Two hundred and fifty children with clinical, biochemical and radiological evidence of vitamin-D-deficiency rickets were studied over a period of 5 years. Their ages ranged from 1 month to 2 years. Breastfed infants formed 63% of total cases. Intramuscular therapy with vitamin D in a dose of 600,000 IU, deep intramuscular, proved to be safe and effective. In contrast, oral vitamin D did not provide such satisfactory results, presumably owing to poor patient/parental compliance. This report reveals that vitamin-D-deficieny rickets is common in Kuwait in spite of abundant sunlight all through the year because children are wrapped up and kept indoors. Insufficient intake of vitamin D is another important factor in the pathogenesis of vitamin-D-deficiency rickets in Kuwait.

Three Arab children with neonatal brucellosis are described. The first presented with late neonatal hyperbilirubinaemia, the second with a septicoemia-like picture and the third was born prematurely and presented with respiratory distress. The diagnosis of brucellosis was based on a positive blood culture and on a high or rising titre of antibodies to the Brucella organism. All the three neonates responded well to antibiotic therapy as monitored by a Brucella titre of less than 1:40 and a negative blood culture 10 weeks after the onset of therapy. The three mothers had Brucella infections during pregnancy and the Brucella agglutination titre of the breast milk was high. No Brucella microorganism was isolated from the breast milk. The mode of transmission of brucellosis in neonates is discussed.

Congenital chloride diarrhoea was diagnosed in 16 Kuwaiti children over a 7 year period (1980-1986) with an estimated incidence of 7.6 per 100,000 live births. The mean age at diagnosis was 3.2 months (range 1 week to 5 months). There were 9 boys and 7 girls with a mean age of 3 years 10 months (range 10 months to 7 years). All children had a shortened gestational period, abdominal distension and chronic diarrhoea. The serum electrolytes in all patients prior to treatment showed hyponatraemia, hypokalaemia, hypochloraemia and metabolic alkalosis. The diagnosis was confirmed by a stool chloride content that exceeded the sum of faecal sodium and potassium. Fifteen patients survived and showed catch-up growth with adequate replacement therapy and 1 died with renal failure.

during which a total of 77,497 cases were recorded (41,594 [53.7%] males; 35,903 [46.3%] females). Kuwaiti children represented 40,738 (52.5%) of the total. Children aged 2 to 5 years constituted 22,805 (29.4%) of the cases, and the age group 1 month to 1 year comprised the second largest group (15,475; 19.9%). Admissions peaked in February (8,425 [10.8%]) and Friday was the busiest day (13,561 [17.5%]). There were 61,242 (79.02%) self-referrals. Respiratory diseases were the most common reason for emergency room visits, and totaled 51,583 (66.5%), followed by gastroenteritis with 19,898 (25.7%). This study points up an alarming increase in the number of visits to the casualty clinics of Farwania Hospital. If this increase continues, this will not only markedly increase the burden to staff but will also adversely affect the quality of services.QA Al-Saleh, QA Al-Saleh, HA Qurtom, MM Lubani, TS Al-Shab, MM A-Rasool, SFAl-Derahl, Trends in Pediatric Casualties in A Regional Hospital of Kuwait. 1991; 11(2): 171-174 Over the past few years, there has been an increase in the number of patients attending the casualty clinic of the Paediatric Department of Farwania Regional Hospital. A high percentage of these patients have required primary care and not emergency medicine, a finding reported by other centers [1][2][3][4][5][6][7]. A lack of information regarding the users of emergency departments in England was stressed by the Korner Working Party [8] and a similar lack exists for Kuwait.This study aims at a statistical analysis of emergency services, and the following parameters were considered: the number of attenders, types of illness, peak hours of use, and the possible misuse of the pediatric casualty services. To the best of our knowledge, no similar study has been done in Kuwait. MethodsFarwania Hospital is a regional hospital serving a total population of 426,319. Its bed capacity is 520, of which 150 beds are allocated for pediatric use. There are local referring polyclinics that provide complete primary medical care from 7:30 AM until midnight. The policy of the hospital is to examine all patients, with or without referral. Five physicians staff the casualty services around the clock.The present study was conducted 1 July 1987 to 30 June 1988. The information obtained for all patients consisted of: age, sex, nationality, day of week and hour of attendance, referral versus non-referral, casualty diagnosis, diagnostic tests, and whether the patient was admitted. ResultsA total of 77,497 cases were recorded, and consisted of 41,594 (53.6%) males and 35,903 (46.4%) females (male to female ratio, 1.16:1). The males outnumbered the females in all age groups. Kuwaiti children represented 40,738 (52.5%) and children of all other nationalities constituted 36,759 (47.5%). Figure 1 shows the age distribution. There were 22,805 (29.4%) children (aged 2-6 years), and these represented the largest group of patients, followed by the age group 1 month to 1 year (15,475 [19.9%]). Figure 2 illustrates the pattern of the t...