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Aim -- To describe 21 cases of symptomatic rickets in adolescents. Methods -- The setting was a primary and secondary care hospital in Saudi Arabia providing medical care to Saudi Arab company employees and their families. Cases of symptomatic rickets diagnosed between January 1996 and December 1997 in adolescents aged 10 to 15 years were assessed with respect to clinical presentation, biochemical and radiological evaluation, dietary assessment, and estimation of sun exposure. Results-Symptomatic rickets developed in 21 adolescents (20 females), with a prevalence rate of 68 per 100 000 children years. Presentation included carpopedal spasms (n = 12), diffuse limb pains (n = 6), lower limbs deformities (n = 2), and generalised weakness (n = 1). Bio- chemical findings included hypocalcaemia (n = 19), hypophosphoraemia (n = 9), raised serum alkaline phosphatase (n = 21) and parathormone (n = 7), and reduced 25-hydroxyvitamin D concentrations (n = 7). Radiological studies were suggestive of rickets in only eight children. All children had an inadequate dietary calcium and vitamin D intake. All but one had less than 60 minutes sun exposure per day. Conclusion-Even in sunny climates, adolescents, especially females, can be at risk of rickets. Hypocalcaemic tetany and limb pains were the most common presenting symptoms. Radiological evidence was not present in every case. [ABSTRACT FROM AUTHOR]

Abstract: Aim: Study of the clinical presentation and laboratory data of type 1 diabetes in the Eastern Province of Saudi Arabia. Methods: The medical records of all affected children during the period 1986–1997 were reviewed for the analysis of clinical and laboratory data. Results: Type 1 diabetes was diagnosed in 46 children, 27 girls and 19 boys, with a mean age at diagnosis of 9.0 yr. The mean duration of symptoms prior to diagnosis was 12.5 d. Depressed consciousness occurred in 10.8% of the patients (none was comatose) and ketoacidosis in 77%. There was no episode of increased intracranial pressure during treatment, nor was there any death. There was a correlation between the central nervous system depression and the degree of hyperglycemia, and also with the severity of acidosis. Conclusions: Although more than three quarters of patients with type 1 diabetes had ketoacidosis on presentation, none was comatose or developed clinical cerebral edema during treatment. The presentation of type 1 diabetes in children from Saudi Arabia seems to differ from reports from developed countries. [ABSTRACT FROM AUTHOR]