The primary objective of the study was to examine the relationship between generic and disease-specific HRQOL scores and metabolic control in children with Type 1 Diabetes Mellitus (T1DM). This cross-sectional study included 65 consecutive children between ages 5 and 18 years with T1DM. According to their values of glycosylated hemoglobin (HbA(1C)), the children were assigned to one of two groups. In Group 1 (N = 21) were the children with HbA(1C) values < 8% (good to moderate metabolic control) and Group 2 (N = 44) were children with > 8% (poor metabolic control). To evaluate generic and disease-specific HRQOL scores in children with T1DM in relation to metabolic control, we used the PedsQL 4.0 Generic Core Scales and the PedsQL 3.0 Diabetes Module. The patients in Group 1, by pediatric patient self-report and parent proxy-report, had statistically better disease-specific HRQOL scores on the diabetes symptoms, treatment barriers, treatment adherence and worry domains in comparison with Group 2. We also found significant correlations between the total generic HRQOL scores and HbA(1C) for both parent proxy-reports' Spearman's coefficient of rank correlation rho = -0.257; p = 0.0412 and pediatric patients' Spearman's coefficient of rank correlation rho = -0.269; p = 0.0313. The current findings suggest that poor glycemic control in children with T1DM is associated with lower generic and disease-specific HRQOL scores in developing and transitional countries.

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Objective – The study was undertaken in order to assess on the basis of the opinions of high school teachers if the conditions exist in their schools to provide adequate assistance to pupils suffering from type 1 diabetes mellitus in a state of hypoglycaemia.  Subjects and Methods – 74 teachers from 35 different schools were surveyed by means of a cross-sectional study. According to whether the school was attended by a pupil suffering from T1DM, the teachers were divided into two groups: group 1 (schools with a pupil suffering from T1DN; n=7) and group 2 (schools without any pupils suffering from T1DM; n=47).  Results – Most of the teachers knew what hypoglycaemia is, and there was no statistically significant difference between the two groups in this regard (p=0.718). There were more negative answers in both groups (p=00.001 and p<0.001) to the question: “Does the school have written instructions on how to treat hypoglycaemia?” In the first group the question: “Can a pupil measure his/her blood sugar levels during lesson time?” received more positive replies (p=0.013), whilst in the second group the difference between the replies was not statistically significant (p=0.144). In response to the question “Does the school have drinks or food available to treat hypoglycaemia?” there were more negative answers in both groups (p<0.001 and p<0.001). To the question: “Can a child suffering from diabetes eat food or have a drink during lesson time?” there were more positive answers in both groups (p<0.001, and p<0.001). In response to the question: “Does the school have people who know how to give an injection of glucagon?” there were more negative answers in both groups (p=0.003, and p<0.001). There were no statistically significant differences between the groups in terms of the answers given. The main reasons for insufficient care for pupils suffering from T1DM whilst in school were seen by 40.5% of teachers as a lack of attention given to the problems of these pupils and the lack of education of teaching staff about T1DM.  Conclusion – The results obtained indicate that the conditions are not met in our schools to provide appropriate assistance to children suffering from T1DM in a state of hypoglycaemia.

Objective – The purpose of this study was to determine median age at menarche in the Federation of Bosnia and Herzegovina (FB&H) and to estimate the distribution of age at menarche for FB&H girls.  Subjects and methods – A cross-sectional study was conducted from September 2002 to May 2003 in all Cantons of the FB&H. The random stratified sample included 19,803 girls aged 9.0 to 17.5 years. Data were collected using the status quo method. Probit analysis was used to estimate median age at menarche and 95% confidence intervals.  Results – The median age at menarche for all FBiH girls is 13.02 years (12.99-13.05, 95% CI). Three percent of all girls start to menstruate before 11.04 years of age (10.98-11.09, 95% CI), and 97% of all girls are menstruating by 15.37 years of age (15.29-15.44, 95% CI). This distribution of ages indicated that ~95% of FB&H girls start to menstruate between 11.04 and 15.37 years of age. The median age at menarche throughout FB&H varied in a range of only six months, from 12.85 in Canton Sarajevo to 13.34 in Canton West Herzegovina. Girls from three Cantons - Canton Sarajevo, Posavina and Una Sana reached menarche significantly earlier than those from other Cantons.  Conclusion – This study enabled the FB&H and each Canton to have standards of age at menarche expressed in percentiles. As no previous information was available about the age at menarche in FB&H, the present results will afford a basis for future studies which should aim at analysing the trend and tempo of secular changes in age at menarche. Â

Background Iodine is necessary for the synthesis of thyroid hormones, which play a decisive role in the development of the brain during fetal and early postnatal life. Objective To evaluate whether prophylaxis with 20 to 30 mg of iodine per kilogram of salt is enough to ensure optimal iodine nutrition during pregnancy in an iodinesufficient area. Methods A cross-sectional study of pregnant women was conducted in 2007. The urinary iodine concentration (UIC) was measured in 300 randomly selected women in Tuzla, Bosnia, and Herzegovina, in all three trimesters of pregnancy. Results The median UIC of the pregnant women was 142 μg/L, ranging from 27 to 1,080 μg/L. The median UIC of the pregnant women in each trimester of pregnancy who were not restricting their salt intake was consistent with adequate iodine nutrition, as defined by the World Health Organization Technical Consultation, whereas the median UIC of women who were restricting their salt intake was insufficient. Conclusions Pregnant women in the urban area of Tuzla had adequate iodine status except for those with restricted salt intake, which presents an increased risk to the mother as well to as the unborn child. Women in the rural area of Tuzla were found to be iodine-deficient, regardless of whether they had restricted their salt intake or not. However, for those pregnant women who have been advised to restrict their salt intake and who thus face the risk of iodine deficiency, the use of salt with higher concentrations of iodine could be advised.

Monitoring the growth and development of children is the main task of preventive programs of pediatric health care. This is the best and simplest way of establishing the state of health of the child population, and at the same time, in the case of growth disorders, to make possible the timely application of possible preventive measures. For each child with short or tall stature in primary health care a detailed medical history should be taken, a physical examination undertaken using anthropological standards, assessment of bone maturation, calculation of genetic potential and basic laboratory tests. If there is a suspicion of normal variants of either short or tall stature, in order to establish a definite diagnosis the patient should be referred to a pediatric endocrinologist. Insofar as this suspicion is confirmed, the patient and his/her parents should be acquainted with the nature of the disorder and given information on attaining the definitive height of the child. The growth of these children should be monitored up to the end of growth at least once a year. In patients whose body height is below the 3rd percentile, or above the 95th percentile, after excluding normal forms of short or tall stature, attention should be turned to discovering the pathological causes of short or tall stature. The examination of these children may be long, complex and expensive, but its needs to be done in stages, mainly in a specialized institution.

BACKGROUND Neonatal TSH screening has as its main goal the early detection and treatment of permanent sporadic congenital hypothyroidism. At the same time neonatal TSH is one of the indicators for monitoring progress towards eliminating iodine deficiency disorders (IDD). AIM To evaluate the usefulness of neonatal TSH screening data as a monitoring tool for IDD evaluation and control in Bosnia and Herzegovina. INFANTS AND METHODS The study included a total of 8,105 newborns. Neonatal TSH was measured in whole blood drawn between day 3 and day 5 of life, spotted on filter paper using a sensitive fluorometric assay (Delfia). RESULTS Levels above 5 mIU/l were found in 282 (5.5%) neonates. Median TSH values and the percentage of samples of neonatal TSH above 5 mIU/l were significantly higher in neonates who were born by Caesarean section (6.4%) compared with neonates born by vaginal delivery (1.4%). CONCLUSION Our findings suggest that neonatal TSH should not be used as a monitoring tool for IDD evaluation and control if iodinated skin disinfectant is used on a large part of the mother's skin in maternity hospitals.

AIM To evaluate the influence of topical iodine-containing antiseptics on neonatal TSH in full-term infants born by Caesarean section in an iodine sufficient area. POPULATION AND METHODS Urinary iodide excretion (UIE) was estimated in 86 mothers on the second day after delivery by Caesarean section and their 86 full-term neonates. The mothers were divided into two groups according to the use of antiseptic to prepare Cesarean sections: 42 mothers who were prepared with povidone-iodine (Isosept, Bosnalijek) comprised the study group, and 47 mothers who were prepared with alcoholic solution (Skinsept color, Ecolab) formed the control group. Neonatal TSH was measured in whole blood drawn between day 3 and 5 of life, spotted on filter paper using a sensitive fluorometric assay (Delfia). RESULTS Maternal and neonatal UIE were significantly higher (p < 0.05) in the study group compared to the control group. No significant difference was found for neonatal TSH. CONCLUSION Our data suggest that perinatal iodine exposure of full-term neonates who were born by Caesarean section in an iodine sufficient area did not influence neonatal TSH, although median UIE was higher, suggesting optimal iodine intake during pregnancy. Further research is needed to define a critical value of urinary iodine concentrations in full-term neonates in an iodine sufficient area that may lead to the impairment of thyroid function.