The importance of role models in medical education cannot be understated. They allow for professional development, aid in career motivation and inspire and educate through example. Unfortunately, I ...cannot admit knowing more than three female role models throughout my time at medical school, and now as a final year student, I am more disappointed than ever for this deficit. My admiration and respect for doctors remains sky high, but from the age of 15, I remember being put off and discouraged from a career in medicine. My first work experience placement was met with disgruntled medical students and doctors warning me to ‘steer clear’ of this career choice. Notably, female doctors would state their reservations about whether they could adequately bring up a stable family together with the demands of this profession. This was an extremely frustrating resolution for me to see as a young, inspired medic- who passionately felt I would work hard to do both. I sought to find out more about the challenges for women in medicine. There lies no dispute that having a stable family life and successful career is no easy feat for women. Yet, the mere choice between a family and/or career is far more intricate than it may seem; it is really a question exploring personal life priorities, resolute character traits and, most importantly, equal gender opportunities and the necessity for greater support for women with families (1). Gender equity and empowerment are inextricably linked to a woman’s entitlement and contribution to the workplace. Evidently, the endless unpaid hours of bringing up a family need greater recognition- arguably a full time job in itself; some people still don’t deem the demanding work of a mother as a career- illustrated by Catherine Deveny’s Guardian article (2). Women are often invited to defend their life choices, or fulfil gender expectations. Maybe, as women we need to alter our own insight into what it means to be a successful career woman and mother. What defines doing ‘well’ when describing family life, a subjective word for such a prevalent aspiration. The deplorable deluge of negative headlines after the report from the Royal College of Physicians (2009) stating women will predominate the workforce in 2017 inflamed public perception with assertions including, “Women docs weaken medicine” (3). This was a shocking flavour of negativism for women in medicine- and added to both my curiosity and anger at the situation. The apparent vulnerability of women is particularly evident amongst certain geographical populations; for example, in Iran, there are palpable traditional differences between genders, rendering unequal social rights, salaries and employment opportunities (4), with further significance on health status. Article 158, of the Third Development plan, instigated a resolute initiative for increasing awareness and incorporation of women in society, which included the promotion of job opportunities for women (5). Furthermore, accessibility of advanced surgical training is highly limited, with Dr Sakineh Pari, born in 1902, being the first Iranian female surgeon (6). Despite the evolution of greater gender equality in Iranian medical employment, it is clear that we need further progress towards true equality. I want to pose a note of reflection: why do these negative perceptions still exist even in 2017? We need to act now to ensure the women of the future have confidence that they can both cultivate a great family and career; it is possible, with the appropriate communication, support and flexibility that are essential to both motherhood and top career posts, especially within countries where gender inequalities are rife.
The gut microbiome is of paramount importance in preserving internal balance in the gastrointestinal tract; therefore, disruptions in its regulation have been linked to the development of ...inflammatory bowel disease (IBD). This article explores the intricate details of the gastrointestinal microbiome as it pertains to inflammatory bowel disease (IBD), with an emphasis on the Middle East. The study reviews the typical gut microbiome, modifications in inflammatory bowel disease (IBD), determinants impacting the gut microbiome of the Middle East, and prospective therapeutic interventions.
Faecal microbiota transplant (FMT) effectively treats recurrent
infection (rCDI), but its mechanisms of action remain poorly defined. Certain bile acids affect
germination or vegetative growth. We ...hypothesised that loss of gut microbiota-derived bile salt hydrolases (BSHs) predisposes to CDI by perturbing gut bile metabolism, and that BSH restitution is a key mediator of FMT's efficacy in treating the condition.
Using stool collected from patients and donors pre-FMT/post-FMT for rCDI, we performed 16S rRNA gene sequencing, ultra performance liquid chromatography mass spectrometry (UPLC-MS) bile acid profiling, BSH activity measurement, and qPCR of
/
CD genes involved in bile metabolism. Human data were validated in
batch cultures and a C57BL/6 mouse model of rCDI.
From metataxonomics, pre-FMT stool demonstrated a reduced proportion of BSH-producing bacterial species compared with donors/post-FMT. Pre-FMT stool was enriched in taurocholic acid (TCA, a potent
germinant); TCA levels negatively correlated with key bacterial genera containing BSH-producing organisms. Post-FMT samples demonstrated recovered BSH activity and
/
CD gene copy number compared with pretreatment (p<0.05). In batch cultures, supernatant from engineered
-expressing
and naturally BSH-producing organisms (
and
) reduced TCA-mediated
germination relative to culture supernatant of wild-type (BSH-negative)
total viable counts were ~70% reduced in an rCDI mouse model after administration of
expressing highly active BSH relative to mice administered BSH-negative
(p<0.05).
Restoration of gut BSH functionality contributes to the efficacy of FMT in treating rCDI.
Anita Ghosh, Diya Kapila, Trisha Ghosh Faculty of Medicine, Imperial College London, Kensington, London, UKWe read with great interest, the article by Djalali et al evaluating the impact of a ...training program during residency, targeted toward primary care.1 This resonated with us from a medical student's perspective as we are fortunate enough to have a similar program at medical school. Although the article states that future career choices are more likely to be determined during residency, we believe that this can be nurtured earlier through knowledge and early exposure.View the original paper by Djalali and colleagues.
PDF
