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Am I going to end with "more research is needed?"

A drop of 3mm Hg - considering the trial only ran effectively for a month, and the potential population level impacts - I think that's quite impressive.

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- the CI for this finding from this > 120 mm Hg subgroup comes awfully close to 0 (-5.9 to -0.1) - effect size of SBP reducing by 3mm Hg is small. We expect meds to make at least 5 mm Hg difference. But...

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Link: www.jacc.org/doi/10.1016/... Weaknesses: - main outcome, null trial slightly underpowered - the 3mm Hg reduction was in a subgroup analysis (pre-specified though which is good) - not clear if the study was powered adequately for this subgroup analysis

jacc.org

Dr Vyom Sharma @drvyom.bsky.social · 10/07/2025

Big claim: HEPA filters can lower blood pressure Below I describe the weaknesses of the trial, but also why it shouldn't be ignored:

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Yes, the GI one is the most convincing claim on that list for being a global trend. Sorry to hear about your ca! I sincerely hope it is being managed well and turns out ok

Dr Vyom Sharma @drvyom.bsky.social · 08/07/2025

Thanks for that link. good read.

Dr Vyom Sharma @drvyom.bsky.social · 08/07/2025

I think there are many environmental concerns like youv'e suggested. But I think that first, we need to be more certain that there truly is an increase in cancer in younger people. And what I'm saying here is that it's not obvious to me that we know this for sure.

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Dr Vyom Sharma @drvyom.bsky.social · 08/07/2025

Big claims about rising cancer in young people globally, esp in Aus "Some increases.. might be explained by changes in the way they are diagnosed - but most cannot" How about: - Increased testing? - Detection of cancers that are more biologically indolent? - Incidental detections? #medsky

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Dr Vyom Sharma @drvyom.bsky.social · 07/07/2025

Had an encounter today that reminded me how we can hold 3 layers of belief - often contradictory: - Proclaimed: what we dare say publicly - Private: what we admit to ourselves - Revealed: what our actions show

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Dr Vyom Sharma @drvyom.bsky.social · 30/06/2025

Nurses when I ask to borrow their pen:

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Dr Vyom Sharma @drvyom.bsky.social · 22/06/2025

Yesterday, Pakistan nominated Trump for the Nobel Peace Prize. Bit quiet today.

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Dr Vyom Sharma @drvyom.bsky.social · 16/06/2025

A senior commander of Iran's revolutionary guard said that if Israel nukes Iran, Pakistan would nuke them back. Pakistan's defence minister denied ever agreeing to this. Pakistan has now closed land and air borders with Iran.

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Reposted by Dr Vyom Sharma

Chris Hayes @chrislhayes.bsky.social · 30/01/2025

He's not blaming DEI, he's blaming women and non white people.

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Dr Vyom Sharma @drvyom.bsky.social · 31/01/2025

I've never seen the US media cycle so utterly unable to keep up. Every single day since Trump's inauguration, roughly 7-12 huge policies, or bonkers statements are reported. Each of them worth a week's coverage. But then, two seconds pass, and something else insane happens.

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Dr Vyom Sharma @drvyom.bsky.social · 31/01/2025

Hey #medsky, what do you think about the real value of Plasma pTau217 test for Alzheimer’s dementia?

Aaron Stewart-Ahn @badideas.bsky.social · 29/01/2025

Reposted by Dr Vyom Sharma

Absolutely batshit you can watch on live TV a rotting whale eating, bear corpse vandalizing, brainworm eaten, anti-science sex pest who drove an ex wife to suicide & looks exactly like corrupted Leland Palmer from Twin Peaks & sounds like Megatron auditioning to be head of America’s healthcare.

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Dr Vyom Sharma @drvyom.bsky.social · 23/01/2025

[Nelson from Simpson’s voice]: HA-HA

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Dr Vyom Sharma @drvyom.bsky.social · 22/01/2025

I'm astonished at the breadth of issues affected by Trumps's myriad executive orders. Huge changes being presented as short, sporadic reports that understandably vanish with each update. The only thing that's surviving the 24 hour news cycle at this point is the Nazi salute.

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Dr Vyom Sharma @drvyom.bsky.social · 20/01/2025

Hey Aussie GP's - have you been ordering pro-BNP's since the rebate availability in November? #medsky

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Reposted by Dr Vyom Sharma

El Yobo @elyobo.bsky.social · 20/01/2025

Maybe there could be a better place for that information

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Reposted by Dr Vyom Sharma

El Yobo @elyobo.bsky.social · 08/01/2025

The appropriate balance is that heritage should be completely ignored when installing solar. In fact, just abolish heritage overlays.

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Dr Vyom Sharma @drvyom.bsky.social · 05/01/2025

Folks, I am telling you, this Aussie cricket team are the loveliest bunch we've had since like... forever. For all the talk about toxic masculinity in sports, now we've got a great bunch - get around em.

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Dr Vyom Sharma @drvyom.bsky.social · 04/01/2025

There is something Shakespearean about the specific tragedy of Kohli's career ending due to his inability to resist a ball outside off, and being undone by it every time. Desperately trying to recapture the magic he once possessed of the most glorious cover drive in cricket.

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Dr Vyom Sharma @drvyom.bsky.social · 01/01/2025

Aww that's so kind of you! Hope to bring you more in 2025!

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Dr Vyom Sharma @drvyom.bsky.social · 30/12/2024

not going to make that mistake again

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Dr Vyom Sharma @drvyom.bsky.social · 30/12/2024

All night I dreamt I was in Adelaide, trying to get a beautiful woman to fall in love with me by mansplaining right censoring on a kaplan-meier curve. Didn’t work. What do women want?

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Dr Vyom Sharma @drvyom.bsky.social · 29/12/2024

Friendly reminder to have your 'see you next year' joke in the holster for a couple of days from now. Use wisely.

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Dr Vyom Sharma @drvyom.bsky.social · 26/12/2024

Did you know that Konstas in Greek means Bazball?

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I have quite a few COPD patients, but rarely make a first diagnosis, so am rarely the one to commence 'first line' therapy

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Dear #medsky GPs - when treating COPD patients 1) are you doing the 'ol stepwise approach, starting with tiotropium, or opting for a stepdown approach and starting sometimes with combination meds? 2) Do you look at eosinophils when choosing COPD inhalers, or nah?

MarkH @markhoofnagle.medsky.social · 23/12/2024

Reposted by Dr Vyom Sharma

All unattended food is fair game on call.

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finally. thanks for telling me.

I estimate there are 40+ movies that I've only seen 70% of the way through. Because until age 13, at 8:30 PM mum would shut the TV and march us off to bed. I still don't know how Waterworld ends.

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To be clear, I think they are amazing medications that can do a lot of good. I have, and will gladly prescribe them when req.

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It just seems to me than any benefit they cause tends to be due to the weight loss - might sound obvious once stated, but it gets lost in the adulation for the newer and broader 'indications' for the GLRP1RA family.