Monthly Archives: December 2016

Why are babies born with blue eyes? The ins and outs of melanin

 

There is no doubt that eye colour is due to genetics, inherited from the parents of a child, however it is also well known that most babies are born with blue eyes. Why?

Ultimately, it is because the melanin within they eyes of a baby has not been fully deposited in their irises or fully developed yet. Melanin is the protein, a brown pigment, responsible for the colouring of your hair, eyes and skin. It darkens due to exposure to ultraviolet light. The amount of melaninthat a baby will develop is coded for in their genes, resulting in different eye colours due to different amounts of melanin being coded for. A high concentration of melanin in your irises result in eyes appearing brown/black, less melanin produces green/grey/light brown eyes, and irises containing very small amounts of melanin appear blue/light grey.

 How does eye colour develop? 

The production of melanin usually increases during the first year of a babies life, resulting in a deepening of eye colour. The time taken to reach a stable colour varies from around six months to two years, and is affected by several factors, many of which environmental. This means that some people have eyes of two colours, and some people experience a change in their eye colour throughout their lives.

 But, not all babies?

The likelihood of an African, Asian or Hispanic baby being born with brown eyes is common, and blue eyes less so. Why? Darker skinned individuals tend to have more melanin in their eyes, resulting in a darker colour. Although, this may still change or deepen over time.

sources: http://chemistry.about.com/cs/howthingswork/f/eyecolor.htm and https://www.healthychildren.org/English/ages-stages/baby/Pages/Newborn-Eye-Color.aspx

 

 

The Treatment of Stable Angina – Pressure Wires

When reading through November’s issue of the BMJ, I came across an editorial entitled, ‘Assessing flow limitation in stable angina’. While admittedly, the first time I read it it made very little sense to me, after a little research and a couple of rereads, the adaptation of cardiology services in order to make the advances in the assessment of stable angina accurate became increasingly apparent.

Stable angina occurs when the heart muscle is deprived from blood and consequently oxygen, and causing uncomfortable pain in the chest, occasionally neck, shoulders and back. It’s the term used to describe discomfort due to coronary heart disease. [1]

As stated in the BMJ, currently stable angina is assessed using an initial angiographic assessment, although studies have shown that flow limitation can be accurately assessed by using a pressure wire to measure the fractional flow reserve. This is because stable angina is often caused by the narrowing of arteries, for instance, this may be due to the build up of fat or cholesterol, or a blood clot.

With such advances in the assessment of stable angina, it became clear to me, that the issue in implementing the use of a pressure wire is widely due to the amount of interventional cardiologists within the UK – around 740. With an estimated 247,000 angiograms completed annually, it currently does not seem to be feasible to implement the use of a pressure wire, as it requires the immediate option of stenting, incase a problem arises.

However, there are huge advantages in the use of a pressure wire. Not all lesions reduce blood flow, some are merely present with no impact on the flow of blood towards the heart, or around the body. Angiograms do not currently make it clear which of these lesions is disruptive. Currently, the measurement of fractional flow reserve, what I understand to be the ratio of distal (situated away from the centre of the body) to proximal pressures (pressures near to the centre of the body) is the only measure which assesses both multiple lesions and vessels. What could this mean? That those people with lesions which reduce blood flow could receive treatment quickly, and those with lesions with no impact on blood flow do not need to undertake the risk of surgery.

This article showed me that the new treatment provides the opportunity to specify the treatment of stable angina further, potentially reducing the amount of patients who go under the knife and thus undergo the risks of surgery. However, it presents new issues in terms of resources and the numbers of cardiologists able to complete the procedure – highlighting again the necessity of adapting cardiology departments, and increasing the numbers of medical professionals.

Sources: [1]http://www.heart.org/HEARTORG/Conditions/HeartAttack/DiagnosingaHeartAttack/Angina-Pectoris-Stable-Angina_UCM_437515_Article.jsp# and The BMJ November Issue

 

Prostate Cancer Treatment – Huge Advances

Today (20.12.16) a news story caught my attention, marking a huge milestone in the treatment of prostate cancer with the development of a drug which can treat the cancer without the side affects of radical surgery. Radiology often sees men experience incontinence and erectile dysfunction as a side affect, which can be hugely damaging to a persons self esteem and personal life. What does this mean? Of those who trialled the treatment, almost 1 in 2 were cancer free after 2 years, compared to around 1 in 7 without the treatment. While not entirely foolproof, what really interested me was how this drug works and its incredible potential.

_93027653_prostate_cancer_laser_therapy_624

The drug is made from bacteria which live on the seafloor in complete darkness – this being the key to the treatment. This bacteria becomes toxic only when it is exposed to light. By inserting fibre optic lasers through the perineum, the bacteria is activated and begins to work on killing cancerous cells, but leaves a healthy prostate behind. The huge benefit of this treatment however, is to the lives of the patients themselves – there were no impacts on sexual activity or urination for more than three months, and after two years the men trialled had no significant symptoms. The success of the trial of this treatment means that potentially, prostate glands may no longer have to be removed to cure the cancer – an incredible feat.

Prostate cancer is a deadly disease, killing around 11,000 men each year. Consequently, I think such an advance in the treatment could be the beginning of controlling such a cancer, and limiting its life long effects. While understandably, when to intervene with a prostate cancer diagnosed patient needs to be considered as tumours are slow growing, the potential is tremendous and the trial is a positive indicator for the development of this treatment.

sources: BBC News, BBC website, http://edition.cnn.com/2016/12/20/health/prostate-cancer-laser-drug-treatment/index.html

Working With A Midwife

Last week, I was lucky enough to undertake work experience with a specialist midwife who deals particularly with safeguarding patients. While predominantly an observation based placement, on Wednesday I took part in a Level 3 Safeguarding course, alongside paediatricians, nurses, radiologists and midwives. This was an incredible opportunity and allowed me not only to speak to healthcare professionals but to understand the approach they take to patients who are vulnerable, or whom they suspect may be physically or mentally abused, mentally ill or a substance misuser.

From this experience, I gained an insight into how important patient care is, and really getting to know your patient. Enabling them to talk to you about what may be their worries increases their chances of getting out of an abusive relationship, reporting sexual abuse or even admitting that they just need help. Similarly, the importance of minor worries being referred was hugely evident, and I learnt that safeguarding is about the accumulation of information to prove whether Child Protection, Early Help or Children In Need plans need to be provided for example. Small bits of information pieced together give a much larger picture. An example of this is, in one instance, if a mother of a baby has special needs and struggles to learn new skills then there is a slight worry. However, if she then is not financially stable, isn’t attending appointments and is with a partner with a history of abuse, then there is a huge worry and intervention needs to be seriously considered. Therefore, this was a huge eye opener to the variety of the role of not only doctors but all healthcare professionals, and that patient care is a varied and in-depth practice, and in some instances more important than clinical techniques.

Similarly, on reflection this work experience taught me how much being in a hospital or medical environment is being part of a team. The importance and significance of every role be it doctor, midwife, nurse or family supervisor just to name a few, was hugely apparent. But more importantly, without constant communication between these roles, patients would not receive adequate care, and could potentially maintain living in a serious environment. I have learnt that working in healthcare is not an individual profession, and patient care is always the priority.

Hello world!

Welcome to my blog!

My name’s Eden and I am planning to use this blog to document my premed experiences, and the journey I take towards being a doctor. Hopefully, this will be a useful source for anyone else considering medicine, and an opportunity for me to document and reflect on my experiences.

I have just returned from an exhausting two days in Nottingham on the Medlink course – exhausting, but the most inspiring and useful course I’ve attended! With tips on applying to medical school I would 100% recommend it to any L6/year 12 student who aspires to be a doctor, not only because of its content but the incredible opportunity to talk to likeminded individuals across the country, and learn about their experiences.

As for a bit of information about me, I am 17 and studying biology, chemistry, maths and history at A-Level in Cambridgeshire. The decision to apply for medicine is not one I’ve made quickly and has taken me a lot of thought, but I really feel like it is the course, and career that suits my personality and caring nature. I am a huge ‘people person’ and love engaging with new people from all walks of life. As for my current work experience, I volunteer at a dementia day centre once a week, but also teach disabled children (alongside other adults and children) to sail.

I hope that at least someone finds this blog useful or interesting, and I’m super excited for whats to come.