SkyNews interview exposing Braverman’s lies is approaching 2 million views.
This is democracy in action.
#BritainIsBetterThanTheTories
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Terrible times, wish we could box those messages away and write off the 2 years as a bad dream.
Just have to say this: there were consequences of every decision made, as doctors we remain accountable for our actions...
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Good summary of evidence for TXA use.
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Summary of evidence for tranexamic acid (courtesy of @MRamzyDO)
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That is wow!
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The double solar storm punch that created a G3 (max) geomagnetic storm on Feb 26th-28th brought colors we hadn't seen in at least 5 years in Lapland 
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Slice up the tennis balls and you can get more in the tube - efficient use of space and increased productivity. But you won't be able to play tennis! Be efficient, be productivity but more importantly be effective - do not forget your purpose...
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'Functional Resonance Analysis Method' or FRAM. Okay, a new addition to the lexicon, but the paper does attempt to delve in to the complex systems, like the Emergency Department. It's an interesting read
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Still trying to get my head around FRAM but will definitely give it a go one day…
This is a brilliant piece: mapping processes in the emergence department using FRAM.
Thanks for sharing @ACarsonStevens twitter.com/ACarsonStevens…
This is a brilliant piece: mapping processes in the emergence department using FRAM.
Thanks for sharing @ACarsonStevens twitter.com/ACarsonStevens…Show this thread
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Thank you Esme for being so kind and thoughtful ♥️
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Instead of asking for presents for her 6th birthday, Esme asked for three coins: one to donate, one to save and one to spend. As a result, she donated £10 to help poorly babies in the Neonatal Intensive Care Unit (NICU) @NorthBristolNHS. Here she is with NICU Matron Amy.Show this thread
read image description
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Free Tibet!!
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Brothers Sisters from #India, today is Independence Day of #Tibet, please celebrate with us !
One day soon, Tibetans and Indians will enjoy Freedom from #China #CCP dictatorship, when CCP will be a bad old remembrance.
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I've always suspected that an advanced alien civilisation with the technology to travel at close to light speed across interstellar distances would arrive in Earth orbit unobserved and proceed to dispatch a fleet of small, easily detectable balloons into our atmosphere.
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"An official admitted he couldn't rule out the objects were extra-terrestrials. The object has been described by defence officials as an unmanned octagonal structure with strings attached to it."
Wow! Aliens use string!? Do they have blu-tak as well?:
bbc.co.uk/news/world-us-
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Latest image of our neighbor planet 'Mars' by Perseverance rover
Readers added context they thought people might want to know
This is a color-corrected composite of images that are over two months old:
mars.nasa.gov/mars2020/multi…
Context is written by people who use Twitter, and appears when rated helpful by others. Find out more.
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Unawareness, ignorance, incomplete knowledge - the 'unknown unknowns'...
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It's not Covid. Part of this is Flu. Large part is likely to relate to capacity (lack of) in the system.
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ONS deaths data has been released for week ending 23 Dec.
2,982 more deaths were recorded in-week compared to the 2015-19 average. That’s 26% more, the largest excess we’ve seen all year.
Year-to-date there have been 567,379 deaths recorded which is 8% more than 2015-19 avg.
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Lost for words.
The following media includes potentially sensitive content. Change settings
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My dad died on Christmas Eve. He waited for an ambulance for 3 hours before it was too late. He was only 58. I’ve fought my whole life to stop this kind of thing from happening. I admit defeat. It’s over. We’ve lost. The Tories have what they wanted. pic.twitter.com/rhvHDcIIZOShow this thread
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Illustrates "flow", a small aberration can easily disrupt a large system.
So much to think about here - capacity, system design, individual factors, role of governance.
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In the resort town of Les 2 Alpes, in the northern French Alps there is a bike race which starts at a 3,400m-high glacier. 1/2
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Data illustrates how the last 12 or so years of government policy have ruined the UK economy and healthcare.
Austerity gutted our country as investment in our infrastructure was curtailed.
It has made everyone worse off.
Thanks for your analysis.
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NEW:
Britain’s grim winter of strikes, falling incomes and a worsening NHS crisis is not some unfortunate series of events
It’s the inevitable result of a decade of Tory austerity that steadily weakened the state’s capacity to respond to shocks
enterprise-sharing.ft.com/redeem/c540270
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Presenting a melange of heartfelt greetings as Team showcases India's unity in diversity by wishing you all a very happy new year in different Indian languages. Please enrich this initiative by posting HNY greetings in your mother tongue too!
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