{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:11:52Z","timestamp":1784542312677,"version":"3.55.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Short stature is a major pediatric concern and a common reason for endocrinology referrals. Although recombinant human growth hormone (rhGH) is widely used to treat short stature, its high cost and variable consequences raise concerns about its rational use and long-term effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS:<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study examined medical records of 260 children aged 3\u201315 years who received rhGH therapy in Kermanshah between March 2021 and March 2022. Attrition occurred due to physician decision, patient unwillingness to continue treatment, or incomplete records, leaving 54 patients eligible for analysis. This attrition highlights a source of selection bias and limits the generalizability of findings. Growth parameters were assessed across three treatment stages. Pearson correlation and repeated measures ANOVA were performed using SPSS version 22 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>The final cohort included 34 girls and 20 boys with a mean age of approximately 10.5 years. Repeated measures analysis demonstrated a significant increase in mean height z-score from the first to the third treatment stage. Pearson correlation showed no significant association between rhGH dose and growth response. Financial constraints and physician decisions were the main reasons for dropout.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>rhGH therapy improved children\u2019s growth parameters independent of dosage intensity. However, the high dropout rate highlights the need for cautious interpretation of the results, as selection bias may have affected the observed results. Transparent reporting of dropout patterns and enhanced financial and clinical support systems are essential to promote equitable access to therapy and strengthen the validity and applicability of future research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jehp.jehp_2156_25","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:00:46Z","timestamp":1782795646000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Impact of growth hormone treatment on childhood growth patterns in Kermanshah: A retrospective cohort study"],"prefix":"10.4103","volume":"15","author":[{"given":"Leila","family":"Solouki","sequence":"first","affiliation":[{"name":"Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran"},{"name":"Health Data Science Research Center, Health Research Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behzad","family":"Mahaki","sequence":"additional","affiliation":[{"name":"Health Data Science Research Center, Health Research Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran"},{"name":"Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danial","family":"Zarei Bidsorkhy","sequence":"additional","affiliation":[{"name":"Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Twana","family":"Jamal Jalal","sequence":"additional","affiliation":[{"name":"Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid Reza","family":"Mojabi","sequence":"additional","affiliation":[{"name":"National center for health insurance research, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Tahvilian","sequence":"additional","affiliation":[{"name":"National center for health insurance research, Tehran, Iran"},{"name":"Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6]]},"reference":[{"key":"R1-20260720","doi-asserted-by":"crossref","first-page":"116","DOI":"10.4103\/jehp.jehp_8_23","article-title":"Child-to-child approach in disseminating the importance of health among children\u2014A modified systematic review","volume":"12","author":"Johnsunderraj","year":"2023","journal-title":"J Educ Health 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