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The objective of the present study was to determine median age at menarche and the influence of familial instability on maturation. The sample included 7047 girls between the ages of 9 and 17 years from Tuzla Canton. The girls were divided into two groups. Group A (N=5230) comprised girls who lived in families free of strong traumatic events. Group B (N=1817) included girls whose family dysfunction exposed them to prolonged distress. Probit analysis was performed to estimate mean menarcheal age using the Probit procedure of SAS package. The mean menarcheal age calculated by probit analysis for all the girls studied was 13.07 years. In girls from dysfunctional families a very clear shift toward earlier maturation was observed. The mean age at menarche for group B was 13.0 years, which was significantly lower that that for group A, 13.11 years (t=2.92, P<0.01). The results surveyed here lead to the conclusion that girls from dysfunctional families mature not later but even earlier than girls from normal families. This supports the hypothesis that stressful childhood life events accelerate maturation of girls.

In the paper it was identified firstly the short stature, then importance of anamnesis, physical examination, anthropometric measurements and calculated parameters of growth. Then followed the classification of causes for short stature with a specific review on differentiation of normal from pathologic variants. Further in the text it was pointed out the importance of observing normal variants of short stature since between 84% and 87% children are with height under the 3rd percentile. Then followed tables showing pathologic causes of the short stature, and then diagnostic and therapeutic approach to the child with proportionately short stature and short stature associated with dysmorphic features.

In the paper it was identified firstly the short stature, then importance of anamnesis, physical examination, anthropometric measurements and calculated parameters of growth. Then followed the classification of causes for short stature with a specific review on differentiation of normal from pathologic variants. Further in the text it was pointed out the importance of observing normal variants of short stature since between 84% and 87% children are with height under the 3rd percentile. Then followed tables showing pathologic causes of the short stature, and then diagnostic and therapeutic approach to the child with proportionately short stature and short stature associated with dysmorphic features.

Goiter frequency and urinary iodine excretion levels were assessed in schoolchildren, aged 7-15 years, living in Tuzla Canton. Goiter frequency was evaluated by clinical examination and ultrasound of the thyroid gland. Goiter by inspection and palpation was found in 19.1% of all subjects, in 19.8% of girls and 18.4% of boys. With regard to updated reference values for thyroid volume reported by WHO and ICCIDD, goiter by ultrasonography was found in 12.9% (n = 62) of all subjects (n = 480). Median urinary iodine was 71.0 micrograms/L. Mild iodine deficiency is observed in Tuzla Canton, based on goiter frequency and urinary iodine excretion. Neonatal TSH results, obtained in the programme of the neonatal thyroid screening, were also analyzed. The frequency of neonatal TSH above 5 mU/L was 12.0% indicating, as two other indicators, mild degree of iodine deficiency in this region. The results underline the inefficacy of iodine prophylaxis with 10 mg K1 per kg of salt in correcting iodine deficiency. On the basis of the study, carried out in the rest of the Federation of Bosnia and Herzegovina, the new regulation was proclaimed in 2001 requiring 20-30 mg of iodine per kg of salt.

H. Tahirovič, A. Toromanović, N. Hadzibegić, D. Stimljanin, R. Konjević, Z. Budimić, H. Cengić, Ž. Rončević et al.

Abstract Assessment of the status of iodine prophylaxis was studied in 5,523 schoolchildren randomly selected in all cantons in Bosnia and Herzegovina Federation (BHF). According to the iodine content of household salt samples, all cantons of BHF were divided into two groups: Group A: 95.5% of the salt used is produced in the Tuzla plant, in which the salt is iodized at 5-15 mg Kl/kg salt, and 4.5% of the salt used is produced in the Pag plant, in which the salt is iodized at 20-30 mg Kl/kg of salt, and Group B: 19.9% of the salt used is produced in the Tuzla plant and 80.1% in the Pag plant. In Group A the amount of iodine in salt was significantly lower than in Group B (11.4 mg/kg vs 18.9 mg/kg, P <0.001). In Group A the prevalence of goiter was significantly higher than in Group B (32.6% vs 19.7%, P <0.001). The highest prevalence of goiter was in Bosnian Podrinje Canton (51.2%) and Central Bosnian Canton (42.6%) while the lowest was in West Herzegovina Canton (12.9%). Significantly higher concentrations of urinary iodine were found in Group B than in Group A (82.6 μg/1 vs 75.2 μg/1, P <0.001). In Group A the percentage of urine samples below 50 μg/1 iodine was significantly higher than in Group B (35.6% vs 26.9%, P <0.001), but there was no difference in the percentage of urine samples with iodine values less than 100 μg/1 (70.7 μg/1 vs 68.25 μg/1, P >0.05). We conclude that FBH is an iodine deficient area and that the improvement of iodine prophylaxis is urgently required, primarily by increasing salt iodine content to 20-30 mg/kg, in order to eradicate endemic goiter.

H. Tahirovič, A. Toromanović, N. Hadzibegić, D. Stimljanin, Z. Budimić, H. Cengić, Ž. Rončević, E. Denjo et al.

Iodine deficiency which causes the wide spectrum of disorders for all ages, is one of the significant public health problem worldwide. From the ancient times different iodine deficiency disorders were noticed in Bosnia and Herzegovina and in its some areas the goiter existed in endemic form. These facts confirm that its soil bas been iodine deficient and that necessity for iodine prophylaxis is obvious on its territory. The study was based on 5,523 children, of both sex boys and girls school age from 7 to 14 years, randomly selected with the equal participate subjects in relation to the age. The sample is representative and it has been assessed based on: total number of school children aged from 7 to 14 years, anticipated prevalence of goiter 5% level of probability 95%, relative punctuality 30% and the factor called "design effect" which is 3. The study was carried out in whole ten cantons in the schools with equal representation among cities and villages. In examining of prevalence of giter we used inspection and palpation. Determination of iodine concentration in urine was carried out by the method is based on Sandel-kolthof's reaction. The technique used for determination of concentration of iodine in salt was iodinemetric titration. The prevalence of goiter was 27.6% in Federation of Bosnia and Heryegovina. The highest prevalence of goiter was in Bosnia Podrinje Canton (51.20%) while the lowest was in West Herzegovina Canton (12.90%). The urinary iodine excretion in investigated children varied from 1 to 208 *mg/L with median of 77.6 *mg/L. Iodine contetn in household salt samples was from 3 to 29.8 mg/kg, range 14.4 + 5.9 mg/kg. The results of our study show the persistence of mild to moderate iodine deficiency in Bosnia and Herzegovine Federation. Therefore according to the recommendations of the World Health Organisation, UNICEF and International Council for Control of Iodine Deficiency Disorders, the salt for human, and animal consumption as well as for food industry which is consuming on its teritory, has to be iodinated on the place of its production without looking back whether or not it is produced or imported in Bosnia and Herzegovina Federation, lodination has to be performed with 20 to 30 mg KI per one kg of salt, thereby an average the iodine content has to be 25 mg per kg. In this way it will be prevented the wide spectrum of disorders, which we often are not aware for that its are caused by iodine deficiency. In addition it will be prevented many very important socioeconomical consequences of iodine deficiency.

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