#phawareness

[phawareglobal]

Raj Parikh, MD, MPH - phaware® interview 517

Dr. Raj Parikh from Hartford Hospital discusses the development of the PH-ILD Detection tool, a screening tool designed to help detect pulmonary hypertension (PH) in patients with interstitial lung disease (ILD) at an early stage. Early detection is critical, as there is often a significant delay in diagnosis of PH in ILD patients, leading to worsened outcomes.

This Special Edition episode is sponsored by Liquidia.

My name is Raj Parikh. I'm the Director of the Pulmonary Hypertension Center at Hartford Hospital in Hartford, Connecticut. I did a lot of my training kind of all over. I went to medical school in New Orleans, Chicago, ended up in Boston, and then made my way back home to Connecticut where I grew up. I've been at Hartford Hospital for the last four years. I started the Hartford Hospital's Pulmonary Hypertension Program from scratch, and I've been building it up since then.

I got involved in Pulmonary Hypertension really during my fellowship at Boston. I really wanted to get involved in the rare disease space of PH, where patients are far and few between, but the ones that are there, they have pretty significant morbidity, mortality, and a poor prognosis. There's limited treatment options and there's limited specialty care for these patients. I really wanted to come back home to my state of Connecticut and build up a program in sort of the area that I grew up in.

Today, I want to talk to you about the PH‐ILD Detection tool that Hap Farber, MD and I have been working on for a couple years. Now, it's in the community. We're encouraging all interstitial lung disease, ILD specialists, general pulmonary docs who see ILD patients to really use this as a way to work on early detection of pulmonary hypertension in interstitial lung disease patients. The reason behind developing the PH‐ILD Detection tool was to really focus on early detection and early screening for pulmonary hypertension that's associated with ILD. The impetus behind that was the development of the first and only FDA approved therapy for PH-ILD, which is inhaled Treprostinil. That was FDA approved back in 2021 after the INCREASE clinical trial.

The PH-ILD Detection tool, the real spirit behind it is patients with interstitial lung disease that develop pulmonary hypertension carry extremely poor prognosis. They need more oxygen. Their quality of life is worse. Their longevity of life and their mortality is worse, as well. These are things we know. We've studied the PH-ILD population for years and years. This is well-established stuff. The key now that we have a therapy that can A, improve the patient's walk distance and therefore their quality of life. B, keep them from having any sort of clinical worsening like ending up in the hospital or having more right heart failure. These are all findings based on the INCREASE trial. So the key really is to detect the pulmonary hypertension as soon as possible in ILD, not just screen for it once a year, or test for it when you meet the patient for the first time and then test for it again every five years.

This is not like colon cancer screening or lung cancer screening. This is active assessment every time you see an ILD patient, you should be thinking, “Okay, do they now have signs of pulmonary hypertension? Should I now be concerned about pulmonary hypertension or should I not be?" There is no standard protocol or standard practice when it comes to screening and detecting for pulmonary hypertension in ILD patients.

Back in 2022, Hap and I really developed eight parameters for PH-ILD detection. We base these parameters off of things that you should routinely already be using to assess a patient's interstitial lung disease. We're talking about 6 minute walk tests, physical exam, pulmonary function testing, assessing whether the ILD patient needs oxygen or not, blood tests, CAT scans, and their prior history and comorbidities. If we take these eight parameters and we assess, okay, which parameters have a higher weight compared to lower parameters that have maybe not as much of a weight in terms of predicting for pulmonary hypertension? We took these eight parameters and basically created a 12 score tool. The score can be anywhere from zero to 12. Four parameters have a weighted score of two points. Four parameters have a weighted score of one point, therefore equaling a max score of 12 points.

Basically, depending on what you score from zero to 12, you are stratified into either low risk for pulmonary hypertension ILD, intermediate risk for PH-ILD, or high risk for PH-ILD. A score of three or below is low risk. A score of four to five is an intermediate risk. A score of six or higher is actually high risk for PH-ILD. What does that mean? What does it mean if you're low versus intermediate or high? Well, that should really dictate what are your next steps. 

If you're low risk, you should reassess the patient at your follow-up visit, whether that's at three months or six months or whatever. If you're intermediate risk, you should get a screening echocardiogram for that patient to make sure there's no signs or development of pulmonary hypertension or right ventricular disease on that echo. If you're high risk, that's a score of six or higher on the PH-ILD Detection tool, you should not only order an echocardiogram, but you should be calling your nearby your local pulmonary hypertension specialist or pulmonary hypertension center and say, "I have a patient with interstitial lung disease. I have a high suspicion for pulmonary hypertension, can you get them into your clinic? Can you get them in for a right heart catheterization for a definitive diagnosis?" 

When we developed this score, we not only first developed it internally retrospectively, but once it was initially published, we discussed it and presented it at an oral presentation at CHEST back in Nashville, so that was a couple of years back. We then actually had seven centers used the score prospectively, and we validated the score by doing a multi-center validation cohort study. That study actually upheld a very significant area under the curve, very significant sensitivity and specificity for a score of six or higher to really strongly predict pulmonary hypertension in interstitial lung disease patients.

As a result of this, we've been working on promoting the use of this PH-ILD Detection tool with local ILD specialists, local general pulmonologists. We use this score not only to predict or increase suspicion for pulmonary hypertension, we've done some other data and we actually presented this information at CHEST, this past year at Boston, where the higher the score you have, the worse your right heart cath hemodynamics are, and therefore the worse your prognosis may be. Some of that is almost common sense, but it's nice to kind of see pen to paper and see that correlation, as well.

We've actually been working on seeing if we can create an app for this score. Now, Hap and I are creating an abbreviated version of the PH-ILD Detection tool to take it instead of eight parameters with 12 points, can we make it three parameters? Can we simplify it even further and make it as simple as possible so that the community pulmonary doctor, the community ILD specialist -- all of them can really focus on how simple it can be to detect and screen for pulmonary hypertension. Mostly because we know that once patients develop PH with ILD, the prognosis is so poor that we want to really act fast. We want to get them diagnosed soon. If we can diagnose them quickly, we can treat them with inhaled Treprostinil. We can mirror some of those outcomes that we saw with the INCREASE clinical trial, and get these patients having a better quality of life, better walk distance, lower proBNP scores, keep them out of the hospital, so on and so forth.

We know from PAH pulmonary arterial hypertension and the REVEAL registry, there's almost a three year delay in diagnosis from the time a patient develops cardiopulmonary symptoms to the point B, which is when they actually have a formal PAH diagnosis. Three years. Those three years are met with seeing different specialists, being in and out of the hospital, having a worsening quality of life because they’re always short of breath and overall just poor more prognosis. If we take that, do we have that exact number when it comes to PH-ILD? No, but we do have an extremely wide range of epidemiology when it comes to PH existence with ILD. PH can range anywhere from 12% to 86% in ILD patients. Why do you have such a wide range? That's because we don't know when to look. We don't know how to look. A lot of times we don't even look and we're getting a lot of that data that 86% is sometimes showing up on autopsy results and transplanted patients.

Then, we're looking back at those autopsy or transplanted lungs and saying, "Oh wow, those patients not only had ILD, they actually had PH as well." That's not something to necessarily be proud or happy about. So it kind of is in the same boat as, what is our delay in diagnosis? What is the window of opportunity that we need to really diagnose and intervene so we can make a difference? There will be a point of no return when it comes to ILD patients with PH. The same way there is sometimes a point of no return with PAH where the patients get so advanced that they're meeting them in the intensive care unit and they're meeting them really on what we call rocket fuel. These patients are looking for the Hail Mary to get better. You're not meeting them in the office, you're not trying to do a 6 minute walk test on them these patients can't even do a 6 minute walk test when they're sometimes at that point of no return. So really what is the sweet spot? I think it is trying to mirror what we went through with PAH several years ago. Developing a registry, understanding more of the referral patterns for PAH and we're trying to extrapolate all of that information and bring it now into this PH-ILD space, as well. 

I know I'm speaking to a lot of the providers and doctors who are involved with taking care of ILD patients, but really switching gears and thinking about it from the patient perspective. If you're a patient who has been diagnosed with any of the many subtypes of interstitial lung disease, I think it's important to be aware of this concomitant process that can occur and that can develop, which is pulmonary hypertension. It is difficult to tease out when you have worsening cardiopulmonary symptoms, worsening breathing symptoms. Is that the interstitial lung disease? Or is that something new such as pulmonary hypertension? I think it's important to think about that and be open with your provider, with your specialist, with your pulmonologist and say, "I'm now feeling this way, and I'm now using this much more oxygen, and wasn't my 6 minute walk distance this far last time and now it's down to this time? Could this be something else? Is this just not necessarily worsening interstitial lung disease or is this a second process?" A second process that now we know we can treat and we can make better. I think that's important to sort of think about. You can be your best advocate when it comes to going into your provider's office and really telling them exactly how you're feeling, and what you're feeling, and how it's different from prior.

My name is Dr. Raj Parikh, and I'm aware that my patients are rare.

Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com Like, Subscribe and Follow us: www.phawarepodcast.com. #phawareMD @HartfordHealthC @Liquidia_Corp @teamphhope #PHILD

Listen and View more on the official phaware™ podcast site

[childheartfoundation]

PH Awareness Month May 2020 Symptoms of Pulmonary Hypertension which sometimes get ignored !

[norayogini]

👉🏻 have you gone out and played, today? . I haven't, and this bugs me. A lot! Explanation: play isn't about just playing football or cards, it's about doing something for the sake of doing it. It brings you joy, and possibly laughter, and it's soooo fulfilling! . . . . . . . . . . Photo taken by @thejackp8 on a bright and hot day ♥️ Outfit entirely by @moonchildyogawear 🌟 #dreamwild #moonchild #getoutandplay #loveandalliscoming #pulmonaryhypertension #phawareness #lovelyfit #ig_mantova #standingpigeon #ekapadarajakapotasana #yogawarriorwoman #moonchildyogawear (at Parco delle Bertone) https://www.instagram.com/p/B0z-kbTD6mT/?igshid=65lrmxvzeepg

[animalactivismhouston-blog]

Fact: Obesity is linked to #meat consumption. Fact: #Obesity puts you at #risk for #pulmonaryhypertension . Fact: People suffering from Pulmonary #hypertension should avoid #cured and #smokedmeat such as #BBQ . So why has the #pulmonaryhypertensionassociation partnering with a #bbqfest in #thewoodlandstx ?? #questionoftheday #disconnect #greed #money #ribs #smokedchicken #cholesterol #thewoodlands #springtx #houstonvegans #veganhouston #houstonvegan #houston #houstontx #houstontexas #houstonevents #houstonanimalactivism #phaware #phawareness (at Town Green Park)

[tegamegadrive]

Celebrating #pulmonaryhypertension day! #phawareness means a lot to me. This year more than others. In June I'll be heading to Canberra to talk at a Parliament dinner and July I'll be presenting in Barcelona!! Spead the word and become #phaware #phriends #phamily #thanksmum #family #sisters #support #worldphday #stepupforph #chronicillness #spoonie #imawarethatimrare #bluelipkiss #veletri

[thomaspelletier]

Month of above is Pulmonary Hypertension Awareness month! #phawareness

[sajid-waseem-u]

بارش کے قطروں کی ہلکی پھوار

پہاڑ کی چوٹی پہ کُرسی لگا کے بیٹھنا

سُلگتا سگریٹ

ہوا میں جھولتی قوس و قزاح

چیل کی شاخوں کی شُوک

اور چائے 🖤

Barish ke qatron ki Halki phawar

Pahar ki choti pe kursi laga ke Bethna

Sulgtaa Cigarette

Hawa main jhoolti qos o qazah

Cheel ki shakhon ki shook

Or chaye 🖤

Sajid waseem

[twinbambi-blog]

This month is Pulmonary Hypertension Awareness month so when @dwooleybooger posted her intention, I jumped on the chance. We were 28 nail addicts who joined in, and this is the result. For more info on my mani see the next post. #therightheart #heart2cureph #phawarenessnails #phawareness (her: Kolding, Denmark)

[phawareglobal]

Episode 517 - Raj Parikh, MD, MPH

Dr. Raj Parikh from Hartford Hospital discusses the development of the PH-ILD Detection tool, a screening tool designed to help detect pulmonary hypertension (PH) in patients with interstitial lung disease (ILD) at an early stage. Early detection is critical, as there is often a significant delay in diagnosis of PH in ILD patients, leading to worsened outcomes.

This Special Edition episode is sponsored by Liquidia.

Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Engage for a cure: www.phaware.global/donate #phaware Share your story: info@phaware.com Like, Subscribe and Follow us: www.phawarepodcast.com. #phawareMD @HartfordHealthC @Liquidia_Corp @teamphhope #PHILD

Listen and View more on the official phaware™ podcast site

[childheartfoundation]

PH Awareness Month May 2020. Pulmonary Hypertension signs which get ignored !

[yeeguan]

Sorry @butta. This was the best I could do for World Pulmonary Hypertension Day 2017. #phawareness #worldphday @phatoronto #cntower #skyline #dusk #toronto #the6ix (at La Maison d'Yee)

[katefitwithkatebridgeman]

The Dash Diet

#phaware #worldphday #pah #scleroderma #systemicsclerosis #raredisease #baby #goodphnews

#cutebabiesofinstagram #yearold #monthsold

#chronicpain #instagrambaby #gjtube #covid #gtube

#phighter #chronicillnessawareness #yearsold #spoonielife #rarediseases #ph #sclerodermaawareness

#chronicfatigue #hypertensionawareness #chronicpainlife #dancer #danceteacher #youdontlooksick

#dance

[aamiribd]

#DailyHadithSMS #Hadith #Quran #islam وَمَثَلُ ٱلَّذِینَ یُنفِقُونَ أَمۡوَ ٰ⁠لَهُمُ ٱبۡتِغَاۤءَ مَرۡضَاتِ ٱللَّهِ وَتَثۡبِیتࣰا مِّنۡ أَنفُسِهِمۡ كَمَثَلِ جَنَّةِۭ بِرَبۡوَةٍ أَصَابَهَا وَابِلࣱ فَـَٔاتَتۡ أُكُلَهَا ضِعۡفَیۡنِ فَإِن لَّمۡ یُصِبۡهَا وَابِلࣱ فَطَلࣱّۗ وَٱللَّهُ بِمَا تَعۡمَلُونَ بَصِیرٌ. سورة البقرة ٢٦٥ And the example of those who spend their wealth seeking means to the approval of Allah and assuring [reward for] themselves is like a garden on high ground which is hit by a downpour - so it yields its fruits in double. And [even] if it is not hit by a downpour, then a drizzle [is sufficient]. And Allah, of what you do, is Seeing. [Surah Al-Baqarah:265] ان لوگوں کی مثال جو اپنا مال اللہ تعالیٰ کی رضامندی کی طلب میں دل کی خوشی اور یقین کے ساتھ خرچ کرتے ہیں اس باغ جیسی ہے جو اونچی زمین پر ہواور زوردا�� بارش اس پر برسے اور وه اپنا پھل دگنا ﻻوے اور اگر اس پر بارش نہ بھی برسے تو پھوار ہی کافی ہے اور اللہ تمہارے کام دیکھ رہا ہے. سورۃ البقرۃ 265 Baqarah:265 Un logon ki misaal jo apna maal ALLAH ki razamandi ki talab main dil ki khushi aur yakeen k sath kharch krty hain, us baagh jesi hy jo onchi zameen py ho aur zoordaar barish uspy barsay aur wo apna phal dugna laye aur agr uspy barish na bhi ho to phawar hi kaafi hy aur ALLAH tmhary kam dekh raha hy. https://www.instagram.com/p/CAji7djhsSE/?igshid=1028jgtulh6wh

[lovertariq]

Five Phrases For Talking And Speaking About Rain

Five Phrases For Talking And Speaking About Rain

five phrases for talking and speaking about rain.

here are some important topics

8 Phrases for cold weather

8 phrases for hot weather

It’s drizzling

it’s raining lightly.

boondha baandi ho rahi hai

phawar phar rahi hai

  it’s pouring.

taiz ya tofani barish ho rahi hai

This is a heavy rain.

It’s raining heavily.

  is it’s raining cats and dogs.

tofani shor wali barish ho rahi hai

 it means…

[adultstories4u]

Saba khuch dair ky baad uthi or apny bedroom main aagai…….or apny kapry utaarny lagi……. Saba ny sub sy pahly apni shirt utaari …… jaisy hi shirt apny sir sy ooper ki to uski unhooked brassier bhi uski shirt ky saath hi oper ko aagai……us ny brassier bhi utaar di or aakhir main apna pajama utaar dya………. jaisy hi apna pajama utara to uski nazar apny pajamy ky apni choot waly hissy pr pari…. jaha pr uski choot main sy nikalny wali Major ky lund ki mani chipki hoi chamak rahi thi…………uski choot main jo mani Major ny daali thi woh ab beh kr bahir aachuki hoi thi or usky pajamy ko geela kr dya tha……

Saba usy dekhti rahi ………….. kameeny ny sub khuch mery andar hi daal dya hai……..agar khuch ho gya to………..???????????????

yahi sochty hoy pata nahi kaisy uski ungli apny pajaamy ki usi jaga pr pohnchi or us ny apni ungli Major ki mani pr phairni shuru kr di……… kitni gaarhi hai yeh……….. Ashraf ki to thori patli lagti hai………….. is main to chipkan bhi ziada lag rahi hai……………. ajeeb si hai………….kaisi boo aarahi hai is main sy………….. yehi sochty hoy Saba ny us pajamy ko thora ooper apny naaki ky paas kya or soonghny lagi…………… lakin isi soonghny ky chakkar main Saba ky naak ki nouk us manni sy lag gai………. or woh mani Saba ki nose pr……….. cheeeeeeeeee cheeeeeeeeeeeeee…….cheeeeeeeeeeeeeeee kya ho gya hai yeh mujhy……………. bekhayali main Saba ny apny usi haath sy apni nose ko saaf krna chaha jis sy woh Major ki mani ko choo rahi thi…….. to us sy kaam ulta or kharab ho gya………. nose pr sy mani saaf hony ki bajaay usky haath pr lagi hoi mani usky onton pr bhi lag gai…………..

abhi Saba koi kapra ya tissue uthaany ka soch hi rahi thi ky uska phone baj utha…………. Saba chounk pari or idhar udhar apna cell dhoondny lagi………… phir bed ki side pr para hoa apna mobile uthaya or dekha to koi unknown number tha…………. Saba ny usy neglect kr dya………… phone band ho gya……….. lakin foran hi phir sy bajny laga………… Saba ny is baar khud number kaat dya………… ku ky Ashraf ny usy sakhti sy mana kya hua tha ky woh koi bhi unknown number attend nahi kry gi…….yeh baat Ashraf ko buhat buri lagti thi…………..or Ashraf ki sakht tabiat ki wajah sy woh us sy darti bhi buhat thi.

Lakin teesri baar jub phone dobara baja to ab darty darty Saba ny call attend ki or dheery sy boli…………Hello………………..doosri traf sy awaaz aai………….. kon bol raha hai……….. Saba hai na tu………. bta jaldi…….

Saba ghabraa gai………koun hai yeh jo aisy baat kr raha hai…………… or maira naam bhi jaanta hai……kon ho sakta hai yeh jisy baat krny ki tameez bhi nahi hai…………usky dimagh main chamaka hua……….. kahin yeh Major to nahi………..

Saba: aaaaaaaaaaaaaa…pppppppppppppp kkkkkkkkkkkouunnnnn boooooll rahy hain…..

Major: ari kuttya jo pooch raha hoon woh bata ky tu Saba hai na???????

Saba: G………..gggggggggggg main Saba hoon prrrrrr aap kkkkoonnnn

Major to jaisy phat hi para: ari kuttya…………rundi ki aulaad…….. mahaa rundi………. abhi mery sy apni choot chudwaa kr aai hai or ab mujhy pehchaan nhi rahi hai……………. abhi tery flat main aa ky tujy apna lund nikaal ky dikhaaoun to phir mujhy pehchaany gi kya………….. haramzaadi……………….

Saba dar gai…………….. woooo w………….woooooooooo …..sorrryyyyyy ………….. mujhy pata nahi chala tha………….. kkkkkkkkkkkkk……. aap hain………….. main unkon number nahi laiti na…………………. tooooooooooooooooooo isi lye…………..

Major: ari kuttya ki aulaad………. yeh unknown number tery baap ka hai…………teri choot ky choodu ka number hai……….aainda kabhi aisa hua na to phir dekhna teri choot hi nahi teri gaand bhi maaroon ga…….. saali kameeni……………..behan ki ludi……

Kouf ky maary Saba ka gala or hont khushk hony lagy……….. us ny apni zubaan apny honton pr phairi un ko geela krny ky lye to………….. waha pr lagi hoi Major ki thori si mani uski zubaan ko lag gai or zubaan ky saath usky monh main Major ki mani ka zaiqa chala gya…………. sath hi Saba ka ajeeb sa monh ban gya……..usky lye to yeh nai cheez hi thi na……kabhi bhi usny aisi gandi harkat Ashraf ky saath nahi ki thi……… us ny to kabhi chooa bhi nahi tha Ashraf ki manni ko to chakhna or taste krna to buhat hi door ki baat thi……….. ku ky Ashraf bhi in sub kharafaat sy door hi rahta tha……. or woh khud bhi aisi baton ko acha nahi samjhti thi.

Major: kaha dafa ho gai hai…………… band kr dya hai kya phone tu ny………..

Saba: nahi nahiiiii ………….. aaaaaaaapppppppp ny ku kya hai …. phoneeeeeeeeeee……..

Major: chek krny ky lye kya tha phone ky tu number theek dy kr bhi gai ky mujhy chootya bana gai hai……………qasam sy agar galat number hota na tera dya hoa to is waqt teri main gaand maar raha hota haram ki jani………..

Major ky monh sy aisi gandi batain or gaalyaan sun sun kr usy ajeeb sa lag rha tha……..ajeeb si halat ho rahi thi……….. usy khuch samjh nahi aarahi thi ky woh kya kry………… kya uska phone kaat dy…….. nahi nahi Major ki call woh kaat nahi sakti thi….. kyu ky yeh iska wahid matlab usy dobara sy apna rape krny ki dawat daina tha……….. us ny khamoshi hi ikhtyaar krna behtr samjha……. uski gaalyon ky baary main us ny aik baar phir Major ko samjhaany ki kosish ki…….

Saba: Major sb plzzzzzzzzzzz aap aisi baatain na kya krain mujhy ……….acha nahi lagtaaaaaaaaaaa…………………

Major: kaisi batain na kya kroon main……….kya acha nahi lagta tujhy..

Saba: ye…ye….. jo aaapppppppp gaalyaan daity hain……….. mujhy or mery shouhar ko……. wooooooooo

Major: ari kuttya tu mujhy bataay gi ky tujhy kya acha lagta hai or kya bura lagta hai………… main koi tera aashiq hoon kya jo dyaan rakhoon ky malka- e- hussan sahiba ko kya bura lagta or kya acha….. ………. saali………… us kameeny gaanduu ko bataya kr ky tujhy kya acha lagta hai or kya bura………… main to jo mery dil main aay ga wohi tujhy bolun ga or wohi tery saath kroon ga……….. aai samjah……

Saba chup ho gai………

Major: kya kr rahi thi tu………..

Saba: gggggggggggggg……gggggggggg woooooooooooo……….. nahaany jaa rahiiiiii thiiiii…………….

Major: achaaaaaaaaaaaaaaaaaaa…………phir to nangi hi ho gi is waqat tu………… bollllllllll

Saba phir sharam sy chup rahi……

Major: monh sy khuch bhoonky gi ya main aaoun khud sy dekhny ky kaisy khari hai tu……..

Saba usky aany ka sun kr dar gai……….. nahi naiiiiiii aap nahiiiiii plzzzzzzzzzzzzzzzzzzzzz idhar nahiiiiiiiiiiiiiiiii

Major: to phir bata jaldi nangi khari hai kya

Saba: G

Major: ari behan ki ludi……… G……. kya hota hai…���….. seedhi trah bata na……………..

Saba: G ……..G main ny kaha ky………. utaary huy hain kapry main…… ny……… nahany ky lye………..

Major hansty hoy………….. saali tu hai to pakki rundi……….. har waqt tujhy bhi nangi rahny ka shouq hai………. abhi mujh sy nangi ho ky chudwaa ky gai ho or phir sy nangi khari hai…………… such such bata ky tery kisi yaar ny to nahi aana tujhy chodny jo nangi ho ky intezaar kr rahi hai……..

Saba:nah…..eeee.nah….eeee aisi koi baat nahi hai…….. mera koi dost nahi hai………..

Major: to phir ky apni choot main ungli kr rahi hai saali ………………. jaisy mery saamny kr rahi thi ……….. kuttya ki trah jhuk kar………….

Saba uski batoon sy garam ho rahi thi……….. uski choot main bhi ajeeb si sarsrahat paida ho rahi thi………… nahi ….nahiiiiii aisa khcu nahi kr rahi…………..

Major: ja dafa ho naha jaa ky………… or ainda jub bhi call kroon to jawab zaroor daina………….samjhi…

Saba: G…………G……… major sb…………..

uski baat poori hony sy pahly hi Major ny phone band kr dya tha………..

Saba ny phone band hony ky baad us number ko ghour sy dekhna shuru kr dya………..or chand lamhon main hi jaisy woh number uski dimagh main jum gya…………..feed ho gya…………… Major ka number usky dimagh ky har har koony main fit ho gya………….. jaisy khuch dair pahly Major ka lund uski choot main fit ho chuka hua tha………….

Saba nahany ky lye chali gai or jaisy thandy paani ki phawar usky jism pr pari or thanda paani behta hoa uski gaand pr gya to aik baar phir tarap kr paani sy bahir aagai………….. apni gaand ko seeshy main dekhny lagi………… bilkul surkh ho rahi thi uski gaand……… jaga jaga surkh nishaan pary hoy thy goori goori gaand pr………… Saba apni gaand ko apny haathon sy sahlaaty hoy sochny lagi………… ab isy kaisy chupaun gi main Ashraf sy…………dekh lya us ny to kya bataoun gi usy……….. chupaana hi pary ga………… aaj bhi usy apny paas nahi aany doon gi…….. choodny nahi doon gi…………… waisy bhi mujhy kon si pyaas hai aaj chudwaany ki…………aaj rest kroon gi………… us kameeny ny choda bhi to itni buri trah sy hai na………… dard kr di hai choot ky andar……..aisy lag raha hai jaisy andar sy chil gai ho……..pata nahi abhi aagy aagy kya khuch sahna pary ga mujhy………… or kitna zaleel kry ga woh Kameena………. kutta…….

Pahly waqya ki trah hi ab phir khuch din bilkul khaamoshi sy guzar

gy……… Major ki traf sy koi bhi ghalat baat na hoi usky saath……….

jub bhi uska phone bajta……. or khaas tor pr Ashraf ki moujoodgi main to

Saba ka dil dhak sy rah jaata ……….. aik hi dar hota ky kahin Major ki

call na ho………….. lakin in dus dinon main Major ny na usy gate pr

raka, na usy call ki or na hi koi message kya………… Saba ny bhi khuch

sukoon ka saans lya ky shayad uski jaan choot gai hai……….. ya shayad

us ko tars aagya hai uski halat pr………….

Lakin phir aik roz khuch ghalat ho gya……… bilkul hi anjaany

main……. Saba ny chaha bhi nahi tha ky aisa khuch ho…….. lakin phir

bhi bus achanak hi ho gya……………

Wednesday ka din tha or Ashraf ny apny factory sy chutti li hoi thi or ghar

pr hi rest kr raha tha…….. dono ny bari dair main uth kr naashta kya or

phir gup shup krny lagy, tv dekhny lagy…….. dophar ky khaany ky baad

qareeb 5 bajy Ashraf ko factory sy call aai or usy unhon ny kisi emergency

kaam ky lye factory aany ko kaha………. Ashraf ny bataya ky uski to aaj

ki leave hai……. lakin usky boss ny kaha ky yaar aaj ka sirf 2-3 ghanty

ka emergency kaam niptaa do aaky to kal ki dobara tum ko poori leave dy doon

ga……….. is baat sy Ashraf khamosh ho gya….or waisy bhi to boss ki

baat maan na hi parti ab bonus main aik chutti or mil rahi thi to us ny

bola, theek hai sir thori dair main aata hoon.

Yeh baat us Saba ko bataai to wo bhi udaas ho gai…… lakin Ashraf ny usy

bataya ky bus 6 sy 8 bajy tak ka kaam hai sirf wo jaldi aa jay ga or agly

din usy ghumaany ly jaany ka promise kr lya to woh khush ho gai…… Ashraf

tyaar hua or jaany ky lye nikla qareeb 5:30 bajy……..Saba apny mamool ky

mutabiq Ashraf ko flat ky darwazy pr chorny aai…….. bazaar sy khuch

raashan mangwana tha woh usi ka bata rahi thi or Ashraf Saba ki traf monh kr

ky uski baat sunta hua or usy jawab daita hua seedyon ki traf barh raha tha

ky achanak sy uski takkar ho gai…………….

andha ho gya hai kya………… dekh ky nahi chala jaata tujh

sy…………… Major ki gussy sy bhari awaaz aai…

Saba bhi ghabraa gai is achanak sy huy haadsy ko dekh kr………..

Ashraf ko pata tha ky uska qasoor hai isi lye Major ki bakwas sun kr bhi woh

apny gussy ko control krty hoy bola……….. sorry

Major: teri sorry gai choot marwaany…………. behnchod seedha dekh ky

chal…………. jaa udhar raha hai or dekh peechy us gashti ko raha

hai…….. raat dil nahi bhara to dobara andar ly jaa youn sar e aam Laila-

Majnoo ka tamasha to na laga………..

Major ki yeh baat sun kar to Ashraf ka khoon hi khool utha…….. usy pata

tha ky woh Major ky muqably ka nahi hai lakin phir bhi apni gussy wali

nature sy majboor ho kar us ny Major ka gyrebaan pakar lya…………. or

yahi thi ghalti jo us sy ho gai………….. or iska nateeja agly hi lamhy

usy mil gya jub Major ka zoor ka aik ghoonsa usky monh pr

para…………… na Ashraf khuch samjh saka or na hi Saba ko baat krny or

beech bachaao kraany ka waqat mila…………. Ashraf ka nichla hont phat

gya or hont sy khoon jaari ho gya……… uska haath bhi Major sy peechy

hat chuka tha or wo usky achanak ky mukkay ki wajah sy peechy ko larkhara

bhi gaya tha…….. Ashraf dobara sy aagy ko baraha to Saba ny foran hi usy

pakar lya…..usy pata tha ky agar phir Ashraf aagy gya to dobara sy Major

Ashraf ka whhi hashar kry ga ga.

Saba: nahi Ashraf nahi………. plz khuch nahi krna……… isky monh mat

lago……. chalo andar chalo……….

Ashraf: kameeny………. haram zaady dekh loon ga tujhy……….

Major: aby ja by jaa…… tu kya dekhy ga mujhy…… dekhna hai to abhi

aaja………….. pata nahi kyun apni is chikni chamaili ky saamny hero ban

ny ki koshish krta rahta hai tu………

Saba: Ashraf andar chalo………..

Major: haan haan ly jaa isy andar…….. or nikaal iski garmi jo isky

dimagh ko charh rahi hai……………

Ashraf khud ko churaany ky lye zoor lagaty huy………… kameeny……..

teri toooooooooooooooooooooo

Major: chul chul bachy shaabash ja andar jaaa………… apni is raand sy

muth marwaa jaa ky agar khara hota hai tera to………..

Saba ny aik nazar gussy sy Major ki traf dekha or Ashraf ko andar laa kar

apna darwaza band kr ky Ashraf ko sitting room main ly aai or sofy pr bethaa

dya………. apny dopatty sy usky nichly hont sy nikalta hua khoon saaf

krny lagi……. phir Saba ny usy paani laa kar dya……

Saba: Ashraf aap factory phone kr do ky aap nahi aa sakty…

Ashraf: khuch thanda party hoy……….. ary nahi yaar…….. khuch nahi

hua theek hoon main……… thora sa kaam hai abhi kr ky aata hoon……

Saba foran hi uthi or jaldi sy Ashraf ky lye juice ka aik glass ly aai or

usy peeny ky lye dya……….. Ashraf ny juice peya or phir apni factory ky

lye nikal gya………….. is baar bina khuch or kharabi huy…….

The post Major Sahb Ki Randiyan – Completed Update 11 appeared first on Desi Stories.

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