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AA Erfan, OA Nafie, AAH Neyaz, MA Hassanein, Vitamin D Deficiency Rickets in Maternity and Children's Hospital, Makkah, Saudi Arabia. 1997; 17(3): 371-373 Exposure to sunlight plays a major role in maintaining calcium homeostasis and bone metabolism in humans. Although it is hard to understand how sunlight becomes involved in such vital processes, it is well recognized that vitamin D is required for the health, development and maintenance of bone throughout life. Casual exposure to sunlight during daily activities provides most of our vitamin D requirement. Although Saudi Arabia receives abundant sunlight during the year, vitamin D deficiency is fairly common, especially in pregnant women, lactating mothers, and their infants, because of minimal exposure to sun. Young children are kept indoors until they are independent, approximately up to two years of age, as their mothers are of the opinion that sun is harmful to the child. In this study we looked for the important factors that might contribute to the occurrence of rickets in the sunlight-rich area of Makkah city. Material and MethodsThis study included 102 infants of different nationalities, aged three to 24 months, 48 (47.1%) of whom were females and 54 (52.9%) of whom were males with newly diagnosed vitamin D deficiency. All infants attended the outpatient clinic of Maternity and Children's Hospital in Makkah and were there for a variety of medical problems over a period of 12 months from July 1993 to the end of June 1994. Other types of rickets than vitamin D deficiency were excluded from this study.Diagnosis of vitamin D deficiency rickets was based on clinical, biochemical and radiological manifestations of the active disease. Each patient was studied for the following: age, nationality, feeding pattern, educational status of the mother, number of children in the family, presenting features of the disease, total serum calcium, serum phosphorus, serum alkaline phosphatase, hemoglobin levels, serum proteins, renal function tests, complete urine examination, and x-ray examination of the ends of long bones at the wrist and ankle joints. BM/Hitachi system 911 was used for all chemical colorimetric reactions. Serum calcium was measured by o-cresolphthalein complexone method, 4 serum phosphorous by Molybdate reaction, 5 and alkaline phosphatase by optimized standard method, confirming to the recommendations of the Deutsche Gesellschaft für Klinische Chemie. 6All patients were treated with oral vitamin D drops. Each infant received 2500 IU of vitamin D daily for one month, then shifted to 400 IU daily, after signs of healing had appeared, confirmed by x-ray of long bones and by normalization of serum alkaline phosphatase. Thirty age-and sex-matched infants who had no evidence of rickets were used as controls. Chi-squared test was used for analysis of the results, shown in Tables 1, 2 and 3. Results and DiscussionNutritional rickets due to vitamin D deficiency continues to be a worldwide problem. Its occurrence is probably highest in many tropical and subtro...

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The age-related values of penile and testicular measurements must be known to be able to determine the abnormal sizes and to monitor treatment of underlying diseases. Our study is a step to achieve accurate reference values of penile and testicular measurements for Egyptian male newborns and infants. Therefore multicenter studies are recommended to establish Egyptian norms.

Background: Development of steroid dependency is one of the difficult problems in the management of children with idiopathic nephrotic syndrome, leading to increased morbidity, complications and cost of treatment. Thus, predicting early in the disease course will be useful in counseling parents and may improve treatment strategy. Objectives: To determine the clinical characteristics that can predict the development of steroid dependency early in the initial episodes of steroid sensitive nephrotic syndrome (SSNS). Patients and Methods: The study included 52 children with SSNS. Their ages ranged from 3 to 16 years. Patients were divided into two groups. Group A consisted of 24 patients with steroid dependency or frequent relapses nephrotic syndrome and group B consisted of 28 patients with complete remission or recurrent nephrotic syndrome. Data obtained retrospectively from patients’ files. Results: Children who require a cumulative steroid dose equal or more than 140 mg/kg to maintain remission during the first 6 months of the disease are at high risk to require steroid sparing agents (SSA) for disease control, and who did not achieve remission by day 20 of the initial prednisone course became steroid dependent with 96% specificity but with low sensitivity (50%). All steroid dependent children in this study showed relapses associated significantly with upper respiratory tract infections. Conclusions: Cumulative steroid dose in the first 6 months of treatment and the need of more than 20 days to achieve initial remission can predict steroid dependency in children with nephrotic syndrome.