GavinC. Arneil

REDUCED PREVALENCE OF RICKETS IN ASIAN CHILDREN IN GLASGOW

As judged by admissions to a childrens hospital, the prevalence of Asian rickets in Glasgow increased from 1960 to 1973 and then decreased gradually. 400 children born of Indian or Pakistani parents (200 in 1974 and 200 in 1979), from two schools, were examined for clinical, biochemical, and radiological evidence of vitamin-D deficiency. In 1974 there were 10 children with florid rickets and 15 with subclinical rickets, whereas in 1979 no child had florid rickets and only 9 had subclinical rickets. Most Asian children now receive vitamin-D supplements. In the short term, general practitioners, physicians, and obstetricians in the United Kingdom must try to ensure vitamin D supplementation not only by children but also by young adults (aged 13-18 years) of Asian origin. A particular target should be pregnant Asian women, to prevent osteomalacia, fetal hypovitaminosis, and congenital rickets. The long-term answer to Asian probably lies in health education and a change towards the Western diet and life-style.

LONG-TERM ASSESSMENT OF CYCLOPHOSPHAMIDE THERAPY FOR NEPHROSIS IN CHILDREN

Abstract There are few reports of long-term follow-up of cyclophosphamide therapy for frequently relapsing, steroid-sensitive, minimal-change idiopathic nephrosis of childhood. In 34 children followed up for two to seven years life-table analysis suggests that 65 % should remain in remission for five years and 46·5% for seven years after cyclophosphamide therapy. The seven-year figure may be unduly low due to 1 late relapser who was found to have a proliferative lesion on repeat renal biopsy. This series also throws light on some factors influencing the possibility of relapse and the incidence of toxic effects of cyclophosphamide.

POST-PERINATAL INFANT MORTALITY IN GLASGOW 1979-81

Post-perinatal infant mortality (PPIM; deaths from the 8th day to the end of the 1st year of life) was studied in Glasgow over the 3-year period 1979-81. The 244 deaths were divided into three main categories--those determined at birth, those due to accidents and acquired disease, and cot deaths. 50% of deaths were determined at birth, and of these 46% were due to prematurity and 49% to congenital disorder. Cot deaths accounted for 44% of the total (88% of deaths not determined at birth) and a definite cause could be identified in only 10% of these. The PPIM rate was 6.1 per 1000 livebirths, a significant part of the infant mortality rate of 12.6. The significance of these findings is discussed in relation to the possible reduction of these figures.