Incidence of type 1 diabetes mellitus in children in Tuzla Canton between 1995 and 2004.
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Adolescent↗
Biomedical subjects
Husref Tahirović
Publications and source records attributed to Husref Tahirović.
Down Syndrome and thyroid gland.
Down Syndrome (DS) or trisomy 21 (T21) is the most frequent and the best known malformation syndrome associated with mental deficiency that appears in human,. Average incidence of this syndrome is about 1:700 newborns. Numerous researchers noted thyroid disorders in people with Down Syndrome but, clinical symptoms of thyroid dysfunction are difficult to separate from DS phenotype. The aim of this study was to examine the thyroid function in the patients with DS. Our results confirmed higher frequency of thyroid dysfunction in DS patients. Higher values of TSH were found in 60,34% of the examined DS patients, which is significantly higher value comparing with the control group (p<0,01). Compensated hypothyroidism was established in 27,92% of the examined DS patients, and most of those (63,23%) were younger than 6 years. The conclusions emphasize the necessity of implementation of thyroid function screening program in persons with DS, and the need for adequate treatment of its dysfunction. Thus, the symptoms of the disease would be alleviated and better physical and mental fitness ensured.
Adolescent↗
[Infants feeding practice in first six month in Tuzla canton].
OBJECTIVE: To investigate the infants feeding practice in first six months in Tuzla canton. METHODS: Observations of feeding practices in first six months of infants life, born in Obstetrics and Gynecology Department in Tuzla in period May-September 2004 who weighted more than 2500 gm and over 37 weeks gestation age. Dates were collected by standardized questionnaire mailed to 493 mothers from 13 regions in Tuzla canton. With questionnaire we mailed the explanatory letter with investigations detail. RESULTS: Exclusive breast feeding at first 3 month was very high reaching from 74.4% in 1 month, 62.3% in 2 month and 50.9% in 3 month of life. After third month exclusive breast feeding was decreasing and reached 12% at sixth month. Predominant breast feeding was reaching from 13.2% at first month, 27.6% at fourth month and 20.7% at sixth month. Breast feeding and complementary feeding before six month was very low, 1% in first month reaching 47.7% in sixth month. Bottle feeding rate was 11.4% in first month and 20% in sixth month of infant life. CONCLUSION: Infants feeding practice in first 6 months was inadequate according to WHO recommendation, exclusive breast feeding for first six months. Breast feeding initiation rate was high but lack of mothers support after discharge and many barriers discourage exclusive breast feeding of infants in first six months in Tuzla canton.
Bosnia and Herzegovina↗
[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↗
[Perception of their social environment and their future in institutionalized school-age children].
Family home and institutions for children without parental care represent the rearing-environments where, from the early years, whole human development goes on. It's known today that despite the recognized importance of inborn traits, the influence of child-rearing environments dominates current models of development. The aim of the study was to investigate the satisfaction with the rearing-environment of school-aged institutionalized children, their dominating feeling and if institutionalization affects life optimism for now and for the future. The study was conducted in two institutions in Bosnia and Herzegovina who share the same care model imitating the traditional Bosnian families where the older children care for the younger siblings. We took as a sample 30 institutionalized children aged 8-12, and for the control group 60 children matched by age and sex. Parents, children and teachers who gave their informed consent answered the questionnaires. It was confirmed that children without parental care are vulnerable group and in a great risk who need urgent help of professional multidisciplinary team of their close and broad environment. Lack of social support cause the withdrawing and suffering and can lead soon or later to problematic behaviour.
Bosnia and Herzegovina↗
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↗
[Importance of immunoglobulins and nutrition in infections in neonates].
The purpose of the study was an estimation of the immunoglobulin serum and the way of nutrition of a new-born child at the beginning of bacterial infections during the first month of life. 120 new-born children (infantiles) of both sexes was prospectively studied, who were born in the Gynecology-obstetrician clinic in Tuzla, in the period from March-May 2000 year. On the base of mothers SES during the pregnancy, new-born children were separated in two groups. Group A was formed of 60 new-born children (32 female and 28 male), mothers had good SES during the pregnancy, and concentration of serum immunoglobulin G (IgG) examined from cords blood, from 10.02 to 17.58 g/L (X 14.48 g/L +/- 1.87). Group B was formed of 60 new-born children (27 female and 33 male), with bad mothers SES and with concentration of IgG from 6.80 to 13.01 g/L (X 10.62 g/L +/- 1.49). Immunoglobulins M and immunoglobulins A were negative in both groups of children. During the first month of life it was studied the way of nutrition and health condition of each new-born child. New-born children with bad mothers SES during the pregnancy, with low values of IgG and who were on the artificial food (nutrition), were showing with the significant difference (p < 0.001) in bacterial infections, comparing with the group who had good IgG. The new-born children with natural nutrition, despite the lower concentration of IgG, were protected from severe bacterial infections.
Bacterial Infections↗
[One hundred thirty years of organizing health care system in Tuzla region].
The organized health care in Tuzla region begins by the establishment of hastahana in Tuzla 1874 year, when thanks the first graduated physician Dr. Mehmed Serbic Sami was opened the Vakuf's hospital in Tuzla, which he success fully lead to his death 1918 year. The great role in the treatment of the become ill inhabitants played the general hosptals, established during Australia-Hungarian period (Tuzla - 1886, Brcko - 1886...) whose capacities later were enlarged, and their health staff enabled at the universitets in the surrounding countries, later also in B&H, during the past period. The significant role in this played also the series of the health educators from which some will become the names in the segment of the health-care in this region and wider. About them and the institutions in this region, which merited not to be overlet to for fulness, the authors write in this paper.
Bosnia and Herzegovina↗
[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↗
Epidemiological and clinical aspects of congenital heart disease in children in Tuzla Canton, Bosnia-Herzegovina.
UNLABELLED: Congenital heart disease (CHD) is among the most frequent of all congenital anomalies. The purpose of this study was to present the results of an initial registration of children with CHD from January 1994 to December 1999 in Tuzla Canton, Bosnia-Herzegovina. The population studied consisted of all 39,699 live-born children in this area. Diagnosis of CHD was made by clinical findings, electrocardiography, chest X-ray, echocardiography, catheterisation or autopsy. In the 6-year period, 243 children were found to have CHD, i.e. a prevalence of 6.12 per 1000 live-born. Critical CHD was present in 58 of them, or 1.46 children per 1000 live-born. The average age at diagnosis was 1.47 years. There were 132 boys (54.3%) and 111 girls. The most frequent anomaly was ventricular septum defect with a prevalence of 2.49 per 1000 live-born, representing 40.7 % of the total anomalies. Of the total group, 46 (18.9%) had extracardiac anomalies related to syndromes. Cardiac surgery was indicated in 98 patients (40.3%) but could only be carried out in 42 (17.3%). A total of 63 (25.9%) patients died, 54 of whom within the 1st month of life. CONCLUSION: congenital heart disease is a very significant health problem in Tuzla Canton. It requires urgent measures in terms of organisation of early diagnosis and proper management.
Abnormalities, Multiple↗
[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↗
[Effect of the pregnant woman's socioeconomic status on serum immunoglobulin levels in the neonate].
Serum concentration of immunoglobulin G (IgG) of new-born child, at the birth, which reach the concentration of an adult persons, are the origin of mother and transferred by active and passive transport, by placenta. Immunoglobulin M (IgM) and Immunoglobulin A (IgA), do not pass the placenta because of their structure. Main condition for passing of IgG are normal period of pregnancy and regular function of placenta. Social-economic status (SES), and also immunologic status of a pregnant woman, an affect on the immunological status of new-born child. 120 pregnant woman and 120 of their new-born children were studied. Pregnant woman were at age of 18-34 years, and during the pregnancy they were healthy. Gestational age of new-born children was from 38 to 40 weeks, and birth weight was from 3000 grams to 4000 grams. The new-born children were from monofertile pregnancies, without visible anomalies and signs of intrauterine suffer. They were divided into 2 groups, 60 patients in every group, in comparison of SES families of a mother, in which she lived during the pregnancy. From every new-born child at the birth, from the blood of a navel it was determined the concentration of serum IgG, IgM and IgA. The values of IgG from the group with bad SES, were significantly lower (p < 0.001), in compare with a group with good SES. There was not statistically important difference between middle values of mentioned parameters among the different sex in the studied groups. Concentrations of IgM in new-born children were below the level of determination or just above it, so they could not be analysed anymore. Immunoglobulins A were not found in both groups, A and B groups.
Adolescent↗