To Dye or Not To Dye

 To Dye or Not To Dye

"Wow! Great moves, Pradeep!" exclaimed our new acquaintance after watching my short dance. "You have a flexible body! Because of your young age, you can pull off those moves." my agonized acquaintance analyzed my performance. "I am your age, Adam," I proudly announced, further astonishing him. He stared at my paltry hair in despair after I compared my age with his. Yes, I did a good paint job, I thought, as a restrained quaint smile pervaded my freshly painted facial hair! This renewed my confidence, and I was never confused about whether to dye or not to dye. 

 

Well, days passed—I mean, months went by—and I went for my job interview. As I explained the reason for my move—my daughter getting married and the other daughter in her Master's—we felt free to explore our ambitions. The interviewer was amazed at my actual age and adored my dexterous dye job!

 

As months went by, I mean years passed by, to dye or not to wasn't even a question! We went to Snoqualmie Falls near Seattle. As the guidance was given by a Ms, we were apparently misguided to the top of the falls! The walk to the bottom of the falls was steep and arduous. We saw several young, athletic men and women panting and walking up the falls! As believers of our perceived age, we both walked down to the amazing falls! That's where our confidence had an amazing fall! Walking up the steep, deep inside, we felt our actual age may overcome our perceived one. However, my painted face had a picture-perfect smile, masking my true age! To our astonishment, a middle-aged couple spotted us and unabashedly asked, "Uncle, why don't you wait here? I will get my car to take you to the upper parking lot. It will be too much to walk at your age". My wife readily agreed, as she was aware of my actual age! I immediately grabbed my phone and took a selfie! Actually, I remembered to dye! I did not miss any strands as well! Who is he then? A radiologist looking through me to diagnose my bone age? My wife insisted, and my twisted ego resisted, but her insistence persisted, and she enlisted the new aspiring radiologist's assistance.  I finally consoled myself that my wife didn't dye her hair so he could predict my age.

 

As hours passed, it was time to head to the airport. We took a connecting train, and it was packed! I moved forward to look for any vacant seats. There were none. As I was turning back to wade through the crowd towards my wife, a middle-aged man in his fifties with flawless grey hair offered to me with the blackest hair, "Uncle, do you want a seat?" I considered asking him to take a selfie and compare it with mine. Who has black hair? Now the question is, to dye or not to dye? It may be time to change the brand, as I introspected and went ahead and changed it.

As days passed, It was time to see the biggest blockbuster-Kalki 2898 AD. After all, it was made by my close friend's son! With my wife waiting in the car, I rushed to purchase the first day's first show tickets. The middle-aged lady at the counter said, "For you, the price is $20 a ticket". I assumed she was giving me a discount based on my imposing mustache. Upon inquiry, she revealed that it was a senior citizen discount. A grand brand or no brand, is it time to disband? I had to take out my ID to prove my young age and disprove her terrible and deplorable assumption. However, I pretended I was purchasing alcohol and hence, I was proving I was above 21!

Well, to dye or not to dye-is that even question?

 

 

Sex-Specific Differences in Nutrient Intake in Late Preterm Infants

by 

Pradeep Alur

 1,*,

Sumana Ramarao

 2,

Addie Hitt

 2,

Simmy Vig

 2,

Radha Alur

 1 and

Naveed Hussain 

https://www.mdpi.com/2683666

Abstract

Challenging the assumption of uniform nutritional needs in preterm feeding, this study identifies crucial sex-specific disparities in formula milk intake and growth among late preterm infants. Premature infants have difficulty regulating their oral intake during feeds, which is why clinicians prescribe feeding volume, calories, and protein via the nasogastric route. However, premature male and female infants have different body compositions at birth, and, subsequently, there is no evidence to suggest that male and female preterm infants differ in their nutritional consumption once they begin feeding ad libitum. This study investigates whether there are any differences in the volume and nutrient intake between the sexes when fed formula ad libitum. Methods: The study involved a retrospective analysis of preterm infants admitted to the NICU and evaluated between 34 0/7 and 36 6/7 weeks of corrected gestation. Late preterm infants appropriate for gestational age who were spontaneously fed formula milk ad-lib and free of any respiratory support for at least two days were included. The study excluded infants with short gut syndrome, severe chromosomal anomalies, or congenital heart conditions. We included 85 male and 85 female infants in this study. The data collected included sex, gestational age, birth weight, anthropometric data at birth, maternal data, nutritional intake, and neonatal morbidity. Results: This study found that female infants consumed more volume, protein, and calories than male infants. The mean formula intake in female and male infants was 145.5 ± 20.8 mL/kg/d and 135.3 ± 19.3 mL/kg/d, respectively, with p = 0.002. However, ad-lib feeding duration was not different between the sexes. Growth velocity was also higher in female infants. Conclusions: This study is the first to demonstrate differences in formula milk intake among late preterm infants fed ad libitum. Additional research is needed to confirm our findings and understand sex-specific differences in neonatal nutrition in extremely early preterm infants.

Association between Weight for Length and the Severity of Respiratory Morbidity in Preterm Infants

 https://www.mdpi.com/2635470

Association between Weight for Length and the Severity of Respiratory Morbidity in Preterm Infants

by Pradeep Alur 1,*,Kristen Harvey 2,Kyle Hart 2,Wondwosen K. Yimer 3 andRenjithkumar Kalikkot Thekkeveedu 4

Abstract

Association Between Weight for Length and the Severity of Respiratory Morbidity in Preterm Infants. Objective: To determine whether higher weight-to-length z-scores after 32 weeks of gestation are associated with higher pulmonary scores (PSs) in preterm infants requiring respiratory support using a prospective observational study. Methods: Infants born at <30 weeks, with a post-menstrual age (PMA) of 30–33 weeks, were enrolled. The infant’s weight, length, and head circumference were measured weekly. Data on calories/kg/d, protein g/kg/d, weight-for-length percentiles, z-scores, and BMI at 33 through 40 weeks PMA were collected. The PS was calculated. Results: We analyzed 91 infants. The mean gestational age was 26.9 ± 1.7 weeks. The mean birthweight was 0.898 ± 0.238 kgs. They were predominantly African American (81.3%) and girls (56%). Postnatal steroids were administered in 26.4% of the infants. The mean duration of invasive ventilation was 19.23 days ± 28.30 days. There was a significant association between the PS and W/L z-score (p < 0.0001). For every one-unit increase in W/L z-score, the PS increased by 0.063. There was a significant association between the PS and W/L percentile (p = 0.0017), as well as BMI (p ≤ 0.0001). For every unit increase in W/L percentile, the PS increased by 0.002, and for a unit increase in BMI, the PS increased by 0.04. The association remained significant after postnatal steroid use, sex, and corrected and birth gestational ages were included in the regression analysis. Nutrition did not affect the anthropometric measurements. Conclusions: Our study is the first to demonstrate that a higher BMI and W/L may adversely affect the respiratory severity in preterm infants. Studies with larger sample sizes are needed to confirm our findings.

Mother Thy Name is Love!

"Mother, thy name is love."

A force to be reckoned with, recognized even by the heavens above.

In every deed, your care is woven,

In every word, love is spoken.

 

Dad may make you mad,

Our follies may make you sad,

Yet, you have made our smiles your only goal,

Showing love is the only way for every soul.

 

When life's tempests rage and roar,

A wicked display it had in store,

Your love revived the strength as never before,

And made us face the world with fear no more.

 

The love you have sown,

Which has grown over the years we have known,

Will there be a day, will there be a way

We can match and repay?

 

Mother- thy name is love!

By

Pradeep Alur. May 12, 2024.

 Happy Nurses' Week!

Lucky we are, we have nurses. 

When life brings a curse 

And the situation becomes adverse, 

The care of a nurse is a soothing verse. 

Lucky we are, we have nurses! 

 

When hope turns to reverse, 

And the options are so diverse, 

And chances seem to be inverse, 

A nurse- your best buddy to converse. 

Lucky we are, we have nurses! 

 

Their hearts are so tender, 

The service they render, 

The fears they disperse, 

The patience they disburse. 

Lucky we are, we have nurses! 

 

Pradeep Alur, MD.  

May 7, 2024. 

 

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!