Blood lead concentrations and the Neuropsychology scores of pregnant women in Klang Valley Malaysia

Pregnant women with high blood lead posed high risk to their fetus as placental transfer can occurs to the fetus. The objective of this study was to identify the relationship between blood lead and the neuropsychological score of women who were in their 3rd trimester of pregnancy. These respondents were undergoing a routine antenatal checkup at a teaching hospital located in Klang Valley areas. Blood lead concentrations were analyzed using graphite furnace Atomic Absorption Spectrophotometer (AAS). The neuropsychological scores were measured with WHO Neurobehavioral Core Test battery (NCTB). The test consists of 7 items, which made up of the Digit Symbol, Trail Making, Digit Span, Benton Visual Retention Test, Pursuit Aiming, Santa Ana Manual Dexterity, Reaction Time and Movement Time tests. The mean blood lead was 7.78±4.77 µg/dL. The mean score for the total NCTB test was 50.00±5.24. Statistical analysis showed blood lead concentrations were inversely correlated with the total NCTB score (r= –0.462, p≤0.01). The correlation was about 21.3%. The General Linear Model (GLM) showed that age (β= –0.15, p=0.017), weight (β=2.67, p=0.05) and height (β=–1.97, p=0.05) also influence the total neuropsychological scores. In conclusion, blood lead reduces the total neuropsychological scores. The scores for each of the 7 items were inversely and significantly correlated with blood lead concentrations except for the Trail Making and Santa Ana Manual Dexterity tests

Blood lead concentration during pregnancy and the health implication to the mothers and their babies

Lead toxicity affects mainly the haematopoietic system, the central nervous system and the excretory system. Blood lead levels of 'b3 10.0 mg/dL can lower intelligence quotient (IQ), impair hearing ability and retard growth in children. Blood lead can also be transferred directly from pregnant mothers to their foetuses. The main objective of this prospective epidemiological study was to investigate the implications of blood lead concentrations among mothers in their third trimester of pregnancy and their infants on the mothers' neurobehavioral status as well as on the mental and physical development of their infants. The Neurobehavioral Core Test Battery (NCTB) was used to assess the neuropsychological status of the pregnant mothers, while the Bayley Scales of Infant Development (BSID) was used to assess the mental, psychomotor and behavioural development of infants at 6 month of age. The study samples comprise 202 mothers in their third trimester of pregnancy and 195 infants born by them. The results of this study showed that the arithmetic mean for mothers' venous blood lead concentration was 7.78 mg/dL and its geometric mean was 6.19 mg/dL, while the arithmetic mean for the cord blood lead concentration was 14.05 mg/dL and its geometric mean was 12.44 mg/dL. The arithmetic mean for infants' capillary blood lead concentration was 2.80 mg/dL and its geometric mean was 2.33 mg/dL. The mean mothers' venous blood lead concentration (9.2 mg/dL) and cord blood lead concentration (15.5 mg/dL) among Indians were the highest in comparison with the Malays and Chinese. The cord blood lead concentration showed direct and significant relationships with mothers' venous blood lead concentration and with the capillary blood lead concentration of infants at the age of 6 months. All of the NCTB test scores showed significant (p < 0.001) inverse relationships with mothers' venous blood lead concentration, except for the Pursuit Aiming test and the Santa Ana Manual Dexterity test; whereas all scales of the BISD tests showed significant (p < 0.001) inverse relationships with infants' capillary blood lead concentration, except for the Emotional Regulations Scale which is a sub-test for the Behavioural Rating Scale (BRS). Mothers who delivered their babies abnormally were found to have a higher (19.0 mg/dL) mean cord blood lead concentration than mothers who delivered normally (13.6 mg/dL). After adjustment for the confounding factors that also influenced NCTB and BSID scores, each increment of I mg/dL in mothers venous blood lead concentration will decrease their mean NCTB scores by 0.56 point, while every increment of 1 mg/dL in infants' capillary blood lead concentration will decrease the PDI, BRS and MDI scores by 9.16, 6.77 and 4.64 points, respectively. In conclusion, low-level lead toxicity at below 10 mg/dL will result in more significant effects on the inhibition of psychomotor and behavioural development in infants as compared to their mental development. This also means that the blood lead guideline for children at 10 mg/dL may not be completely protective for infants against neurotoxin effects of lead

A compilation of nanotechnology in thin film solar cell devices

Nanotechnology has become the world attention in various applications including the solar cells devices due to the uniqueness and benefits of achieving low cost and better performances of devices. Recently, thin film solar cells such as Cadmium Telluride (CdTe), Copper-Indium-Gallium-diSelenide (CIGS), Copper-Zinc-Tin-Sulphide (CZTS), and Dye-Sensitized Solar Cells (DSSC) enhanced by nanotechnology have attracted much attention. Thus, a compilation of nanotechnology devices giving the progress in the solar cells has been presented. It is much related to nanoparticles or nanocrystallines, carbon nanotubes, and nanowires or nanorods structures

Blood Lead Concentrations and The Neuropsychology Scores of Pregnant Women in Klang Valley, Malaysia

Pregnant women with high blood lead posed high risk to their fetus as placental transfer can occurs to the fetus. The objective of this study was to identify the relationship between blood lead and the neuropsychological score of women who were in their 3rd trimester of pregnancy. These respondents were undergoing a routine antenatal checkup at a teaching hospital located in Klang Valley areas. Blood lead concentrations were analyzed using graphite furnace Atomic Absorption Spectrophotometer (AAS). The neuropsychological scores were measured with WHO Neurobehavioral Core Test battery (NCTB). The test consists of 7 items, which made up of the Digit Symbol, Trail Making, Digit Span, Benton Visual Retention Test, Pursuit Aiming, Santa Ana Manual Dexterity, Reaction Time and Movement Time tests. The mean blood lead was 7.78±4.77 µg/dL. The mean score for the total NCTB test was 50.00±5.24. Statistical analysis showed blood lead concentrations were inversely correlated with the total NCTB score (r= –0.462, p≤0.01). The correlation was about 21.3%. The General Linear Model (GLM) showed that age (β= –0.15, p=0.017), weight (β=2.67, p=0.05) and height (β=–1.97, p=0.05) also influence the total neuropsychological scores. In conclusion, blood lead reduces the total neuropsychological scores. The scores for each of the 7 items were inversely and significantly correlated with blood lead concentrations except for the Trail Making and Santa Ana Manual Dexterity tests

Intergration of Islamic input in medical curriculum - Universiti Sains Islam Malaysia (USIM) experience

Muslim doctors are those qualified doctors who practise their professional knowledge and skills in line with Islam and upholds the highest standards of ethical and professional behaviour. The medical curriculum of the Faculty of Medicine and Health Sciences of Universiti Sains Islam Malaysia (USIM) was designed with the integration of Islamic input which aims at producing doctors who are able to practise medicine that is integrated with Islamic, moral and ethical values. Halaqah Studies and Fundamental Islamic Knowledge (FIK) courses such as History of Medicine in Islam, Science and Medicine in Quran and Sunnah, Akhlak and Tasawuf, Islamic Jurisprudence and Medical Ethics and Fiqh Issues are taught to students during the pre-clinical and clinical phases. Memorization of selected Quranic verses throughout the programme aim to get the students to apply the verses of the al-Quran into practice in everyday life and especially in their clinical practice. Islamic values are emphasised during doctor-patient interactions in all clinical postings. Islamic knowledge and values integrated in the curriculum are assessed in written and clinical examinations. The outcome of the integration of the Naqli component in the medical curriculum has been demonstrated positively by the students in the patient management problems and clinical consultations. Studies on the outcome of the integrated Islamic input in the medical curriculum among the clinical students and graduates are being carried out

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)