Including Intelligence Quotient Research Articles

Effect of Executive Function on Health-Related Quality of Life in Children with Chronic Kidney Disease.

As the highest function in the brain that regulates our daily activity, executive dysfunction might affect someone's health-related quality of life (HRQoL), especially in those with chronic diseases, including chronic kidney disease (CKD). Neurocognitive functions, including intelligence quotient (IQ) and executive function can be affected through various mechanisms in CKD. However, there was still no specific study regarding how IQ and executive function might affect HRQoL in children with CKD. To assess Executive Function's impact on HRQoL and to find association between treatment modalities and CKD stages with HRQoL in children with CKD. A cross sectional study was conducted at Pediatric Nephrology Clinic at Hasan Sadikin General Hospital, Bandung, Indonesia from September 2022 to April 2023. We included 38 children whose age range were 6-16 years 11 months old with CKD stage III - V. Assessment tools used were: BRIEF questionnaire for executive function; WISC III tool for IQ; PedsQLTM questionnaire generic module for HRQoL. Data was analyzed using SPSS ver. 26.0. Total number of samples was 38. Complete examinations were done on 30 patients. Eight other patients did not undergo the IQ test. There was a negative correlation between executive function components scores (GEC, BRI, MI) with HRQoL scores on parents' proxy in all domains. We found no correlation between HRQoL and IQ scores, but we found a correlation between IQ and CKD stage. There was a significant difference in HRQoL from the children's perspective among the three modalities; children who underwent conservative treatment were having the best HRQoL scores. Interventions to improve executive function of children with CKD should be done to improve their HRQoL in the future. Early diagnosis and treatment of CKD should be done at the earliest to improve neurocognitive function and HRQoL.

Adaptive Behavior of College Students With Autism

As an increasing number of individuals with autism spectrum disorder (ASD) matriculate on college campuses, all stakeholders should be prepared to meet their needs. Despite a body of literature describing adaptive behavior deficits of individuals with ASD, there is a paucity of research examining these skills among those who are college-ready. The present study investigated the adaptive behavior of a diverse group ( N = 27) of incoming college students with ASD and examined to what extent these skills could predict initial academic success. Despite average intelligence and good academic indicators, deficits in communication, socialization, and daily living skills were found. No models, even those that included intelligence quotient (IQ) and SAT scores, were predictive of first-semester or first-year grade point average (GPA). Importantly, freshman-to-sophomore retention appeared higher than the university average. Findings suggest that practitioners and families should consider adaptive behavior in addition to intellectual and academic capabilities when considering postsecondary opportunities and available supports.

Problem Finding, Divergent Thinking, and Evaluative Thinking Among Gifted and Nongifted Students

Investigations of differences between gifted and nongifted students have examined cognitive abilities, including intelligence quotient (IQ) differences, higher order thinking skills, and divergent thinking (DT). However, little is known about differences in problem finding (PF). Moreover, previous works on gifted students have never explored associations between PF and evaluative thinking (ET). Both PF and ET play a role in the creative process. The present study tested relationships between PF, DT, and ET and examined differences between gifted ( N = 175) and nongifted students ( N = 188). An analysis of variance (ANOVA) revealed significant differences between gifted and nongifted students’ PF, DT, and ET, with effect sizes (η2) ranging from 0.048 to 0.192. Gender differences were also analyzed; gifted girls scored significantly higher than gifted boys in PF fluency and originality, DT originality, and in ET in PF. Originality scores in DT and PF significantly predicted the accuracy of students’ ET ( R2 = 34%–42%). Finally, canonical correlation analyses showed moderate-to-strong correlations between DT, PF, and ET scores. Limitations of this study are discussed.

Ventrolateral prefrontal hemodynamic responses in autism spectrum disorder with and without depression.

In clinical settings, autism spectrum disorder (ASD) with comorbid depression is often difficult to diagnose, and should be considered in treatment. However, to our knowledge, no functional imaging study has examined the difference between ASD adolescents with and without comorbid depression. We aimed to compare the characteristics and prefrontal brain function of ASD with and without depression in order to identify a biological marker that can be used to detect the difference. Twenty-eight drug-naïve adolescents with ASD (14 ASD with and 14 ASD without depression) and 14 age- and gender-matched adolescents with typical development were evaluated using several variables. These included intelligence quotient, autism quotient, depression severity using the Beck Depression Inventory 2nd edition (BDI-II), and level of social functioning using the Social Adaptation Self-evaluation Scale (SASS). In addition, frontotemporal hemodynamic responses during a verbal fluency task (VFT) were measured using functional near-infrared spectroscopy (fNIRS). The ASD group, including both of the ASD with and ASD without depression groups, showed smaller hemodynamic responses than the typical development group in portions of the left dorsolateral prefrontal cortex (DLPFC), bilateral ventrolateral prefrontal cortex (VLPFC) and anterior part of the temporal cortex (aTC) during the VFT. Moreover, the smaller hemodynamic responses in the right VLPFC during the VFT in the ASD group were associated with the worse BDI-II and SASS scores. Furthermore, the ASD with depression group showed smaller hemodynamic responses in the right VLPFC during the VFT than the ASD without depression group in a direct comparison. Adolescents with ASD showed reduced activation in broad frontotemporal regions during a cognitive task compared with those with typical development. More specifically, the right VLPFC activation reflected the level of self-estimated depression and social functioning in the ASD subjects, and could be used to discriminate between ASD adolescents with and without depression.

Children Treated for Nonsyndromic Craniosynostosis Exhibit Average Adaptive Behavior Skills with Only Minor Shortcomings.

Adaptive behavior skills are important when assessing cognitive functions related to daily life; however, few studies have assessed these skills in patients treated for nonsyndromic craniosynostosis. In this study, the authors assessed the adaptive behavior skills of children treated for craniosynostosis and examined whether their outcomes are related to surgical technique. The Adaptive Behavior Assessment System, 2nd Edition, parent report was used for children (age, 7 to 16 years) treated for sagittal (n = 41), metopic (n = 24), and other rare synostoses (n = 8). Background data, including intelligence quotient, were controlled for confounders. All evaluated children treated for craniosynostosis were estimated as lower in all aspects of adaptive behavior skills (full-scale, conceptual, social, and practical composites; effect size, 0.36 to 0.44) as compared with norms. The sagittal group showed shortcomings in social composite (effect size, 0.48) and subscales measuring self-care and self-direction, although no difference was observed between spring-assisted surgery and pi-plasty regarding outcomes of adaptive behavior skills. In addition, children treated for metopic synostosis showed results indicating shortcomings with adaptive behavior according to the full-scale, conceptual, and social composites (effect size, 0.53 to 0.61) relative to norms. Furthermore, attrition analysis revealed no significant differences between responders (rate, 80.2 percent) and nonresponders. These results found that children treated for craniosynostosis display average adaptive behavior skills, and that the two surgical techniques used to treat sagittal synostosis did not differ in their behavioral outcomes. Therapeutic, III.

Managerial intelligence of hospital managers in Sari, Iran

Background: Managers’ performance mainly depends on their intelligence, knowledge, skills, personality and organization’s structure, culture and resources. Managerial intelligences is vital for hospital managers’ success. This study aimed to measure the managerial intelligence of hospital managers in Sari, Iran.
 Methods: This descriptive and cross sectional study was conducted in 2017 in Sari, Iran. 294 managers at various managerial levels of hospitals participated in this study. A questionnaire was developed, tested and used for measuring management quotient (MQ). The questionnaire had 3 dimensions including intelligence quotient (IQ), emotional quotient (EQ), and political quotient (PQ). The MQ index ranges between 0 and 1. Higher MQ score indicates better managerial intelligence. SPSS 19 software was used for data analysis. Descriptive statistics such as Mean, Standard deviation, Frequency and Percentage, as well as analytic statistics such as T-test, Spearman correlation and Regression was used.
 Results: The mean score of hospital managers MQ was 0.74 (good). The mean of IQ, EQ and PQ scores were 0.70, 0.77 and 0.75 respectively. A meaningful statistical correlation was observed between IQ and EQ and also between EQ and PQ. Male mangers, top managers, those with higher educational background and those working in logistics departments reported higher MQ.
 Conclusion: Hospital managers reported high MQ in Sari, Iran. The MQ assessment should be considered as a perquisite for recruiting hospital managers.

Physical performance, demographic, psychological, and physiological predictors of success in the U.S. Army Special Forces Assessment and Selection course

This study assessed predictors of successful selection in the very challenging and stressful United States Army Special Forces Assessment and Selection (SFAS) course among 800 Soldiers. A battery of measures were collected during the course and their ability to predict selection were assessed using logistic regression and chi-square tests. Physical performance measures were most predictive, including road march times, land navigation coordinates found, run times, fitness test score, obstacle course score, and pull-ups (p < .05). Soldiers that were officers or 18× enlisted (fast-tracked to SFAS), had <1 year of active duty, ≥ bachelor degree, no children, were not married, and were Ranger school graduates were more likely to be selected (p < .05). Several psychological measures were predictive, including intelligence quotient, grade level equivalents, resilience score, military aptitude score, and grit (p < .05). Basal serum physiological markers weakly predicted selection and were weakly associated with behavioral assessments. Lower C-reactive protein (< 9.5 nmol/L) and higher cortisol and sex-hormone binding globulin (SHBG) predicted selection (p < .05). Higher C-reactive protein (≥ 9.5 nmol/L) was associated with lower fitness test scores and slower road march time (p < .05). Cortisol was correlated with higher grit and resilience scores (p < .05). SHBG correlated with higher grade level equivalents and better performance on pull-ups, land navigation, obstacle course, and the fitness test (p < .05). Testosterone was correlated with faster run and road march times (p < .05). Dehydroepiandrosterone-sulfate (DHEA-S) correlated with lower resilience scores, and DHEA-S, epinephrine, and norepinephrine correlated with worse performance on several physical events (p < .05). These findings suggest measures that could be targeted in interventions to monitor and enhance performance and resilience.

Cognitive Development and Academic Achievement Extent of Association - A Review Report

Education, cognition and learning have become integral part of every child’s personality. These inseparable aspects are considerably vital in shaping the individual and helping him to achieve success. In the schools and educational institutes where education has been taken on priority, the cognitive abilities and excellence in mastering them mitigate the burdens and stress in educational system. In this context, it is assumed that when the children are taught as per their affinity and dominant multiple intelligence, they can learn better and turn into efficient learners. This review paper has been written in order to compile the augmented knowledge into systematic and scientific information to ensure that the educational processes can become lucid for masses. The valid studies related to cognitive development including intelligence quotient, focus factor, decision making ability, creative quotient and academic achievement in light of multiple intelligences were selected. The review studies have been taken on international basis for universal application. It was inferred after the review that the concept of teaching students through multiple intelligences approach should be adopted to make create a meaning and impactful teaching learning process.

Neuropsychological characteristics of child and adolescent offspring of patients with schizophrenia or bipolar disorder

BackgroundSchizophrenia (SZ) and bipolar disorder (BD) are considered neurobiological disorders which share some clinical, cognitive and neuroimaging characteristics. Studying child and adolescent offspring of patients diagnosed with bipolar disorder (BDoff) or schizophrenia (SZoff) is regarded as a reliable method for investigating early alterations and vulnerability factors for these disorders. This study compares the neuropsychological characteristics of SZoff, BDoff and a community control offspring group (CC) with the aim of examining shared and differential cognitive characteristics among groups. Methods41 SZoff, 90 BDoff and 107 CC were recruited. They were all assessed with a complete neuropsychological battery which included intelligence quotient, working memory (WM), processing speed, verbal memory and learning, visual memory, executive functions and sustained attention. ResultsSZoff and BDoff showed worse performance in some cognitive areas compared with CC. Some of these difficulties (visual memory) were common to both offspring groups, whereas others, such as verbal learning and WM in SZoff or PSI in BDoff, were group-specific. ConclusionsThe cognitive difficulties in visual memory shown by both the SZoff and BDoff groups might point to a common endophenotype in the two disorders. Difficulties in other cognitive functions would be specific depending on the family diagnosis.

Critical Combinations of Radiation Dose and Volume Predict Intelligence Quotient and Academic Achievement Scores After Craniospinal Irradiation in Children With Medulloblastoma

To prospectively follow children treated with craniospinal irradiation to determine critical combinations of radiation dose and volume that would predict for cognitive effects. Between 1996 and 2003, 58 patients (median age 8.14 years, range 3.99-20.11 years) with medulloblastoma received risk-adapted craniospinal irradiation followed by dose-intense chemotherapy and were followed longitudinally with multiple cognitive evaluations (through 5 years after treatment) that included intelligence quotient (estimated intelligence quotient, full-scale, verbal, and performance) and academic achievement (math, reading, spelling) tests. Craniospinal irradiation consisted of 23.4 Gy for average-risk patients (nonmetastatic) and 36-39.6 Gy for high-risk patients (metastatic or residual disease >1.5 cm(2)). The primary site was treated using conformal or intensity modulated radiation therapy using a 2-cm clinical target volume margin. The effect of clinical variables and radiation dose to different brain volumes were modeled to estimate cognitive scores after treatment. A decline with time for all test scores was observed for the entire cohort. Sex, race, and cerebrospinal fluid shunt status had a significant impact on baseline scores. Age and mean radiation dose to specific brain volumes, including the temporal lobes and hippocampi, had a significant impact on longitudinal scores. Dichotomized dose distributions at 25 Gy, 35 Gy, 45 Gy, and 55 Gy were modeled to show the impact of the high-dose volume on longitudinal test scores. The 50% risk of a below-normal cognitive test score was calculated according to mean dose and dose intervals between 25 Gy and 55 Gy at 10-Gy increments according to brain volume and age. The ability to predict cognitive outcomes in children with medulloblastoma using dose-effects models for different brain subvolumes will improve treatment planning, guide intervention, and help estimate the value of newer methods of irradiation.

Neural predictors of individual differences in response to math tutoring in primary-grade school children

Now, more than ever, the ability to acquire mathematical skills efficiently is critical for academic and professional success, yet little is known about the behavioral and neural mechanisms that drive some children to acquire these skills faster than others. Here we investigate the behavioral and neural predictors of individual differences in arithmetic skill acquisition in response to 8-wk of one-to-one math tutoring. Twenty-four children in grade 3 (ages 8-9 y), a critical period for acquisition of basic mathematical skills, underwent structural and resting-state functional MRI scans pretutoring. A significant shift in arithmetic problem-solving strategies from counting to fact retrieval was observed with tutoring. Notably, the speed and accuracy of arithmetic problem solving increased with tutoring, with some children improving significantly more than others. Next, we examined whether pretutoring behavioral and brain measures could predict individual differences in arithmetic performance improvements with tutoring. No behavioral measures, including intelligence quotient, working memory, or mathematical abilities, predicted performance improvements. In contrast, pretutoring hippocampal volume predicted performance improvements. Furthermore, pretutoring intrinsic functional connectivity of the hippocampus with dorsolateral and ventrolateral prefrontal cortices and the basal ganglia also predicted performance improvements. Our findings provide evidence that individual differences in morphometry and connectivity of brain regions associated with learning and memory, and not regions typically involved in arithmetic processing, are strong predictors of responsiveness to math tutoring in children. More generally, our study suggests that quantitative measures of brain structure and intrinsic brain organization can provide a more sensitive marker of skill acquisition than behavioral measures.

Comparative genomics of aldehyde dehydrogenase 5a1 (succinate semialdehyde dehydrogenase) and accumulation of gamma-hydroxybutyrate associated with its deficiency

Succinic semialdehyde dehydrogenase (SSADH; aldehyde dehydrogenase 5A1 [ALDH5A1]; locus 6p22) occupies a central position in central nervous system (CNS) neurotransmitter metabolism as one of two enzymes necessary for γ-aminobutyric acid (GABA) recycling from the synaptic cleft. Its importance is highlighted by the neurometabolic disease associated with its inherited deficiency in humans, as well as the severe epileptic phenotype observed in Aldh5a1-/- knockout mice. Expanding evidence now suggests, however, that even subtle decreases in human SSADH activity, associated with rare and common single nucleotide polymorphisms, may produce subclinical pathological effects. SSADH, in conjunction with aldo-keto reductase 7A2 (AKR7A2), represent two neural enzymes responsible for further catabolism of succinic semialdehyde, producing either succinate (SSADH) or γ-hydroxybutyrate (GHB; AKR7A2). A GABA analogue, GHB is a short-chain fatty alcohol with unusual properties in the CNS and a long pharmacological history. Moreover, SSADH occupies a further role in the CNS as the enzyme responsible for further metabolism of the lipid peroxidation aldehyde 4-hydroxy-2-nonenal (4-HNE), an intermediate known to induce oxidant stress. Accordingly, subtle decreases in SSADH activity may have the capacity to lead to regional accumulation of neurotoxic intermediates (GHB, 4-HNE). Polymorphisms in SSADH gene structure may also associate with quantitative traits, including intelligence quotient and life expectancy. Further population-based studies of human SSADH activity promise to reveal additional properties of its function and additional roles in CNS tissue.

A study on cognitive function and event related potential in chronic alcoholism patients

Objective To evaluate cognitive function of chronic alcoholism patients.Methods The Wechsler Adult Intelligence Scale-Revise in China(WAIS-RC) and WMS-RC,including intelligence quotient,logical Memory.visual memory and stroop test,were investigated and P300 component of auditory event-related potential (ERP,P300),especially the subcomponents P3a and P3b were examined in 100 chronic alcoholism patients,and 70 healthv people matched in age,sex and educational level as controls.Results Compared with controls,the score of Verbal intelligence quotient(VIQ),Performance intelligence quotient (PIQ),Full-scale intelligence quotient (FIQ),logical memory,visual memory (immediate and delayed),and stroop test were significant lower (P <0.05.P＜O.01)in chronic alcoholism patients,but the latencies of P3a and P3b wave were significantly prolonged.the amplitude of P3a and P3b wave were significantly decreased in chronic alcoholism patients.Conclusion Chronic alcoholism patients have cognitive function impairment,and P300 is a more sensitive to discover the impairment of the cognitive function. Key words: Chronic alcoholism ;  P300 potential ;  Cognitive function ;

Effects of repeated pesticide exposure on the peripheral and central nervous systems

This study was designed to compare organic farmers (comparison group) and pesticide-using farmers (pesticide group) in terms of neurobehavioral performance and sensorimotor function. The subjects were recruited in October 2004 from Chungnam Province and the neighboring Jeolla Province in western South Korea. Psychological assessment was carried out using the Wechsler Adult Intelligence Scale, the Mini-Mental State Examination, and the Bender Gestalt test. Neuroselective sensory nerve conduction threshold was measured at both left and right middle fingers by using an electrodiagnostic device to determine current perception thresholds (CPTs). Three independent CPT measurements were obtained from each test site by using sinusoidal stimuli at three frequencies. CPT testing showed no difference between the two groups. No significant differences were found in the large myelinated (2000 Hz stimulation; cutaneous touch, pressure), small myelinated (250 Hz stimulation; mechanoreceptive, pressure, temperature, fast pain) and small unmyelinated (5 Hz stimulation; polymodal nociceptive, temperature, slow pain, postganglionic sympathetic) C-fibers. Furthermore, there was no difference found between the pesticide and comparison groups in psychological variables, including intelligence quotient, orientation, memory, calculation, similarities, visual sensitivity, and psychomotor speed. In conclusion, chronic pesticide exposure has no apparent effect on either the peripheral or central nervous system in Korean farmers.

White Matter Lesions Detected by Magnetic Resonance Imaging After Radiotherapy and High-Dose Chemotherapy in Children With Medulloblastoma or Primitive Neuroectodermal Tumor

White matter lesions (WMLs) have been described as a delayed effect of cranial irradiation in children with brain tumors, or a transient subacute effect characterized by an intralesional or perilesional reaction. We report the occurrence of subacute WMLs detected by magnetic resonance imaging (MRI) in children treated for medulloblastoma or primitive neuroectodermal tumor (PNET) and document the associated clinical, radiologic, and neurocognitive findings. Among 134 patients with medulloblastoma or supratentorial PNET treated prospectively with risk-adjusted craniospinal irradiation and conformal boost to the tumor bed, followed by four high-dose chemotherapy (HDC) cycles with stem-cell rescue, 22 developed WMLs on T1-weighted imaging with and without contrast and/or T2-weighted imaging on MRI. Patients had > or = 12 months of follow-up. Neurocognitive assessments included intelligence quotient (IQ) tests and tests of academic achievement. Twenty-two patients developed WMLs at a median of 7.8 months after starting therapy (range, 1.9 to 13.0 months). Lesions were predominantly in the pons (n = 8) and cerebellum (n = 6). Sixteen patients (73%) had WML resolution at a median of 6.2 months (range, 1.68 to 23.5 months) after onset; two patients developed necrosis and atrophy. Three developed persistent neurologic deficits. Cumulative incidence of WMLs at 1 year was 15% +/- 3%. Patients with WMLs had a significant decline in estimated IQ (-2.5 per year; P = .03) and math (-4.5 per year; P = .003) scores. WMLs in medulloblastoma or PNET patients treated with conformal radiotherapy and HDC are typically transient and asymptomatic, and may mimic early tumor recurrence. A minority of patients with WMLs develop permanent neurologic deficits and imaging changes. Overall, the presence of WMLs is associated with greater neurocognitive decline.

An examination of the degree to which IQ, memory performance, socio‐economic status and gender predict young children's suggestibility

Purpose. This study examined whether several interrelated cognitive and socio‐demographic factors predict the degree to which 3‐ to 5‐year‐old children acquiesce to an interviewer's misleading yes/no questions.Method. 220 children were administered the Yield subscale of the Video Suggestibility Scale for Children. The independent variables included Intelligence Quotient (IQ), memory performance (the number of details recalled about the video), socio‐economic status (SES) and gender.Results. Hierarchical regression analyses revealed that all the variables made a significant independent contribution to predicting children's suggestibility when age (in months) was controlled for. Intelligence was the main predictor (uniquely explaining 6% of the variance); children with higher IQ scores were less suggestible than children with lower IQ scores. SES and memory performance inversely predicted children's suggestibility, uniquely explaining 2% and 1% of the variance respectively. Gender explained 2% of the variance, indicating that girls were more suggestible than boys.Conclusion. Suggestibility is a complex, multidimensional construct. Thus, more informative and consistent results in the area of individual differences in children's suggestibility can only emerge from the adoption of larger scale investigations of the combined and independent contributions of numerous interrelated cognitive and demographic factors.

Behaviour and developmental effects of otitis media with effusion into the teens

OBJECTIVETo examine whether behavioural or cognitive sequelae of otitis media with effusion (OME) continue into late childhood and the early teens (11–18 years).SETTINGData from a large multipurpose birth cohort study:...

Relative risk for cognitive impairments in siblings of patients with schizophrenia

Background: Patients with schizophrenia have impairments in several domains of cognition, including working memory/executive function, verbal memory, language, oculomotor scanning/psychomotor speed, and general intelligence. Impairments have also been found in unaffected siblings, suggesting they could be heritable. To assess the suitability of cognitive dysfunction for use in genetic studies, we estimated relative risk (λ) in a large cohort of siblings. Methods: One hundred forty-seven patients with schizophrenia, 193 of their siblings, and 47 control subjects were studied using a neuropsychological test battery, which included intelligence quotient (IQ), Wide Range Achievement Test, Wisconsin Card Sort, Wechsler Memory Scale (revised), California Verbal List Test, Trails A and B, and Letter and Category Fluency. Relative risk was estimated using a cutoff score of 1 SD below the control mean. Results: As expected, patients performed markedly worse than control subjects on all tests except the Wide Range Achievement Test. Siblings had impaired performance on the Wisconsin Card Sort and Trails B, with trends for reduction ( p = .01–.05) on the California Verbal List Test and Letter Fluency. Relative risk to siblings was elevated on the Trails B (λ = 4.0) and California Verbal List Test (λ = 2.8). Trends ( p = .01–.05) for increased λ were also seen for Wisconsin Card Sort, Letter Fluency, Wechsler Memory Scale and decline in IQ (λ = 1.74–2.4). Correlations between tests of different cognitive functions were weak, indicating they measure relatively independent processes. Conclusion: Unselected siblings of patients with schizophrenia have impairments in several cognitive domains. Relative risk scores were in the moderate range, suggesting a significant genetic component. Impairments on one test only weakly predicted impairments on other tests. Thus, cognitive phenotypes identify distinct, familial traits associated with schizophrenia. Using this dimensional approach to subdividing schizophrenia may reduce the clinical and genetic heterogeneity of schizophrenia and improve the power of genetic studies.

Plumbism--a mimicker of common childhood symptoms.

Lead poisoning is a preventable entity that can affect almost every system of the body. Its toxic effects range from subtle common childhood symptoms to even death. In a prospective study forty six children with at least one symptom compatible with plumbism were enrolled after screening patients attending medical services at AIIMS. The work-up included a detailed clinical history and examination including intelligence quotient (IQ) and behaviour. Blood lead levels were estimated in all with due precautions. Their ages ranged from 2.5 to 18 years and M:F ratio was 2:1. The common symptoms included unexplained recurrent colic (39), anorexia (21), sporadic vomiting and constipation (13), pigmented gum lines (11), growth failure (11), history of pica (9) etc. None of the children had acceptable blood lead levels (< 10 micrograms/dl). Ninety three per cent children had levels > 20 micrograms/dl and 47.8% had > 45 micrograms/dl. Statistically significant correlation with blood lead levels was seen with most symptoms. Plumbism can mimic common childhood illnesses and should be investigated in children with a clinically compatible profile. Community awareness with regard to pica reduction may be an important preventive measure. This silent epidemic needs to be aggressively tackled by a multipronged approach.

Scheduling Prenatal Care for Low-Risk Women

Prenatal care is the foundation of all health care: the medical circum- stances of birth predict not only immediate neonatal outcome but also long-term outcome, including intelligence quotient and school perfor- mance. 1