The Cardiff Anaesthetic Record System has been used to examine the hospital mortality rates and relative risks for patients having anaesthesia who have certain preoperative conditions coexisting with their disease requiring surgery. Each preoperative condition was associated with a higher mortality rate than occurred in patients with no preoperative condition (for example ischaemic heart disease 7%, diabetes 5.7%, no preoperative condition 0.5%). Mortality was greater for emergency than for elective operations. In contrast to an increasing mortality by age, the relative mortality risk decreased, suggesting that in older age groups coexisting disease may be less important than other risk factors in determining mortality.
Ethnic minorities in Britain having their origins in the West Indies, the Indian sub-continent (Asian), China and Africa consume diets which differ in varying degree from those of the indigenous population. These minority groups are in general well nourished and almost certainly share obesity with the host population as their commonest nutritional problem. Infantile rickets and iron deficiency anaemia are seen in a small number of the children of all ethnic minorities. Nutritional deficiencies of folic acid and vitamin B,* outside infancy are virtually confined to the Asian population and result from their dietary habit of lacto-vegetarianism. Vitamin D deficiency leading to rickets and osteomalacia is widespread among Asians in Britain. The contribution of dietary factors to rickets and osteomalacia is the subject of current debate. This paper deals mainly with the prevalence, prevention and aetiology of Asian rickets and osteomalacia with particular emphasis on dietary risk factors for the development of these diseases.
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