Incidence of type 1 diabetes mellitus in children in Tuzla Canton between 1995 and 2004.
Explore the source record for details and available documents.
Adolescent↗
Biomedical subjects
Alma Toromanović
Publications and source records attributed to Alma Toromanović.
[How much can school staff help children with diabetes type 1 in school?].
PURPOSE: The aim of the study was to estimate, according to parents and their children with diabetes, how far school personnel have an understanding of diabetes and is trained to provide appropriate treatment of diabetes emergencies. WORK METHOD: The study included 37 children and adolescents with diabetes type 1 (17 girls and 20 boys) from 31 schools in the Canton of Tuzla, aged 7-18 years. A descriptive research method was used in the study and for data gathering a closed type survey was used. RESULTS: Only 13 or 35.3 % of the 37 surveyed parents were satisfied with the care of their child with diabetes at school, while 24 or 64.7 % parents expressed dissatisfaction with it. According to the parents' statements, class teachers are 100 % informed about the existence of students with diabetes type 1 at their schools, while PE teachers (97.9 %) and the headmasters of the schools (81.1 %) are less well-informed. Regarding the question about whether the school personnel is trained for diabetes-related tasks, the parents answered YES in 25.7 % cases; 54.3 % of them answered NO, and 20 % of them answered DON'T KNOW. However, only 35.2 % of parents found that some of the employees at the school are trained to recognize the symptoms of hypoglycemia while the number of positive answers concerning treatment of hypoglycemia (18.9 %) or glucagon administration (13.5 %) was much lower. The answer to the question: "Is blood glucose testing allowed in the classroom?" in 91.5 % cases was YES, 5.7 % NO and in 2.8 % of cases was DON'T KNOW. CONCLUSION: The results of our survey show that children with diabetes do not have appropriate diabetes care in school.
Adolescent↗
Clinical presentation of primary congenital hypothyroidism: experience before mass screening.
Primary congenital hypothyroidism is a common preventable cause of mental retardation. Neonatal thyroid screening is highly successful in early diagnosis and the improvement of developmental prognosis in the hypothyroid neonate. However, rarely cases could be missed, so doctors must be aware of the earl symptoms and signs of hypothyroidism. Therefore, the purpose of this study was to emphasize the presenting clinical features of primary congenital hypothyroidism at the age of diagnosis. The study population included 17 children with primary congenital hypothyroidism who attended the Department of Pediatrics, University Clinical Center Tuzla between 1986 and 1999. The diagnosis of all patients was confirmed by serum thyroid function tests (T4 and TSH). Of the 17 patients 10 (58.8%) were diagnosed in the first three months of life and 3 of them (17.6%) between fourth and sixth month of life. Four children (23.5%) were diagnosed after the age of six months. In the first three months of life hypothermia, constipation, jaundice, poor feeding, hoarse cry, macroglossia and hypoactivity were the moste common symptoms. Among the 17 patients with primary congenital hypothyroidism 5 of them (29.4 %) were diagnosed to have disgenetic thyroid tissue and 12 (70.6%) as having dyshormonogenesis. TSH and T4 levels were higher in patients in whom thyroid tissue was dysgenetic as comapared with those with dyshormonogenesis but the difference was not statistically significant (p > 0.05). Now it is expected that neonatal screening program in Bosnia and Herzegovina Federation will contribute to the detection of primary congenital hypothyroidism in early days of life. However, until an effective screening test is not yet routine in whole country, paediatricians should consider the diagnosis of hypothyroidism whenever it is clinically suggested.
Congenital Hypothyroidism↗
Thyroid volume measurement by ultrasound in schoolchildren from mildly iodine-deficient area.
Thyroid size was estimated by ultrasound and physical examination in 480 schoolchildren (238 boys and 242 girls), 7-14 years old, living in Tuzla Canton. By physical examination goiter was found in 13.5% (n=65) of subjects. When compared with the upper limits of the reference thyroid volumes reported by WHO and ICCIDD, goiter by ultrasonography was found in 12.9% (n=62) of all subjects. All goitrous children had a diffuse goiter. The differences in mean thyroid volumes between groups with and without goiter detected by physical examination were significant in all age groups (p<0.05). The results of ultrasound examinations correlate well with palpatory findings and show higher values for the thyroid volume in children with goiter. It generally confirms the values of the findings by palpation, even in areas with mild iodine deficiency.
Adolescent↗
Menarcheal age of girls from dysfunctional families.
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.
Adolescent↗
[Short stature].
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.
Body Height↗
[Occurrence of goiter, urinary iodine excretion and TSH in neonates in the Tuzla Canton].
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.
Adolescent↗