I am a survivor of CPM. You are the fiirst I have seen put the blame where it belongs, the doctor. My hospital completely covered it up. I believe they thought I would die, thats what they told my family...when they asked to stop life support. Erlanger Hospital in Chattanooga, TN
hi. first thing thanks to god. u recovered from this disease. but I have few questions. how long it took u to recover from this disease? my mother is suffering from this disease and she is on come for about three months. my email is ma.chandra007@gmail. com I need ur help in the form of suggestions so I can take care my mother or help her in her recovery. thanks in advance.
hi. can you share your email so I can personally ask you some help about your experience my mom is suffering from this deciese. doc has rapedly corrected sodium she has been in state of paralysis for past 4 and half month.
Thank you soooooo much , it is the best explanation i ever heard...i never was able to understand anything about hyponeutremia treatment, fluids balance and differences in IV fluids fast and strength. You solved a big and important part of this problem by this 14 minutes video but i would love to listen to more of your videos 👍
Dear Dr. Andras, My father was admitted with low sodium levels and was treated with infusion of sodium with NaCl 3%, he is also diagnosed with OSD now and in hospital since one month. He is not on life support anymore (which he was for 2 days because of low sodium levels). Since he was diagnosed with OSD, he was treated with bringing down the sodium levels to around 120 mmol and was maintained to around 125 mmol for long. In his initial days, he was totally unresponsive with no eye movement and all limbs were not moving at all. He has shown response to this and his eye movements have returned and him lower limb movements are also showing good response. Starting with his leg fingers, then tow and now to knee shows fair bit of movement. His upper limb movement is not so good though. His neck movement is also shown minor improvement. All this because of right physiotherapy sessions and proper care, he has no other clinical case of blood pressure, sugar level or any other long running disease. What else can be done to correct this and how long will my father will take to recover? thank you very much for this video .... it answered lot of my question.
My father was admitted into the hospital with low sodium. A few days later he was unable to talk, walk and eat. They told us he had a stroke but found out after he died and had and brain autopsy that is was ODS. Because he drank and was labeled a “alcoholic” we can’t get a lawyer to help. Hospital killed him and gets away with it.
I'm here to see such comments(i think he was treated wrong initially) ..... My uncle admitted hospital 2 days ago .... Past history as per Dr. he has psychotic problem undergo severe anti psychotic dosed drug.. later he developed tremor, less talkative , for long now he developed high bilirubin level...on the same date he having dyspnea I just give him budesonide(i thought he has airway congestion) and oxygen support so that until i reach and admit he atleast have sufficient oxygen in blood to survive now Dr listen everything and diagnosed he has hyponatremia.... He undergo treatment now..... Now it seems he is fine now....
My mother is also diagnosed with osmotic demyelinating syndrome. I am devastated and cried hard when i came to know that she has no treatment and she will stay like this forever or she may even die due to complications. I didn’t lose hope and started searching for treatments. I am from medical insurance background and knew many doctors. I found many cases/journals/treatment records of osmotic demyelinating syndrome. Even though its not an established treatment but there are cases of complete recovery by plasmapheresis and IVIG therapy. I found a hospital in hyderabad india who was familier with these therapies and infact treated many similar cases.
Hi, I’m actually searching myself for people who are dealing with this terrible syndrome. My brother-in-law has been now diagnosed with this syndrome he cannot move. It is very sad to watch. It has been one year. I’m searching for answers or anybody that has also been dealing with this terrible syndrome . Help
Thank you! Finally I am able to understand what is the difference in treatment Acute vs chronic. Before I couldn’t understand why the rate of treatment matters
We don't want patients to have severe symptoms or levels below 120 (very Dangerous, even deadly). Therefore we need to quickly stabilize the levels, but not quicker than 6 mmol/24h
Thank you for your straight talk. Would supplements possibly help a person recovery more likely? And of course they aren't going to admit wrongdoing. They would rather blame the patient or mislabel the matter
Hi. First thank you for your clear answer about normosaline on the other video! Since i m dealing with lots of hypoNa everyday i got one question about ODS. In fact, today i suspected it for the first time. I got a practical question about how to manage such a situation. Once you suspect ODS like for example a patient with brutal bilateral vision loss with history of chronic HypoNa (106 at entrance) with mild symptoms treated really fast by another doctor (126 after 2days)... now at 134. what should we do first? After a negative complete ophtalmological examination i asked for a cerebral MRI. I would say once you have MRI arguments for ODS you can start desmopressin right? Or is it possible to start before further exploration. I thought that if i use desmopressin and it comes out that it isnt ODS than i would put the patient in acute hypoNa with risk of cerebral edema... most doctors i asked were not really familiar with ODS. Thank you:)
hi dok, im so glad know about this video. i just want to know, i thing my mom get CPM after recovery hypotermia natrium 103 in 3 day already back to normal 147, but now my mom lost consciousness, now already 1 month, when she lost consciousness, she now can open eyes but not response at all include all body. how recocery it ? how long my mom can wake up from her lost consciousness ?. what treatment should we do for make fast restore to normal?
Almost exactly a year ago, after 2 weeks of headaches I didn't wake up in the morning, was found lifeless by a friend, was diagnosed with severe hyponatremia, sodium of 100mmmol/l, I have experienced all of these things, couldn't cough, swallow, and now I have very little control of my fingers in my left hand. I get spasms in my left leg and left arm My chance of survival was 20% but, here I am ;)
Hi doctor, how if patient already get it, how save it how fix patient how heal patient? Because my mother now can not do anything. :( is posible make she normal again?
119 sodum level.. first time it was low.. when the administered sodium constantly along with potassium, my head hurt so bad constantly for days while they were giving me sodium.. that was many months ago.. things got worse with me over time I feel in my entire body and brain. Was given sodium on other occassions too, rapidly for days straight. Another time was given sodium when I didn't even need it..... all my muscles started jumping in my body when it was being given to me and I didn't even need it.
My mom had this yesterday her symptoms were a week of dizziness. She is on hydrochloroyyhiazide two doctors missed this and taken her to Emergency room 115 MMOl she was bumped up 122 pretty fast. Older with RA taking lots meds. Speech and her thinking was very poor at 115MMOL her walking is bad because RA and her speech was tough to see because she has hearing aids and sounds funny anyways.
plus i think it effected my heart.. weird heart beats... I am so weak from doing nothing, nothing at all. weakness, tingling, numbness, I just pray that i pass on peacfully with no pain.
Do you mind if i asked a stupid question please?? I apologize for my stupidity but I thought to ask this question as I started to understand something from your videos which I thought i will never understand it 😅😅😅. Q) you said Maximum we can give is (6 mmol/L a day) of 3% NaCL IV and that the fast it depends on the patient if its Acute or chronic,......so how I’m going to prescribe it??? I have in hospital: (0.9% , 3% & 5% NaCL) There is : -250 ml , 500 ml and 1 Liter . And then i need to wright the speed: (In one hour, 2.h , 4.h, 6.h , 8.h or 12.h) So how should I calculate 6mmol/L in a day in the prescription??
I help my Mom with home hemodialysis and her sodium was 126 in the ER this morning. She has had cognition changes since April, low potassium, muscle weakness, increased urination, swallowing issues, slow processing, nausea, extreme hypertension for her, red eyes, leg and foot pains, recent headaches, tremoring, and constipation. We only have .9 saline. If this were your Mother what steps could you take at home to carefully help her get better? We have to do hemodialysis tonight and her potassium was 4.1 in the ER. Her thyroid med needed to increase a little. We have a nephrology appt tomorrow but I am worried we won't get help to fix this. Do you have any ideas that you might try yourself in this scenario? Thank-you (That locked in syndrome you mentioned scares me because Mom can still talk and she remembers things but she isn't initiating anything...sometimes it improves but I never know how to help her to continuously improve.)
My grandmom is also kidney failure….. we are doing dialysis 3 times a week for 6 years….she suddenly started losing conscious….. 6 day later after so many tests Ct scan MRI we found she has OSD. Hope your mom is doing fine. God bless her
in the hyponatermia video you said treat with 100 ml in 10 min and to avoid ODS we dont exceed 6 mmol per day as a clinician why do i have to work with 2 units instead of one
a week after i was given sodium ( not needed ).. i started gettting weird feelings in the head, strokes, going unconcious and not breathing, horrible pain in back of the head.. Went to ER and they said I was crazy and sent me home. Went to another ER, they did a cat scan and It made the feelings in my brain worse. My brain is constantly dizzy all the time now. I became very very weak afterwards.. didn't conntect the dots... it's too late now for any time of treatment. I know I'm knocking on deaths door.
It should be made mandatory for doctors to get their license renewed probably every 5 years so that they dont play with the lives of their patients who treat them as god. Incompetence in a doctor results in loss of a patient life or may even make him handicapped for the rest of his days.
Hello sir , my father 60 years suffered sodium over correction from last 4 years, he can't speak, all his body not work properly, he himself walk few 100 meters or he totally depends on us, now question is any chance to recovered. If possible I want to discuss all his condition with you, hope you help us thanks
Hi Doc, please answer me as the patient is in electrolyte correction treatment. He has hypokalemia (2.7) and hyponatremia (110). In a day he is treated with: - OTSU NS NACL 0.9% 25ML - OTSU NS NACL 0.9% 100ML PIGGYBACK INF - NACL 3% 500ML INF (OTSU) - OTSU-NS NACL 0.9% 100ML PIGGYBACK INF - ASPAR K 300MG TAB - NACL 1GRAM CAP - OTSU NS NACL 0.9% 100ML PIGGYBACK INF - KSR 600MG FC SR TAB will this treatment impact Osmotic demyelination syndrome?
I'm not allowed to give direct advice online for real patients that I have never seen. All I can say is this: these values are very severe and it needs to be corrected with 3% NACL and not too much 0,9% NACL. Please don't give more than 300ml 3% NACL daily. Please do regular daily control of the lab values. The potassium can be given orally, but I would give intravenous if the patient is in the hospital. BUT as I said, the doctors that are treating the patient needs to decide about the treatment because they know all the information about the patient.
@@aRchLee7 21 times 24 hours = 504ml every day. I think its too much. BUT they have diluted it with 0,9%, , so the concentration is not that extreme. BUT in the end, its too much NACL in my opinion, since they are giving 325ml 0,9%.and 500ml 3%. I would rather give it slower. Even by severe neurological symptoms, there should only be given max 300ml 3% daily. As I said, if you are not sure whether your doctor is doing it correctly, always ask them why they do it, and if necessary ask for a second opinion from another doctor in the hospital or in another hospital. There may be some information that I dont know about the patient, so I can not give you a statement about what to do. I can only highlight basic science information.
@@drandrasfazakas thanks, Doc for the input. after 3 days of home care with water restriction and oral NaCl 6Gram (2 morning, 2 afternoon, 2 evening), and KSR 600mg (1 morning, 1 afternoon, 1 evening), the patient's Na is now at 129 and K at 3.0. And then the patient is hospitalised again 3days with 0.9% Na 500ml + 25ml KCl daily without water restriction. The Na is now still at 129, K drop to 2.1. Do you think we need to go back with water restriction?
I am a survivor of CPM. You are the fiirst I have seen put the blame where it belongs, the doctor. My hospital completely covered it up. I believe they thought I would die, thats what they told my family...when they asked to stop life support. Erlanger Hospital in Chattanooga, TN
hi. first thing thanks to god. u recovered from this disease. but I have few questions.
how long it took u to recover from this disease?
my mother is suffering from this disease and she is on come for about three months.
my email is ma.chandra007@gmail. com
I need ur help in the form of suggestions so I can take care my mother or help her in her recovery.
thanks in advance.
@@coolmanishch i am still recovering, movement is key
@@coolmanishch i am at 2 years, still.only 50 percent...but, every case is differenrt
+todd morrison hi can you share your email so I can personally ask you some help.
hi.
can you share your email so I can personally ask you some help about your experience my mom is suffering from this deciese. doc has rapedly corrected sodium she has been in state of paralysis for past 4 and half month.
This is one of the first things in my medical lecture and you just explained it in such a good way.
You are just something else. The amount of detail is commendable.🌹
Thank you soooooo much , it is the best explanation i ever heard...i never was able to understand anything about hyponeutremia treatment, fluids balance and differences in IV fluids fast and strength.
You solved a big and important part of this problem by this 14 minutes video but i would love to listen to more of your videos 👍
Excellent guide lines from Doctor..Thanks a lot
Thank you very much. Your knowledge is greatly appreciated.
So thorough and helpful!
You are very good!! You explained this very well. Thank you
I really liked your explication keep going🤩
Great job sir
Thank you, nice channel
DR A.F boss your clip is very informative and very practical,,,,i learnt a lot of things
NEURO DR ABID
Dear Dr. Andras,
My father was admitted with low sodium levels and was treated with infusion of sodium with NaCl 3%, he is also diagnosed with OSD now and in hospital since one month.
He is not on life support anymore (which he was for 2 days because of low sodium levels). Since he was diagnosed with OSD, he was treated with bringing down the sodium levels to around 120 mmol and was maintained to around 125 mmol for long.
In his initial days, he was totally unresponsive with no eye movement and all limbs were not moving at all.
He has shown response to this and his eye movements have returned and him lower limb movements are also showing good response. Starting with his leg fingers, then tow and now to knee shows fair bit of movement.
His upper limb movement is not so good though.
His neck movement is also shown minor improvement.
All this because of right physiotherapy sessions and proper care, he has no other clinical case of blood pressure, sugar level or any other long running disease.
What else can be done to correct this and how long will my father will take to recover?
thank you very much for this video .... it answered lot of my question.
Did your father recovered or what……plz answer my mom has OSD 7 days before…..
@@playboy8651 he has not recovered fully. He is still bed bound. And lost all his limb movements. It's unfortunate but he iss still ok
Thanx for adding value on internet and in my understanding
The best video. Thank u sooo much
My father was admitted into the hospital with low sodium. A few days later he was unable to talk, walk and eat. They told us he had a stroke but found out after he died and had and brain autopsy that is was ODS. Because he drank and was labeled a “alcoholic” we can’t get a lawyer to help. Hospital killed him and gets away with it.
I'm here to see such comments(i think he was treated wrong initially) ..... My uncle admitted hospital 2 days ago .... Past history as per Dr. he has psychotic problem undergo severe anti psychotic dosed drug.. later he developed tremor, less talkative , for long now he developed high bilirubin level...on the same date he having dyspnea I just give him budesonide(i thought he has airway congestion) and oxygen support so that until i reach and admit he atleast have sufficient oxygen in blood to survive now Dr listen everything and diagnosed he has hyponatremia.... He undergo treatment now..... Now it seems he is fine now....
great lesson, very clear!
Great work dr ur amazing thank u
Brilliant explanation
Thanks your time to share this informative video, does chronic hyponatremia causing dysphagia in elderly patient?
My mother is also diagnosed with osmotic demyelinating syndrome. I am devastated and cried hard when i came to know that she has no treatment and she will stay like this forever or she may even die due to complications. I didn’t lose hope and started searching for treatments. I am from medical insurance background and knew many doctors. I found many cases/journals/treatment records of osmotic demyelinating syndrome. Even though its not an established treatment but there are cases of complete recovery by plasmapheresis and IVIG therapy. I found a hospital in hyderabad india who was familier with these therapies and infact treated many similar cases.
At Which Hospital in Hyderabad?
At Which Hospital in Hyderabad?
@@vedangbaxi nims hospital
@@mohammedmustafa6198 Ok, Thanks.
Hi, I’m actually searching myself for people who are dealing with this terrible syndrome. My brother-in-law has been now diagnosed with this syndrome he cannot move. It is very sad to watch. It has been one year. I’m searching for answers or anybody that has also been dealing with this terrible syndrome . Help
Thanks..it was so nice and useful
Thanks..nicely explained👍
Its very importantant information.
Thank you for very good explanation
Men im from algeria and i think you are great keep coming we are tuned
i agree
Thank you! Finally I am able to understand what is the difference in treatment Acute vs chronic. Before I couldn’t understand why the rate of treatment matters
We don't want patients to have severe symptoms or levels below 120 (very Dangerous, even deadly). Therefore we need to quickly stabilize the levels, but not quicker than 6 mmol/24h
Thank you 🙏 doctor
Thank you for your straight talk. Would supplements possibly help a person recovery more likely? And of course they aren't going to admit wrongdoing. They would rather blame the patient or mislabel the matter
Discussed very easily 👍👍🥰
Sir it's very helpful
Thanks dr: u explain so well thanku
Hi. First thank you for your clear answer about normosaline on the other video! Since i m dealing with lots of hypoNa everyday i got one question about ODS. In fact, today i suspected it for the first time. I got a practical question about how to manage such a situation. Once you suspect ODS like for example a patient with brutal bilateral vision loss with history of chronic HypoNa (106 at entrance) with mild symptoms treated really fast by another doctor (126 after 2days)... now at 134. what should we do first? After a negative complete ophtalmological examination i asked for a cerebral MRI. I would say once you have MRI arguments for ODS you can start desmopressin right? Or is it possible to start before further exploration. I thought that if i use desmopressin and it comes out that it isnt ODS than i would put the patient in acute hypoNa with risk of cerebral edema... most doctors i asked were not really familiar with ODS. Thank you:)
Thankyou sir!!👍👍
hi dok, im so glad know about this video. i just want to know, i thing my mom get CPM after recovery hypotermia natrium 103 in 3 day already back to normal 147, but now my mom lost consciousness, now already 1 month, when she lost consciousness, she now can open eyes but not response at all include all body. how recocery it ? how long my mom can wake up from her lost consciousness ?. what treatment should we do for make fast restore to normal?
Almost exactly a year ago, after 2 weeks of headaches I didn't wake up in the morning, was found lifeless by a friend, was diagnosed with severe hyponatremia, sodium of 100mmmol/l, I have experienced all of these things, couldn't cough, swallow, and now I have very little control of my fingers in my left hand. I get spasms in my left leg and left arm My chance of survival was 20% but, here I am ;)
Pray for my mum 😢 she at hospital I hope she get better here low too we will find out 2moro
Why did this occur
My pituitary tumor bled and this made my antidiuretic hormone go off the rails.@@christopherdowd5010
Hi doctor, how if patient already get it, how save it how fix patient how heal patient? Because my mother now can not do anything. :( is posible make she normal again?
Can giving orally in diet too fast also cause problems with some one with mild Low Na. And how would this effect some one with hydrocephalus
Can I increase sodium level by drinking water mixed with Himalayan salt? How many gram of salt to consume per day roughly?
What is the reason for hyponatremia for normal person having diabetes,blood pressure,cholesterol?
119 sodum level.. first time it was low.. when the administered sodium constantly along with potassium, my head hurt so bad constantly for days while they were giving me sodium.. that was many months ago.. things got worse with me over time I feel in my entire body and brain. Was given sodium on other occassions too, rapidly for days straight. Another time was given sodium when I didn't even need it..... all my muscles started jumping in my body when it was being given to me and I didn't even need it.
My mom had this yesterday her symptoms were a week of dizziness. She is on hydrochloroyyhiazide two doctors missed this and taken her to Emergency room 115 MMOl she was bumped up 122 pretty fast. Older with RA taking lots meds. Speech and her thinking was very poor at 115MMOL her walking is bad because RA and her speech was tough to see because she has hearing aids and sounds funny anyways.
Can we give the patient salt capsules??
plus i think it effected my heart.. weird heart beats... I am so weak from doing nothing, nothing at all. weakness, tingling, numbness, I just pray that i pass on peacfully with no pain.
ples reply
Do you mind if i asked a stupid question please?? I apologize for my stupidity but I thought to ask this question as I started to understand something from your videos which I thought i will never understand it 😅😅😅.
Q) you said Maximum we can give is (6 mmol/L a day) of 3% NaCL IV and that the fast it depends on the patient if its Acute or chronic,......so how I’m going to prescribe it???
I have in hospital: (0.9% , 3% & 5% NaCL)
There is : -250 ml , 500 ml and 1 Liter .
And then i need to wright the speed:
(In one hour, 2.h , 4.h, 6.h , 8.h or 12.h)
So how should I calculate 6mmol/L in a day in the prescription??
can this be cured in long term?
I help my Mom with home hemodialysis and her sodium was 126 in the ER this morning. She has had cognition changes since April, low potassium, muscle weakness, increased urination, swallowing issues, slow processing, nausea, extreme hypertension for her, red eyes, leg and foot pains, recent headaches, tremoring, and constipation. We only have .9 saline. If this were your Mother what steps could you take at home to carefully help her get better? We have to do hemodialysis tonight and her potassium was 4.1 in the ER. Her thyroid med needed to increase a little. We have a nephrology appt tomorrow but I am worried we won't get help to fix this. Do you have any ideas that you might try yourself in this scenario? Thank-you (That locked in syndrome you mentioned scares me because Mom can still talk and she remembers things but she isn't initiating anything...sometimes it improves but I never know how to help her to continuously improve.)
My grandmom is also kidney failure….. we are doing dialysis 3 times a week for 6 years….she suddenly started losing conscious….. 6 day later after so many tests Ct scan MRI we found she has OSD. Hope your mom is doing fine. God bless her
@@playboy8651 thank-you and prayers for your family! (Does OSD = obstructive sleep disorder?)
Can you give us example and how to calculate exactly if we deal with sever chronic hyponatremia
Pediatric patients
in the hyponatermia video you said treat with 100 ml in 10 min and to avoid ODS we dont exceed 6 mmol per day as a clinician why do i have to work with 2 units instead of one
Sanad Benali Because it’s science... get used to it lol
a week after i was given sodium ( not needed ).. i started gettting weird feelings in the head, strokes, going unconcious and not breathing, horrible pain in back of the head.. Went to ER and they said I was crazy and sent me home. Went to another ER, they did a cat scan and It made the feelings in my brain worse. My brain is constantly dizzy all the time now. I became very very weak afterwards.. didn't conntect the dots... it's too late now for any time of treatment. I know I'm knocking on deaths door.
hy r u alive
It should be made mandatory for doctors to get their license renewed probably every 5 years so that they dont play with the lives of their patients who treat them as god. Incompetence in a doctor results in loss of a patient life or may even make him handicapped for the rest of his days.
👍👍
Hello sir , my father 60 years suffered sodium over correction from last 4 years, he can't speak, all his body not work properly, he himself walk few 100 meters or he totally depends on us, now question is any chance to recovered. If possible I want to discuss all his condition with you, hope you help us thanks
medicine available in Sidha vithiyam in tamilnadu india
Hi Doc, please answer me as the patient is in electrolyte correction treatment. He has hypokalemia (2.7) and hyponatremia (110). In a day he is treated with:
- OTSU NS NACL 0.9% 25ML
- OTSU NS NACL 0.9% 100ML PIGGYBACK INF
- NACL 3% 500ML INF (OTSU)
- OTSU-NS NACL 0.9% 100ML PIGGYBACK INF
- ASPAR K 300MG TAB
- NACL 1GRAM CAP
- OTSU NS NACL 0.9% 100ML PIGGYBACK INF
- KSR 600MG FC SR TAB
will this treatment impact Osmotic demyelination syndrome?
I'm not allowed to give direct advice online for real patients that I have never seen. All I can say is this: these values are very severe and it needs to be corrected with 3% NACL and not too much 0,9% NACL. Please don't give more than 300ml 3% NACL daily. Please do regular daily control of the lab values. The potassium can be given orally, but I would give intravenous if the patient is in the hospital. BUT as I said, the doctors that are treating the patient needs to decide about the treatment because they know all the information about the patient.
@@drandrasfazakas many thanks for asnwering, Doc. Does that mean treatment of NACL 3% 500ML INF (running at 21ml/h) is completely too quick?
@@aRchLee7 21 times 24 hours = 504ml every day. I think its too much. BUT they have diluted it with 0,9%, , so the concentration is not that extreme. BUT in the end, its too much NACL in my opinion, since they are giving 325ml 0,9%.and 500ml 3%.
I would rather give it slower. Even by severe neurological symptoms, there should only be given max 300ml 3% daily.
As I said, if you are not sure whether your doctor is doing it correctly, always ask them why they do it, and if necessary ask for a second opinion from another doctor in the hospital or in another hospital.
There may be some information that I dont know about the patient, so I can not give you a statement about what to do. I can only highlight basic science information.
@@drandrasfazakas thanks, Doc for the input. after 3 days of home care with water restriction and oral NaCl 6Gram (2 morning, 2 afternoon, 2 evening), and KSR 600mg (1 morning, 1 afternoon, 1 evening), the patient's Na is now at 129 and K at 3.0. And then the patient is hospitalised again 3days with 0.9% Na 500ml + 25ml KCl daily without water restriction. The Na is now still at 129, K drop to 2.1. Do you think we need to go back with water restriction?
Medicine available Sidha vaithiyam medicine at tamilnadu india
Don’t repeat everything, just make it short. Ppl who are here has some idea of the contents….you are good though
Hi Andras
I have sent a mail.Please help
urgently advise.
Yes that bad doc was female
sohail asghar stfu🙄