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

Joined April 2013
519 Photos and videos
Highly recommend attending this session; it was pivotal to help my find guidance and advice for own journey
Today at 3pm at The Learning Studio in the Networking Super Center, join us for a session targeted towards transitions in training for IMGs @atscommunity @atsearlycareer #ats2026
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Join us in the Learning Studio Wednesday, May 20, at 11AM located at the Networking Super Center (NSC) for our session "Reliable Lung Sounds: Practical AI at the Point of Care". Add to your itinerary now: ow.ly/kpE450YW5bu
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Daily SBTs are stand in patients undergoing mechanical ventilation but are there any true minimal ventilator settings for SBT? What do you use @ZonairKhanMD @Narpaul94 @jamilmshahi @emireles_c @GallodeMoraesMD Source: DOI: 10.1056/NEJMoa2209041 DOI: 10.4187/respcare.10642
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One of my favorite things to teach in MICU is how to ventilate a patient with asthma. some very basic changes can set your patient for success; let me know what else would you do @emireles_c @Thind888 @IM_Crit_ @jamilmshahi @RobChatburn @chatterJ5 @respresource
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The Critical waterfall concept of Perfusion in Shock Source: doi.org/10.1016/j.jcrc.2026.… @ZonairKhanMD @jamilmshahi @Narpaul94
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The classic Lassie Challenge in the MICU, a must know for everyone when dealing with AKI. @ZonairKhanMD @Narpaul94
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Diastology Basics in the ICU. @Pocus101 @ZonairKhanMD @Narpaul94 @msiuba
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How to assess PA-RV coupling with echo; Grade I - IV Source: doi.org/10.3390/jcm9030831
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My approach to cough management in ILD
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You pay annual fees, which give you some benefits that include journal access, and congress reduced attendance fee. But patients in many countries are led to believe that it was those famous societies that approached the doctors and chose them because of their brilliance, not tru
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It is important to know that many medical societies charge exorbitant amount of money to give you titles like FACC , FESC , SCAI etc, you apply,if your credentials are approved you get ok’d then you have to pay a hefty annual fee, you are not nominated or selected, you apply& pay
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Very impressed with @NotebookLM, still learning but pairs well if you keep notes for “second brain” like system; helps reproduce a concise summary from multiple sources. Amazing times
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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
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
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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
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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/10.1056/NE…
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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
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
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Becomes much more relevant in light of recent events #MUFC
1 Feb 2024
"This is football heritage" When Jose Mourinho delivered this iconic speech as Man United manager 🗣
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20 Dec 2025
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.
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
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17 Oct 2025
Historic Day! SEVA comes to Philadlephia with PCCM fellows from @JeffPulmonary @EinsteinPccm attending live course. @emireles_c sharing insights
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6 Oct 2025
Making a presentation for #CHEST 2025 and reading a review article on the topic that has quotes other review articles/opinions for supporting their point without any link to original data. Luckily @RsrchRabbit rescued me.
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5 Oct 2025
I agree that an unusually high number of ASH abstracts from a student or resident can raise concerns. Quality research demands time, rigor, and genuine intellectual contribution, which is challenging to achieve at that scale without compromising standards. Unfortunately, the pressure to amass publications for competitive training positions often fuels a culture of quantity over quality. This can lead to borderline ethical practices, like minimal involvement in projects or reliance on questionable methodologies, often within loosely connected research groups lacking cohesive goals or in-person collaboration. Academic institutions should prioritize fostering meaningful, ethical research with long-term vision over short-term resume-padding, as this trend undermines the integrity of scientific inquiry and fails to build true research expertise.
Unpopular opinion but seeing someone with >10 ASH abstracts as a student/resident seems like a red flag to me. Quality research takes time, and unless you are a full time scientist (or a faculty with multiple mentors) I'm not sure how this can be achieved.
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