Baseline serum 25(OH)D concentration below 50 nmol L(-1) was associated with an increased risk of stress fracture. Further studies into the effects of vitamin D supplementation on stress fracture risk are certainly warranted.

A detailed study of the nose in cases of leproma tous leprosy was undertaken at Victoria Hospital, Dichpalli, India and the results correlated with the general clinicaI findings. The histological details of the study will be presented elsewhere. The signs and symptoms of nasal involvement are described and it is stressed that this involvement occurs early in the disease processo The importance of all leprosy workers being aware of nasal involveme nt is pointed out and it is recommended that facilities for local care of the nose in leprosy should be established wherever the disease is treated. Possible mechanisms whereby leprosy ma y be transmitted are discussed.

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Reduced impact attenuation and ability to withstand load were implicated in tibial stress fracture risk.

Currently, little is known about the length of time required to rehabilitate patients from stress fractures and their return to preinjury level of physical activity. Previous studies have looked at the return to sport in athletes, in a general population, where rehabilitation is not as controlled as within a captive military population. In this study, a longitudinal prospective epidemiological database was assessed to determine the incidence of stress fractures and the time taken to rehabilitate recruits to preinjury stage of training. Findings demonstrated a background prevalence of 5% stress fractures in Royal Marine training; femoral and tibial stress fractures take 21.1 weeks to return to training with metatarsal stress fractures being the most common injury taking 12.2 weeks. Rehabilitation from stress fractures accounts for 814 weeks of recruit rehabilitation time per annum. Stress fracture incidence is still common in military training; despite this stress fracture recovery times remain constant and represent a significant interruption in training. It takes on average 5 weeks after exercise specific training has restarted to reenter training at a preinjury level, regardless of which bone has a stress fracture. Further research into their prevention, treatment, and rehabilitation is required to help reduce these burdens.