@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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Played a bit in our clinical lab today- learning about the processing and prep of respiratory samples (swabs and sputum) for viral PCR. Look at my concentration- you’d think I’d never held a pipette before 😂 • #medicalmicrobiology #virology #pcr #inthelab #medicine #pipette #doctors #doctorslife #doctorsofinstagram #instascience #labcoat #virus #flu #fluseason #coldandfluseason #pa #nurses #medstudent #clinical #concentration #science #lifeoflearning #lovemyjob #infectiousdisease

What’s the ultimate biological badass? 👇 • Has to be the virus- as a fan of parasites generally, the virus feels to me like a super smart parasite. Small, clever and often mutating, viruses actually invade your cells 😱 and merge themselves into your DNA in order to reproduce. Sneaks! We still have so much to learn about them and yet, despite some awesome antiviral drugs (for example, against HIV, Hep B and more recently Hep C), the biggest weapon we have against them tends to be the human immune system. That’s why we have vaccines against Polio, Measles, Rabies etc 💉; that’s why if a non-immune pregnant woman is exposed to chicken pox we give her human antibodies to protect her 🤰🏿; that’s why we check patient antibody levels to common (‘sleeping’) viruses before we give them drugs to dampen their immune system for example transplant patients. 💊 • Viruses are so good at surviving as part of you, scientists think that up to 10% of you is made up of viral DNA, acquired over millions of years. Think virus and think NINJA! 😎 • #virology #vintagehair #purple #doctorslife #oncall #ninja #science #inthelab #virus #parasites #medicalmicrobiology #infectiousdiseases #medicine #nurses #pa #medicalstudent #alwayslearning #cells #mindblown #coolfact #dna #genome #microbiome #doc #medic #physician #virologist

Merry Christmas everyone 🎄 (Microbe art by Michelle, an awesome BMS) 🔬 • #doctorsofinstagram #science #christmastime #workhardplayhard #microlove #microbialart #agarart #microbiology #fun #lovemyjob #medicalmicrobiology #medical

Given that not long ago was World AIDS Day and I’m now working in Virology, I thought I’d share a little of my learning about HIV. 👍 • Prior to starting antiretroviral therapy on newly diagnosed patients, the centre here runs Resistance Testing. This is to check for mutations in the virus that means we couldn’t use some medications. Thankfully, modern drugs are so good that it can mean the virus has to undergo a number of mutations to be truly a problem. One of the commonest mutations is the M184V mutation, a notation that tells virologists which proteins have been swapped and where within the virus’ genetic mutation. Resistance commonly occurs in two ways- it can either be transmitted (ie, the mutation was already in the virus the patient caught), or it can develop (usually the patient has a reasonably high circulating amount of virus and has been taking their meds intermittently so the virus is exposed to just enough drug to mutate rather than be suppressed). 😕 • The interesting thing is that mutations are hard work for the virus- it has to sacrifice something in order to maintain it so we say it affects the “viral fitness”. This can theoretically make it easier to control with the right drugs. It does of course depend on the type of mutation. M184V is ‘selected for’ by exposure to the drugs emtricitabine and lamivudine and reduces susceptibility to them more than a 100-fold. Fortunately though, the virus will readily revert with a switch of meds (taken properly!) and is therefore unlikely to be a transmitted resistance. 🙌 • There are, however, more significant (and thankfully rare) resistance mutations such as K65R which confers resistance to multiple agents. It does though, increase susceptibility to AZT, another medication.👌 • Virology, like all branches of microbiology, is a fight with nature. But in most instances, we’re still winning. And HIV medicine continues to go from strength to strength, with most of our patients in the UK doing extremely well and leading normal, healthy lives. We often only need to monitor virus levels to keep an eye out for possible resistance- keeping up with meds minimises this risk ❤️

Well, it’s been an intense month! Hence I’ve been quite absent from here (miss me?- don’t answer that) 😂 • So, I’ve been working on a number of things. I’ve been looking at PhD application deadlines, I’ve been to two conferences/meetings on ID/micro and the also the microbiome and I’ve presented at a meeting for gastroenterologist, talking about research around the microbiome and the relationship between it and obesity/diabetes. (Paper I really need to read more on- artificial sweeteners may cause changes in the microbiome that increase the risk of diabetes!) 😱 • All of this has sat alongside my clinical work, finishing an audit/research question, finishing a paper we’re writing, helping to supervise a Med student, tying up results for our study that are coming through, trying to see my family and trying to sort my next rotation in Virology that I start next week. 👍 • Gonna be a steep learning curve again as I try to get my head around viruses and work out my potential PhD options. How’s your November been? Any tips for learning about viruses and applying for PhDs welcome! 👇 • #doctorsofinstagram #scicomm #science #gutmicrobiome #microbiome #virology #microbiology #infectiousdiseases #laptop #bioinformatics #doctorslife #conferences #busylady #researchlife #academia #workhardplayhard #girlboss #womeninacademia #womeninscience #womeninmedicine #medstudent #premed #nurses #pa #workstyle

“Then I rose, and walking back to the suffering-house forgot again my own wounds, for the sake of healing theirs.” - Anon 👩🏻‍⚕️ • There is an odd dichotomy in medicine- as doctors we’re supposed to be both bullet proof guides through bad news and fear whilst simultaneously being compassionate human beings. We hold ourselves to account and we expect that each patient should also get the best from us, regardless what horrendous situation we’ve just come out from; regardless of which patients we might have just lost. 😔 • For the most part, this becomes doable with only a vague risk of hardening of the heart. But sometimes, you particularly connect with the person you’re caring for, the way human beings do and should. And sometimes, that means that your mum/dad/grandma’s doctor mourns their passing like they’ve lost someone when you lose them too. They just can’t always show it. 💕 • Over the years, some patients that you lose just stay with you. One of my first patients as a doctor, who comforted ME because HE was dying; the lady who told me she’d miss me because she thought I was ‘lovely’; the old man who wished me a life as grand as his; the brave lady who told me I couldn’t help everyone, every time. ❤️ • So on this night where the veil between the ‘worlds’ is most thin, I’m remembering not only my own lost loved family members, but those of other people too. 👩🏻‍⚕️ • Samhain 💕 • #doctorsofinstagram #medic #samhain #halloween #death #skeleton #alwayslearning #lovedones #humanity #humans #emergencymedicine #medicine #medstudent #nursing #pa #sepsis #acutemedicine #allhallowseve #skull #doctorslife #scrubslife #stethoscope #healinghands #healthcareprofessional

Much of microbiology is like gardening. Not everything grows, it takes some watering and patience to get things to grow, and sometimes there are weeds- not everything that grows is significant. 🔬 • Image: blood culture bottles 👩🏻‍⚕️ • #doctorsofinstagram #doctorslife #sepsis #infection #microbiology #scicomm #science #infectiousdiseases #blood #cultures #agar #photography #pretty #gardening #medicine #pa #nurses #medic #studygram #medical #artsy #biomedicalscience

Streptococcus agalactiae (or Group B Strep) can be a perfectly harmless bug that lives in our bowels, ‘bits’ and waterworks. However, as with any bug, if it gets into the wrong place, it can be trouble! 👩🏻‍⚕️ • This grew from someone’s blood sample (definitely not where you want to find it!) and this can happen particularly in elderly patients, diabetics... anyone with a weakened immune system. They often have features of cellulitis or other skin and soft tissue infections. 🔬 • I think it always looks quite ‘neat’ on a plate, but the only way to tell if it is a group B is to test it with an antigen kit and/or put it on MALDI. Treatment is often penicillin-based 💊 • There’s another group of people we might worry about this bug in, if we find it living happily in their genital tract. Any ideas? 👇 • #microbiology #inthelab #labcoat #womeninmedicine #infectiousdisease #infections #gbs #doctorsofinstagram #womeninscience #scicomm #healthcare #medicine #medic #agar #womenshealth #pregnancy #neonatal #obgyn #o&g #obstetrics #streptococcus #clinical #pa #nurses #midwives #medicalstudent #studygram

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