The Spectrum of Renal Osteodystrophy: A Clinical, Biochemical, Radiological and Histopathological Study

The chief mineral source of Jammu province is bauxite, an aluminium ore, so a possibility of water being heavily polluted with aluminium is prevalent. Hence, in an effort to relate this regional geographical aspect with aluminium bone disease (ABD) in chronic renal failure (CRF), 50 cases of CRF were prospectively evaluated. Patients were subjected to a thorough history and clinical examination. Biochemical parameters along with raiological skeletal survey and iliac crest bone biopsies were undertaken. Sixty-eight per cent of CRF patients were also consuming aluminium containing phosphate binders (ACPB) at that time. The study revealed an occurrence of ABD in 10% of CRF patients. It was found predominantly superimposed upon osteomalacia (8%) and mixed osteodystrophy (2%). Superimposed ABD on osteomalacia was found more frequently in pre-dialysis (10.8%) than after haemodialysis group (7.69%). Moreover, the incidence of ABD superimposed on osteomalacia and mixed osteodystrophy was higher in the ACPB group (14.7%) than the post-haemodialysis group (7.69%). Correlating, the pre-dialysis, post-haemodialysis and ACPB ingestion status of CRF patients on one hand and histologically proven ABD on the other, it was deduced that the majority of cases of CRF having ABD was seen in ACPB ingestion group (14.7%) followed by pre-dialysis (10.8%) and post-haemodialysis (7.69%) groups. Thus it was concluded that in the present work, ACPB ingestion was the major source of aluminium deposition in bones of patients with CRF rather than the water used in dialysis or possible pollution of drinking water with aluminium in our province.

Empowering young girls for health and development.

Yuvati Vikas Kendra (YVK) model of empowering young girls in the age bracket of 7-19 years could raise the level of awareness and generate self-esteem and self-confidence in over 50% of young girls over a period of six months of operation. The YVK model was utilised by 37-55% of enrolled girls in different age brackets; thus these centres functioned well below their installed capacity. Functional inter-sectoral linkages have to be developed for better impact and better coverage. Data based information from other models of empowerment such as schools, non-formal system of education and Integrated Child Development Services Scheme, is called for to choose different alternatives for our country, as no uniform system can succeed in this vast country. Diversified modes and approaches for empowerment of young girls are needed.