Introduction: Anemia in preterm infants is the pathophysiological process with greater and more rapid decline in hemoglobin compared to the physiological anemia in infants. There is a need for transfusions and administration of human recombinant erythropoietin. Aim: To determine the frequency of anemia in premature infants at the Pediatric Clinic, University Clinical Center Sarajevo, as well as parameter values in the blood count of premature infants and to explore a relationship between blood transfusions with the advent of intraventricular hemorrhage (determine treatment outcome in preterm infants). Patients and methods: Research is retrospective study and it included the period of six months in year 2014. Research included 100 patients, gestational age < 37 weeks (premature infants). Data were collected by examining the medical records of patients at the Pediatric Clinic, UCCS. Results: The first group of patients were premature infants of gestational age ≤ 32 weeks (62/100) and the second group were premature infants of gestational age 33-37 weeks (38/100). Among the patients, 5% were boys and 46% girls. There was significant difference in birth weight and APGAR score among the groups. In the first group, there were 27.42% of deaths, while in the second group, there were only 10.53% of deaths. There was a significant difference in the length of treatment. There was a statistically significant difference in the need for transfusion among the groups. 18 patients in the first group required a transfusion, while in the second group only 3 patients. Conclusions: Preterm infants of gestational age ≤ 32 weeks are likely candidates for blood transfusion during treatment. Preterm infants of gestational age ≤ 32 weeks have the risk of intracranial bleeding associated with the application of blood transfusion in the first week of life.

Introduction: Malignancies in children are second most frequent cause of death after accidents in pediatric age, while leukemias represents 30% of all malignancies of children age. Aim: To present the social and demographic characteristics of patients with a diagnosis of leukemia in Bosnia and Herzegovina during six years period. Patients and Methods: The study included 97 patients (from birth to 18 years old) with diagnosis of acute leukemia. Results: During the aforementioned period at the Pediatric Clinic of University Clinical Centre Sarajevo, 244 patients with the diagnosis of malignancy were treated (99 children were with leukemia (40.6%). Acute leukemia’s were diagnosed in 97 patients and chronic in 2 patients. Out of 97 treated patients with acute leukemia, they almost of all cantons of Federation of Bosnia and Herzegovina, Brcko District and the Republic Srpska. Patients were usually coming from the Tuzla Canton Federation of Bosnia and Herzegovina (28 patients). Based on the cytomorphological diagnosis of patients according to the FAB classification, the most was a present ALL-L1 type of acute leukemia’s. Mortality of patients with ALL was 15,3%, while mortality of patient with AML was 36,8%. Conclusion: In Bosnia and Herzegovina, during six year period, the largest number of patients with leukaemia came from Tuzla Canton. The most common age of patients was preschool and school ages. Male sex was dominant in patients with diagnosis AML. According to the FAB classification, ALL-L1 type of acute leukemia was the most common.

Diabetes mellitus Type 1 is one of the most common diseases in childhood. Severe, secondary diseases like hypertension or blindness are results of micro- and macrovascular complications caused by insufficient glycaemic control. Especially adolescent patients with type 1 diabetes have a lower adherence rate. The DIADEMA trial proved that community pharmacist in collaboration with diabetologists and diabetes advisors can have a positive impact on the therapy of adolescents with type 1 diabetes. This article highlights and explains which components of the pharmacist intervention caused the preferable adjustments and improved the insulin therapy of the patients.

Introduction: While the influence of type 1 diabetes mellitus (T1DM) on periodontal health is well established, results of previous studies regarding the association of this metabolic disease and caries experience are rather inconsistent. The aim of this study was to assess the differences between caries status of healthy and adolescents with T1DM, as well as to determine the differences in caries experience among diabetic patients in relation to their metabolic control.Methods: Assessment of caries status was performed using the DMFT index (decayed, missing, and filled teeth). The study group (Diabetic) included 60 patients diagnosed with T1DM, aged 12-18 years, from Sarajevo Canton. This group was divided into two sub-groups: a sub-group Diabetic-W consisted of 30 patients with well-controlled glycaemia, while a subgroup Diabetic-P comprised of 30 patients with poorer glycemic control. The control group consisted of 30 age-matched metabolically healthy individuals.Results: The T1DM adolescents had a significantly higher (p < 0.01) mean DMFT score than the healthy subjects, 11.49 and 6.19 respectively. Statistically, the diabetic group had also significantly higher values of the D and M components. Concerning the metabolic control, mean DMFT score in the Diabetic-W subgroup was lower (10.57) than in the Diabetic-P subgroup (12.39), however the difference was not statistically significant.Conclusions: The results demonstrate that the T1DM patients have a higher caries experience, regardless of the degree of metabolic control. The level of untreated dental decay and missing teeth components among the diabetic adolescents indicates irregular dental attendance.

Frequent downloading and analysing data from IP memory especially bolus delivery evaluation are very important for better regulation of T1DM in pediatric patients with IP treatment.. We analyse data from 41 patients (M24/F17), mean age 13,5 years, 15 prepubertal/26 pubertal, mean diabetes duration 7,1± 2,4 years, mean HbA1c 8,9 ±1,3 %., delivered mean 5,4±1,65 boluses daily. Lowest HbA1c (7,6± 1,0 %) was in patients delivered 8-10 boluses daily, and the worst HbA1c (11,1±2,1%) was in patients with 1-3 boluses daily. NS difference was between bolus number (5,6/5,3) in prepubertal and pubertal patients. Only 12 patients (29%) used Bolus Wizard (BW) calculation in everyday pump use, and they had significantly lower HbA1c than non BW users (8,22/8,99 %, p < 0,05). Patients who delivered more insulin of total daily insulin intake in bolus form had significantly lower HbA1c level (p<0, 05). There was no significant difference in correlation of number of delivered boluses and diabetes duration, and with duration of insulin pump treatment. AIMS AND OBJECTIVES

The aims of the study were to estimate the prevalence of excessive weight in infants and school-age children in Sarajevo Canton, to isolate the main causative agents and to propose a strategy for its efficient prevention. The methods included anthropometry and originally designed questionnaire. Calculated body mass index was classified according to the criteria proposed by Centre for Disease Control and Prevention (CDC). The research included 3608 students from elementary and secondary schools from Sarajevo Canton. Nearly 1/5 of subjects had excessive body weight while 12.49% of students were malnourished. Elementary school lower graders had the highest grade of excessive weight, while the secondary school students exhibited the lowest grade of excessive weight. During school hours, about 42.47% of students were fed on bakery produces and snacks. Non-sparkling, thickened juices are frequently consumed beverages (20.65%), second only to water (51.82%). 58.15% of children consume sweets on daily basis. This is even more prominent among secondary school students (80.85%). Only 1/3 of students practice sports on daily basis, while 8.51% of them rarely engage in sports. Elementary school lower grade students had the lowest level of activity while the secondary school students were the most active. As many as 27.56% students spend two hours or more sitting by the computer or TV set. The most significant mediators of excessive weight gain are sedentary life-style, frequent consumption of sweets and thickened juices and unsuitable nutrition during school hours. Continuous preventive and therapeutically activities must be undertaken among as wide population as possible.

In this paper we present study of metabolic control in children suffering from TYPE 1 Diabetes Mellitus (T1DM) who use insulin pump (IP) therapy, and who were treated at Paediatric Clinic in Sarajevo. In retrospective study we followed all T1DM patients with IP therapy introduced in the period from 1st March 2005 to 1st September 2008. We analyzed their age and sex structure, therapy before IP use, and the metabolic control of T1DM represented with glycosylated haemoglobin (HbA1c) value just before and 6 months after IP therapy introducing. The total number of observed patients was 39. There were 24 boys (61,5 %) and 15 girls (38,5 %) with the age range between 12,3 +/- 3,2 years. Most patients were from age group 8-14 years. In the same number of patients 17 (43,6 %) diabetes duration was less than 5 years and 5-10 years. Before IP introduction most patient 61,5 % use therapy with insulin analogues. Mean value of HbA1c before IP therapy introduction was 8,57+/-1,65 % and 6 months after IP therapy introduction HbA1c 7,53 +/- 0,81 % (p = 0,0009). There was significant reduction HbA1c values even 6 month after IP therapy introduced. Therapy with IP in children with diabetes was very efficient in achieving therapeutic goal of T1DM treatment (HbA1c<7,0 %) what will protect patients from appearance and progression of chronic micro vascular complications on eyes, kidneys and peripheral nerves.

AIM To present results of growth hormone (GH) stimulating test by insulin induced hypoglycaemia in the last three years. In the period from from 1992-1999. we could not perform any test for GH measuring because of lack of kits. PATIENT AND METHODS Indications for measuring GH are body height < p3, bone age < p75 of proper for age or growth velocity < 4 cm/yearly. GH measuring test is performed by radioisotope method: results < 7 mlU/1 confirm absolute and 7-15 mIU/l partial GH deficiency. RESULTS During three years' long period GH test was performed in 54 patients: 33 (61%) boys mean age of 11.8 years and in 21 girls (39%) mean age off 9.2 years. 32% of patients were from Canton of Sarajevo, 18.5% from Zenicki and the same percent from Unsko-sanski, 17% from Middle-bosnian Canton, 11% from Hercegovinian and 4% from Tuzlanski Canton. In 80% of patients body height was < p 3.80% of patient had delay in bone age more than 1 year. Results of test in 13 patients confirmed absolute and in 18 patients relative deficiency of GH. Only 4 patients with absolute GH deficiency are under GH therapy. CONCLUSION Introducing GH measuring test again is useful. There is a great number of patients with absolute and relative GH deficiency (57%), so it is necessary to centralize evidention and medicine supply for those children.

The aim of this study is to show positive allergy test od tree pollen, grass pollen and weed pollen in children with season allergic rhinitis. In the study is comprised 335 children, which are tested in Pulmoallergologic out-patient department of Paediatric clinic in Sarajevo in last three years from march 1999 to march 2002 year. In testing was used prick-test with Bencard firm allergen. Criterion for positive reaction was urtica, which appear 20 minutes after testing, with diameter equal or bigger than 3 mm, and erythema was 10 mm. Positive results on tree pollen was in 98 children (29.2%), on grass pollen in 210 children (62.6%), and on weed pollen in 27 children (8.0%). In group of tree pollens Coryllus avellana pollen (Hazel pollen) has the biggest number of positive results in 74 children (75.5%), in group of grass pollens Poa pratensis pollen (Mcadow grass pollen) has biggest number of positive results in 169 children (80.4%) and in group of weed pollens main allergen is Ambrosia clator (Rag weed) in 25 children (92.0%). In therapy of our children we preferred nasal topical corticosteroide Fluticason propionate Flixonase (GlaxoSmithkline) in one daily dose 50 mcg and we had fast and prolonged result in amelioration of symptoms.

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.

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.