For dust you are and to dust, you shall return To fill a little urn

 

O' my progenitor giving birth to a zebra made her apple of the eye

First words she heard from medic's lips while putting 

His finger on the baby " you are going to die"

He meant the death when the baby was 16 days old

Instead of heaving  a sigh and wiping the eye,

He uttered "You're too good to die, you are my Gold"

Love is so simple,  quote a phrase, 

" Why mustn't I try?

The zebra is my stardust falling from the sky"

As I became 9 months old 

Parents said " a very precocious child"

Process of walk through the various steps involved,

But I could walk and talk ,laugh and never cry

Pleasurable experience was a precocious child

In drizzling rain who smiled

What is the world of love?

As an ideal father wanted to see his loved ones safe

Because of his immense faith in siblings, he didn't know she was unsafe

As you learn to control life it becomes joyful

Giggles, chuckles, smiles

The melody of the universe makes life beautiful

There are some toying somewhere between love and abuse

Some try to keep behind the scenes

Some gloat, flaunt, show off

I had not enjoyed extraordinary luck in life and love

 I  have been living with my mother at that very moment, doing nothing.

We all know charity begins at home.

You got no reason to wander, you got no reason to roam.

When family is dying at home

Biting your lip with hate as if all is froth

Thou shalt turn solitary waste

These days people understand only their own troubles and see their own perspectives

Needing hype is their objective

It seems to them very effective

There were many generous people who could do the duty, perform the responsibility 

"he had sworn ardent, answering commitment to his pater.

I can't care for you because I have a wife 

I will look after you later

After your death in the next life."

Soft-brained, weak-minded, chicken-hearted people get the best attention

People are too complicated to be figured out objectively, plus they are known to change their mind!

Craving a deeper sense of satisfaction

With a few dead trees surrounding their lives, 

 And lack of dentistry thrives

 Every single person seems to be the mirror image of the other,

children of one mother: run away from holding hands of the other

 Living in a mixture of the garbage

Shouting themselves aficionados of life. 

I ask you, My Lord, what do they perceive life is? 

I think for them life and lust are synonymous.

 Everyone has a similar hobby, that of collecting money.

 Whereas a warrior is like an elephant in the room

 Something everyone is aware of, but which is being ignored 

Unfelt? Ignored?

Because everybody finds discussion about illness uncomfortable.

Everywhere there's some chaos and uproar 

Never seen or heard this before

Everyone is leading a filthy life

Nobody is troubled by other folks's strife

Want an immortal life

God tell me in my prayers

Why do they  never clean up the dust settling in layers?

 

From dust you are and to dust, you shall return

To fill a little urn

Baba on your birthday I feel you around me

Did I meet up with your expectations?

I know I have one way ticket

I never thought wicked

I never quit it

In my little visit

After my difference

With patience

Don't I deserve a little breath of peaceful fresh air?

Lovey times not lonely times

 It's not easy to regain childhood brighter than the stars in the sky

I used to laugh, never cry

It is easy to excuse the shortcomings of early childhood

Mother mine, her glance as she smiled wheat germ or not it should

Made it a sweet sunny childhood

Many an hours I spent in the strife of the good and the evil, 

Man became his own  evil

And man became his devil

Do you believe that it's only when confronted with something that Completely befuddles us that we experience the sense of speechless wonder?

Wondrous moment of illumination

The vastness of the universe

Gave me an unique place  

Seared birth cord

Made the ties between us stronger by Lord

But felt so happy, glad, the pleasure of my playmate

The child in me finds glimpses of the eternal playmate.

And the playmate is the Reality, 

That makes it possible for the child to find delight in every activity

Even a surgery to control a rogue gene

Mum, the Queen, and the Genie

As a child when I found myself leaving her womb

The terror of all terrors, realms of phantom gloom,

Mother’s tears  shed on their haughty, arrogance, and insolence  ;

 The imperishable faith of a devotee prayed but couldn't hide her tears while praying and questioning God

 The spears of trouble she felt in her own wounds.

"Thy judgment was in the mute" 

As I feel suffering and pain in my sleeplessness:

The pure, virtuous upright Mother:

 In the tears of the night of the desolate: in the pale morning-light of sadness

In her loneliness

Said " Lord be my witness"

" I pray to thee keep her from sickness away, goodness, and sweetness

And kindness, tenderness for her"

O Terrible, they in their reckless greed blaze into the daughter  to rob thee.

But the weight ailment grew immense, too heavy to carry or to remove.

Thereupon Mum cried to thee and said, “Cure them,  the terrible!”

"Thy love burst in storms, throwing them down, scattering them all in the dust.

If only childhood could be eternal

Eternal love, unbearable loss, and fear vanquished

We are Warriors and sickness no need to be banished

No man of means

Because of the rotten extremes and a handful of unfilled dreams

 While changing, stays the same

The stronger mind of evolution

Is the cycle of creation

Endows us with wisdom

Paint the sky with words of wisdom

Bring us back to solid ground

Afterlife is a delusion

Life is motivation

 After a long slumber, a child is born from the womb of the mother

Life became heaven when her daughter 

Looked at woman divine and said " Mum"

World Kindness Day

 

World Kindness Day is a global day that promotes the importance of being kind to each other, to yourself, and the world.

 The purpose of this day, celebrated, is to help everyone understand that compassion for others is what binds us all together. 

For whatever men say in their blindness,

And in spite of the fancies of youth,

There's nothing so kingly as kindness,

And nothing so royal as truth.

Nobody understands your true worth is in being,

 not appearing - the best like

In doing, each day that goes by,

Some little good - not in dreaming

Of great things to do by and by.

The pleasure buggy of life  drove on; our journey’s end

Had a sad and lonely life without any friend

In the crossroads of life nobody did comprehend

Just remember that death is not the end

The sun agleam but a raindrop

As the teardrop falls no forthcoming friendliness

Fleeting kindness

Everywhere I feel pettiness

Help before nemesis

Creation of men who has anger and ego stuffed inside was a bad move of the Cosmic project

He who laughs longest

With a tattered body

Loves to study

Standing up to every test

Met the worst with her best

The diarrhea might tell you the truth 

Symptomatic brain metastases

With dismal prognosis

Early detection and treatment is advisable

Well, I say you can't indemnify

So medical men think about it detect and identify

Before there are more irredeemable losses.

Hah! They heard it for the first time and I am dealing with it mostly in brain in Irrfan Khan's case this is laudable 

The neuroendocrine system comprises a complex architecture of cells that are capable of producing neuroendocrine neoplasms (NENs) throughout the body. These cells are found diffusely throughout different organs and are well described throughout the gastrointestinal tract, the respiratory tract and within the central nervous system (CNS). While NENs are known to develop in all of the aforementioned systems, there are only few reports to suggest NENs originating primarily from the brain. Neuroendocrine cells are naturally involved in the coordination of neurotransmitter-initiated synthesis and release of biologically active substances. Therefore, NENs possess unique properties such as secreting physiologically active amines and peptidyl hormones which allow NENs to retain unique methods for identification.

The incidence of NENs has been prominently increasing over the past two decades.This is believed to be secondary to increased detection rates. While the incidence is increasing, these tumours are still very uncommon, and they account for only 4%–6% of all extracranial malignancies.NENs most commonly arise from the lungs, liver and the gastrointestinal tract.

In rare instances, NENs can metastasize to the CNS. The incidence of patients with NENs having brain metastases is <5%. Furthermore, only 1.4% of metastatic brain tumours are NENs, and the majority of these lesions originate from primaries in the lung.6 When patients do present with metastatic NENs to the brain, they typically present with other local and distant metastases.

Often, when NENs of the brain are discovered as the first sign of disease, an extracranial primary tumour is discovered on further diagnostic imaging. In cases when the extracranial NENs are diagnosed first, the time to brain metastasis is an average of 13 months. Brain metastases are associated with a poor prognosis, with a median overall survival of 8 months from the diagnosis of CNS involvement. However, the leading cause of death in patients with metastatic CNS NENs is secondary to systemic disease progression itself, with the majority of cases being associated with organ dysfunction (eg, liver failure).

Primary NENs versus NEN metastases to the brain, and that longer periods of surveillance are likely required for primary NENs. This is important because the prognosis between primary NENs and metastatic NENs to the brain are vastly different and should not be treated as equal diseases. An unfortunate patient eventually died of her recurrence secondary to complications of a ventriculoperitoneal shunt placed for treatment of hydrocephalus from the disease.

Brain metastases are associated with a poor prognosis, with a median overall survival is dismal from the diagnosis of CNS involvement. However, the leading cause of death in patients with metastatic CNS NENs is secondary to systemic disease progression itself, with the majority of cases being associated with organ dysfunction (eg, liver failure).When patients do present with metastatic NENs to the brain, they typically present with other local and distant metastases.Worsening headaches, nausea and emesis.

Help before nemesis.

Creation of men who has anger and ego stuffed inside was a bad move

 He who laughs longest

With a tattered body

Loves to study

Standing up to every test

Met the worst with her best

The diarrhea might tell you the truth 

Symptomatic brain metastases

With dismal prognosis

Early detection and treatment is advisable

Well, I say you can't indemnify

Serious trouble will bypass you 

Just because there's a smile on you

Doesn't mean you're 

Helping with your head off,

Your encouraging words

"You want to get any test you want..

Pay for it and get it done wherever you want"

Successfully fend off the ailment

Rasping, hacking, coughs

While breathing

Weezing can hear my own breath

Whanging headache

Its a cold in the nose

Its a pain in the neck

It'll make me a wreck

Will life never treat me decently?

 I am wracked by despair!

 My head is pounding

Shaky and infirm and unable to hold

Being deaf can't hear what Mum told

I don't swallow what other people told me

Never being able to swallow

Haunting events follow

Rasping, hacking, phlegm-laden noise follow

The engine started long time ago

With signs of going slow

Always forgetting to slow down

With maximum battery charge

War drums beating, giddy as the World is large

Never took a slow, idle, leisurely walk

Had an opportunity to incessantly talk

My life slowed down

Before the car started moving forward

One terrible night nausea attacked 

Oh, this is a true yet funny fact

Circumstance or fact, situation

Psychologically inspired destination

Slimy stuff came out while having dinner.

Destined to make me thinner

 It was awful on 10th February

Shitty scary

 I had diarrhea and vomiting the entire night

 In the morning I saw in the process I lost weight. 

Being overweight 

I was overjoyed to become  slimmer.

Medics had forgotten about my hypodense pancreas areas

Careful monitoring

 Lethal cancer , the body harbouring

Early detection, and appropriate treatment,

Frequent maltreatment

Is common as medical men wear degrees as ornaments

Their Demonic side was produced

As I have them few news

 The most harmful consequences can be greatly reduced, 

Or in some cases even prevented entirely.

Loathe the laughter and happiness 

Of a happy sufferer 

 So you dare feel guilty

As they having such a good time 

When a friendly prey is struggling

 Your path is what you  create for yourself. 

You shall be  reaping what you have sown.

Knowledge is not your own

Fighting lethal cancer with knowledge, spirit, strength confidence

 I've never been in low spirits

Intelligence, confidence, the strength of spirit

Never been dispirited: deprived of spirit, hope, enthusiasm

While crossing the deep chasm

Living in a fractured World 

Invigorating effect on my body and my spirits

But O, sick people of the world,

Are always hurled

Forget your troubles and let your woes lay

And when again there's morning they'll wash away

Put me in a gale of laughter spirits will rise more

There was the shrieking  of a door

 Being torn from its rusty, creaky hinges

Anything worth dying for is certainly worth living for

That I am  here--- that life exists,

 And identity, that the powerful play goes on

The meanness of spirit, slowness of intelligence

I was not sick of any fear from thence

My best defense is belligerence

All dumb arrogance 

In a soup of anger, frustration ,fear

Without broadcasting it

Feel so good to say

A deeper sense of satisfaction

PRRT is recommended for patients who have somatostatin receptor-positive

Vibes I got from medical folksies so  negative 

As a matter of fact that sound the opposite

If you don't have a stable but progressive NET cancer

As I qualify for PRRT thats my  best answer

To win the War.

 Receiving a dose of amino acid solution through an IV to protect the kidneys from radiation

Like chemotherapy it's not a tradition.

 By reducing how much radiation they absorb. 

They don't blunder, bungle or poorly perform

Then, octreotide, a synthetic cell-targeting protein, or peptide, 

Life has been ebb and tide

Neuroendocrine tumors (NETs) are neoplasms derived from nerve and endocrine cells.

Hippocrates is often credited with developing the theory of the four humorsm

—blood, yellow bile, black bile, and phlegm—and their influence on the body and its emotions.

NETs have the ability to produce hormones and have similarities with nerve cells, 

NETs were called “carcinoid” 100 years ago and were considered benign neoplasms. 

Metastatic disease is a major prognostic factor in neuroendocrine neoplasms

 in addition to differentiation and proliferation rate 

Currently they are considered to be malignant, WHO's histopathological classification eliminated the “carcinoid” label in 2000.

In the WHO classification of 2010, NETs were defined as neuroendocrine neoplasms and were classified as NET G1, NET G2, NEC (large cell or small cell type), mixed adeno neuroendocrine carcinoma (MANEC), hyperplastic, and preneoplastic lesions, by the Ki-67 index.

NETs are increasing and are therefore attracting interest and attention.

Generally, the majority of metastases occur in the liver, lungs, and bone.

As during acidity they shone

Other sites are rarer, and brain metastases are very rare.

Here we present a probable primary brain NET. To knowledge, this is the first reported case of a primary NET arising in that anatomical location.

Brain metastases (BM) are rarely reported in patients with neuroendocrine carcinoma (NEC) of non-lung origin and neuroendocrine tumors (NET) of the gastro enteropancreatic (GEP) or bronchopulmonary system.

Nobody ever miss'd them.

But her tight fisted mastery and ego missed them

 However, symptomatic brain metastases are associated with dismal prognosis, so early detection and treatment could be advisable

In almost all cases, the presence of BM was a characteristic of a systemic dissemination

 And disease progression.

Symptomatic brain metastases are associated with dismal prognosis, so early detection and treatment could be advisable

Proteins are made of amino acids arranged in a linear chain joined together by bonds of peptide

 Is combined with a small amount of radioactive material,

Or radionuclide, to create a radiopeptide.

When the radiopeptide is injected into a patient’s bloodstream, it binds to protein receptors called somatostatin receptors, located on NET cells,

Delivers high doses of radiation to the tumor. Because it’s a systemic treatment,

Like lock and key they tell

She isn't a doctor who's halfway decent

PRRT targets NETs with somatostatin receptors anywhere in the body.

Her work has always been shoddy

The amino acid solution is also delivered to PRRT patients Post radiopeptide injection.

For years some practiced practiced at the art of deception

Because small amounts of radiation may remain in the body, patients are generally advised to take certain precautions after treatment, especially for the first one to two days.

NETs that cannot be removed with surgery

 Are typically treated with hormone therapy 

to control symptoms and tumor growth. 

But in cases when tumors continue to grow despite treatment,

Would use PRRT who's halfway decent

Use of contrast agents has resulted in reduced radiation, while maintaining image quality. 

"If you want my advice or support..you cannot dictate what test or scan I do and how"

"You want to get any test you want..pay for it and get it done wherever you want"

Well, I say you can't indemnify the loss to my health 

Ma'am Director of Nuclear Medicine at FMRI just concerned about power, wealth, rank 

Momma you stank

Wise yourself up

Instead of talking pointedly

Primary well-differentiated neuroendocrine tumors arising in the intracranial portion of the central nervous system (CNS) are occasional findings.

 

On the other hand, the CNS more frequently represents a metastatic site for primary poorly differentiated NET arising elsewhere, most often in the lung (small-cell lung cancer) .

In such cases, other secondary lesions, such as liver, lung and lymph nodes metastases, are often detected synchronously or metachronously with CNS localizations.

Patients with brain metastases are rare;

"Payal...there are many centres offering PRRT..please go to them. I will never do what I am not convinced will help my patient."-- don't prefer tyrant 

You define them as you call this one ignorant

Thinking they are the masters under the illusion of wealth, 

Facts are superior to lies,

Conflict between science and ethics

And lies cannot cover up facts

 Desired superiority thinking of attainments

Calcifications are visible within the necrotic areas of a tumor nest

My spleen isn't a jest

Neuroendocrine differentiation was confirmed using the following immunohistochemical markers: 

Chromogranin, synaptophysin and neural cell adhesion molecule.  

 With one study reporting a median survival time of 10.0 months after diagnosis of brain metastases 

Overall, brain metastases occur in 1.5–6% and their detection is usually preceded by the documentation of the primary, extracranial tumor 

Nevertheless, neuroendocrine markers have been found to be overexpressed in rare oral neuroendocrine tumors, 

But also in quite common inflammatory conditions, such as severe periodontitis. 

The monitoring of neuroendocrine markers is, thus, a common factor of interest among dentistry and neurology: the analysis of neuroendocrine markers in oral diseases may be predictive and prognostic about the severity of neurological ailments

There are only a few reports to suggest NENs originating primarily from the brain. Neuroendocrine cells are naturally involved in the coordination of neurotransmitter-initiated synthesis and release of biologically active substances.

Therefore, NENs possess unique properties such as secreting physiologically active amines and peptidyl hormones which allow NENs to retain unique methods for identification

People are too complicated to be figured out objectively, plus they are known to change their minds! 

When you hear hoofbeats, think of horses not zebras

The wrongness of the moment

So frivolous, so ridiculous!

Gotten more out of life!