PRESENTATION OF OSTEOMALACIA IN KOHISTANI WOMEN
AbstractBackground: Osteomalacia is a common diagnosis in the Kohistani women presenting with aches and pains. This study was conducted to assess calcium and Phosphate levels in Kohistani women with osteomalacia. Methods: 50 diagnosed cases of Osteomalacia selected from amongst the women presenting with body aches were included in the study. History regarding age, marital status, parity, dietary habits, socioeconomic status etc was taken. Results: The median age was 23 years. 74% were married. Most of the women had 5 children (mode). Nine (18%) patients had hypocalcaemia, 10 (20%) had hypophoshatemia. Alkaline phosphatase was elevated in 13 patients (26%). Six (12%) patients were pregnant at the time. 74 % of patients belonged to the poor class. 70% of the patients drank less than 1 cup of milk per day. Body aches (100%), waddling gait (14%), proximal myopathy (12%), bone tenderness (6%) and carpopedal spasm (8%). Conclusions: We therefore conclude that in comparison with other parts of the world where individual risk factors cause osteomalacia, Kohistani population has a higher frequency of osteomalacia due to aggregation of three major factors namely lack of sunlight due to geographical location, excessive clothing blocking available sunlight and nutritional deficiency.Keywords: Osteomalacia, Body aches, Serum Calcium, Serum Phosphate, Alkaline Phosphate
Binet A; Kooh SW. Persistence of Vitamin D-deficiency rickets in Toronto in the 1990s. Can J Public Health. 1996 Jul-Aug; 87 (4): 227-30.
Woitge HW; Scheidt Nave C; Kissling C et al. Seasonal variation of biochemical indexes of bone turnover. J Clin Endocrinol Metab. 1998 Jan; 83 (1): 68-75.
Abd-el-Fattah M, Gabrial GN, Shalaby SM, Morcos SR. An epidemiological and biochemical study on osteomalacia among pregnant women in Egypt. Z Ernahrungswiss. 1978 Sep;17(3):140-4.
Schnitzler CM, Solomon L. Osteomalacia in elderly White South African women with fractures of the femoral neck. S Afr Med J 1983;64(14):527-30.
Gullu S, Erdogan MF, Uysal AR, Baskal N, Kamel AN, Erdogan G.A potential risk for osteomalacia due to sociocultural lifestyle in Turkish women. Endocr J 1998 Oct;45(5):675-8.
Rab SM. Occult osteomalacia amongst healthy and pregnant women in Pakistan. Lancet. 1976 Dec 4;2(7997):1211-3.
Lowenthal MN, Shany S. Osteomalacia in Bedouin women of the Negev. Isr J Med Sci. 1994 Jul;30(7):520-3.
Thomas MK; Lloyd Jones DM; Thadani RI; Shaw AC. Hypovitaminosis D in medical inpatients. N Engl J Med. 1998 Mar 19; 338 (12): 777-83.
Hoshino H; Kushida k; Takahashi M; Kawana K; Denda M; Yamazaki K; Inoue T. Characteristics of Biochemical Markers in patients with metabolic bone disorders. Endocr Res. 1998 Feb: 24 (1): 55-64.