@dresmerelda

ID/Micro Academic Doctor & Smiley-faced lover of purple

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Category: Travel

Peru- it’s not all Kissing Bugs of course!

July 21, 2017July 26, 2017Leave a comment

Peru's an amazing travel destination and a great place in which to learn Spanish too. For the most part I've stayed in Cusco (I've been to Peru twice) which gives relatively easy access to lots of fabulous tourist destinations like Macchu Picchu. If you want to do the Inca Trail then you need to … Continue reading Peru- it’s not all Kissing Bugs of course!

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Did you know there are only a few things that “win” a patient a bed on the Intensive Care Unit, and sepsis can cause many of them? 😔 • So, tell me- why do you think a patient might need specialist ICU input? What things can be done on ICU that can’t be done elsewhere in a hospital? (Answers in my stories later this week)👇 • #medicine #sepsis #infection #hospital #hospitalbed #medic #medstudent #doctorsofinstagram #doctorslife #intensivecare #microlove #patientcare #nhs #pa #nursing #health #healthcareprofessional #vintagehair #lovemyjob #womeninmedicine #physician #emergencymedicine

#Repost @thescicommunity @the_sushi_scientist ・・・ Part 5 - Why don’t antibiotics work on viruses? By @dresmerelda . • Bacteria are neat little “boxes”- on the outside there is a cell wall and on the inside are all the cogs that keep it working: its genetic material and proteins. Antibiotics are designed to work on specific parts of the bacteria- either by attacking the cell wall (for example, penicillins and many other similar types of antibiotic), or the different proteins/protein machinery within the bacterial cell. The thing is, viruses have different structures- in particular, they don’t have the cell walls that most of our effective antibiotics work on. So trying to treat your cold with antibiotics does nothing to the virus causing it. As with any drug, the effort to make antibiotics is a battle between targeting the right thing (ie, bacteria) without damaging any potentially similar proteins that your body makes (that’s why the cell wall is such a popular target- it’s only in bacteria, not humans nor viruses). 🤔 • But antibiotics are safe, right? Mostly yes, and if needed they can be life saving. However, it’s important to remember two things: 1, all drugs have side effects (if you don’t need the drug, why take even the smallest risk of potential damage?); and 2, unnecessary use of antibiotics increases the risk of any partially killed bacteria fighting back and becoming resistant to antibiotics, and 3, many of the bacteria in your body are your “friends on the inside.” Studies on the human microbiome (the community of bacteria and other organisms that live and work happily with your body) have shown that negatively changing the precious balance of good bacteria in and on your body can put people at risk of not just infection, but other diseases like diabetes, asthma, even auto-immune diseases! 🤗 • So, next time you get a cold, spare a thought for all your good bacteria and don’t be surprised if your doctor wants to save them- unless your doctor thinks you have signs of an additional bacterial infection, you don’t need, and shouldn’t want, antibiotics 💕 • #microbiology #researchlife #microbiome #medicine #virology #infection #sepsis #instascience

Geeking out 😁 • For the first 6 months of their lives, babies also get immunity from their mums against malaria. Then they lose it and need to develop their own. Things get risky again for folks in countries with high exposures during pregnancy. At this point, the malarial parasite can create proteins to receptors in the placenta that the woman’s immune system has never encountered before. 🔬 • Anyone know any genetic conditions that can possibly protect people from developing severe malaria? 👇 • #infection #malaria #parasitology #infectiousdiseases #microlove #vlog #learning #womeninmedicine #travellerslife #globalhealth #womeninscience #research #geeklife #globetrotting #doctorsofinstagram #medicine #travelhealth #instascience #medic #mondaymotivation

Did you get it right? What should you pretty much always consider in the returning tropical traveller with a fever? 🧐 • Malaria! It helps to know which countries and places are malaria-risk areas but you almost guarantee a risk in African countries as they have it year round at sea level. So, to test the patient, you need a blood sample. The lab will then run an antigen test to see if the cells in your body are shouting out that they’ve been infected (this first pic is actually a hiv testing kit but the principle is the same- a bit like a pregnancy test, it’s either positive, negative or failed). The lab will then create two sets of slides: thick and thin films. 💉 • A thick film is like a smear of blood- some of the cells are on top of each other, it often looks messy down the scope, but to the experienced microscopist it’s a quick way of scanning a large volume of blood cells so as to look for parasites. A thin film is one cell layer thick- see pic 2- SO MUCH easier to read. 🔬 • See those ring shapes in the red blood cells- anyone know which type of malaria this is? 👇 • #malaria #travelmedicine #infectiousdiseases #bloodfilm #blood #scientist #biomedicalscience #inthelab #diagnostics #medicine #medic #africa #globetrotting #treatment #parasitology #microscope #alwayslearning #worldly #globalhealth #health

“A thirty year old man has come back from Sierra Leone 3 weeks ago and is now unwell with a fever. What should we test for and what should we treat him for?” 👩🏻‍⚕️ • Fever in the returning traveller is an important part of the ID doctor’s job. Working through it involves knowing the history and symptoms of the patient, dates of travel, risk behaviours/exposures, pre-travel shots and travel meds and current in-country infection risks. Nathnac, ECDC, CDC and the WHO response sites are important sources of up to date info- is there an Ebola outbreak in the country for example? Timings and dates can help docs work out possible Infectious causes according to incubation times (Time from infected to infectious and symptomatic)🔬 • What infection should pretty much always be tested for in the returning traveller, particularly from African countries? 👇 • #infection #medicalcases #medicine #laptop #travel #globetrotter #wanderlust #parasites #lovetotravel #lovetolearn #lovemyjob #instascience #lovemedicine #medic #medstudent #nursing #pa #emergencyroom #diagnosis #mysterydiagnosis #travelhistory #wednesdaywisdom #wanderlustwednesday #microbiology

Thought I’d share some plans and reintro myself to new followers! 🥳 • I’m Farah. I’m a medical doctor and have been for almost a decade- had various jobs in general medicine, anaesthetics and critical care, emergency medicine and now specialising in Infection (Infectious Diseases and Microbiology). I’ve also been doing some research on the Gut Microbiome, trying to get set up for a PhD, teaching advanced life support and generally learning how to keep adulting! 🤓😎 • So, yes- at first glance it looks like I do a weird mix of stuff but variety is the spice of life, right?! I’m thinking of changing my feed slightly so would appreciate feedback please; plan is this: 🧐 • a medical post (usually about a particular infection/clinical case) 👩🏻‍⚕️ • a follow-on/linked post showing what the medical lab then does to test/prove the diagnosis, and how we interpret that clinically too 🔬 • a post about microbiome stuff/research interests 💩 • a post about life hacks while I journey through it myself! 🤦🏻‍♀️🤷🏻‍♀️😜 • Tell me what you think below please. Is there anything you’d like to see more of?👇 • #womeninstem #researchlife #doctorsofinstagram #microbiology #microscopy #womeninmedicine #medicine #medstudent #healthybalance #lifestyle #inthelab #infection #phd #virology #parasitology #science #instascience #vlog #mondaymotivation

Viruses are obligate intracellular parasites: they need to ‘reproduce’ or replicate themselves in the cells of the thing they’ve infected. The long held assumption is that all of a virus’ genetic material has to be in the same cell to make a new copy of itself...right? 🦠 • WRONG! At least for some viruses. Some viruses split up their genetic building blocks into several packages. This has always been a little baffling as the likelihood of more than 3 packages getting into one cell is almost impossible. Sicard et al looked at a Faba Bean virus that splits into 8- after all, if something is impossible, why do it, virus?! 🧐 • By colour-tagging the segments, they found the virus doesn’t bother trying to get all its packages into one cell. Rather, the virus swaps what each cell doesn’t have with other cells!? (“Want some of the coat protein?- swap you for some packaging protein?”) It works across multiple cells in its host 🤯 • Why am I suddenly talking about plants? Other such “multipartite” viruses include Rift Valley Fever Virus, a disease that can affect humans mildly or cause severe symptoms similar to Ebola. Schreur and Kortekaas showed a few years ago that RVFV doesn’t have to form a “complete” virus particle to continue its infecting work... There is still a lot more we need to understand about viruses. And understanding often means finding treatments 👩🏻‍⚕️🕵🏻‍♀️🔬 • [Picture: BMS Lena prepping blood samples for viral PCR; doi for papers in comments] ☺️ • #science #scicomm #virology #mindblown #research #academia #virus #infectiousdiseases #lovemicrobiology #sciencesaturday #lovemyjob #medical #inthelab #pcr #lablife🔬 #alwayslearning #fish #labcoat #womeninstem #evidencebased #patientcare

The three main principles of treating patient infections/sepsis to my mind are these: 👩🏻‍⚕️ • it’s usually the “right bug” (living happily in one part of your body) ending up in the “wrong place” (eg, urine infections are often due to bugs from the bowel) 🕵🏻‍♀️ • fit your antibiotic to cover your “Gram” (see below)👇 • there’s no such thing as a “strong” antibiotic- just broad or narrow, mostly according to what type of “Grams” they cover. Don’t throw bleach at spilt milk when a cloth would do, doctors! It’s when we go overkill with antibiotics that resistance starts to breed... 😕 • So what’s a Gram? It’s a type of staining technique. (FYI American friends, I get well confused when you talk about crackers and it sounds like you’re talking about stains! 😂) Staining bacteria relies on using properties within their cell walls to our advantage. 🔬 • Staining is an old, easy, quick and cheap way of identifying bacteria- takes less than ten minutes. The commonest is “Gram” staining, where Gram positive bacteria stain purple as they have a thick sugar-protein mesh in their cell walls that traps the violet stain; Gram negative bacteria go a red-pink colour as most of the stain washes away as their mesh is thinner. This stain pictured is different- it’s staining for TB with auramine-rhodamine so it lights up (“fluoresces”) like stars in a night sky under a special microscope (swipe to see). 😍 • #microbiology #medicalmicrobiology #medicine #medic #doctorslife #antibioticresistance #antibioticapocalypse #antimicrobial #science #gramstain #microscopy #studygram #medicalstudent #clinicalscientist #biomedicalscience #nursing #savelives #sepsis #infectiousdiseases #scienceart #pretty #medschool #instascience #mondaymotivation #alwayslearning

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