Jonathan Ryder, MD
@jonathanrydermd.bsky.social
Adult ID and Assistant Prof at UNMC | Former IUSM IM & Truman State | Abx Stewie, Infxn Prevention, Digital MedEd, Podcasts, Medical History, Reading Non-Fiction, Running/Cycling | Posts are mine
Reposted by Jonathan Ryder, MD
As expected, Canada has lost its measles-free status because of the long-running outbreak there. With it goes the #measles elimination status of the entire zone of the Americas, the only division of the #WHO to ever have achieved measles elimination. www.statnews.com/2025/11/10/m...
Canada loses measles elimination status — as does the entire Americas region
Canada has formally lost its measles elimination status, the country’s public health agency announced, triggering the loss of that status throughout all of the Americas.
www.statnews.com
November 10, 2025 at 2:49 PM
As expected, Canada has lost its measles-free status because of the long-running outbreak there. With it goes the #measles elimination status of the entire zone of the Americas, the only division of the #WHO to ever have achieved measles elimination. www.statnews.com/2025/11/10/m...
Reposted by Jonathan Ryder, MD
More evidence to be aggressive with Linezolid dosing in ECMO.
#IDSky
link.springer.com/article/10.1...
#IDSky
link.springer.com/article/10.1...
Underexposure of linezolid in critically ill patients with extracorporeal membrane oxygenation (ECMO): results from a monocentric study including blood samples from 52 patients - Infection
Purpose Linezolid serum concentrations in critically ill patients show high variability. In this retrospective study, we analysed the linezolid plasma through levels (Cmin) in patients on intensive ca...
link.springer.com
November 10, 2025 at 2:29 AM
More evidence to be aggressive with Linezolid dosing in ECMO.
#IDSky
link.springer.com/article/10.1...
#IDSky
link.springer.com/article/10.1...
Reposted by Jonathan Ryder, MD
📣 In a US cohort of >2500 #bacteremia patients, #Serratia marcescens was associated with persistent bacteremia and cardiac devices. Yet WGS showed genetic diversity of isolates: infections are not clonal.
#IDSky #clinmicro #MedSky @vancefowler.bsky.social
www.cmi-comms.org/article/S295...
#IDSky #clinmicro #MedSky @vancefowler.bsky.social
www.cmi-comms.org/article/S295...
Clinical and genomic characterization of Serratia bloodstream infections
Previously considered a rare opportunistic pathogen, Serratia is now an emerging cause
of bacteraemia. We compared the risk factors and outcomes of patients with Serratia
bacteraemia relative to other...
www.cmi-comms.org
November 10, 2025 at 12:53 PM
📣 In a US cohort of >2500 #bacteremia patients, #Serratia marcescens was associated with persistent bacteremia and cardiac devices. Yet WGS showed genetic diversity of isolates: infections are not clonal.
#IDSky #clinmicro #MedSky @vancefowler.bsky.social
www.cmi-comms.org/article/S295...
#IDSky #clinmicro #MedSky @vancefowler.bsky.social
www.cmi-comms.org/article/S295...
Reposted by Jonathan Ryder, MD
What’s the optimal antibiotic duration after DAIR for acute periprosthetic joint infection (PJI)?
🌍 An international consensus led by ID faculty Dr. Geno Tai and colleagues recommends at least 12 weeks of therapy. #IDSky #MedSky #OrthoSky
🌍 An international consensus led by ID faculty Dr. Geno Tai and colleagues recommends at least 12 weeks of therapy. #IDSky #MedSky #OrthoSky
2025 ICM: Debridement, Antibiotics, and Implant Retention (DAIR)
James Cashman, Paul McCarroll, Peter Choong, Pedro Ivo Carvalho, Nicolaas Budhiparama,
Ewout S Veltman, David Dewar, Mehmet Kursat Yilmaz
www.arthroplastyjournal.org
November 9, 2025 at 2:53 PM
Reposted by Jonathan Ryder, MD
Hey ID Fellows, what are your favorite ID consults? Asked that question during a recent visit to the ID division at Johns Hopkins, and here's what their fellows said. #IDSky
blogs.jwatch.org/hiv-id-obser...
blogs.jwatch.org/hiv-id-obser...
Favorite ID Fellow Consults: Johns Hopkins Edition
Just back from a visit to the Infectious Diseases Division at Johns Hopkins, thanks to the kind invitation of current ID chief Dr. Amita Gupta and her predecessor, Dr. David Thomas. On a personal note...
blogs.jwatch.org
November 7, 2025 at 9:55 PM
Hey ID Fellows, what are your favorite ID consults? Asked that question during a recent visit to the ID division at Johns Hopkins, and here's what their fellows said. #IDSky
blogs.jwatch.org/hiv-id-obser...
blogs.jwatch.org/hiv-id-obser...
Reposted by Jonathan Ryder, MD
With UW’s Dr Paul Pottinger and others, new discussion re: fostering ID advocacy in ID fellowship.
They note:
Policies with a negative impact on ID clinical care, public health, & research underscore the importance of mobilizing the field of ID to advocacy
academic.oup.com/ofid/advance... #IDSky
They note:
Policies with a negative impact on ID clinical care, public health, & research underscore the importance of mobilizing the field of ID to advocacy
academic.oup.com/ofid/advance... #IDSky
Amplifying Our Voices: Fostering Advocacy in Infectious Diseases Fellowship
This white paper, devised from the Infectious Diseases Society of America's National Training Program Director annual meeting, outlines practical strategie
academic.oup.com
November 7, 2025 at 1:47 PM
With UW’s Dr Paul Pottinger and others, new discussion re: fostering ID advocacy in ID fellowship.
They note:
Policies with a negative impact on ID clinical care, public health, & research underscore the importance of mobilizing the field of ID to advocacy
academic.oup.com/ofid/advance... #IDSky
They note:
Policies with a negative impact on ID clinical care, public health, & research underscore the importance of mobilizing the field of ID to advocacy
academic.oup.com/ofid/advance... #IDSky
Reposted by Jonathan Ryder, MD
A paper doesn’t have to be widely read/cited to matter.
If you wrote it with a trainee, at least you know that one person learned something.
🎧 The Host Response: Publication for the Non-Publicationist
#idsky #meded
If you wrote it with a trainee, at least you know that one person learned something.
🎧 The Host Response: Publication for the Non-Publicationist
#idsky #meded
On being quietly pleased with small academic wins.
On learning to say no.
On the psychic who told my mother that I’d be published.
It’s a reflection on writing, and on protecting your bandwidth.
🎧 The Host Response: Publication for the Non-Publicationist
#idsky #meded #academicmedicine
On learning to say no.
On the psychic who told my mother that I’d be published.
It’s a reflection on writing, and on protecting your bandwidth.
🎧 The Host Response: Publication for the Non-Publicationist
#idsky #meded #academicmedicine
Episode 14 - Publication for the Non-Publicationist
Podcast Episode · The Host Response: A FirstcallID Podcast · 11/02/2025 · 5m
podcasts.apple.com
November 7, 2025 at 2:13 AM
Reposted by Jonathan Ryder, MD
TB survivors face a high CPA burden: 9% during treatment, 13% post-treatment. For those with symptoms, rates rise to 20% and 48%. Routine CPA screening is essential. 📊🦠##idsky
A Systematic Review of Chronic Pulmonary Aspergillosis Among Patients Treated for Pulmonary Tuberculosis
Tuberculosis (TB) is a major global health concern, with long-term complications persisting even after successful treatment. Chronic pulmonary aspergillosis (CPA) is a progressive fungal disease that frequently develops in TB survivors, contributing to post-TB lung disease. The true burden of CPA among patients with TB remains unclear due to diagnostic challenges and limited data. We aimed to estimate the prevalence of CPA among patients with prior or concurrent TB.MethodsWe conducted a systematic search in PubMed, Cochrane Library, Web of Science, and Science Direct through 10 January 2025. Eligible cohort and cross-sectional studies reported CPA prevalence in patients diagnosed with TB based on clinical symptoms, radiographic abnormalities, and microbiological evidence. Three reviewers screened 1575 unique studies, assessed 118 full texts, and included 22 studies (2884 patients). We conducted a meta-analysis using a random-effects model to estimate pooled CPA prevalence, with subgroup and meta-regression analyses exploring factors influencing CPA burden.ResultsCPA prevalence varied by timing of assessment and symptom status. Among all patients with TB, CPA prevalence was 9% (95% confidence interval [CI]: 6%–12%) during treatment and 13% (95% CI: 6%–27%) posttreatment. Among patients with persistent respiratory symptoms, CPA prevalence was 20% during treatment and 48% (95% CI: 36%–61%) posttreatment. Meta-regression identified symptom status and timing of CPA assessment as significant predictors of CPA prevalence.ConclusionsThe high CPA burden among TB survivors, particularly those with persistent symptoms, underscores the need for routine CPA screening in TB programs. Early detection and targeted interventions could reduce respiratory complications and improve patient outcomes.
academic.oup.com
November 7, 2025 at 8:30 AM
TB survivors face a high CPA burden: 9% during treatment, 13% post-treatment. For those with symptoms, rates rise to 20% and 48%. Routine CPA screening is essential. 📊🦠##idsky
Reposted by Jonathan Ryder, MD
A PIV bundle based on best evidence demonstrated promising results in reducing catheter-associated phlebitis & SAB…
- hand hygiene
- aseptic technique
- timely removal
- transparent dressings
- line extensions
SAB reduced 41%, phlebitis reduced 14-28%. #IDSky
www.sciencedirect.com/science/arti...
- hand hygiene
- aseptic technique
- timely removal
- transparent dressings
- line extensions
SAB reduced 41%, phlebitis reduced 14-28%. #IDSky
www.sciencedirect.com/science/arti...
Implementation of a Peripheral Intravenous Catheter Bundle to Reduce Phlebitis and Hospital-Onset Staphylococcus aureus Bacteremia: A Quality Improvement Project
Peripheral intravenous catheters (PIVCs) are widely used in hospitals and account for up to one-third of hospital-onset Staphylococcus aureus bacterem…
www.sciencedirect.com
November 7, 2025 at 1:41 PM
A PIV bundle based on best evidence demonstrated promising results in reducing catheter-associated phlebitis & SAB…
- hand hygiene
- aseptic technique
- timely removal
- transparent dressings
- line extensions
SAB reduced 41%, phlebitis reduced 14-28%. #IDSky
www.sciencedirect.com/science/arti...
- hand hygiene
- aseptic technique
- timely removal
- transparent dressings
- line extensions
SAB reduced 41%, phlebitis reduced 14-28%. #IDSky
www.sciencedirect.com/science/arti...
Reposted by Jonathan Ryder, MD
🆕🔥State-of-the-Art Review with 🌟s @trubianojason.bsky.social : Antibiotic Allergy—A Multidisciplinary Approach to Delabeling #idsky
url: academic.oup.com/cid/article/...
url: academic.oup.com/cid/article/...
November 6, 2025 at 8:09 PM
🆕🔥State-of-the-Art Review with 🌟s @trubianojason.bsky.social : Antibiotic Allergy—A Multidisciplinary Approach to Delabeling #idsky
url: academic.oup.com/cid/article/...
url: academic.oup.com/cid/article/...
Reposted by Jonathan Ryder, MD
Aerosolizing pathogens from sink drains? New study shows it can happen & possibly cause transmission
Drain biofilm bacteria found in droplets and aerosols ▶️ spread into room
Possible sources of HAIs #IDSky
📄: www.ajicjournal.org/article/S019...
Drain biofilm bacteria found in droplets and aerosols ▶️ spread into room
Possible sources of HAIs #IDSky
📄: www.ajicjournal.org/article/S019...
November 6, 2025 at 6:18 PM
Aerosolizing pathogens from sink drains? New study shows it can happen & possibly cause transmission
Drain biofilm bacteria found in droplets and aerosols ▶️ spread into room
Possible sources of HAIs #IDSky
📄: www.ajicjournal.org/article/S019...
Drain biofilm bacteria found in droplets and aerosols ▶️ spread into room
Possible sources of HAIs #IDSky
📄: www.ajicjournal.org/article/S019...
Reposted by Jonathan Ryder, MD
To follow up this post, I looked up some of the available data and ran some numbers. Math isn't my forte so I had my senior partner look over them but please correct me if you see flaws @jonathanrydermd.bsky.social
Someone way smarter than me once posted the MIC math behind the 2g/12 ceftriaxone for strep pneumo meningitis and also a discussion of how many pt would need vanco to treat 1 CRO resistant S.pneumo. Anyone remember? @bradspellberg.bsky.social @jgpharmd.bsky.social
November 6, 2025 at 6:09 PM
To follow up this post, I looked up some of the available data and ran some numbers. Math isn't my forte so I had my senior partner look over them but please correct me if you see flaws @jonathanrydermd.bsky.social
Reposted by Jonathan Ryder, MD
NEW: Billions of pounds of food are imported to the U.S. each year.
The FDA inspects foreign producers to ensure what we're eating is safe from pathogens and dangerous manufacturing practices.
But now, after Trump's drastic staff cuts, these inspections have plummeted to a historic low.
🧵/
The FDA inspects foreign producers to ensure what we're eating is safe from pathogens and dangerous manufacturing practices.
But now, after Trump's drastic staff cuts, these inspections have plummeted to a historic low.
🧵/
Foreign Food Safety Inspections Hit Historic Low After Trump Cuts
The dramatic shift in oversight comes at a time when the U.S. has never been more reliant on foreign food, which accounts for the vast majority of the nation’s seafood and more than half its fresh fru...
www.propublica.org
November 6, 2025 at 1:30 PM
NEW: Billions of pounds of food are imported to the U.S. each year.
The FDA inspects foreign producers to ensure what we're eating is safe from pathogens and dangerous manufacturing practices.
But now, after Trump's drastic staff cuts, these inspections have plummeted to a historic low.
🧵/
The FDA inspects foreign producers to ensure what we're eating is safe from pathogens and dangerous manufacturing practices.
But now, after Trump's drastic staff cuts, these inspections have plummeted to a historic low.
🧵/
Reposted by Jonathan Ryder, MD
The National STD Curriculum (www.std.uw.edu) has launched the long-awaited Image Library and Weekly Quiz series...
Test your STI knowledge, learn and obtain free CME!
www.std.uw.edu/image-librar... #IDSky #STI
Test your STI knowledge, learn and obtain free CME!
www.std.uw.edu/image-librar... #IDSky #STI
November 5, 2025 at 10:19 PM
The National STD Curriculum (www.std.uw.edu) has launched the long-awaited Image Library and Weekly Quiz series...
Test your STI knowledge, learn and obtain free CME!
www.std.uw.edu/image-librar... #IDSky #STI
Test your STI knowledge, learn and obtain free CME!
www.std.uw.edu/image-librar... #IDSky #STI
Reposted by Jonathan Ryder, MD
Who knows, you guys might even get temocillin soon too! 😉
My take: IV fosfo has a couple of handy off-label uses... tricky VRE infections (in combo), occasional meningitis with unusual orgs/allergies, resistant pyelo when beta-lactams truly contraindicated.
Sodium load is a real issue tho.
My take: IV fosfo has a couple of handy off-label uses... tricky VRE infections (in combo), occasional meningitis with unusual orgs/allergies, resistant pyelo when beta-lactams truly contraindicated.
Sodium load is a real issue tho.
November 5, 2025 at 8:46 PM
Who knows, you guys might even get temocillin soon too! 😉
My take: IV fosfo has a couple of handy off-label uses... tricky VRE infections (in combo), occasional meningitis with unusual orgs/allergies, resistant pyelo when beta-lactams truly contraindicated.
Sodium load is a real issue tho.
My take: IV fosfo has a couple of handy off-label uses... tricky VRE infections (in combo), occasional meningitis with unusual orgs/allergies, resistant pyelo when beta-lactams truly contraindicated.
Sodium load is a real issue tho.
Reposted by Jonathan Ryder, MD
IV fosfo finally FDA approved in US for cUTI d/t E. coli or Kleb pneumo.
-How much will it cost?
-Folks willing to use it for Kleb (or other Enterobacterales) in the absence of CLSI BPs?
-Dose: 6G IV q8h…Tolerability in real-world? 🤔
Lots of questions to consider….
#IDSky #AMSsky
-How much will it cost?
-Folks willing to use it for Kleb (or other Enterobacterales) in the absence of CLSI BPs?
-Dose: 6G IV q8h…Tolerability in real-world? 🤔
Lots of questions to consider….
#IDSky #AMSsky
🔥Meitheal Pharmaceuticals Receives Approval from the US FDA for CONTEPO™ (fosfomycin) for injection in Patients ≥ 18 Years Having Complicated Urinary Tract Infections (cUTI),Including Acute Pyelonephritis🔥#idsky
www.businesswire.com/news/home/20...
www.businesswire.com/news/home/20...
November 5, 2025 at 4:57 PM
Reposted by Jonathan Ryder, MD
If 1% of ED LPs end up being for Pneumo, and 1% of Pneumo in adults is R, you will do 10,000 vanco courses for every 1 patient with CTX-R pneumococcal meningitis. That will definitely cause a large amount of AKIs and VREs.
In LA, we recommend NOT adding vanco until LP CSF WBC/% PMN known.
In LA, we recommend NOT adding vanco until LP CSF WBC/% PMN known.
November 5, 2025 at 3:52 PM
If 1% of ED LPs end up being for Pneumo, and 1% of Pneumo in adults is R, you will do 10,000 vanco courses for every 1 patient with CTX-R pneumococcal meningitis. That will definitely cause a large amount of AKIs and VREs.
In LA, we recommend NOT adding vanco until LP CSF WBC/% PMN known.
In LA, we recommend NOT adding vanco until LP CSF WBC/% PMN known.
Reposted by Jonathan Ryder, MD
Yup, posted on the other platform. For PK, 2 gm CTX Cmax blood 250 mcg/ml, 10% CSF = 25 at peak. 4-6 hr half life:
T0 = 25
T4 = 12.5
T8 = 6.25
T12 = 3.125 --should be above MIC whole interval.
As far as the massive overuse of vanco, does depend on geography. In much of US, CTX-R rare in adults...
T0 = 25
T4 = 12.5
T8 = 6.25
T12 = 3.125 --should be above MIC whole interval.
As far as the massive overuse of vanco, does depend on geography. In much of US, CTX-R rare in adults...
November 5, 2025 at 3:52 PM
Yup, posted on the other platform. For PK, 2 gm CTX Cmax blood 250 mcg/ml, 10% CSF = 25 at peak. 4-6 hr half life:
T0 = 25
T4 = 12.5
T8 = 6.25
T12 = 3.125 --should be above MIC whole interval.
As far as the massive overuse of vanco, does depend on geography. In much of US, CTX-R rare in adults...
T0 = 25
T4 = 12.5
T8 = 6.25
T12 = 3.125 --should be above MIC whole interval.
As far as the massive overuse of vanco, does depend on geography. In much of US, CTX-R rare in adults...
Reposted by Jonathan Ryder, MD
Someone way smarter than me once posted the MIC math behind the 2g/12 ceftriaxone for strep pneumo meningitis and also a discussion of how many pt would need vanco to treat 1 CRO resistant S.pneumo. Anyone remember? @bradspellberg.bsky.social @jgpharmd.bsky.social
November 5, 2025 at 3:28 PM
Someone way smarter than me once posted the MIC math behind the 2g/12 ceftriaxone for strep pneumo meningitis and also a discussion of how many pt would need vanco to treat 1 CRO resistant S.pneumo. Anyone remember? @bradspellberg.bsky.social @jgpharmd.bsky.social
@glaucomflecken.bsky.social hitting close to home with this ID doc at the soccer game....
Reflexively, I couldn't help screaming in my head...don't put DEET on the net, only use permethrin on clothing!!
#IDSky
www.youtube.com/shorts/Q8UGF...
Reflexively, I couldn't help screaming in my head...don't put DEET on the net, only use permethrin on clothing!!
#IDSky
www.youtube.com/shorts/Q8UGF...
Infectious Disease Doctor Goes To A Soccer Game
YouTube video by Dr. Glaucomflecken
www.youtube.com
November 5, 2025 at 7:39 PM
@glaucomflecken.bsky.social hitting close to home with this ID doc at the soccer game....
Reflexively, I couldn't help screaming in my head...don't put DEET on the net, only use permethrin on clothing!!
#IDSky
www.youtube.com/shorts/Q8UGF...
Reflexively, I couldn't help screaming in my head...don't put DEET on the net, only use permethrin on clothing!!
#IDSky
www.youtube.com/shorts/Q8UGF...
Reposted by Jonathan Ryder, MD
SHEA is proud to offer several scholarships to support training and professional development in healthcare epidemiology, infection prevention, antibiotic stewardship, & public health.
Apply for a scholarship to SHEA Spring by December 12th, 2025 at 11:59pm ET!
For more information: bit.ly/49zQ7Du
Apply for a scholarship to SHEA Spring by December 12th, 2025 at 11:59pm ET!
For more information: bit.ly/49zQ7Du
November 4, 2025 at 8:26 PM
SHEA is proud to offer several scholarships to support training and professional development in healthcare epidemiology, infection prevention, antibiotic stewardship, & public health.
Apply for a scholarship to SHEA Spring by December 12th, 2025 at 11:59pm ET!
For more information: bit.ly/49zQ7Du
Apply for a scholarship to SHEA Spring by December 12th, 2025 at 11:59pm ET!
For more information: bit.ly/49zQ7Du
Reposted by Jonathan Ryder, MD
🆕 New in ICHE: Genomic epidemiology of HAI respiratory viruses in Pittsburgh, 2018–2020
🧬 WGS of 436 healthcare-associated respiratory virus infections:
• 14 clusters ▶️ 36 patients
• Clusters often in a single unit
• Avg cluster duration 16 days (range 0-55)
#IDSky
📄: doi.org/10.1017/ice....
🧬 WGS of 436 healthcare-associated respiratory virus infections:
• 14 clusters ▶️ 36 patients
• Clusters often in a single unit
• Avg cluster duration 16 days (range 0-55)
#IDSky
📄: doi.org/10.1017/ice....
November 4, 2025 at 7:06 PM
🆕 New in ICHE: Genomic epidemiology of HAI respiratory viruses in Pittsburgh, 2018–2020
🧬 WGS of 436 healthcare-associated respiratory virus infections:
• 14 clusters ▶️ 36 patients
• Clusters often in a single unit
• Avg cluster duration 16 days (range 0-55)
#IDSky
📄: doi.org/10.1017/ice....
🧬 WGS of 436 healthcare-associated respiratory virus infections:
• 14 clusters ▶️ 36 patients
• Clusters often in a single unit
• Avg cluster duration 16 days (range 0-55)
#IDSky
📄: doi.org/10.1017/ice....
Wow! IV Fosfomycin coming to the US soon?!!
#Breaking FDA gave the nod to Meitheal Pharmaceuticals for its antibiotic, Contepo, an intravenous fosfomycin offering a new mechanism of action and a promising option for adults with complicated urinary tract infections. #IDsky #Medsky
FDA Approves IV Antbiotic, Contepo, for Complicated Urinary Tract Infections | Contagion Live
The federal agency gave the nod to Meitheal Pharmaceuticals for its antibiotic, Contepo, an intravenous fosfomycin offering a new mechanism of action and a promising option for adults with complicated...
www.contagionlive.com
November 4, 2025 at 6:23 PM
Wow! IV Fosfomycin coming to the US soon?!!
Reposted by Jonathan Ryder, MD
In this cohort study of 348,885 patients who underwent 1 of 10 major surgical procedures, non–β-lactam SAP was associated with 1.8-fold higher odds of SSI #IDSky #AMS
An argument *for* beta lactam use for SAP, and also for delabeling of inaccurate PCN allergies...
jamanetwork.com/journals/jam...
An argument *for* beta lactam use for SAP, and also for delabeling of inaccurate PCN allergies...
jamanetwork.com/journals/jam...
β-Lactam vs Non–β-Lactam Antimicrobial Prophylaxis and Surgical Site Infection
This cohort study compares risk of surgical site infection among patients treated with β-lactam vs non–β-lactam surgical antimicrobial prophylaxis.
jamanetwork.com
November 4, 2025 at 3:50 PM
In this cohort study of 348,885 patients who underwent 1 of 10 major surgical procedures, non–β-lactam SAP was associated with 1.8-fold higher odds of SSI #IDSky #AMS
An argument *for* beta lactam use for SAP, and also for delabeling of inaccurate PCN allergies...
jamanetwork.com/journals/jam...
An argument *for* beta lactam use for SAP, and also for delabeling of inaccurate PCN allergies...
jamanetwork.com/journals/jam...
Reposted by Jonathan Ryder, MD
We are back with a new episode!! Check out the latest with a recording from #IDWeek2025 with Drs. Camille Kotton & Roy Chemaly!
#idsky
#idsky
November 4, 2025 at 3:13 PM
We are back with a new episode!! Check out the latest with a recording from #IDWeek2025 with Drs. Camille Kotton & Roy Chemaly!
#idsky
#idsky