Assessment of the current status of iodine prophylaxis in Bosnia and Herzegovina Federation.

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 KI/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 KI/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 microg/l vs 75.2 microg/l, P < 0.001). In Group A the percentage of urine samples below 50 microg/l 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 microg/l (70.7 microg/l vs 68.25 microg/l, 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 in the Federation of Bosnia and Herzegovina]. / Jodni deficit u Federaciji Bosne i Hercegovine.

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.

[Hepatotoxicity of cyclosporine in patients with kidney transplants]. / Ispitivanje hepatotoksicnosti ciklosporina u pacijenata sa transplantiranim bubrezima.

In this study we have analyzed the liver transaminases levels in the 15 patients after kidney transplantation. All these patients have taken immunosuppressive cyclosporine therapy. The transaminases levels were determined by using the method Bergmayer kinetic ultraviolet test on the apparatus Tehnicon-Opera. The well known fact is the liver intoxication the same as kidney intoxication, if patients take cyclosporine for a long time. The average of the grafts in these patients were 9 years (ages between 1 and 16). The liver transaminases level was normal in all of groups of patients except for one who had high liver transaminases levels. After the correction cyclosporine therapy in the patient, the liver transaminases levels were normal. There was no possibility for monitoring of cyclosporine during the war, so the patients were determining the dose of cyclosporine on their own without any consulting with doctors. The most reliable method of cyclosporine applications is its determination, every day monitoring, and dosing by monitoring, which means concentrations in the reference values.

[Serum cyclosporine levels in patients after kidney transplantation]. / Vrijednosti ciklosporina u serumu pacijenata poslije bubrezne transplantacije.

In this study we have analyzed the cyclosporine levels in patients after kidney transplantation. The cyclosporine levels are determined by using fluorescence polarization immune-assay and monoclonal whole blood test. We analyzed nine patients with transplanted kidneys who were on specific immunosuppressive cyclosporine therapy. The cyclosporine determination was performed in these patients three times in the span of 14 to 29 days. The cyclosporine levels in seven patients were in reference interval between 100 and 300 ng/ml of whole blood. In the first determination the values in two patients were out of reference interval, one value was lower, and the other one was higher then reference interval. In second determination after dose correction in patients who had lower cyclosporin level the new level was normal and the other patient cyclosporine value was lower then in the first determination, but still a little higher then reference values.

[Evaluation of monitoring the efficacy of phenobarbital as an anticonvulsant agents using the fluorescence-polarization immunoassay]. / Procjena efikasnosti monitoringa fenobarbitona kao antikonvulzivnog agensa, primjenom fluorescentno-polarizacijskog imunoeseja.

Estimation of the monitoring efficiency of Phenobarbital as anti seizure agent was performed by using fluorescence-polarization immunoassay on analyzer ABBOTT TDx. Determined values have shown that Phenobarbital monitoring is extremely important in the prevention of epileptic seizures, especially considering its ability to induce a microsomal drug-metabolizing system.