Sex and Ice Cream: Does Dairy Consumption Boost Fertility?

cravingsofalunatic-pink-lemonade-ice-cream-4For some career-oriented women, settling down and starting a family may seem to be a nonviable option when other goals must come first. Defined as failure to conceive after 1 year of regular unprotected sexual intercourse, infertility is rare in women in their early 20s but as time flies to 40, you’ll find that more than half of women are infertile. Beyond age 43, pregnancy is rare and associated with higher incidences of down syndrome. Causes of infertility include anovulatory cycles or ovarian dysfunction as well as acquired disorders like polycystic ovarian syndrome (PCOS).

Time is of the essence and the pervasive biological clock ticks along relentlessly, but fortunately, the decades-old cryoprotective therapy option, or “freezing your eggs,” can offer hope to women struggling to find the right partner and in-vitro fertilization can aid those who are struggling to conceive.

Sugar and spice and everything nice…At the Museum of Ice Cream, Miami

While fertility clinics across the United States can charge on average $15,000 and only a handful of states cover some procedure costs through insurance, I had a the serendipitous chance to catch up with the top reproductive specialist of St. Louis, Missouri who renders services for only $7,000 out of the expanding Fertility Partnership clinic while working an event. Despite skepticism that lower costs equate to lower quality services, Alan Simckes, MD insists that the higher price tag for IVF is a simply a result of supply and demand and scorns physicians who charge exorbitant medical costs to desperate couples with dreams to conceive a child. Dr. Simckes 62% live birth rate and low costs have couples flying in from as far as Nigeria for fertility treatment and has challenged other reproductive specialists in his area to lower their cost of treatment. His eccentric demeanor, good humor, and blunt no BS attitude has inspired confidence in many couples.

Besides nutritional supplements of folic acid  to decrease probability of birth defects like neural tube defect, it is rumored that consuming ice cream can increase a woman’s chance to conceive. The pressing question is: Is dairy food consumption associated with live birth among women undergoing infertility treatment?

28471293_10103765530398948_3250817957945141981_nIntake of high-fat dairy foods was associated with a lower risk of ovulatory infertility, and intake of low-fat dairy foods was associated with a higher risk of ovulatory infertility (Chavarro et al., 2007). More simply stated: women who eat low-fat dairy foods may have a higher risk of infertility than those who treat themselves to full-fat ice cream or cheese. It is possible that dairy foods may have different relations with infertility risk and with infertility treatment outcomes and Dr. Simckes is an advocate of eating ice cream before starting treatment.


While the exact mechanism is unknown, benefits of eating high fat dairy are highest in women who are older than 35 years old. Overall, high fat dairy intake does not appear to harm IVF outcomes and, if anything, is associated with higher chances of live birth, especially in older females so eat up if you’re looking to conceive or are getting ready to donate or freeze your eggs! You are what you eat and they say that little girls are made up of sugar and spice and everything nice. Interestingly enough, if you become pregnant with a girl, you also happen to be carrying your potential future grandchildren since females are born with all of their eggs–imagine them to be as sweet as ice cream you eat!


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Skoch, I. R. (2010, July 22). Why Is IVF So Expensive in the United States? Retrieved March 04, 2018, from

Dairy intake in relation to in vitro fertilization outcomes among women from a fertility clinic

M.C. Afeiche, Y.-H. Chiu, A.J. Gaskins, P.L. Williams, I. Souter, D.L. Wright, R. Hauser, J.E. Chavarro

Hum Reprod. 2016 Mar; 31(3): 563–571. Published online 2016 Jan 18. doi: 10.1093/humrep/dev344

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Smoke & Mirrors: Nicotine Addiction Goes Beyond Aesthetics

Wigged out at Wigwood Miami 2018 Platinum blonde wig courtesy of Ilona Hair

The queens and in-betweens were lined up two-deep at the mirror in the girl’s bathroom touching up hair and makeup for the second annual Wigwood event held at Gramps, Wynwood. I squeezed in for a quick sexy check and to make sure my new wig was on straight. Modern pin-up art of Miss Toto, a triple threat drag performer, body builder, and marine researcher recently named one of Miami’s Most Interesting People of 2017, is plastered dead center.

Miss Toto, also known as Queen, also known as Rock Evans, also known as my boss for the nation-wide tobacco-free lifestyle campaign, This Free Life, is venerated by her countless admirers in the community and is living proof that we are multifaceted as human beings; there are absolutely no limits to who and what we can identify as. If you wish to opine in any other way, the self-proclaimed “Selena Williams of drag” has biceps, quads, and a personality big enough to crush your closed mind into glitter dust–

They say the future is female.  Modern pin-up art of drag performer and visual artist, Miss Toto, featured at Gramps, Wynwood Art District

–besides, don’t some of our very forefathers also happen to be posing in glamour portraits wearing elaborate wigs whilst gracing our US currency?  Miss Toto is the epitome of good health and uses her queen status as a platform to educate people in her community to use PrEP, a pill that helps inoculate against the spread of HIV and also loans her likeness to the This Free Life tobacco-free campaign. In this day and age, we can all roll our eyes at the widely accepted fact that smoking is detrimental to our health but yet and still the pressing issue is that the United States of America, a capitalist country historically funded by tobacco exports, is a place where tens of thousands of LGBT people die every year from tobacco use. That contributes to the 480,000 total people in the U.S. who are killed by smoking-related disease annually. In fact, smoking kills more people in the U.S. than AIDS, alcohol, car accidents, homicide, suicide, illegal drugs, and fires combined. This vital information is revealed in night clubs and lounges where smoking is still pervasive through in-person engagements that offer colorful swag giveaways and sometimes free event admission in return for a few minutes of event patron’s valuable time and attention.

Harebrained fill-in-the-blank questions like: 27746740_10103709930581428_1236833356_o

reinforce awareness to the smoking issue  which truly is as dramatic as the queens that support the cause make it out to be. While cigarette smoke can cause signs of aging, busted teeth, and ashtray aroma breath, there is much more internal damage than what meets the eye.

Cigarrete smoke has carcinogens, substances that cause cancer, like:
-Carbon monoxide

Not only does cigarette smoke cause squamous cell carcinoma of the lung, it is commonly associated as a risk factor for cancers like:
-Bladder cancer
-Pancreatic cancer
-Uterine cancer
-Cervical cancer


Don’t take any drags, just be a queen!
Nicotine is a fat soluble molecule that is self-titrated by the smoker, depending on the amount inhaled. It is absorbed into the bloodstream and binds to a nicotinic receptor in the central nervous system. When nicotine binds to the receptor, neurotransmitters like dopamine are released. Increased dopamine in certain parts of the brain like the ventral tegmental area can cause increased sensation of pleasure, reward, and attention.

When nicotine binds to receptors in the the peripheral nervous system, its stimulant properties increases:
-Blood pressure
-Heart rate
-Cardiac contractility
-Gastrointestinal contractility

Class Notes: The effect of nicotine on the peripheral nervous system and central nervous system

While smoking has evolved and “vaping” e-cigarettes was recently born from newer technology which is thought to be safer than traditional cigarettes, the same addictive properties of nicotine remain an issue. Vape products still contain cancer causing chemicals like formaldehyde and diacetyl and the systemic effects of using the vape products over time are unknown.

Class Notes: the chemical irritants of  cigarette smoke over time causes structural changes in cells that produce mucus. Smokers who have developed chronic bronchitis have a characteristic cough they rely on to remove mucus plugs. YIKES!

Fast forward to those who smoked over the years and are now in their 50s, smoking over time is a risk factor leading to chronic obstructive pulmonary disease or COPD, an umbrella term that includes chronic bronchitis and emphysema. Chronic bronchitis is characterized by a productive cough. Smoking and irritants from chemicals cause a change in the cells that make up mucus glands and goblet cells. The changes are known as hypertrophy and hyperplasia, meaning they get larger in size and multiply. Since there is a structural change, people that suffer from chronic bronchitis are frequently relying on coughing to remove mucus plugs from their lungs and are also prone to microbial infections since bacteria enjoy living in the conditions the mucus produces. More on COPD, cor pulminale, and asthma soon! Are you bored yet? I don’t care. I’m studying for my EOR with or without you here 🙂

This Free Life is not just a cause, it is an expression of freedom! Why smoke when you can slay all day? To find out more about events in your city and how to be tobacco free, click here!


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Agaku et al. Tobacco Product Use Among Adults – United States, 2012-2013. Morbidity and Mortality Weekly Report (MMWR). 2014; 63(25):542-547
Hecht SS. Research opportunities related to establishing standards for tobacco products under the Family Smoking Prevention and Tobacco Control Act. Nicotine & Tobacco Research. 2012; 14(1):18-28.
U.S. Department of Health and Human Services (USDHHS). A Report of the Surgeon General: Preventing Tobacco Use among Youth and Young Adults. We Can Make the Next Generation Tobacco-Free (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human
Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2012.



Reggaeton and Rocephin: What to do When Your “Amante de Una Noche” Goes Wrong

natti-natasha-ft-bad-bunny-amant-400x240.jpgJust ten days shy of its release to YouTube, an impressive 50 million hits from fans worldwide was achieved by Amantes de una Noche, which translates to “lovers for one night” or “one night stand”, a collaboration between Pina Record’s Natti Natasha and Bad Bunny. Regarded as the most awarded up-and-coming female artist of the Latin Urban music scene, the voluptuous Dominican beauty bared most of her assets on a vibrant, neon-infused house party set where Venezuelan director, Nuno Gomes’, imagination came to life in a sizable mansion located on the outskirts of Miami. The 31-year-old sensation started heating up her career by piggy-backing off of Ozuna’s success after the duo released the hit single, Criminal. In a male-dominated industry, Natti Natasha proves she can take control. In a behind-the-scenes Instagram post where she rides the mechanical bull from the set of her sophomore single, she captioned, “Si domino a un toro imaginate a un conejo” (If I can dominate a bull, imagine a bunny).

Si domino un toro, imaginate a un conejo

Natti Natasha wasn’t the only female on set dominating. Casted party guests from the video include Miami’s very own Millenium Dance Complex’s owner and artistic director, Vanessa Sanquiz, who choreographed the video and performed alongside her talented faculty of dancers who transformed into letter jacket-wearing cheerleaders that  brought the music to life.  A slew of party reveling characters, myself included, created by stylist Mileidy Carmago made an appearance on set, vibing with the colorful hues around them. Skilled makeup artists put the finishing touches on everyone. The filming begins and   El conejo malo trails Natti around the mansion, the two trade anguished flirty looks before agreeing to a one-night stand — only.


Criticized by some for its hypersexuality, glorification of women, and salacious lyrics, the reggaetón genre of music has been threatened for ban in the past by countries like Cuba, one which is notorious for restriction. The reality is: the music is hard to resist–even the spoilsport policemen that busted the party at the end of the video decided to join the fun! Sex sells and the concept of lovers for one night has gone viral. From the set to the smart phone, the clubs and down to the very act of wham-bam-thank-you-ma’am, the infectious beats of Amantes de una Noche that millions enjoy so much are contagious enough that if you add a few too many cocktails and go along with the song title, you might end up being a part of Miami’s syphilis explosion among other STD epidemics. So how can we save Miami from itself? Choosing to keep your clothes on, prevention with condom barriers, and treatment. Spare yourself a costly and unnecessary trip to the emergency room because below is information about two common diseases and some resources for public facilities that provide Miami residents with free or low-cost STD tests including chlamydia, gonorrhea, hepatitis B, hepatitis C, Herpes, HIV, and syphilis.

Neisseria gonorrhea, a gram-negative diplococcus bacteria

Neisseria gonorrhoeae is a gram-negative diplococcus bacteria that is closely related to other human Neisseria species. Classic presentation is a man with a urethral discharge; women are often asymptomatic, but may have vaginal discharge. Higher risk is attributed to those with multiple partners in recent months, known partner with gonorrhea, drug use, prior STD, and men who have sex with men. If left untreated N gonorrhoeae can disseminate to areas of the body to cause skin and synovial infections; rarer complications include meningitis, endocarditis, and perihepatic abscesses. The main treatment for uncomplicated gonorrhea is dual therapy with single-dose intramuscular ceftriaxone, or Rocephin by trade name,  plus single-dose oral azithromycin. The treatment of N gonorrhoeae is important in the prevention of infertility, chronic pelvic pain, and ectopic pregnancy in women. If acquired congenitally from an infected mother, the neonate can present with ophthalmia neonatorum, which left untreated can cause blindness.

Chlamydia Trachomatis is a gram negative obligate anaerobic bacteria

Chlamydial genital infection is the most frequently reported notifiable disease in the US. Many infected individuals are asymptomatic. In women, there may be cervical inflammation or yellow, cloudy discharge from the cervix. In men, there may be a discharge from the penis. Untreated or inadequately treated patients risk possible ascending infection and further complications. Patients also risk spreading the infection to sexual partners. It is treated with azithromycin and doxycycline. Sometimes medical professionals will treat both gonorrhea and chlamydia empirically if either infection is suspected. 

Class notes: Azithromycin is a macrolide antibiotic that slows bacterial growth by targeting the 50 S subunit responsible for bacterial protein synthesis.


Behind the scenes with Bad Bunny. Did you know Bad Bunny bagged groceries at a supermarket before he became famous? 

Apenas diez días después de su lanzamiento a YouTube, se registran impresionantes 50 millones de visitas de admiradores de todo el mundo para Amantes de una Noche, una colaboración entre Natti Natasha de Pina Records y Bad Bunny. Considerada como la artista femenina prometedora más premiada de la escena musical latina urbana, la voluptuosa belleza dominicana le mostró la mayor parte de sus activos en una vibrante fiesta que dio la luz a la imaginación del director venezolano, Nuno Gomes, en una mansión ubicada alrededor de Miami. La sensación de 31 años de edad comenzó a calentar su carrera por el éxito de Ozuna para el lanzamiento de su primer sencillo, Criminal. En una industria dominada por hombres, Natti Natasha demuestra que puede tomar el control. En un post de Instagram detrás de la escena donde monta el toro mecánico desde el set de su segundo single, subtitulaba “Si domino a un toro imagina a un conejo.”

Playing the “raver chick” on the set of Amantes de una Noche. 

Natti Natasha no era la única mujer en el set que dominaba. Los invitados a la fiesta elegidos del video incluyen a la propietaria y directora artística de Miami Millenium Dance Complex, Vanessa Sanquiz, quien coreografió el video y actuó junto a su talentosa facultad de bailarines. Una gran cantidad de personajes deleitables diseñados por la estilista Mileidy Carmago hicieron su aparición en el set, vibrando con los coloridos colores que los rodeaba. Los maquilladores expertos se pusieron los toques finales a todos.


Criticado por algunos por su hipersexualidad, glorificación de mujeres y letras salaces, el género de la música reggaetón ha sido amenazado de prohibición en el pasado por países como Cuba, que es notorio por su restricción. La realidad es que la música es difícil de resistir, ¡incluso los policías que destruyeron la mansión al final del video decidieron unirse a la fiesta! El sexo se vende y el concepto de amante por una noche se ha vuelto viral. Desde el set, hasta el smartphone, las discos, y el mismo acto de wham-bam-thank-you-ma’am, los ritmos de Amantes de una Noche que millones disfrutan tanto son tan contagiosos que cuando se agrega un pocos cócteles y coinciden con el título de la canción, es posible que termines siendo parte de la explosión de la sífilis en Miami, entre otras epidemias de ETS. Entonces, ¿cómo podemos salvar a Miami de sí mismo? Ahórrese un viaje a la sala de emergencias porque a continuación encontrará información sobre enfermedades comunes y algunos recursos para instalaciones públicas que brindan a los residentes de Miami pruebas de ETS gratuitas o de bajo costo que incluyen clamidia, gonorrea, hepatitis B, hepatitis C, herpes, VIH y sífilis .

The following public facilities provide Miami, Florida area residents with free or low-cost STD tests including chlamydia, gonorrhea, hepatitis B, hepatitis C, Herpes, HIV, and Syphilis

Las siguientes instalaciones públicas brindan a los residentes del área de Miami, Florida, pruebas de ETS gratuitas o de bajo costo, que incluyen clamidia, gonorrea, hepatitis B, hepatitis C, herpes, VIH y sífilis:

Out of the Closet – Biscayne
2900 Biscayne Blvd.
Miami, FL 33137
(305) 764-3774
Pharmacy (305) 764-3780
HIV Testing: Mon-Fri 10 am-7pm,
Sat-Sun 10 am-5 pm

Miami Dade County Health Department (Refugee Health Assessment Clinic)
315 NW 27th Ave
Miami, FL 33125

Miami Dade County Health Department (Downtown STD Clinic)
1350 Northwest 14th Street
Miami, FL 33125

Miami Dade County Health Department (Little Haiti Center)
300 NE 80th Terrace
Miami, FL 33138

Miami Beach Community Health Center (North Health Center)
11645 Biscayne Boulevard Suite 103-104
Miami, FL 33181

Centers for Disease Control and Prevention. Sexually transmitted disease surveillance, 2014. November 2015. (last accessed 9 August 2016).
Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64:1-137

Mind Blown: What is Charles Bonnet Syndrome?

I Blew My Mind

During my clinical rotation for emergency medicine, I noticed a strobing flash of light that morphed into a swirling rainbow in my left upper field of vision–something I recognized to be a scintillating scotoma, a symptom I learned about during  a  neurology and ophthalmology module.

Depiction of  my left upper visual field loss

The scotoma progressively worsened for more than one day, so I went to the ophthalmology emergency department for further investigation since the symptoms outlasted the amount of time an ocular migraine, an initial hypothesis, would typically last and possibly was caused by a tear in my retina. These days, good vibes only is the quintessential millennial philosophy–and while it is powerful to be positive I certainly don’t want to be one to suffer from persistent Polyanna syndrome. It’s best to take off the rose-tinted glasses from time to time. A possible downfall of the medical field is those in practice must practice negative thinking; the worst-case scenario must always be considered first and ruled out. Talk about extreme neuroticism when negative thinking goes unchecked!

Depiction of a scintillating scotoma

Of course, it’s not in my nature to have that train of thought since I’m inherently more whimsical, but training insists upon me changing my mind. After undergoing tests that ruled out a retinal tear, I was sent to imaging for an MRI.

“Are you ready for take-off, captain?” The technician joked after he prepared and positioned me for imaging.

“Sit back, relax, and enjoy the ride.”

After spending quite some time in a metal tube listening to banging noises mixed with smooth jazz, I returned to the ophthalmology department. Radiology sent back a report that stated I had a hemorrhagic lesion in the right temporal lobe. I revealed I am a student earlier in the consult so the doctor enthusiastically went through the differentials list as if she was Vanna White revealing all the prizes behind door number four. In descending order of priority, she had down choroid plexus cyst, vascular anomaly, choroid plexus papillae, and metastasis.

MRI image of a cavernoma

I took it with a smile. I was actually amused. This is the stuff I’m practicing and playing “doctor” with now to perform in the future. But then my eyes started to water and she positioned her smile to neutral.

“It’s a lot to take in. I know. Try not to go home and Google too much,” she advised, and wrote me a doctor’s note excusing me from my rotation. I always knew I had a few screws loose up there, but now my brain is actually bleeding. Though a brain metastasis was a low priority on the list of differentials, the pressing anxiety of not knowing the exact answers sent me on an emotional roller coaster and evoked a few days period of nerve racking self-reflection leading up to the follow-up appointment with a neurosurgeon.

A New Stroke of Insight

When I followed up with a neurosurgeon several days later, it was confirmed that I have a cavernoma, a venous malformation that may have been present since birth which hemorrhaged. Thankfully, this is a benign condition and there is a 1% chance that it will bleed again. Essentially, I had a small stroke and immediately I likened some of my initial symptoms from my hemorrhage to My stroke of insight,  a Ted Talk by Jill Bolte Taylor that my pathophysiology professor once referenced.

I was cleared to go back to my emergency medicine rotation the day after my consult with the neurosurgeon. I continued to have minor visual deficits in the left upper field and a focal area that was sore in the place I had the hemorrhage, but it did not impede with my ability to work.

That evening when I came home and was relaxing while looking at the white wall in my room, I noticed images in the same left upper field of vision that has had deficit. It began with a dancing lightning bolt that transformed into neon logos similar to what you would see in Times Square. The flash of light transformed into a set of glowing brass knuckles that pounded thin air. A flock of black birds flew from my right peripheral vision to the left upper field of vision as if they were escaping me. Red lines were dancing in thin air. An infinite row of Christmas tree cartoons transformed to an infinite row of cacti cartoons in a blinking array! An adorable elephant cartoon grabbed a growing beanstalk with its trunk from thin air!

Cartoon depiction of my experience with Charles Bonnet Syndrome courtesy of

Rows of dozens of yellow race cars were parked with spinning wheels. One by one, different profiles of people from a range of ethnicities began to appear, none of which I could recognize. Each were looking towards the ground with their necks flexed then extended their neck until their profile was parallel with mine. They each turned their head to gaze into my eyes and disappeared.

Depiction of release phenomena

One person was a  man with a swirl of corn row braids. He performed the same action, but this time he turned to face away from me and the back of his head began twirling, showing off a mesmerizing spinning pinwheel of braids. The flock of birds flew by, escaping me yet again. The Times Square neon billboards began flashing. And then it was the dancing lightning bolt all over again. I was mesmerized. Everything I saw was pleasant, but I was aware that the images were not real because only my left upper field of vision was affected. I could still see my roommate, bed sheets, pillows, lamp and desk–all of the familiar things in my room.

Free Your Mind: Release Phenomena as Mental Catharsis
After suspecting that the visual hallucinations were potentially focal seizures, I made another follow-up appointment with a neurologist. After my office visit, I was educated on release phenomena, or Charles Bonnet Syndrome. It is well known that Charles Bonnet Syndrome (CBS) can be elicited by a lesion to the periphery or anywhere along the visual pathway.  Though I was told that I may be one of the youngest patients that the neurologist has met in person to have experienced this type of phenomena, I found that it can strike at any age. It has been a truly fascinating experience to see first hand what the brain will do to compensate for a loss of visual field and the type of stimuli my brain inserted when there was a void in the field contralateral (on the opposite side) to my hemorrhagic lesion. Interestingly enough, every human is capable of such a release phenomena. The brain seems to not only need visual input but a changing and diverse form of input for normal functioning and seems to crave it. Without it, the brain imposes its own meaning. It seems that variety is not just the spice of life, it is essential to thrive.


Being a physician assistant student has been an incredible learning adventure thus far. Reality certainly can be stranger than fiction. I’m not sure which specialty I will pursue once I complete my training at school, but fortunately the physician assistant profession offers flexibility and neurology is a field I would love to be involved in. Our brains are incredible artists. Since release phenomena typically include visual hallucinations of cartoon-like images, I thought the topic could be a great medical metanarrative. It is also a wonderful coincidence that my friend, Jorge Muniz, PA-C, could depict my story since he is a medical illustrator. I told him about my experience and he captured it in the cartoon above.  Needless to say, although it was Art Basel week in Miami when this happened, I didn’t feel like I missed out on much by staying in and thanks to the collaboration, some of the art in my mind’s eye has been captured.

Why is this patient having visual hallucinations?
Soofi, Tahra MSPAS, PA-C; Mackner, Andrew; Skorin, Leonid Jr. DO, OD, MS
Journal of the American Academy of PAs: January 2018 – Volume 31 – Issue 1 – p 55–56doi: 10.1097/01.JAA.0000527712.46439.63 A Difficult Diagnosis
Merabet LB, Maguire D, Warde A, Alterescu K, Stickgold R, et al. (2004) Visual hallucinations during prolonged blindfolding in sighted subjects. J Neuroophthalmol 24: 109–113.

Experience Well Skin: Erno Laszlo Vitamin C Peel Mask


Enjoying the citrus scent after applying the two-step Vitamin C skin peel by Erno Laszlo

Thanks to Influenster and their partnership with Erno Laszlo, I received a full-sized 1.7 ounce complimentary sample of the Vitamin C Peel mask in the mail. With one week left in my dermatology rotation, I was thrilled to incorporate this new element to my skin care regimen since the stress of looming end-of-rotation exams has caused my face to break out over the last few months. For clear skin, consistency is key, striving for flawless is certainly a daily battle and good  hygiene is a necessity!

Erno Laszlo’s two step peel retails for $100.00 online and in stores.

The structure of every living cell in your body influences how it functions. When free radicals are left behind on your skin, they harm it by breaking down the proteins and fatty acids that comprise it and disturb the normal pH. These effects are cumulative and can change the nature of the skin. When they harm the sebaceous gland, they can increase the production of sebum and leave the skin open to bacterial infections. Any kind of stress, in my case, stress from exams, can trigger an inflammatory response leading to inflammatory pimples which include papules and pustules. These papules and pustules develop when blocked pores get increasingly irritated. Non-inflammatory pimples, on the other hand, include blackheads and whiteheads, and are generally smaller and easier to treat. They develop when skin pores become plugged with oil, dead skin cells, and bacteria. Common bacteria that thrive on the surface of the skin are Propionibacterium acnes and the staphylococcus species, which is a gram positive bacteria. Gram positive bacteria are protected by

content_image_-_types_of_acne_vulgaris_comedonea thick wall. We all may ponder where we come from, but in the world of biology, the central dogma is always the answer meaning DNA makes RNA and RNA makes proteins. In order to shut down the the machinery bacteria use to make protein, clindamycin, an antibiotic which targets a subunit of the machinery used to prevent the bacteria from making the protein components it needs for growth. Fortunately, during my rotation I was able to treat my acne with a combination of Onexton (clindamycin phosphate and benzoyl peroxide) Gel, 1.2%/3.75%, a prescription topical antibiotic cream, and Aczone (dapsone 7.5%) gel samples provided by my preceptor. A common side effect to treating acne with these topical medications can be skin dryness and after a couple of weeks using the medicated topical treatments, I felt as though my lackluster, dull skin needed a boost.

I owe 50% of my beauty to my mother and the other 50% to Erno Laszlo,” – AUDREY HEPBURN

To add intrigue to the brand, having perfected the world’s most coveted complexions from Europe to Hollywood, Dr. Erno Laszlo brought his skincare philosophy to New York City in 1927.  There, he introduced celebrity clients like Audrey Hepburn to his signature double cleanse and cultivated the brand’s customized approach to skincare.

Peel and Reveal.
Powered by super-nutrient Vitamin C, the clarifying two-step peel gently polishes skin!  Vitamin C is a potent antioxidant that also can help combat toxin exposure and acne. Products formulated with vitamin C can also help reduce the appearance of an uneven skin tone and reveal bright, radiant skin. Best of all, vitamin C is an appropriate choice for all skin types! To optimize skincare, using the Erno Laszlo scrub in combination with a broad-spectrum SPF 15 or higher liquid foundation or sunscreen creates the ultimate anti-aging power duo and prevents against common skin ailments seen with prolonged sun exposure such as seborrheic keratosis and actinic keratosis, a condition that can develop into the deadly squamous cell carcinoma.


Step 1 Massage the blissfully citrus scented peel into your skin to gently exfoliate for up to three minutes. This helps remove the free radicals, dirt, dead skin, and bacteria that has accumulated throughout the day.






Step 2 Activate brightening and moisturizing—you simply peel away to uncover instant radiance. I felt the two step process working together to reveal refreshed skin! Don’t forget to rinse well and pat dry when you are done! My complexion felt much smoother and more radiant once I was finished!
Thanks again to Influenster and Erno Laszlo for sharing this skincare experience with me! Check out my other beauty blogs from Influenster and click here to find out how you can receive complimentary samples delivered directly to your door.

Photo credit:

Class Notes: a diagram of the epidermis and dermis. Did you know that the skin is the largest organ of the human body?



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Combating Mal de Ojo: How To Gain Cross-Cultural Medical Competency Abroad

Review Jennifer Sills Volunteer in Quetzaltenango GuatemalaTo have an edge on other applicants, aspiring medical students may take the initiative to gain relevant experience and increase cross-cultural competency by volunteering through non-profit organizations on medical missions. Many of the skills I practiced during a medical mission trip through A Broader View Volunteers in Quetzaltenango, Guatemala contributed to my learning experience for the pediatric module during my didactic first year of physician assistant training. I have found that learning can sometimes become solidified retrospectively. In this case, I performed clinical skills before I learned about the theory behind child growth, development, disease processes and the wellness examination.

A church in Quetzaltenango, Guatemala.

From a Western medical perspective, vaccinations are an essential part of pediatric wellness but medical theory holds no weight when it conflicts with patient belief. Despite a paper published in The Lancet led by Dr. Andrew Wakefied which suggested that the measles-mumps-rubella (MMR) vaccine might be linked to autism and retracted for insufficient data in the late 90s, the autism idea has been perpetuated by celebrity figures like Jenny McCarthy who supported anti-vaccination in the past. One of the recurring failures of health care worldwide is that people mistrust physicians and other medical personnel, not only because what they prescribe may clash with their personal beliefs, but simply because of communication difficulties, inconsistencies in information, or because they feel that they are being treated poorly. Many expectant parents are worried about the potential consequences of vaccinations, but leaving your child unvaccinated can ultimately lead to worse outcomes that can be fatal.

A vaccination schedule poster at Puesto de Salud in Quetzaltenango, Guatemala

Mistrust in Western medicine theory and practice, of course, goes beyond borders to Latin America. The eyes cannot see what the mind does not know and to an untrained mind, viruses and bacteria aren’t usually the first thought when health problems present. Guatemala is an incredibly superstitious country, especially in rural areas, and supernatural pathologies typical of Mayan culture like “mal de ojo,” the evil eye, are prevalent. Mal de ojo occurs when one looks upon another with envy and inflicts harm like fever, cough, diarrhea, and rash; typical symptoms of rotavirus, hepatitis A, and other viral and bacterial diseases. This is partly why many Guatemalan mothers who came to the medical mission site, Puesto de Salud, wrapped their infants in layers of blankets. In Guatemala, blankets serve to keep the infants warm and also to conceal babies from the evil eye. It is important to listen to patient complaints with an open mind and, in this case, incorporate Mayan tradition with modern medicine. The Guatemalan government has made efforts to bring awareness and free vaccinations at sites like Puesto de Salud to the people and as a volunteer, I was able to work alongside Guatemalan doctors, nurses, and students to administer vaccines and educate patients on the well-child examination and family planning.

An educational pamphlet about vaccinations.

A Broader View Volunteers is just one non-profit corporation that is a liaison to serving your world-wide community, but it has connections to many different experiences whether preserving sea turtle habitats, offering support to victims of domestic violence,  or working with medical or dental patients piques your interest.  Below is my review of my experience with A Broader View Volunteers.

1- How was the local ABV Coordinator and the support provided in-country?
All of the information and support I received from the ABV coordinator was accurate, concise and very helpful. All of the support provided was great.

2- What was the most surprising thing you experienced?
I knew that the medical system would be different in Guatemala so I came to the program with an open mind. The simplicity of a paper system as opposed to the complexities of  electronic medical records in the US was both surprising and refreshing. Also, the nursing students here had much more autonomy than US students!

3- What was most difficult to experience?

I have family who live in rural areas of the  Philippines, so being in Guatemala felt familiar and reminded me of me experiences in La Union. Being away from the comforts of home was the most difficult. Sometimes I just wanted to eat Taco Bell. It took me a really long time to find one, but I finally did and it was worth it!

4- Any tips for future volunteers… (clothing, travel, personal items, donations)

Don´t bring anything of extreme value whether it be monetary or personal value! Plan on bringing bathing suit if you are going to visit the hot springs!

5.-Other things volunteers should know:

a. Don´t go to the cemetery with valuables in hand! Many thieves prey on unsuspecting victims there! I was attacked knife point by a thief who wanted my cell phone but luckily he ran off when he noticed a funeral procession crossing nearby.
b. Drink bottled water!
c. Souvenirs are less expensive in Xela than Antigua.
d. You can barter prices!

There’s something about Maria. The Santa Maria Volcano makes the view from the Quetaltenango cemetery stunning.

6- How would you describe your accommodation, meals, security (e: host family, on-site, shared)

Great accommodation and meals. Ms. Lilian was a great cook. I was invited to attend posadas, so I was able to get involved with a holiday ritual and meet the neighbors.

7- What was your favorite memory of this trip?

Meeting native Guatemalans, interacting with babies, and cultural outings such as posadas were my favorite memories of the trip. Also, making Christmas cookies was a great memory!

8- How was the ABV USA support prior traveling?
Everything was well-planned and instructions were concise. There was a welcome packet that described exactly how the reception process would be and gave an overview of the homestay family.

As a tax exempt 501(c)(3) non-profit charity organization A Broader View receives 100% of funding from volunteers’ program fee donations.

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Call  toll free at 866-423-3258


Baer, R. D., Weller, S. C., Faraco, J. C. G., & Martín, J. F. (2006). Las enfermedades populares en la cultura española actual: un estudio comparado sobre el mal de ojo. Revista de Dialectología y Tradiciones populares, 61(1), 139-156.
Eggertson, L. (2010). Lancet retracts 12-year-old article linking autism to MMR vaccines.
McCarthy, J. (2008). Mother warriors: A nation of parents healing autism against all odds. Penguin.

Moshi Moshi! Are You Craving Mochi?/¡Moshi Moshi! ¿Antojas Mochi?


At MOMI Ramen in Brickell. Kimono romper by Steps New York

If you’re dying to jet-set but other responsibilities are keeping you grounded, a taste of Asia is just footsteps away for Brickellistas! Located about a block away from Mary Brickell Village, MOMI, a quaint restaurant bursting with culture, offers authentic Japanese ramen and does not disappoint! The  store front has a brick exterior with large windows adorned with Japanese characters in red and blue neon that lure in guests.

Ramen noodles by MOMI

Inside is a small dining area and the language barrier with the servers makes you feel like you’re elsewhere.  The walls are lined with a variety of sake bottles and from just about any table, you have a front row seat to watch the chef prepare your meal. You might notice an ATM machine in the corner, a second reminder that the place is cash only in case you missed the warning posted on the door. Some may be put-off by the exorbitant prices (some ramen bowls go for $30.00!) and the brow-raising cash policy, but  MOMI monopolizes Miami and goes unparalleled since there is a lack of Asian dining choices in the city.

Mochi (餅) from MOMI Ramen

Mochi is one of my favorite desserts. It is made from glutinous rice, pounded into paste and molded into any shape. If you’re into a squishy powder texture, give it a try!
MOMI Ramen
5 SW 11th St, Miami, FL 33130

¡Si tienes ganas de jet-set, pero otras responsabilidades te están manteniendo en la tierra, un sabor de Asia está cercita para los Brickellistas! Ubicado una cuadra desde Mary Brickell Village, MOMI, un pintoresco restaurante repleto de cultura, ofrece ramen japonés auténtico. El frente de la tienda tiene un exterior de ladrillo con grandes ventanas con carectetes japoneses en rojo y azul neón que atraen a la gente paseando.19441203_10103207351214508_1620141697_n El interior es un pequeño comedor y la barrera del idioma con los meseros te hacen sentir como si estuvieras en otro lugar. Las paredes están revestidas con una variedad de botellas de sake y desde casi cualquier mesa, tienes un asiento de primera fila para ver el chef preparando la comida. Puedes anotar un cajero automático en la esquina, un segundo aviso de que el lugar solamente acepta efectivo en caso de que no diste cuenta a la advertencia publicada en la puerta. Algunos pueden ser aplazados por los precios exorbitantes (¡algunos ramen salen por $ 30.00!) Y te puede molestar la política de efectivo, pero MOMI monopoliza Miami y va sin competencia, desde que hay una falta de opciones de restaurantes asiáticos en la ciudad. Mochi (餅) de MOMI Ramen.  Mochi es uno de mis postres favoritos. Está hecho de arroz glutinoso, molido en pasta y moldeado en cualquier forma, pruébelo hoy!

MOMI Ramen
5 SW 11th St, Miami, FL 33130


How to Make Mochi Rice Balls:

For those looking for a home-made fix, here’s some step-by-step instructions to make Mochi rice balls that I found on Pinterest!


For the Mochi:
  • 1 cup of *sweet* rice flour {not regular rice flour}
  • 4 tbsp sugar
  • 1 tbsp sifted cocoa
  • ½ tsp fine salt
  • 1 cup of cold coffee
  • Dusting of wheat/corn starch/sweet rice flourClick here! for step-by-step instructions!




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