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

All Women are at risk of getting Cervical Cancer. It often affect women over age 30.

Long-lasting infection with certain types of human papillomavirus (HPV) are the main cause of cervical cancer.

HPV is a virus that is passed from one person to another during sex.

A Thread 🚺

More than half of sexually active people might have HPV at some point in their lives, but few women will get CERVICAL CANCER.

Early Screening tests & the HPV vaccine can help prevent cervical cancer.

When cervical cancer is diagnosed early, it is highly treatable &....

2/cont.

associated with long survival and good quality of life.

Most (almost all) cervical cancers are caused by HPV.

There are many types of HPV.
Some HPV types can cause changes on a woman’s CERVIX that can lead to cervical cancer as time goes on, WHILE other types can cause genital

or skin WARTS . HPV is so common that most people get it at some time in their lives.

HPV usually causes no symptoms so you can’t tell that you have it. For most women, HPV might be SELF LIMITING (ie it will go away on its own); However, if it doesn't, there are a chances that

over time it may result to cervical cancer.

OTHER FACTORS CAN INCREASE YOUR RISK of CERVICAL CANCER —
•Having HIV/AIDS
•Smoking.
•Using Oral contraceptives (birth control pills) for a long time (5+ years)
•Having birth to many children (4+ yrs).
•Having many sexual partners

I am no psychiatrist or therapist, but I have been on the receiving end of verbal abuse, multiple times over decades, and managed to escape and recover from (most of) the trauma. I'm not sure that really "qualifies" me to say the following, in the academic sense, but...1/

I am seeing the press engaging in what I would call verbal abuse. When you invite a "guest" onto a program to present his or her POV, or to discuss their "expert" opinion on a subject, and then laugh at them, roll your eyes and talk over them, ask only rhetorical questions 2/

...and then accuse the guest of harming/doing disservice to the audience, you are behaving like an abuser. You are "informing" no one of anything other than your willingness to bully and abuse other human beings. Hosts with honest disagreements can and should ASK questions 3/

The hallmark of sincere disagreement is the listener who first checks for understanding of the speaker's POV, then asks why they say that. The host could challenge their arguments on the merits, with their evidence, then allow the guest to respond. This is how adults act. 4/

Immature, irrational, indoctrinated, and/or abusive, people talk OVER, mock, belittle, and accuse guests with different points of view of being "dangerous" or "harming" viewers/listeners. This is the behavior of deeply insecure people who know their ideas lack merit. 5/

“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.…

I do want to talk a bit about connections, conflicts and information during a pandemic. Since @fordnation insinuated I have COI which I don't, let's take a look at a single instance where @fordnation and Hospital for Sick Children are both making interesting decisions.

Both share a powerful supporter in Peter Gilgan, who has been a great supporter of Sickkids

But his company, Mattamy Homes, has also substantially bankrolled Ontario Proud, which I have reason to believe pushed the Postmedia hit on my reputation.

Sickkids and Mattamy have very close ties. Here is Mary Federau, a longtime Sickkids exec who has moved to Mattamy but remains involved with the Sickkids foundation:

Mary's bio is too modest. It looks as though it has been scrubbed a bit over the last 72 hours. Here's the google cache from Jan 25: