Chanza Shaikh

Grateful, humbled and in awe. Alhumdulilah a billion times. Can’t believe it!! But your girl has MATCHEDDDDD ☺️✨#Match2023 #NRMP #MatchDay2023

Among patients with a preserved ejection fraction at least 1 year after myocardial infarction, stopping beta-blockers was noninferior to continuing therapy with respect to major clinical outcomes. Full SMART-DECISION trial results and Research Summary: nejm.org/doi/full/10.10…

🩸 Bleeding on anticoagulation is NOT a complication… it’s a turning point ⚠️ The problem We prescribe anticoagulants to prevent: 👉 Stroke 👉 MI 👉 VTE But the most frequent complication is: 👉 Bleeding And here’s the uncomfortable truth: > Bleeding often determines prognosis more than thrombosis 🧠 Why this matters Bleeding is NOT just an event. It triggers: ❌ Treatment interruption ❌ Fear-driven underdosing ❌ Permanent discontinuation 👉 Leading to ↑ stroke, ↑ MI, ↑ mortality 🔥 Key clinical reality 📊 Major bleeding: ~1-3% per year 30-day mortality >15% 1-year mortality >25% 👉 That’s NOT benign ⚖️ The real battlefield Every anticoagulated patient lives here: 👉 Thrombosis vs Bleeding And we often focus on only one side. 🧠 What experts are telling us (ESC) This is the new paradigm 👇 1️⃣ Risk is dynamic Bleeding risk is highest: 👉 Early after starting anticoagulation 👉 In elderly / multimorbid patients 👉 Reassess continuously, not once 2️⃣ Not all bleeding is equal 🚨 Critical sites = high mortality: Intracranial GI Retroperitoneal Pericardial 👉 Even small volumes can kill 3️⃣ Combination therapy is dangerous 👉 OAC + antiplatelet = 2–3× ↑ bleeding ✔️ De-escalate EARLY ✔️ Avoid triple therapy when possible 4️⃣ Prevention is powerful Simple interventions: ✔️ PPI for GI protection ✔️ Avoid NSAIDs / SSRIs when possible ✔️ Correct dosing (DOAC underdosing = worse outcomes) 👉 Most bleeding is preventable 🚨 When bleeding happens Think in 3 steps: 🩸 1. Stabilize Stop anticoagulant Airway, oxygen, access Fluids + transfusion 🧪 2. Reverse (if needed) VKA → PCC + Vitamin K Dabigatran → Idarucizumab FXa inhibitors → PCC (± Andexanet) 🔎 3. Find and control the source Endoscopy IR embolization Surgery ⚠️ The biggest mistake > “Let’s stop anticoagulation and never restart” 🧠 The evidence says: 👉 NOT restarting = ↑ stroke + ↑ death ✔️ Restart early when safe ✔️ Individualize timing + dose 🔄 The future We are moving toward: 👉 Personalized anticoagulation 👉 Dose tailoring 👉 Drug selection based on bleeding profile 🎯 Take-home message Anticoagulation is NOT binary. It is: 👉 A continuous balance 👉 A dynamic decision 👉 A personalized therapy 🤓 Final thought > The goal is not to avoid bleeding The goal is to survive both bleeding AND thrombosis 📚 Reference Galli, M., Simeone, B., ten Berg, J., et al. (2026). European Heart Journal: Acute Cardiovascular Care. doi.org/10.1093/ehjacc…

Link is Sinatra’s son?! No F way! #Paradise

A patient told me I was a blessing during their hospital stay. I’m not the one to tear up, but that truly meant a lot- such a sweet moment and a real confidence boost 🥹

Unhealthy obsession with @7BrewCoffee 😭

Or selective socialization. instagram.com/reel/DWXPCVRCN…

Presented at #ACC26: Among patients with a preserved ejection fraction at least 1 year after myocardial infarction, stopping beta-blockers was noninferior to continuing therapy with respect to major clinical outcomes. Full SMART-DECISION trial results: nejm.org/doi/full/10.10… @ACCinTouch

@Emaperidol I feel the same way sometimes

Please replace me with AI I’m begging

Probably needed a hug, decided to go to medical school instead.

It’s my lucky day — I’m getting a lot of doctors following me, so I’ll say this plainly. I have a child on the severe end of the autism spectrum. I’ve lived this. Anything you want to get done — evaluations, therapy, specialists — it’s a wait with no end in sight. And that’s before you even get into whether insurance will cover it. Some days it feels like we’re making progress. Some days it feels like we’re losing the fight. When we first tried to see a Developmental Behavioral Pediatrician, the wait time was 2 years. TWO YEARS. He has an incredible care team. Truly some of the best. But even then — the bottleneck isn’t quality. It’s access. Medicine isn’t a field where we have “too many people.” The barrier to entry is already extreme. The pipeline is long. The demand is massive. There is no surplus of doctors. There is a shortage. And when you have a shortage: — wait times go up — access goes down — families like mine sit and wait More doctors doesn’t hurt the system. It helps it. It reduces wait times. It improves access. It gives families a fighting chance. I’ll keep speaking up for this. Because this isn’t theoretical to me. It’s real life.

Hi Everyone - 🥸Here are all the 27 late breaking clinical trials presented at @ACCinTouch (ACC.26) with session number, day, time, and objective. 😱See you in NOLA: 👇👇👇

🤓🔥The 2026 Surviving Sepsis Campaign update are out!! And does not overturn sepsis care, but it clearly shifts the field from rigid protocol thinking toward more individualized decision making, stronger implementation, and broader recovery planning. From a bedside perspective, the most important change is not a new miracle therapy, but a more clinically mature framework. Compared with 2021, the 2026 recommendations place greater emphasis on structured sepsis response systems such as a code sepsis or sepsis huddle, continued rejection of qSOFA as a stand alone screening tool, and a more operational diagnostic pathway using cultures, lactate, and early clinical reassessment. The antibiotic message is also more refined: immediate treatment within 1 hour remains central for septic shock and for probable or definite sepsis without shock, while possible sepsis without shock still allows a short diagnostic window before antibiotics, rather than automatic indiscriminate administration. The hemodynamic section is where the philosophical shift becomes most visible. The 30 mL/kg initial crystalloid strategy remains, but 2026 makes the reassessment mindset more explicit, including how weight can be calculated in obesity and when early concurrent vasopressors may be justified in unstable shock. Balanced crystalloids remain preferred, but routine albumin is de emphasized, with the panel now suggesting crystalloids alone over crystalloids plus albumin, while acknowledging that albumin may still be reasonable after large crystalloid exposure or in cirrhosis. This is a meaningful departure from 2021, where albumin was suggested more directly after large crystalloid volumes. Just as important, 2021 had no recommendation on restrictive versus liberal fluid strategy after initial resuscitation, whereas 2026 now allows either approach after the first 30 mL/kg based on patient and system factors, and even introduces the concept of active fluid removal after the acute resuscitation phase. Clinically, that is a major step toward phase specific resuscitation rather than endless fluid accumulation. Another relevant evolution is that 2026 is more explicit about what not to do. The guideline suggests AGAINST using antipyretics to improve outcomes, against IV vitamin C, against blood purification techniques, against vitamin D, and against probiotics for sepsis treatment. That matters because the update is telling us, more clearly than before, that sepsis care should focus less on physiological cosmetic correction and more on interventions with plausible patient centered value. 🤓Bottom line: The 2026 SSC guideline is less protocol driven, more phenotype aware, and more longitudinal in its view of care. 📃References Prescott HC et al. Surviving Sepsis Campaign. Intensive Care Med. 2026. DOI: 10.1007/s00134-026-08361-1. Surviving Sepsis Campaign 2021. DOI: 10.1007/s00134-021-06506-y.

Best Eid gift! Graduation in 3 months, but who’s counting 🙋🏻‍♀️

@Abubakar_sedeq It’s a very hard process and it took every 2nd person at least 3-4 years to reach this point, after competing at a global level.

I think we produce really good Doctors.... Because Every 2nd person got Matched.

REHEALTH AF: first prospective study of ablation vs no ablation in pts ≥80 w/ #AFib. Ablation improved functional & structural outcomes; prognostic benefit emerged after multivariable adjustment. jacc.org/doi/10.1016/j.… #JACCCEP #epAblation

"I got matched" "I finally got in" "I'm going to be a physician now" Congratulations guys. You earned it

Um paradoxo clássico na insuficiência cardíaca aguda: você inicia diuréticos para descongestão…e a creatinina sobe. Isso frequentemente leva à redução ou suspensão de diuréticos. Isso faz sentido? Vamos entender melhor. Segue o fio 🧶

@NotoriousS1Q3T3 Big congratulations!!! Celebrate 🎉

DELAYED, NOT DENIED!!!!! I AM GOING TO BE AN EMERGENCY MEDICINE PHYSICIAN!!!!! 😭😭😭😭😭 This last year was quite literally the hardest year of my life. Opening that email a year ago and feeling my heart sink into the pit of my stomach was the worst feeling ever, compounded by the demoralizing process of having to go immediately compose myself enough to go through the SOAP. And, it was made even worse by the fact that, though I love my TY program and the growth I have had this year, I ultimately did not get an EM position in the SOAP, which was what I really wanted. But despite wanting to give up, I kept my nose to the grindstone and I persevered, working relentlessly to overcome the failure of my 2025 Match. Hard work pays off. Pardon the French, but I fucking did it y’all. I am quite literally shaking and crying in clinic. It was all worth it. Every single moment of effort was worth it. I am good enough, and I deserve to be an emergency medicine physician, which is the farthest thing imaginable from how I felt this time last year. 😭😭😭😭😭

@Az_capone1 Yes!!

Does anyone else still collect fridge magnets when they go on holiday ?

“What you doing this weekend” Me: Enjoying my rent