![](https://pbs.twimg.com/tweet_video_thumb/En_39XFXIAESsZl.jpg)
My last #tweetorial focused on the GCS. Now let's look at another hugely important clinical window into the brain: the pupil. What does a 'blown pupil' really imply? What about small fixed pupils? To understand this, we need to see how pupil size is governed. #FOAMed 1/20
![](https://pbs.twimg.com/tweet_video_thumb/En_38qKW8AE8xsM.jpg)
![](https://pbs.twimg.com/tweet_video_thumb/En_39XFXIAESsZl.jpg)
![](https://pbs.twimg.com/media/En_rS-KWMAAwNio.jpg)
![](https://pbs.twimg.com/tweet_video_thumb/En_3_U5WMAUx3wP.jpg)
![](https://pbs.twimg.com/tweet_video_thumb/En_4ATSWEAE7-Sc.jpg)
The classical example is pontine haemorrhage - deep coma and pinpoint pupils. 12/20
More from Health
1/
Remember woman who tuk multiple @SriSriTattva products 4 range of problems frm diabetes 2 gas 2 liver disease & developed liver failure, listed for liver transplant?
Here is original thread:
https://t.co/PXxI1Slyv2
23 samples, Analysis results
#MedTwitter #livertwitter
2/
Before I go into results, I must say this was overwhelming. There was SO MUCH the lab identified, impossible to put everything here. So I made a summary. At the end of this thread, I have linked a full analysis described in Excel format. Some results were VERY concerning
3/
How did we analyse?
Here R links 2 methods
They R high end, done under strict protocols
Frm Ministry of Forest, Environment, Climate / NABL approvd Lab
ICP-OES https://t.co/O1CLhqVQAu
GC MSMS https://t.co/zRJoXyWQIr
FTIR https://t.co/goAembQ08p
Here is list V analysed 👇
4/
Sample names written on top (each column).
First 5 samples: C what we identified in #Ayurveda #medicines
Antibiotics
Steroids (anabolic/synthetic)
#NARCOTICS - LSD, Morphine
Blood thinners (possible reason Y bleeding tests were off the roof in the patient)
Heavy metals!
5/
Next 5 samples (total 10 now)
Mercury is clear winner. Almost all samples
See controlled substances - Butyrolactones https://t.co/CPz0FwPEOm, methylamine https://t.co/OZnXY7U9UQ
Alcohols, industrial solvents
Rare metals - cobalt, lithium
Again lots of blood thinners
#Ayush
Remember woman who tuk multiple @SriSriTattva products 4 range of problems frm diabetes 2 gas 2 liver disease & developed liver failure, listed for liver transplant?
Here is original thread:
https://t.co/PXxI1Slyv2
23 samples, Analysis results
#MedTwitter #livertwitter
![](https://pbs.twimg.com/media/ErTR583UcAA_y2Z.jpg)
Middle-aged woman wit jaundice (bilirubin 34), liver failure. Liver #Transplant this week.
— (Cyriac) Abby Philips (@drabbyphilips) December 7, 2020
\U0001f633Cause\U0001f447#Ayurveda #medicines total 23\U0001f616 by @SriSriTattva & @SriSri 3-6 mnth 4 sugar, pressure, #COVID19 #ImmuneBoosters, #memory, #liver tonic.
Sent 4 analysis.#livertwitter #MedTwitter pic.twitter.com/uz3FCiVJ3f
2/
Before I go into results, I must say this was overwhelming. There was SO MUCH the lab identified, impossible to put everything here. So I made a summary. At the end of this thread, I have linked a full analysis described in Excel format. Some results were VERY concerning
3/
How did we analyse?
Here R links 2 methods
They R high end, done under strict protocols
Frm Ministry of Forest, Environment, Climate / NABL approvd Lab
ICP-OES https://t.co/O1CLhqVQAu
GC MSMS https://t.co/zRJoXyWQIr
FTIR https://t.co/goAembQ08p
Here is list V analysed 👇
![](https://pbs.twimg.com/media/ErTUg5IVgAAYzLu.png)
4/
Sample names written on top (each column).
First 5 samples: C what we identified in #Ayurveda #medicines
Antibiotics
Steroids (anabolic/synthetic)
#NARCOTICS - LSD, Morphine
Blood thinners (possible reason Y bleeding tests were off the roof in the patient)
Heavy metals!
![](https://pbs.twimg.com/media/ErTUoxYU0AA0gN1.jpg)
5/
Next 5 samples (total 10 now)
Mercury is clear winner. Almost all samples
See controlled substances - Butyrolactones https://t.co/CPz0FwPEOm, methylamine https://t.co/OZnXY7U9UQ
Alcohols, industrial solvents
Rare metals - cobalt, lithium
Again lots of blood thinners
#Ayush
![](https://pbs.twimg.com/media/ErTVV3-UUAcTqey.jpg)
🚨Important changes to lockdown/self-isolation regulations from 5pm
The Health Protection (Coronavirus, Restrictions) (All Tiers and Self-Isolation) (England) (Amendment) Regulations 2021
£800 'house party' FPN & police can now access track & trace data
https://t.co/k9XCpVsXhC
“Large gathering offence”
As trailed by Home Secretary last week there is now a fixed penalty notice of £800 (or £400 if you pay within 14 days) for participating in an gathering of over 15 people in a private residence
Fixed Penalty Notices double for each subsequent “large gathering offence” up to £6,400
Compare:
- Ordinary fixed penalty notice is £200 or £100 if paid in 14 days
- Holding or being involved in the holding of a gathering of over 30 people is £10,000
Second big change:
Since September has been a legal requirement to sell-isolate if you test positive/notified by Track & Trace of exposure to someone else who tested positive
Police can now be given access to NHS Track & Trace data if for the purpose of enforcement/prosecution
This will make it easier for police to enforce people breaking self-isolation rules. Currently there has been practically no enforcement.
Data says only a small proportion of people meant to be self-isolating are fully doing so.
The Health Protection (Coronavirus, Restrictions) (All Tiers and Self-Isolation) (England) (Amendment) Regulations 2021
£800 'house party' FPN & police can now access track & trace data
https://t.co/k9XCpVsXhC
![](https://pbs.twimg.com/media/Es5a9hTW8AArx33.png)
“Large gathering offence”
As trailed by Home Secretary last week there is now a fixed penalty notice of £800 (or £400 if you pay within 14 days) for participating in an gathering of over 15 people in a private residence
![](https://pbs.twimg.com/media/Es5QTdAWMAMNxfu.jpg)
Fixed Penalty Notices double for each subsequent “large gathering offence” up to £6,400
Compare:
- Ordinary fixed penalty notice is £200 or £100 if paid in 14 days
- Holding or being involved in the holding of a gathering of over 30 people is £10,000
![](https://pbs.twimg.com/media/Es5QbXSXAAACxy0.jpg)
Second big change:
Since September has been a legal requirement to sell-isolate if you test positive/notified by Track & Trace of exposure to someone else who tested positive
Police can now be given access to NHS Track & Trace data if for the purpose of enforcement/prosecution
![](https://pbs.twimg.com/media/Es5QrfxXMAAX9ZY.png)
This will make it easier for police to enforce people breaking self-isolation rules. Currently there has been practically no enforcement.
Data says only a small proportion of people meant to be self-isolating are fully doing so.
Very important that obvious failures with Track and Trace and self-isolation (study late last year said 18% of people complying https://t.co/dhJUZ7Pm0l) are not painted as an enforcement issue. Plainly not. Would just pass buck to police who have almost no capacity to enforce https://t.co/Eb4Kl5Ze0E
— Adam Wagner (@AdamWagner1) January 25, 2021
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A brief analysis and comparison of the CSS for Twitter's PWA vs Twitter's legacy desktop website. The difference is dramatic and I'll touch on some reasons why.
Legacy site *downloads* ~630 KB CSS per theme and writing direction.
6,769 rules
9,252 selectors
16.7k declarations
3,370 unique declarations
44 media queries
36 unique colors
50 unique background colors
46 unique font sizes
39 unique z-indices
https://t.co/qyl4Bt1i5x
PWA *incrementally generates* ~30 KB CSS that handles all themes and writing directions.
735 rules
740 selectors
757 declarations
730 unique declarations
0 media queries
11 unique colors
32 unique background colors
15 unique font sizes
7 unique z-indices
https://t.co/w7oNG5KUkJ
The legacy site's CSS is what happens when hundreds of people directly write CSS over many years. Specificity wars, redundancy, a house of cards that can't be fixed. The result is extremely inefficient and error-prone styling that punishes users and developers.
The PWA's CSS is generated on-demand by a JS framework that manages styles and outputs "atomic CSS". The framework can enforce strict constraints and perform optimisations, which is why the CSS is so much smaller and safer. Style conflicts and unbounded CSS growth are avoided.
Legacy site *downloads* ~630 KB CSS per theme and writing direction.
6,769 rules
9,252 selectors
16.7k declarations
3,370 unique declarations
44 media queries
36 unique colors
50 unique background colors
46 unique font sizes
39 unique z-indices
https://t.co/qyl4Bt1i5x
![](https://pbs.twimg.com/media/DrIk2JhU8AAjf_m.jpg)
PWA *incrementally generates* ~30 KB CSS that handles all themes and writing directions.
735 rules
740 selectors
757 declarations
730 unique declarations
0 media queries
11 unique colors
32 unique background colors
15 unique font sizes
7 unique z-indices
https://t.co/w7oNG5KUkJ
![](https://pbs.twimg.com/media/DrIk3TjU0AAhf3D.jpg)
The legacy site's CSS is what happens when hundreds of people directly write CSS over many years. Specificity wars, redundancy, a house of cards that can't be fixed. The result is extremely inefficient and error-prone styling that punishes users and developers.
The PWA's CSS is generated on-demand by a JS framework that manages styles and outputs "atomic CSS". The framework can enforce strict constraints and perform optimisations, which is why the CSS is so much smaller and safer. Style conflicts and unbounded CSS growth are avoided.