Internal medicine journal
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Internal medicine journal · Feb 2025
Iron optimisation in pregnancy: a Haematology in Obstetric and Women's Health Collaborative consensus statement.
Anaemia is a well-recognised and widely accepted consequence of iron deficiency (ID); however, the two diagnoses are not synonymous with the effects of ID occurring long before the development of anaemia. In adults, ID can cause physical and neuropsychological symptoms, including lethargy, altered mood and poor concentration, reducing an individual's quality of life. Foetal and neonatal ID has been associated with impaired neurocognitive development with lasting effects despite iron replacement in early life. ⋯ This consensus statement was developed by the Haematology in Obstetrics and Women's Health (HOW) Collaborative and utilised the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to evaluate evidence and strength of recommendations. Recommendations are as follows: (i) Routine ferritin screening should be performed in all pregnant women (GRADE 1C) at booking and 24-28 weeks. Repeat testing should be performed at 36 weeks if clinically indicated or if the woman is previously unscreened. (ii) ID in pregnancy should be defined as a ferritin level <30 μg/L (GRADE 1D). (iii) An appropriate oral iron formulation should be offered as first-line therapy for obstetric ID (GRADE 1B). (iv) Alternate-day oral dosing can be considered to limit side effects in women with obstetric ID (GRADE 2B). (v) Intravenous iron should be offered to women with ID/ID anaemia who are intolerant of or refractory to oral iron or in the third trimester (GRADE 1B).
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Internal medicine journal · Feb 2025
Teaching contributions of senior clinicians in a Basic Physician Trainee training programme.
Education of Basic Physician Trainees (BPTs) in preparation for their Royal Australasian College of Physician Divisional Examinations requires time contribution by senior medical staff towards formal teaching activities. This study, conducted at a major metropolitan teaching hospital, sought to quantify the time commitment of senior medical staff towards teaching of BPTs in one clinical year, as well as the perceptions of those staff regarding time commitments through anonymous questionnaire. Senior medical staff involved in formal teaching activities provided a mean of 10 h; questionnaire respondents indicated a mean contribution of 20 h. This study highlights the significant time contribution of senior medical staff to formal teaching activities for BPTs, as well as identifies possible unmeasured teaching contributions.