Alleyn's Medical Society: Professor Bainbridge on Promoting Sight by Regenerative Medicine

Ophthalmology, the study of the eye, is a discipline leading the frontier in regenerative medicine. Indeed the eye is one of only a few organs on the crest of a wave of revolutionary stem cell and gene therapy research. The progress seen over the past few years has been phenomenal with recent developments in a branch of new cell-based therapies that promote healing by inserting new cells into diseased tissue or reactivating stem cells that proliferated during the eye’s development.

Professor James Bainbridge is Chair of Retinal Studies at UCL and worked on the first gene therapy for inherited blindness ever in 2007. Professor Bainbridge has been at the very epi-centre of developments within Opthamology, in 2011 he worked alongside the American bio-tech company Advanced Cell Technology (ACT) to apply regenerative medicine to 12 patients with Stargardt’s Macular Dystrophy- which causes progressive loss of sight. The trial has been seen as a ‘milestone’ in working towards curing forms of inherited blindness using regenerative medicine.

Professor Bainbridge first gave Alleyn’s Medical Society an overview of the ‘facts and figures’ when it comes to Ophthalmology: 39million people in the world are blind, blindness has been rated the greatest medical fear even over cancer and other chronic diseases and ophthalmology surprisingly represents 20% of surgeries in America. What at first may appear to be a minor aspect of medicine in actual fact makes up quite a large proportion of our healthcare service. Even so whilst Professor Bainbridge’s research centres around Macular Dystrophy he discussed how on a day to day basis the majority of cases he comes into contact with are for cataracts- clouding of the lens inside the eye which leads to a decrease in vision. Cataract surgery is only done under local anaesthetic rather than general meaning most surgeries are done whilst the patient is awake- he stated that whilst that may seem a little daunting in reality most patients aren’t frightened by the scalpel coming towards them and during surgery can have an intense and abstract viewpoint due to the work done on the back of their retina.

Professor Bainbridge went on to explain that whilst the recent develop he’s seen and been a part of are amazing from a scientific perspective the greatest reward is the fulfilment of patients and families he’s seen as the work has been successful- after it all Medicine is about people not just science.
 
-Izzie

Alleyn's Medical Society: Dr Malik Ramadhan on what it mean's to be an A&E consultant

Emergency Medicine is the fast paced frontier of healthcare and the only thing really that all patients have in common is the severity of their conditions. Aside from that each new case that comes in has the potential to be absolutely anything within the gigantic spectrum that is medical conditions. Doctors working in acute medicine must be calm mannered and confident, skillful and certain with their differential diagnosis of a condition and quick to spot mistakes. If not errors can lead to potentially life altering effects for patients.

Dr Malik Ramadhan works as clinical director of A&E and acute medicine for the Bart's Health Trust, the biggest NHS Trust in the country with a workforce of 15,000. Dr Ramadhan visit was certainly a reminder that Doctor's roles aren't restricted to that only of a care provider but also as an educator and communicator, as he kept the audience on their toes by posing questions and initiating discussion. Dr Ramadhan began by discussing his work and how the geography of his catchment area affects the number of different kinds of cases he sees day to day. Working in a catchment area which is the most deprived in all of England Dr Ramadhan commented on the high number cases of diseases such as Tuberculosis, Pneumonia and also drug related conditions, in addition he commented on how he had recently even come across scurvy and leprosy, diseases we rarely associate with modern British healthcare. 

Dr Ramadhan stated that the main affect of the geography of this catchment area is the high level of stabbing injuries. Stabbing injuries are associated with knife crime which is high in north-eastern parts of London. Dr Ramadhan then went on to explain the physiology behind the body's response to being stabbed and how wounds are treated. Our blood pressure is controlled by the enzyme Renin in our kidneys, and steroids formed from cholesterol we ingest. Dr Ramadhan highlighted how whilst learning all about the biochemistry of these molecules may seem unhelpful and unnecessary during medical school he's now aware more than ever of the importance of a sound anatomical and biological understanding of how the body works in applying this knowledge in his work diagnosing patients. 

Dr Ramadhan progressed on to discuss the dangers of bacterial infections in a stabbing wound, demonstrating quite graphically the effect this can have on the body. Dr Ramadhan highlighted the reality of emergency medicine, it's severe and unforgiving to mistakes and often doesn't end in the 'happy endings' we might expect, yet even so it's rewarding and a profession that provides something absolutely fundamental to our society, literally saving lives every day.

-Izzie