Agha Shabbir, Abid Ali Qureshi, Mehfooz Ur Rehman, Javaid Iqbal, Asim Mumtaz, Mumtaz Jabeen Babar, Sajid Maqbool.
Fluorosis in a suburb of Lahore (A report).
Pak J Pathol Jan ;12(3):139-43.

Few cases of bone deformity (fluorosis) were reported from a village. 25 km from Lahore in June 2000. Survey of the area identified 174 children with deformity of similar nature in four villages Their ages ranged between 2 5 to 18 years with equal sex distribution Onset of disease was with pains & aches especially in lower limbs followed by deformity of limbs Genu valgum (63%) was the commonest deformity followed by anterior bowing of tibia (25%) stiffness of points and spine (9%) and genu varum (3%) Chocolate colour staining & pitting of teeth was a universal finding Fifteen percent children were hypo calcemic, most of these had severe bone deformity Alkaline phosphtase was high in 100% cases Radiologically osteosclerois & coarse trabecular pattern was seen in mild to moderate cases while growth arrest lines bone in bone pattern and calcification a tendinous insertions were findings in moderate to severe cases Fluoride content from various sources of drinking water was as high as 29 PPM (WHO recommendation for safe drinking water is 0.6 PPM). Children with mild to moderae deformity were given physiotherapy and gait training while severe deformities were treated surgically Facility of safe water from deeper subsoil has now been provided to two villages.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals -