Sameed M

5.6K posts

Sameed M banner
Sameed M

Sameed M

@_MSAMEED

Pulmonary & Critical Care @ClevelandClinic. #FOAMed. 🏴󠁧󠁢󠁳󠁣󠁴󠁿🇵🇰🇺🇸Tweets reflect my personal opinion. Director ILD clinic @JeffHealthEH @WeAreJefferson

Cleveland, OH Katılım Nisan 2013
1.6K Takip Edilen2K Takipçiler
Sameed M
Sameed M@_MSAMEED·
While I’m not a cardiologist (thankfully 😅), here are my 2¢ on the statin debate: 🔹 Lower LDL → fewer heart attacks & strokes. Evidence is strongest after you’ve already had one. ✔️ In primary prevention, benefit depends on baseline risk (ARR often ~1–2% over ~5 years in lower-risk groups). The myth that cholesterol is all bad was recently challenged by a Swedish study (AMORIS Cohort, a 35 year long study of 44,000 patients) which showed people who ended up living > 100 years had moderately high cholesterol (~ 130 LDL-C) Genes - South Asians are dramatically under represented in all the trials around cholesterol and major coronary events, South Asians are also genetically more prone to diabetes and metabolic syndrome due to genetic differences in insulin sensitivity and beta cell reserve; also we achieve high plasma levels of statin at lower dose compared to Caucasian so we experiences higher incidence of side effects from these medication including up to 30% chances of inducing diabetes (a known side effects of these drugs) In the end we are consultants giving medical advice, every patient is different - if they wish to try a holistic approach that is life style and diet based then we should encourage it as long as it is safe and the trends are in the right direction (hip-waist ratio, lean body mass, inflammation levels) If there is a clear harm from not starting a medication, the patient should be informed and a shared decision should be made. #LoveYourHeart
English
0
0
4
403
Ali Zafar
Ali Zafar@AliZafarsays·
Thank you so much Doc for sharing your valuable insight. I love learning about health and fitness and wanted to take your advice on the the following. If a 45-year-old male presented with the following profile, along with a history of chronically elevated LDL cholesterol, what would your line of action be? (Other respected doctors in the house, feel free to comment and give your feedback 🙏) HbA1c 6.0 percent hs-CRP less than 0.40 mg/L Total cholesterol 311 mg/dL Triglycerides 478 mg/dL LDL 155 mg/dL HDL 44 mg/dL Non-HDL 267 mg/dL ApoB 1.49 g/L ApoA1 1.58 g/L ApoB/ApoA1 ratio 0.9
Aftab Khan, MD@aftab_usa

As a doctor practicing medicine in the USA for a quarter of a century, I appreciate your thoughtful perspective and commitment to lifestyle changes—lifestyle is indeed foundational for metabolic health, and many patients achieve meaningful improvements in lipid profiles and blood sugar through disciplined diet, exercise, and weight management. That said, robust clinical evidence from large randomized trials and meta-analyses shows that when LDL cholesterol remains elevated despite optimal lifestyle efforts (or in higher-risk individuals), statins significantly reduce cardiovascular events and death. They lower LDL-C effectively and cut major adverse events by 20-30% per 1 mmol/L reduction, including reductions in cardiovascular mortality (often 15-25% relative risk reduction in high-risk groups) and all-cause mortality in many settings. For those needing even more aggressive LDL lowering (e.g., familial hypercholesterolemia or very high residual risk), PCSK9 inhibitors (added to statins) further drop LDL-C by 50-60% and reduce key events like heart attack, stroke, and revascularization by 15-27%, with emerging data showing benefits in cardiovascular death reduction in certain trials. Guidelines prioritize lifestyle first, but evidence-based medications like these are not “masking” symptoms—they target the causal driver (elevated LDL) to prevent plaque progression and events, often saving lives when lifestyle alone isn’t sufficient. Always personalize under medical guidance. Keep up the great work on health!

English
20
2
32
24.3K
Sameed M
Sameed M@_MSAMEED·
While I’m not a cardiologist (thankfully 😅), here are my 2¢ on the statin debate: 🔹 Lower LDL → fewer heart attacks & strokes. Evidence is strongest after you’ve already had one. ✔️ In primary prevention, benefit depends on baseline risk (ARR often ~1–2% over ~5 years in lower-risk groups). The myth that cholesterol is all bad was recently challenged by a Swedish study (AMORIS Cohort, a 35 year long study of 44,000 patients) which showed people who ended up living > 100 years had moderately high cholesterol (~ 130 LDL-C) Genes - South Asians are dramatically under represented in all the trials around cholesterol and major coronary events, South Asians are also genetically more prone to diabetes and metabolic syndrome due to genetic differences in insulin sensitivity and beta cell reserve; also we achieve high plasma levels of statin at lower dose compared to Caucasian so we experiences higher incidence of side effects from these medication including up to 30% chances of inducing diabetes (a known side effects of these drugs) In the end we are consultants giving medical advice, every patient is different - if they wish to try a holistic approach that is life style and diet based then we should encourage it as long as it is safe and the trends are in the right direction (hip-waist ratio, lean body mass, inflammation levels) If there is a clear harm from not starting a medication, the patient should be informed and a shared decision should be made. #LoveYourHeart
Ali Zafar@AliZafarsays

Thank you so much Doc for sharing your valuable insight. I love learning about health and fitness and wanted to take your advice on the the following. If a 45-year-old male presented with the following profile, along with a history of chronically elevated LDL cholesterol, what would your line of action be? (Other respected doctors in the house, feel free to comment and give your feedback 🙏) HbA1c 6.0 percent hs-CRP less than 0.40 mg/L Total cholesterol 311 mg/dL Triglycerides 478 mg/dL LDL 155 mg/dL HDL 44 mg/dL Non-HDL 267 mg/dL ApoB 1.49 g/L ApoA1 1.58 g/L ApoB/ApoA1 ratio 0.9

English
0
1
8
1.3K
Sameed M
Sameed M@_MSAMEED·
A new paradigm in IPF care, inhaled Treprostinil therapy reduce FVC decline compared to placebo with 75% of the patients being on background therapy. Exciting times #IPF #ILD
NEJM@NEJM

In the phase 3 TETON-2 trial involving patients with idiopathic pulmonary fibrosis, inhaled treprostinil was associated with a smaller decline in forced vital capacity and a lower risk of clinical worsening than placebo over 52 weeks. Full trial results: nejm.org/doi/full/10.10…

English
0
0
5
377
Sameed M
Sameed M@_MSAMEED·
@qatarairways @zaeemahmad41 @qatarairways this is recurring pattern, and mostly your staff at these local airports are responsible; there is very little interest from the airlines to train their staff, or enforce any accountability for the draconian ways at the airport. Take your business elsewhere
English
1
0
1
41
Qatar Airways
Qatar Airways@qatarairways·
@zaeemahmad41 @zaeemahmad41 Greetings Ahmad. We would like to further investigate your concern. Your collaboration is crucial for us to provide the necessary support. Please reach out to us via direct message for any additional inquiries and assistance.
English
2
0
3
1.3K
Zaeem Ahmad
Zaeem Ahmad@zaeemahmad41·
When system errors become customer extortion: My experience with @qatarairways I’m sharing this publicly because after weeks of emails, calls, and escalations — including CC’ing senior management — I still have not received the refund I am owed. On 22 January 2026, at Lahore Airport, I was forced to pay $1,840 USD for luggage I had already prepaid weeks earlier. What actually happened: On 13 December 2025, I purchased 45kg of extra luggage for €503. On 20 January 2026, I purchased another 20kg. Total prepaid: 65kg, plus the standard 50kg allowance for two passengers. At the airport, Qatar Airways ’ system failed to show the original 45kg, even though I had confirmation emails and bank statements. The supervisor acknowledged seeing a payment but said he “could not trace the reference” — and I was told that I would not be allowed to board unless I paid again. With only minutes left before departure, I was forced to pay $1,840. What has happened since: @qatarairways refunded €503 on 15th of Feb, confirming the original 45kg payment DID exist. This proves the airport charge was incorrect. I am still owed the remaining amount: $1,840 – €503 = approx. €1,100. My follow‑up emails have gone unanswered for weeks. Every phone call ends with: “We are working on your complaint.” Why I’m posting this: This is not just about money — it’s about accountability and fair treatment. No passenger should be double‑charged due to a system error and then ignored for weeks. All documentation — receipts, booking confirmations, and payment proofs — has already been provided multiple times. I hope this post encourages a timely and fair resolution. #aviationnews #fraud #travelnightmare #ConsumerRights #QatarAirways @MohsinnaqviC42 @MaryamNSharif @IrishTimes @aviation @EU_Consumer @HIAQatar @qatarairways @qrsupport @BBCWatchdog @theairhelper @ecc_ireland @beuc @elliottdotorg
English
8
6
9
1.6K
Sameed M
Sameed M@_MSAMEED·
@worqas I would refine it, add MCT oil and called it Bullet Chai. Very healthy if you are planning keto diet.
English
1
0
3
601
Waqas
Waqas@worqas·
Put a little coconut oil in your chai. Patent pending.
English
25
12
273
17.8K
Sameed M
Sameed M@_MSAMEED·
@forsan87 Lovey app, simple yet elegant full marks
English
0
0
1
20
Forsan
Forsan@forsan87·
Ramadan apps shouldn’t feel outdated. So I built one in pure SwiftUI that feels like a modern iOS product. Meet Siraj 🌙
English
291
147
2.2K
206K
Sameed M
Sameed M@_MSAMEED·
Indeed, the path to mastery is not paved with certainty, but with the quiet bow of humility— the lifelong learner who kneels before the unknown. It is resilience that becomes their companion, the courage to reach, to falter, to fall— and still return, hands open, heart unafraid of beginning again.
English
1
0
0
30
Ariel J Garnero
Ariel J Garnero@ArielG_RRT·
@_MSAMEED @emireles_c You are not the only one off. The problem comes when people that have learnt the taxonomy, publish about complicated modes and assign TAGs to them, which are wrong. Assigning TAGs is simple for basic modes, but for the complicated ones: "please, consult with the experts".
English
1
0
0
34
Sameed M
Sameed M@_MSAMEED·
Interesting study…. Q for my #SEVA team do we have this mode in the Rosetta? Looking at the flow wave and the details on this FCV tag seems to be VC-CMVr. @emireles_c @ArielG_RRT
Anesthesiology Journals@_Anesthesiology

Flow-controlled ventilation is a newer alternative positive pressure ventilation mode that allows control of airway flows. Becker et al. investigated if this mode reduces the inflammatory stimulus compared to conventional pressure-controlled ventilation: ow.ly/neWT50Ye2jY

English
3
0
6
642
Ariel J Garnero
Ariel J Garnero@ArielG_RRT·
@_MSAMEED @emireles_c As a matter of fact, I did not follow the conversations about the TAG for FCV, but Rob already classified it.
English
2
0
1
46
Yogesh Reddy
Yogesh Reddy@yreddyhf·
Do you know how to use the PA occlusion maneuver during RHC to diagnose PVOD? Pretty useful as in this case to diagnose, and we walk through the complex considerations in separating from regular precapillary PAH @CircAHA ahajournals.org/doi/10.1161/CI…
Yogesh Reddy tweet media
English
1
10
43
4.1K
NEJM Clinician
NEJM Clinician@NEJMClinician·
In episode 9 of Clinical Conversations, Dr. Rahul Ganatra (@rbganatra) and Dr. Raja-Elie Abdulnour (@BageLeMage) discuss a study on sodium bicarbonate infusions in patients with severe acidemia and acute kidney injury. Listen to the full episode: nej.md/49Ezoh0
English
1
2
99
3.1K
Sameed M
Sameed M@_MSAMEED·
@AmjadKanj Absolutely agree a very excellent starting point
English
0
0
1
96
Amjad Kanj
Amjad Kanj@AmjadKanj·
IMO, one of the best-written guidelines in pulmonary medicine. Another excellent figure featured below. Therapy should always be individualized, with ICS 🟥 likely beneficial in a subset of pts guided by hx&tests (eg BEC,eNO) Must-read for trainees/generalists/specialists alike!
ERS publications@ERSpublications

The @EuroRespSoc guidelines for the management of bronchiectasis in adults provide an evidence-based framework for the management of patients with bronchiectasis bit.ly/3VBk0eC

English
2
5
12
3.2K
FrameTheGlobe
FrameTheGlobe@FrameTheGlobe·
21/21 Pakistan has been in institutional decline for three decades, its sovereignty sold off piece by piece by elites who profited from the arrangements. Imran Khan represented a four-year interruption to that program not a solution, but a speed bump. His removal in 2022 didn’t create the crisis. It removed the last obstacle to its completion. Sudan shows you where this leads: over 40,000 dead so far, with IHC’s investments “secured” by militia proxies who commit atrocities while the world looks away. The pattern is documented in diplomatic cables and corporate filings. The motivation is on the record in that 2007 cable. The methodology has been refined over decades across multiple countries. What we’re witnessing isn’t Pakistan falling. It’s the final phase of a plan that’s been running for thirty years, now executing at full speed with no resistance left. Mohamed bin Zayed’s anxiety about Pakistan in that 2007 cable wasn’t worry. It was target identification. And the machine built to address it has been patient, methodical, and devastatingly effective.
English
24
41
125
5.8K
FrameTheGlobe
FrameTheGlobe@FrameTheGlobe·
Imran Khan was bad for Pakistan until you read the fine print and look behind the curtain. UAE’S SILENT CONQUEST🧵 1/21 In 2007, a US diplomat captured something extraordinary in a cable back to Washington. Mohamed bin Zayed, de facto ruler of the UAE, was speaking with unusual candor about democracy in the Muslim world. His words were chilling: “Muslims should never have free elections.” He named three countries that kept him awake at night, Egypt, Saudi Arabia, and Pakistan. The reason? “If Egypt has free elections, they will elect the Muslim Brothers.” This wasn’t the musing of a worried observer. This was strategy from a man who runs one of the world’s wealthiest states. And Pakistan, nuclear-armed with 240+ million Muslims, was squarely in his sights.
FrameTheGlobe tweet media
English
63
591
1.2K
219K
Sameed M
Sameed M@_MSAMEED·
I can resonate with this sentiment about @qatarairways as we had very bad experience with an infant in lap about 2 years ago, they denied my daughter essential rights to sit with her mother and changed the seat of the infant in lap without notice. A detailed letter to @qatarairways and FAA did not result in any acknowledgment of fault. The system is not meant for families traveling with kids.
Rahul Prakash@prakashmoney

Flying @qatarairways = a nightmare. Recently I posted how adding our lap infant was impossible so we had to buy a new ticket for wife + baby (6wks still no refund) Then they lost our bags for 3days without everything even baby items that we had to hurry and buy... @traveloneworld

English
1
0
12
1.9K
Ariel J Garnero
Ariel J Garnero@ArielG_RRT·
@Vent_Busters @DrSateeshPCCM @ventilacionmeca @DocMusician @DrMiguelIbarra1 @emireles_c @CCF_PCCM @OfVentilation @IM_Crit_ @critconcepts @MegriMohammed @SaudiRTs @RespiratorySCCM @_MSAMEED used the same ASL5000 I use n you can visually differentiate P from Flow triggering. Flow has an initial flow rise before main flow starts while P does not. You can program the ASL based on P to make the effort, but what you set on the vent makes the graphic difference
English
1
0
0
58

Keşfet

@qatarairways @zaeemahmad41 @MohsinnaqviC42 @MaryamNSharif @IrishTimes @aviation @EU_Consumer @HIAQatar