Omar (dromar.eth)

A calcium "CAC" score of zero is one of the most reassuring findings in preventive cardiology. But for South Asians, I do not think it should always be treated as the end of the cardiovascular risk conversation. And why CCTA has a place. CAC measures calcified plaque. It is useful, accessible, and often clinically helpful. But it does not directly answer whether non-calcified, or soft, plaque is present. That distinction matters. South Asians often develop cardiovascular disease earlier, at lower BMI, and with risk patterns that can be underestimated by generic thresholds. In selected patients, especially those with symptoms, premature family history, diabetes or insulin resistance, elevated ApoB, elevated Lp(a), or a story that does not fit the number, CAC=0 may still leave an important question open. That is where CCTA, AI-QCT, FFR-CT, and stress CMR enter the conversation. Not as blanket escalation, but as different tools for different biological questions. The point is not “CAC vs CCTA.” The point is: What biology are we trying to detect? This is the first piece in Zinda Futures, a series on how future-facing medicine needs to be calibrated for South Asian biology instead of simply layered onto population averages. Read the full piece: The Calcium Score Can Be Zero. The Plaque Risk May Not Be. https://blog.zinda.health/p/the-calcium-score-can-be-zero-the?r=1fp8g

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California doesnt have school buses. after school pickup is navgating nearly 100s of teenagers riding down in e-bikes

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Have had 3 e-bike trauma cases this past month. All under 45yo. 1 lost a leg 1 punctured a lung with shattered ribs 1 got hit by a F350 Something has to be done with these.

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If anyone is looking for an amazing and accurate body measurement tool then would recommend Renpho. Much more accurate and precise than In-body imo and used by more and more researchers now. It’s as close to a Dexa as you can get and much less expensive/can do it at home. https://amzn.to/3K5R78g

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Big news today: GLP-1 shortage is over. This will have big implications for compounding pharmacies, patients but much much more Essentially, FDA declared not that Ozempic/Wegovy (semaglutide) shortage resolved, meaning compounded GLP-1s are no longer allowed, tanked HIMS stock. For perspective, ~25% of GLP-1s are compounded, serving millions of patients. And a big source of revenue for compounders that have shifted biz models, but even more so developed these into robust treatments (ex: B12/sema combo) Compounders are now challenging in court to continue production, tirzepatide is already in court, semaglutide cases likely will join in. During this time, while the current lawsuit ongoing, FDA is maintaining its enforcement discretion. Now here is where this turns another corner:

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Feels like in this productivity-obsessed world, conversations about literature—sci-fi, hidden classics, all of it—are getting harder to find. Strange how we sideline what sparks imagination for what just optimizes time. Boredom has become a scarcity.

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Had a patient today with pretty bad sepsis, bed bound from stroke with parkinson dementia. His wife is also walker bound with early dementia. Son takes care of both of them, works from home. Nice to see that in our individualistic society these days. Met a hero today.

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