To Ditch or Switch!

 

Health is unpredictable, so we need to save so we don't cave into the grave health expenses wave. One of the government-approved is a flexible savings account (FSA) for a fixed amount to surmount taxable amounts. Money is deducted from pretax to take care of the task of health maintenance.

Well! At this stage of the health-thwarting rage of the age, FSA takes the front stage! Though the amount is meager, I am still its eager seeker; as the adage goes-something is better than nothing. With advancing technology, we can now use a debit card from FSA for health-related purposes. My employer provides WEX to use our flex amount. Using our beloved cell phones to scan health receipts and upload them into WEX made it convenient.

So, the other day, I saw my cardiologist for a routine follow-up. 

He promptly billed me for $400. My health insurance, of course, has a combustible deductible and humbly provides us with a venue to take care of this deductible in the form of a copay. The copay was $242.92. You don't need to pray to pay this copay when you have WEX as the fairway! I used my smart Android phone to scan the receipt and converted it into a pdf file in style with a smile. I uploaded the WEX receipt into my nonvexing flexible WEX!

Now comes the expect the unexpected, as Casio says! WEX responded after two days that WEX is for health-related purposes only. Though health has many physical, mental, etc. aspects, the Internal Revenue Service does not recognize SEX as part of health maintenance and hence will not allow Flex's WEX to be used for Sex! I was perplexed!

 I went to a physician, not to such a vibrant technician. I again checked to see if it was addressed to me; mortifyingly, it was! The receipt did not have anything that could be confused with sex. I even verified on the dark web to see if my cardiologist's name was spelled similarly to a porn star! That was not the case either!

When I investigated further over the phone in a secluded area, as it would involve a lot of sex words, It became clear that my phone converted the WEX receipt into a sex receipt, and the file's name changed to "Sex receipt-April 20-2023.pdf". They did not even open the document as their screening software blocked it due to its file name! Hmm! Now I do not know if I should ditch my phone or switch from Flex's WEX!

Modern Technology Modulating Couple

 Modern Technology Modulating Couple

We are a loving couple, so we love to argue. Argument brings out the best in us in using the language. Of course, we end up explaining what that word meant or what we meant in that context. Ultimately, we apologize for the poor choice of words because we never intended that way anyway! As we learn to choose our terms wisely, we sometimes need help. We seek help from our counter-arguing spouse for the correct word. 

However, after providing the apt word, he/she won’t accept that characterization, and the exchange becomes heated and animated! Though our following dramatic expressions never make it to Oscar nominations, they usually result in hoo-hah lively disagreement. However, in our case, the roof of the car opened up with our gestures! The rain was pouring outside! 

Nature naturally cooled our tempers as we scrambled to find the switch to close the sliding roof. My paltry hair was vastly wet, and the makeup needed cleanup! We looked at each other and laughed loudly! The voice assistant in the car sensed we enjoyed the open roof and opened the top again! We promised each other we would not take our devotion to expressive emotions outside. Knowingly or not, the current technology dispelled dissensus and compelled consensus in us against automation. Ultimately, technology brought us closer together!

Life Energy!

 We say the body is the temple of God

And the heart is His altar!

In this temple resides the divine energy

And both work in perfect synergy!

None can create or destroy this energy

It is devoid of any lethargy

As it can change from one form to another!

When it energizes this mortal body

Undeniably but fleeting

We call it a being

Sleeping, breathing

Walking and talking

Laughing and loving!

We cherish everything

Seeing and unseeing!

Forget not, it is this ever-changing energy

But not this mortal physical form

Which gave us this joy and tears!

The thoughts, the memories

The moments and the madness,

All perceived of this divine energy!

 

Yet in times of darkness

We lose our sharpness

And just see the amalgamation of the five elements

Blended with integuments

Perceived with sentiments!

Be reminded that it is divine energy

Ever dynamic that we savored

And which is deathless and perpetual!

We the energy in this amalgam

Will continue to cherish

As We will never perish!

 

Pradeep Alur.

April 1, 2022.

 

 

 

Sex differences in preterm nutrition and growth: the evidence from human milk associated studies

 

https://rdcu.be/cHF1l

Review Article

Published: 24 February 2022

Sex differences in preterm nutrition and growth: the evidence from human milk associated studies

Pradeep Alur & Sumana Ramarao 

Journal of Perinatology (2022)

Abstract

Sexual dimorphism of the fetus manifests itself even during pregnancy. Preterm births are more common in pregnancies with male fetuses. Intrauterine and postnatal growth nomograms are sex-specific. The human milk composition in term infants appears to be sex-specific. Early nutrition has sex-specific effects and neurodevelopmental outcomes. A large same-sex twin study suggests that a mother’s own milk (MOM) provides sex-specific growth advantages probably related to the calibration of a mother’s milk based on her newborn’s sex. Formula composition does not vary with infant sex, which may be one reason why body composition data favors the use of MOM over formula. However, given the lack of data on this subject, we need more detailed information on how the sex-specific micronutrients in MOM influence infant well-being. We also need more information to ascertain the sex differences in infants’ macronutrient requirements, such as whether preterm females have higher fat requirements and preterm males have higher protein requirements for optimal growth and neurodevelopmental outcomes. This information may also influence milk banking and the use of donor human milk (DBM). Further research may help us determine if we should provide sex-specific DBM to those preterm infants who cannot get their MOM.

Our Vacation in A Great Location!

 

Yellowstone was the cornerstone for the establishment of National Parks in America. Hence, it became my dream to visit. By August, the desire was so overgrown that it had outgrown my ability to resist, and as a result, my family was flown to this well-known Yellowstone! The spirits were ebullient, but the flight was turbulent! The flight was three and half hours from Atlanta to Jackson Hole. Do you know that Jackson Hole is not a city? Hole is the whole valley amid the majestic Tetons. The food rather tiny teeny-weeny almonds was served on the plane. Our family was not seated together. I was not sure if airlines were concerned about infighting on the flight. I also wondered if Alexa alerted the airlines! In any case, I had suspicion if my co-passenger would have opposition to my devouring of the delectable miniature snack. When he bent down to fetch his bag, I quickly gulped the nuts innocently.

We were delighted to alight the flight and then proceeded to get our rental car. When the Enterprise announced we were getting Ford-Bronco, I imagined 1994 Bronco. However, it matched the small-scale snack package we were recently treated to. Our delight declined as the air in one of the rear tires also declined. Fortunately, Enterprise gave us an immense surprise by providing us Toyota Rav-4 for the same rental price. How can we not praise the Enterprise!

  

Yellowstone is a beauty to behold! Different terrains in different places were delightfully engaging and enchanting. Waterfalls were amazing, and the geysers and fumaroles were alluring! Wildlife was plentiful and beautiful, but Bears were barely seen. The craving to see this carnivore was so high that anyone uttering “where” would lead to the commotion of cameras for Bears! But eventually, everyone would settle for chipmunk likeness. Bison were bountiful. The herds of bison and buffaloes were a spectacle to behold. The nonchalant behavior and majestic walk of these colossal creatures were captivating. A thin fog percolating the picturesque pastures upsurged the beauty of the background. Hordes of people would hurriedly stop to feast their eyes on these handsome herds.

Coyotes were camouflaged and often eluded the eager eyes. We were lucky to see one that was spotted by a patient enthusiast. Nevertheless, we were jubilant! Lamar Valley is acclaimed for its array of animals. Meandering through this valley was mesmerizing. We had a good peek at Pronghorns too! Several others were lucky to gaze at the grizzlies and distantly sight the wolves. I believe that the planets in our horoscopes did not align for eight straight days to enable us to see them in the wild. We went to Bear & Wolf Discovery Center in West Yellowstone town to satiate our senses. However, one of the visitors staying at our hotel used to describe how they saw several black bears with cubs and even grizzly bears. I was tempted to ask his time and date of birth to compare our horoscopes. When we expressed our intense desire to follow his route, he told us his deep desire to take a break that day!  I never thought my horoscope would be so goofed up! My wife went and bought a birthstone ring for me to boost our prospects.

Every major scenic stop-over was an absolute must. However, parking was a significant issue with almost 1-2 miles away from the actual parking lot. Searching for a spot was arduous and laborious except for the handicapped spot. I was alluded to ask if falling hair and balding head qualified for such a parking slot! I quickly erased that idea after looking around and watching the bountiful bald heads! 

Finally, we hiked up the Fairy Falls trail to see the gorgeous Grand Prismatic. The colors were imposingly impressive as the hot spring stood there, still giving us a lifetime thrill and killing our will to move from the hill. However, the chill on the hill made us intensely seek grand peematic on Grand Prismatic. Nature is powerful, and the call of Nature is, of course, most powerful! With speed, we reached the rest area, we were sure we would have broken the Olympic record of 1000 meters dash!

 

   

The Flowers’ Fervor

 

The Flowers’ Fervor

Chided by the flowers adversely

the previous day for trashing them mercilessly,

I felt remorse and walked back into the garden sheepishly.

 

Soft aroma filled winds gently blowing

The sun tenderly kissing the buds to wake up

The blossoms began to sway to the lilting breeze!

Lord! Not sure if they were enjoying the Nature

Or saying no to this creature,

Hesitantly, I advanced,

To seek pardon, as they glanced!

With a soothing timbre

And lovely glimmer

They announced

“We are from this Nature

And hence our nature

To make one and all around us happy.

It’s our joy to see you enjoy

It’s for others that we exist

On your happiness, we subsist.

The fragrance, after you relish

Don’t trash, for us to perish.

After you savor

Be kind to us for the favor

That’s the code of the cosmos!

If nature is hurt

The power it can exert

Nothing can cope

Nothing will be left for hope.

Live in the Nature

One with the Nature!

Oh! One more thing!

For generations, we gave you bliss

Our final goal, we don’t want to miss

Take us to the Lord’s altar

Our divine destination

Our final integration!

Isn’t that your consideration?

Said the flowers with fervor.

            Pradeep Alur. August 15, 2020.

 

 

Dress Wise!

Dress- Wise

Oh, what a day, I pondered as I meandered the long corridor to the parking lot! I did not realize that my excitement was just beginning when I heard the fascinating ring tone of my captivating wife. She lovingly enquired about my day and touchingly added a chore without delay. "Hey, don't forget to buy a nice dress for Gomini. It is her birthday, and we are going to surprise her." Sensing possible excuse of a long day, she hit me with a sentiment, "she truly believes you are her brother." It was the moment when truth felt feeble in the face of the emotional upheaval! She concluded her charming conversation that she would text me the size and reminded me of my dexterity in dress selection. The gentle reminder of my finesse in figuring out the fabulous fabric facilitated me to forget my fatigue and browse at Belk.
The dresses were abundant, designs redundant, I was reluctant for a consultant, and yet, I was triumphant. The lady at the dress section after her inspection, commended my selection. After reaffirmation, I whistled my way to home. My attempt to show off as the doyen of dress selection was dotingly declined for lack of time. Savoring her unwavering confidence, I quickly freshened, and we drove off to Gomini's house.

As we alighted, Gomini was delighted. We hugged her and wished her a great birthday. After the exchange of pleasantries, we jovially asked what Madhav (Gomini's husband) bought for her. She very proudly displayed the gold necklace he bought with gleaming eyes. Marveling at Madhav's spousal love, Radha gently nudged me to show her the gift we purchased. Taking stalk of the situation, without much hesitation, shortening the anticipation, I began the demonstration of the culmination of my imagination.

"OMG! It's lovely! So pretty! OMG," Gomini exclaimed in sheer exhilaration. As she began to reassess the dress, tears began to express, and distress became difficult to suppress. She became emotional! We both moved close to her, and I blurted, "it's a small gift, and we are happy it complements Madhav's beautiful necklace." Gomini looked at me, and I saw a tinge of melancholy in her eyes. Her sadness vanquished my gladness. She said, "bhayya (oh brother), do I look so fat to you! I never imagined you had that impression!" It was my time to cringe and singe. How did my assignment turn into my arraignment! Radha immediately grabbed the dress, and the size startled her! She was bewildered to find it big-way big! She stared at me and the expression needed no sub captions to declare how I repeatedly screw up simple tasks!

To pacify Gomini, I said that I righteously followed her bhabi's (sister-in-law) directions. I affirmed that I never question Radha's orders but only obey them. Do or die, and never ask why! Hence, it was not my imagination of her body image but strictly sticking to the specifications. My pride as a dress connoisseur expeditiously evaporated. Radha and I took our phones out to show the text. Then Radha started laughing. Radha apparently typed 8 petite. Her iPhone had its own mind, corrected it to 8 prettier. I was positively convinced to buy a pretty dress at size 8 rather than 8p.
Gomini quickly comprehended the confusion and burst out laughing, hugging both of us. After discerning the smartness of the smartphones, embracing what we read and what it means can make a mighty difference, and how autocorrection may lead to dejection and misperception, with that introspection, I realized the conception of the gift cards.

You may not be dress-wise, but never be size-unwise to avoid surprises that may arise and that's my advice!

Nature As Our Teacher

Every morning the sun rises
For eons, without compromises
Warmth he provides everyday
One cannot repay in anyway
He does without expectation
He does without invitation.

Untiringly the globe revolves
Admiringly the seasons, it provides
For the life as it evolves
Does it without remuneration
Does it without discrimination.

For others when we do a little
Without a recompense, should we belittle?
We live in this Nature
Can we learn from this Nature?
Treat Nature as our teacher!
To do a bit more
Expecting nothing more.
If that could become our nature
Peace and joy will be our daily feature!
Pradeep Alur, July 26, 2020.

Oh Mother!

Oh mother! Oh mother!
Wish we can be together

You are such a soother, oh mother!
For you make any problem a feather
And cajole us to wither any weather!
The times with you, oh mother!

We immensely cherish and treasure
As you fill our minds with pleasure
And banish all our pressure
Your love, oh dear mother!

how can any mortal measure?
The Nature’s splendor is your nature, oh mother!

by
Pradeep Alur. May 10, 2020.

Corona the Heartless

Corona the Heartless

Corona the heartless
Putting the world in utter distress
Is it a revenge?
That Nature arranged!

Cast or creed
Religion or region
You did not discriminate
Neither language nor age
You didn’t bother to differentiate

Country or continent
Competent or incompetent
Nothing mattered but your commitment
Celebrity or without identity
You showed the same intensity

Are you sending us a message?
Even with your wreckage
That all humans are one
And discriminate no one?



Importance is not in the handshake
but in the differences, we forsake
Though, we keep six feet apart
What matters is the good vibes we impart

From the Nature you came
to remind us to proclaim
that humans are the same
and we come from the same divine frame.

By
Pradeep Alur.
3/21/2020.

Stress and Wellbeing. Tackling the Root Cause-My Personal Journey.

Oh Mother!

Oh, mother the love you shower 
Has the tenderness of a flower 
The joy, when the life tries to devour 
You stand with us like a tower 
And bestow us the mental power 
To tide over the maladies to ashore  
When the life is an abyss 
You are such a bliss 
For the caressing hand that you lend 
That we ultimately depend 
Oh mother! You are our best friend 
And most definitely the Godsend! 
 
Pradeep Alur. May 12 2019. 

What Man Proposes Bank Disposes With Bonus

Whether you are married or not, it doesn’t matter. You just need money. That’s where the banks come into play. The banks are very generous; Of course, with your money. Once (decades ago) I wrote a check for $970, and my bank seemed very liberal in the payout. They extrapolated their collective view that $0 in your account has no value and added that 0 to my $970 and issued $9,700 to the already rich landlord company. Since my account did not have sufficient balance to meet their generosity, they kindly froze my account and imposed overdraft fees.

As if this is not enough of a headache for my bald head, my cellphone check that also arrived that day for clearance bounced for lack of funds. The carrier was not happier as my bank set up a barrier for me to pay the dime on time and hence put me off-line. To add salt to the injuries, my credit card check for $980 also bounced for the same reason. The credit card company tried to reach me; I believe, but alas my cellphone had no service. If the credit (card) cannot debit (your account) it will edit your score and discredit your card. I was at a gas station, and my credit card was denied. I had $11 in my wallet, which was enough to buy some chocolate but won’t be enough for filling the tank. I went into the gas station to use the ATM to withdraw, and I had the shock of my life as I had no funds, and they digitally informed that I couldn’t withdraw even one-digit currency! I was 40 miles away to buy furniture at an outlet shop on sale.

I could hardly buy 2 gallons of gas, due to my credit impasse. As a fellow in neonatology, I rarely believed in astrology but felt I should have checked out numerology at least. Moreover, It was unclear how my dear $8,000 could queerly disappear. After I reached home, I realized that cellphone service was turned off rather than lacked the signal. As it was a weekend, the bank was closed in the afternoon, and I couldn’t contact them until Monday. I had to spend the rest of the weekend trying to comprehend and talking to a friend as to what he would recommend!

When I finally reached my bank, they graciously informed me that the dot after 970 was not distinct, and hence the confusion. I asked them why did they not give 97,000 instead of being miserly with $9700 if the dot was indistinct! The teller felt terribly sorry for underpaying the landlord and called the branch manager, who read the amount written in words on the check for a long time as if English was his fifth language and placed his sympathetic hand on my shoulder to announce poignantly that the landlord should return my money. When I cornered him that it was their fault, and they should put back money in my account, he looked clueless and gently asked me from which account I was asking him to transfer the money! It appeared the bank’s generosity towards the business customers equals their atrocity towards the individual customers! After I threatened that I would inform the FBI about this bank fraud, the general manager rushed to sort things out.

It took me ten days to get things straightened out. However, in the meantime, my credit rating took a hit for failing to pay the bills on time. The bank which sank my account to blank, and shrank my credit score to tank, sent a note to thank and to rank their service as swank. I thought it was a prank!

Sex Differences in Nutrition, Growth, and Metabolism in Preterm Infants

Front. Pediatr., 07 February 2019 | https://doi.org/10.3389/fped.2019.00022

Biological differences between the sexes are apparent even from the early part of the pregnancy. The crown-rump length is larger in male fetuses compared to females in the first trimester. Placentae of male and female fetuses have different protein and gene expressions, especially in adverse conditions. Even within the intrauterine milieu, the same extracellular micro RNA may show upregulation in females and downregulation in male fetuses. There appears to be a natural survival advantage for females. Maternal glucocorticoids (GC) play an important role in fetal growth and organ maturation. However, excess glucocorticoids can not only affect growth but the response may be sex-specific and probably mediated through glucocorticoid receptors (GR) in the placenta. Mild pre-eclampsia and asthma are associated with normal growth pattern in males, but in female fetuses, they are associated with a slowing of growth rate without causing IUGR probably as an adaptive response for future adverse events. Thus, female fetuses survive while male fetuses exhibit IUGR, preterm delivery and even death in the face of another adverse event. It is thought that the maternal diet may not influence growth but may influence the programming for adult disease. There is growing evidence that maternal pre-pregnancy overweight or obesity status is directly associated with a higher risk of obesity in a male child, but not in a female child, at 1 year of age. It is observed that exposure to gestational diabetes is a risk factor for childhood overweight in boys but not in girls. It is fascinating that male and female fetuses respond differently to the same intrauterine environment, and this suggests a fundamental biological variation most likely at the cellular and molecular level.

Which one should we use- Birth Weight or Current Daily Weight?

Many use birth weight for calculations of protein, calories, and fluids in preterm infants. However, frequently current daily weight is also used for such calculations. Until now, there was no evidence which strategy is better. We now have evidence to sort out this debate.

International Journal of Pediatrics
Volume 2018, Article ID 2045370, 6 pages
https://doi.org/10.1155/2018/2045370