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Summary:The present autopsy study has revealed that infection, contributing to 47 percent of the deaths, was the leading cause of child hood mortality from early neonatal period through school age period, with the highest incidence of 40 percent in the pre-school age period. The six leading infections, in descending order of frequency included pneumonia, meningitis, tuber culosis, measles, malaria and neonatal tetanus. Other common causes of mortality in the series included asphyxia in 11.0 percent, congenital malformations in 10.4 percent and malignancies in 8.7 percent of the total deaths. While preventable conditions generally, including infections, birth asphyxia, malnutrition, birth injuries and accidents accounted for 66.4 percent of the deaths, neonatal problems of asphyxia, birth injury and low birthweight contributed to 18.0 percent of the mortality. On the basis of the present findings, it is suggested that in order to reduce childhood mortality to acceptably low levels, improvement in obstetric and perinatal services in our institution should be undertaken. Furthermore, health education to parents, immunizations and economic improvement of parental status, should he carried out to prevent infections, malnutrition and accidents.

Summary:. Clinical and pathological features in 23 children who developed acute renal failure from what was subsequently proven to be diethylene glycol poisoning are presented. Symptoms of cases included anuria, fever, diarrhoea and vomiting. Eighteen (78.3%) had hepatomegaly, 11 (47.8%) had evidence of respiratory dis tress and 7 (30.4%) had acidotic breathing. Seven (30.4%) of the children were dehydrated on physical examination. Alteration in the level of consciousness was observed in 13 (56.5%) children. The major biochemical abnormalities were acidosis and elevated blood urea nitrogen. Although serum bilirubin was normal in those in whom it was determined, the liver enzymes were elevated in the 2 patients in whom they were determined. Patients were treated as for acute renal failure of renal origin and four children had peritoneal dialysis. Twenty-two (95.6%) of the patients died and outcome was unknown in the remaining patient who was dis charged against medical advice. Autopsies in 7 patients revealed a characteristic nephrotoxic acute tubular necrosis and centrilo bular hepatic necrosis characterized by vacuolar and ballooning degeneration of the metabolically active renal tubular cells and hepatocytes.