Small Thread on who are " ASHA workers " & why did the WHO recognize them . These million plus workers have helped India put more than 1.8 billion doses in arms over rough terrain , mountains , snow filled gorges & overwhelmed rivers, sometimes at huge risk to their lives ctd) ImageImage
2/n They climbed over difficult terrains , over snow full mountains , across deep gorges.... these are strong women of #India 🇮🇳🙏ctd) ImageImage
3/n Sometimes we may see them go into homes , go to fields, barns... no place is unapproachable for these women ..🙏🇮🇳ctd) ImageImage
4/n Going door to door , they brought a unique sense of calm & local support to the vaccination efforts by being the outreach of the system ctd) ImageImage
5/n They were sometimes abused by the ANTIVAX but they kept ploughing through to mobilize the people , really great effort🙏🇮🇳 ImageImage
6/n Asha is a Hindi word which means " Hope " , today by being recognized by the WHO , their heartfelt hopes & desires must have been fulfilled just as mine 🙏🇮🇳 end Image

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More from @Rpshahmemorial1

May 24
After top 100 updates we will put the top 120 updates , we will start with a thread of top 100 & then move along .
It is a concerning since we may end up seeing either multiple pandemics together or relay race as new organisms try jump into humans ctd)
101/n Whie people like all of us were fighting #Covid , #Hepatitis in kids we all missed how 1284 people got #monkeypox with lethality of 4.5 % ctd) Image
102/n Interesting paper on efficacy of soaps shows that 1 min hand washing to be effective in cell free virus but not as much in intracellular virus doi.org/10.1016/S0166-…
Ctd) Image
Read 21 tweets
May 22
Top 100 updates about #MonkeyPox & why I think it has become the biggest outbreak in the last 50 years outside Africa , the earlier 70 are here

And I will start after 70 now in the thread below
71/n Biden finally comments on monkeypox , saying: "It's something that everybody should be concerned about."😢😢. So there is definitely more than we know , it is not everyday that the President comments on stuff. Ctd)
72/n A child has been rushed to the intensive care unit of a London hospital after they were diagnosed with monkeypox, as per reports. 😢😢 ctd)
Read 31 tweets
May 21
Why I feel we will have a much bigger outbreak of #MonkeyPox & top 70 updates ( we had 50 yesterday ) in the thread below . Let's start by what we already know & then go further

Ctd)
51/n Spain is seriously looking at whether the 80K strong LGBT community get together was a super spreader , they are also trying to find if one of the Saunas ( where gay men go for sex) has been the source , so the consequences are not due to genital spread but congregation ctd)
52/n The problem is its large number of likely reservoirs and things we probably can't entirely avoid including animal droppings : rats, mice, squirrels, shrews, opossums, ground hogs etc . So once it gets into a geographical location #monkeypox will be a tough nut ctd)
Read 21 tweets
May 19
The UK has started stockpiling vaccines after similar information from the US , Meanwhile Montreal has 17 cases and it's spreading under the radar .
Image
2/n It seems to me that all viruses have become overactive Mozambique🇲🇿confirms first wild poliovirus case in 30 years. Case in child in Tete province follows detection of similar strain in Malawi in February, officials say.This was also seen in Isreal 😢😢
Ctd)
3/n Though we dont want this to be a political issue BUT to change information as such will probably boomerang as kids show up with lesions on face ctd)
Read 30 tweets
May 19
Small thread on why I think we will see a bigger outbreak of #monkeypox d/t #COVID19 .We know Covid causes T cell response suppression in some & also complement mediated injury leading to effective reduction in levels of complements (hypocomplementemia) ctd)@fitterhappierAJ ctd)
2/n We know for a fact that at least in kids the complement induced injury caused hypocomplementemia in young , this was one of the pathways of acute liver injury in some kids , if the complement system is exhausted
#monkeypox
doi: 10.1097/INF.0000000000002804. PMID: 32639461.
@medriva @VirusesImmunity @britsocimm @KunstJonas @ManojShukul @Kanupriya78 @kumarmanish9 @RonaldKlain @G_LaryeaAdjei @amrit_lohia 3/n We also know that #Covid causes direct infection of T cells and leads to lymphopenia , we need to understand that post #Covid the T lymphocytes arent there to save infection ctd) .
Read 20 tweets
Apr 29
Long Thread -1/n
There is a visible effort by some quarters to steer the discussion about Pediatric Liver Injuries away from Covid ( blame Lockdowns & Adeno) . So let's recap what we already know from SARS & MERS effects on the liver ctd)
2/n We know that the liver injury can be due to -direct viral replication, caused by poor blood flow ( hypoxia) , caused by ventilation ( In PICU) , Immune response, breakage of the gut vascular barrier and the alteration in the gut bacteria ( gut - liver axis) and drugs ctd)
3/n When you have 15% people have raised liver function tests in SARS , I think it is fool hardy to try and distract attention away from hepatic issues in Covid since SARS is the closest that we have and not Adeno dx.doi.org/10.1016%2Fj.am…
Read 12 tweets

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