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Article
Non CNS pediatric malignancies in Mosul

Authors: Sahar K. Omar سحر خطاب عمر --- Likaa Fasih Al-Kzayer لقاء فاصح --- Khalil I. Mahmood خليل ابراهيم محمود
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2010 Volume: 36 Issue: 1&2 Pages: 86-91
Publisher: Mosul University جامعة الموصل

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Abstract

ABSTRACT
Objectives: To find out the types of pediatric malignancies in patients from Mosul, their age and sex distribution as well as the death rate among these diseases with special emphasis on acute lymphoblastic leukaemia.
Patients and methods: A survey which was conducted in Mosul pediatric wards of oncology in Alsalam, Ibn Sina general hospitals and Ibn Alatheer hospital for pediatric diseases on 228 children of both sexes, their ages were less than 12 years from year 2001-2007. The clinical data were taken from their case sheets regarding age, sex, clinical presentation at time of admission and the lab tests including tissue biopsy as well as bone marrow examination.
Results: The commonest 3 types of these malignancies were acute lymphoblastic leukaemia (ALL) (43.4%), lymphoma (19.5%) and neuroblastoma (7.9%). The mean age of presentation was 65 months; the majority of cases were between 13 months - 6 years. Males predominate in a ratio of 1.28/1. Regarding ALL the main clinical features at presentation were fever, pallor, bone pain and bleeding. All cases were treated as inpatients. Death rate was high (35.08 %), the commonest causes were sepsis, bleeding and progressive disease.
Conclusion: There were different types of malignancies in children in Mosul, the commonest were ALL, Lymphoma and neuroblastoma, with high death rate.

Keywords: Pediatric, malignancies.

أهداف البحث: لمعرفة أنواع الأمراض السرطانية عند الأطفال في الموصل كذلك الأعراض السريرية لكل نوع مع تشديد خاص على ابيضاض الدم.التصميم والمشاركون: دراسة وصفية أجريت على 228 طفلا في ردهات الأطفال في مستشفيات السلام وابن سينا وابن الأثير والتي تعالج فيها سرطانات الأطفال لكلا الجنسين وأعمارهم أقل من 12 سنة بين عامي 2001-2007. وأخذت المعلومات من سجلات المرضى فيما يخص العمر، والجنس والأعراض السريرية وقت دخول المستشفى مع الفحوصات المختبرية التي أجريت ومن ضمنها الخزعة النسيجية وفحص نخاع العظم.النتائج: تبين ان الأمراض السرطانية الثلاثة الأكثر انتشارا عند الأطفال هي: ابيضاض الدم (43,4%)، السرطانات اللمفاوية )19,5%) وسرطان الغدد الكظرية (7,9%) وكان معدل عمر الأطفال وقت الدخول الى المستشفى هو 65 شهرا ومعظم الأعمار كانت تتراوح بين 13 شهرا -6 سنوات ومعظم الحالات كانت من الذكور بنسبة الذكورالإناث (1.28 1). بالنسبة لابيضاض الدم كانت أهم الأعراض السريرية وقت الدخول الى المستشفى هي الحمى، الشحوب، ألم في العظام والقابلية على النزف. جميع الأطفال المرضى بالسرطان أدخلوا المستشفى وعولجوا فيه. كانت نسبة الوفيات عالية (35,08%) وأهم أسباب الوفيات كانت خمج الدم، النزف، متلازمة تحلل الورم وتقدم المرض.الاستنتاج: أهم الأمراض السرطانية عند الأطفال في الموصل هي ابيضاض الدم، السرطانات اللمفاوية وسرطان الغدد الكظرية. نسبة الوفيات كانت عالية.

Keywords

Pediatric --- malignancies


Article
The Role of Highly Sensitive Troponin I in Diagnosis and Prognosis of Dilated Cardiomyopathy in Pediatric Age Group

Authors: Eman Hassan Al-Hmairy --- Yasar Mohammed Hassan Al-Shamma --- Muntadhar Yahya Al- Muhanna
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 3 Pages: 697-705
Publisher: Babylon University جامعة بابل

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Abstract

The aim of this study, is to evaluate the role of highly sensitive serum troponin I in diagnosis and prognosis of children with dilated cardiomyopathy. This study included 48 children with dilated cardiomyopathy with left ventricular dysfunction, that diagnosed clinically by history, clinical examination ,electrocardiography and echocardiography, including 2D-echocardiography, M-mode and Doppler study. Echocardiography regarded as the corner stone in the diagnosis of dilated cardiomyopathy. Those patient were subdivided to 15 children present with acute heart failure (Acute DCM) (8 female and 7 male), and 33 children who are known cases of dilated cardiomyopathy reported in the cardiology out clinic with chronic cardiac dysfunction (18 female and 15 male),both groups followed for one year with regular clinical, laboratory and echocardiographic evaluation during treatment coarse for cardiac dysfunction , another 48 control healthy child with same age groups involved in the study (25 female and 23male), the age of both patient and control groups ranging from 1month- 12 years. All patient had cardiac dysfunction at the time of attendance . We found that most patient with Dilated cardiomyopathy with acute left ventricular dysfunction had high serum level of highly sensitive troponin I at the time of presentation. Those patients with chronic Dilated , usually had serum troponin above the detectable limit and significantly more than control group. During follow up all patient show to decrease their serum troponin I level with improvement of their cardiac function till reaching normal or nearly normal level if Left ventricular function improved toward normal value, while those remain with left ventricular dysfunction for longer period despite treatment shown to have higher troponin level. This negative relationship between highly sensitive troponin I indicates that the highly sensitive troponin I is important for both diagnosis and prognosis of patient with dilated cardiomyopathy.


Article
PEDIATRIC INGUINAL HERNIA IN BASRAH

Authors: Sadik H Kadhem --- Haithem H Ali --- Haider A Jassim
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2015 Volume: 21 Issue: 2 Pages: 61-65
Publisher: Basrah University جامعة البصرة

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Abstract

Abstract Inguinal hernia repair is one of the most frequently performed surgical procedure in pediatric patients. An inguinal hernia does not resolve spontaneously and must be repaired because of high risk of complications. The aim of this study is to determine epidemiologic index and complications of inguinal hernia in pediatric patients. This retrospective study was carried out in the Basrah Children Hospital. All patients who underwent surgeries for inguinal hernia from 2012 to 2014 were included in this study. Their hospital records were reviewed for age, sex, side of the hernia, presentation, wound infection, recurrence, and other complications. In this study, 877 children were included. 766 (87.3%) were boys and 111 (12.7%) were girls. Most common age of presentation is between 6 months to 6 years which compromise 54.6%. Right-side and left-side inguinal hernia was observed in 531 (60.5%) and 276 (31.5%) cases, respectively. Bilateral inguinal hernia was observed in 70 (8%) cases. One hundred forty eight (16.9%) children presented as emergencies with irreducible hernia. Emergency presentation was more in male gender and more in the first 6 months of life. Postoperative complication rate for elective was 3.2% and for emergency groups was 51.7%. In conclusion, most of the hernias involved male patients. Postoperative complications were observed in 51.7% of the emergency cases, so inguinal hernia in children should be operated as early as possible to avoid incarceration and to decrease post-operative complications.


Article
Tracheostomy in Children Indications, Results and Complications

Authors: Raed AbdulSahib Khefi --- Firdaws Fadhil Ridha --- Samah Abbas Hummadi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 1 Pages: 46-51
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:To provide an overview of pediatric tracheostomy, focusing on indications, surgical techniques and complications. The indications for pediatric tracheostomy are changing. Today the most common indication is assisted ventilation. Tracheostomy complications are more likely in children than in adult and more common in children under two years particularly preterm infant.The general indications for tracheostomy are as follows:•Relieve upper airway obstruction.•Prevent complications of prolonged intubation•Reduce anatomical dead space•Allow suction toilet of the tracheaOBJECTIVE: To evaluate the indications and complications of tracheostomies performed in children.PATIENTS AND METHOD:This is prospective study of 20 patients for whom tracheostomy was done during a period of two years (from October 2011 to October 2013).Demographic data and details of the surgical work and the follow up notes were collected.Descriptive, and analytic statistics were applied to the set of data using the Microsoft excel 2010 computer system.RESULTS:Total of twenty patients were included in the study. The age range was 2months – 12 years there were 14 males and 6 females. Fifty percent of the patients were 5 year old or younger. Sixty five percent of the operations were performed as elective procedures, and 35% as emergency.The peak incidence of tracheostomy was at 5 years (25%).The most common indication was the need for assisted ventilation 60%.The most common underlying cause behind tracheostomy was the neurological impairment whether chronic or traumatic (n=13; 65%), followed by airway trauma.No intraoperative complications were reported, and the postoperative complication rate was 25%. Tracheostomy tube (PORTEX blue line) obstruction was the most common encountered complication.Fourteen patients were decannulated (70%) with mean duration prior to decannulation 19.7± 18.95 days.There were no tracheostomy related mortalities.CONCLUSION: A ssisted ventilation is the most common indication for traceostomy in pediatric age group. Tracheostomy in children is a safe procedure with negligible intraoperative complications.


Article
A STUDY OF BLOOD CHOLESTEROL AND RELATED RISK FACTORS IN PRIMARY SCHOOL CHILDREN OF DUHOK GOVERNORATE, KURDISTAN REGION, IRAQ
دراسة الكوليسترول في دم مع عوامل الخطورة المرتبطة بها في اطفال المرحلة الابتدائة في محافظة دهوك , اقليم كوردستان , العراق

Authors: DHIA J. AL-TIMIMI ضياء التميمي --- SHERWAN F. SALIH شيروان فرمان صالح --- HIVI M. MAHMOUD هيفي محمود
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2014 Volume: 8 Issue: 2 Pages: 20-29
Publisher: University of Dohuk جامعة دهوك

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Abstract

ABSTRACTObjective: To determine blood cholesterol levels and related risk factors ofhypercholesterolemia in a sample of primary school children from Duhok governorate.Methods: A cross sectional- study of 1136 primary school children (572 males, 564 females)aged 6-10 years; from December 2013 to May 2014 was conducted. A structuredquestionnaire was used to get information relating to animal fat intake, social status; andfamily history of diabetes mellitus, hypertension and hypercholesterolemia. The childrenwere examined for height, weight, blood cholesterol levels and the body mass index (BMI)were calculated. Hypercholesterolemia defined according to the American Academy ofPediatrics (AAP) guidelines. A cutoff point of < 170 mg/dl of total cholesterol used toclassify children as on desirable level, borderline 170-199 mg/dl and high > 200 mg/dl.Results: The mean blood cholesterol was 154.4±35.8 mg/dl with a range of 76-278 mg/dl.Desirable, borderline and high blood cholesterol levels were defined in 745(65.6%),286(25.2%) and 105(9.2%) children, respectively. Of 1136 children, 50(4.4%) wereoverweight; mean blood cholesterol in overweight was 181.2 mg/dl compared to 153.8 mg/dlin not overweight children (P < 0.01). Mean blood cholesterol levels were not significantlydifferent by age, gender, positive family history of children for diabetes mellitus,hypertension and hypercholesterolemia, animal fat intake/week and social status. Odds ratioof having high blood cholesterol levels in overweight children compared to not overweightchildren was 2.14 (95%Cl 1.21-3.78).Conclusions: A borderline or abnormal blood cholesterol level screened by the AmericanAcademy of Pediatrics guidelines (AAP) values defined in one third of primary schoolchildren. Overweight was the major risk factor for elevated blood cholesterol in primaryschool children from Duhok governorate.

خلفية البحث والأهداف: لتحديد مستويات الكوليسترول في الدم مع عوامل الخطورة المرتبطة بأرتفاع الكوليسترول في عينة من اطفال المرحلة الابتدائية في محافظة دهوك.طرق البحث: أخذت الد ا رسة مقطعية، حيث تألفت من 1136 طالب من طلاب المرحلة الابتدائية ( 572 ذكر، 564 ١٠ سنوات؛ من الفترة ما بين كانون الاول 2013 لغاية أيار 2014 . استعمل اسيبيان منظم لجمع - إناث) من عمر 6 معلومات تتعلق بأخذ الدهون الحيوانيه, الحالة الاجتماعية, و تأريخ العائلة متضمنا ارتفاع ظغط الدم, مرض السكر,وأرتفاع الكويستيرول في الدم. تم فحص طول الاطفال, او ا زنهم, مستوى الكوليستيرول وكذلك تم قياس مؤشر كتلة الجسم تم تحديد أرتفاع الكوليستيرول في الدم حسب قيم ارشادات الاكاديمية الامريكية للأطفال. تم استعمال نقطة .(BMI) 199-170 واعتبارها mg/dl 170 كمستوى مرغوب فيه للكوليستيرول في الدم, على الحواف mg/dl الفصل اقل من .200 mg/dl عالي اذا كان يساوي أو أكثر من .76-278 mg/dl 154.4±35.8 مع مدى يت ا روح من mg/dl النتائج: معدل القيمة لمستوى الكوليستيرول في الدم كان745 و (65.6%), 286( مستويات الكوليستيرول المرغوبة, والتي على الحواف والعالية عرفت في (% 25.250 كانوا ا زئدي الوزن; معدل القيمة لمستوى الكوليستيرول ( 105 طفل، على التوالي. من 1136 طفل, (% 4.4 (9.2%) معدل .(P < 153.8 في الاطفال الذين هم ليسوا ا زئدي الوزن ( 0.01 mg/dl 181.2 مقارنة ب mg/dl في الدم كان القيمة لمستوى الكوليستيرول في الدم لم يكن يختلف بشكل ملحوظ بالعمر, الجنس, ايجابية وجود مرض السكر في العائلة لوجود odds او ارتفاع ضغط الدم او ارتفاع الكوليستيرول في الدم او أخذ الدهون الحيوانيه والحالة الاجتماعية. نسبة ال 2.14 95%Cl ارتفاع الكوليستيرول في الدم في الاطفال ا زئدي الوزن مقارنة بالذين هم ليسوا ا زئدي الوزن كان - 1.21 3.78 الاستنتاج: ارتفاع الكوليستيرول في الدم او شذوذه والتي تم مسحها من قبل قيم ارشادات الاكاديمية الامريكية للأطفال عرفت في ثلث اطفال المرحلة الابتدائية. زيادة الاوزن كان عامل الخطورة الاساسي لزيادة الكوليستيرول في الدم لدى اطفال المرحلة الابتدائية في محافظة دهوك.


Article
Maxillofacial trauma among children below 15 years in Sulaimani city/ Iraq

Author: Falah A. Hawramy BDS, HDD, FICMS
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2011 Volume: 14 Issue: 1 Pages: 225-230
Publisher: University of Kufa جامعة الكوفة

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Abstract

The management of maxillofacial trauma in children differs from that of adults due to concern for growth and dentition development. Although the incidence and distribution of the pediatric facial trauma is common, there were few reports about this type of trauma. The aim of this study was to analyze the patterns of facial injuries in a sample of Sulaimani City children. The study included the records of (168) child patients sustained maxillofacial injuries. The data analyzed according to sex, age group, type of injury, site of injury, cause of injury and associated injuries. The results showed the male patients (57.7%) affected more than females while the most age group affected by trauma was (1-5) years. Soft tissues involved in (77.9 %) of the injured children and the chin was the most affected area (26.7%). Fall on the ground was the most cause of trauma (26.19%) followed by fall from height (25%). The dentoalveolar injuries were the most concomitant trauma (14.88%). This study provides a clinical data about the pediatric maxillofacial trauma for medical education and health care programs.


Article
Demographic and Clinical Presentations of Pediatric Hydrocephalus in Medical City

Authors: Mahjoob N. Al Naddawi --- Numan Nafie Hameed --- ,Amal A. Rasheed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 2 Pages: 139-144
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Hydrocephalus is distension of the ventricular system of the brain related to inadequate passage of cerebrospinal fluid from its points of production within the ventricular system to its points of absorption into the systemic circulation.OBJECTIVE:To study the demographic and clinical presentations of pediatric hydrocephalus in medical city complex , Baghdad.PATIENTS AND METHODS:This is a prospective study ,which was carried out on 100 children with a mean age+- standard deviation ( 24.3 +/- 16.06 )months and median 16 months, who were admitted to Children Welfare Teaching Hospital & neurosurgical department ( Surgical Specialties Hospital) / Medical City complex, Baghdad in the period from April first 2009 to October first 2009. A specially designed questionnaires were used to aid the investigators in performing a family interview. General and neurological examinations, and investigations including neuroimaging studies were done.RESULTS:Of 100 patients,(62%)were males and (38%) were females, with male to female ratio of 1.6:1. Family history of congenital anomaly was positive in (26%) of patients, while hydrocephalus was positive in (14%). Seventy-Two percent of patients had congenital hydrocephalus. Eighty–Seven percent of patients were full term. Fifty-Seven percent of patients were products of NVD ,while (43%) were products of CS,(2%) of them were emergency CS& (41%) were elective. The macrocephaly was diagnosed or noted at birth in (32%)of patients. The study showed that U/S finding of hydrocephalus was positive in (49%).CONCLUSION:The majority of the patients had congenital hydrocephalus, but there was delay in the diagnosis of macrocephaly. Prenatal ultrasound diagnosis yield was low in this study. Family history of hydrocephalus and other neural tube defect was important to be elicited


Article
Autism Among Children Attending Pediatric Psychiatric Department in Child's Central Teaching Hospital in Baghdad: a Descreptive Study

Authors: Autism Among Children Attending Pediatric Psychiatric Department in Child's Central Teaching Hospital in Baghdad: a Descreptive Study --- Jaafar Muhamed Hassan --- AL- Ghabban --- Haider Abdul Muhsin
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 4 Pages: 504-511
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Autism is a spectrum of neuropsychiatric disorders that affects children from all ethnic andsocioeconomic backgrounds. The diagnosis is based on their developmental and medical history as wellas observations of their social, communicative, and play behaviors that usually begin before age of threeyears.OBJECTIVE:A descriptive study of autism to describe the prevalence of autism among childhood psychiatricdisorders, the age for diagnosis of autism, sex distribution, family history and the clinical features ofautism.PATIENTS AND METHODS:A cross-sectional study included a sample of 208 children with psychiatric disorder, who wereattending pediatric psychiatric department evaluated for the criteria of autism. Data collected wereincluding (the age at the diagnosis, sex, family history and clinical characters included the main clinicalfeatures and other associated features of autism).RESULTS:Of the 208 patients registered psychiatric problem, 33(15.87%) met criteria for autism, the mean age forthe diagnosis of autism was 5.45 years with the boys more predominant than girls. Three main clinicalfeatures of autism are communication abnormality, social abnormality and behavioral abnormality. Thecommunication abnormality were the most commonest features. Other associated features includedenuresis (the commonest), encopresis, sleep problems, over activity and anxiety. Macrocephaly andseizure are important clinical characters of autism presented in 12% and 9.1% respectively.CONCLUSION:Autism is not rare and autistic children represent a significant subgroup of children with seriouspsychiatric disturbance. Speech delay and abnormalities in language are the hallmark features ofautistic disturbance.


Article
Autism Among Children Attending Pediatric Psychiatric Department in Child's Central Teaching Hospital in Baghdad: a Descreptive Study

Authors: Entissar Hadi AL- Shimery --- Jaafar Muhamed Hassan --- AL- Ghabban --- Haider Abdul Muhsin
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 4 Pages: 504-511
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Autism is a spectrum of neuropsychiatric disorders that affects children from all ethnic andsocioeconomic backgrounds. The diagnosis is based on their developmental and medical history as wellas observations of their social, communicative, and play behaviors that usually begin before age of threeyears.OBJECTIVE:A descriptive study of autism to describe the prevalence of autism among childhood psychiatricdisorders, the age for diagnosis of autism, sex distribution, family history and the clinical features ofautism.PATIENTS AND METHODS:A cross-sectional study included a sample of 208 children with psychiatric disorder, who wereattending pediatric psychiatric department evaluated for the criteria of autism. Data collected wereincluding (the age at the diagnosis, sex, family history and clinical characters included the main clinicalfeatures and other associated features of autism).RESULTS:Of the 208 patients registered psychiatric problem, 33(15.87%) met criteria for autism, the mean age forthe diagnosis of autism was 5.45 years with the boys more predominant than girls. Three main clinicalfeatures of autism are communication abnormality, social abnormality and behavioral abnormality. Thecommunication abnormality were the most commonest features. Other associated features includedenuresis (the commonest), encopresis, sleep problems, over activity and anxiety. Macrocephaly andseizure are important clinical characters of autism presented in 12% and 9.1% respectively.CONCLUSION:Autism is not rare and autistic children represent a significant subgroup of children with seriouspsychiatric disturbance. Speech delay and abnormalities in language are the hallmark features ofautistic disturbance.


Article
Evaluation of The Response of Children with Short Stature to A Six Months Treatment with Recombinant Human Growth Hormone

Author: Abdulabbas Abduon Hadi
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2016 Volume: 9 Issue: 2 Pages: 2569-2574
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Human Growth hormone (GH) is 191amino acids protein , gene located on long arm of chromosome 17. its secretion is under control of 2 hypothalamic hormones: growth hormone releasing hormone(GHRH) and somatostatin. Growth hormone is a major promoter of anabolism, its effects on growth are believed to be indirect ,being mediated through peptides called somatomedins or insulin-like growth factors (IGFs) that in turn mediate many of the growth promoting effects of Growth hormone . Recent advances have focused on biological actions of IGFs & their six well defined binding proteins (IGFBPs), the major one is IGF-BP3 which decreased in GH-deficient children. IGFs are GH-dependent serum peptide with potent metabolic & mitogenic activities believed to be responsible for growth effects of GH, they stimulate cellular replication & differentiation . Objective: To evaluate the difference in the response of the children with short stature (of different causes) to a six months treatment with recombinant human GH .Patients And Methods: this is a prospective study in which a total no. of 84 pt (with age ranging from 4-20 years) were included. They were presenting to the endocrine clinic in Al-Mansour teaching hospital for children in 2002 with short stature & growth delay. After the final diagnosis was made, all pt were treated by recombinant GH (in a dose of 0.1-0.2 unit/kg / day) by subcutaneous or intramuscular route at night time (7-8pm) , After completing 6 months of treatment with GH, the patients were evaluated again for height and height velocity, weight, bone age, height age, sexual maturity rate, testicles and phallus in male. Results: There was no significant difference in response to the therapy between male and female ; the mean height velocity in male was 9.37 +/-3.99 cm / year (ranging from 1-19 cm) and the mean height velocity in female was 9.90 +/-4.39 cm / year ranging from 3-20 cm . Conclusion: Growth hormone therapy is effective in increasing the height velocity in most patients with short stature and it should be initiated as early as possible to improve height as much as possible.

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