References
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A 74-year-old man with double vessel coronary artery disease presented with angina on exertion grade II associated with hypertension. He was a reformed smoker and was leading an active life for his age. He came from Jhunjuna province of Rajasthan, India, which is notorious for a high fluoride content in the drinking water. He gave a history of difficult spinal block for transurethral resection of prostrate, some 10 years earlier, which he recollected as 3–4 ‘pricks’ in his back. On examina
Abstract
Chronic fluorosis is a widespread disease-related to the ingestion of high levels of fluoride through water and food. Prolonged ingestion of fluoride adversely affects the teeth, bones and other organs and alters their anatomy and physiology. Fluoride excess is a risk factor in cardiovascular disease and other major diseases, including hypothyroidism, diabetes and obesity. Although anaesthesiologists may be aware of its skeletal and dental manifestations, other systemic manifesta
1. Introduction
Dental fluorosis and skeletal fluorosis are major public health concerns around the world. Regions with a high prevalence of such illnesses have been recently documented in Asia, particularly in China [1,2,3,4], India [5,6,7,8], Pakistan [9,10,11], and Sri Lanka [12,13,14]. In Africa, dental fluorosis is prevalent mainly in Sub-Saharan countries, including Kenya, Tanzania, Uganda, Ethiopia, Eritrea, Sudan, Ghana, Malawi, Niger, Nigeria, Mozambique, and South Africa [15,16,
The main hypothesis that explains how voriconazole can generate or trigger this periostitis is subacute fluoride toxicity, secondary to the use of the antifungal agent. Voriconazole contains in its structure three fluorine atoms that represent 16.25% of its molecular weight. This means that a dose of 400 mg contains 65 mg of fluorine (6). In addition, 5% is metabolized into free fluorine. The risk of skeletal effects is elevated in patients with fluoride intakes greater than 6 mg/day (7). When p
