Cent Of Women Research Articles

Entrepreneurial Aptitude of Women of an Aspirational District of Uttarakhand

A cross-sectional study was conducted for assessing the entrepreneurial aptitude of women in two blocks (Kashipur and Gadarpur) of Udham Singh Nagar, Uttarakhand. A purposive sampling technique was utilized for selecting the respondents. A structured questionnaire vetted by experts and pretested through a pilot study on 45 respondents was developed. Data on women entrepreneurs, self-assessment, and perception of farm women regarding entrepreneurial aptitude was collected from 214 women during the month of June 2022 to August 2022. Results revealed that only 28.50 per cent of women were running their own enterprises, whereas 40.98 per cent of them were engaged in vegetable production/commercial farming. 89.25 per cent of women were interested in running an enterprise and 84.11 per cent had a motto to earn money. 84.11 per cent of the respondents were interested in backyard poultry and 31.31 per cent in spice production. It was concluded that women in the study area had an aptitude for adopting enterprises for improving their quality of life, which needs to be nurtured.

Incidence & factors influencing maternal near miss events in tertiary hospitals of Maharashtra, India.

Government of India (GoI) released operational guidelines for maternal near miss-review (MNM-R) in 2014 for use by programme managers of public health system to assist them for conducting MNM-R. The objective of the present study was to review the incidence and factors influencing MNM events in two tertiary hospitals of Maharashtra, India, as per the operational guidelines of the GoI released in 2014 and identify delays based on three-delay model to prevent such events in future. This prospective observational study was conducted in two tertiary hospitals of Maharashtra, from July 2018 to November 2020. All women during pregnancy, childbirth or postpartum upto 42 days meeting the eligibility criteria of MNM as per the 2014 GoI guidelines were included as cases (n=228), interviewed and discussed during the monthly MNM meetings at these hospitals. The incidence of MNM was 11/1000 live births; the ratio of MNM to maternal deaths was 1.2:1. Leading causes of MNM were haemorrhage (36.4%) and hypertensive disorders of pregnancy (30.3%). Haemorrhage was maximum (70.6%) in abortion and ectopic pregnancies. Majority of the women (80.2%) were anaemic, of whom 32.4 per cent had severe anaemia. Eighty six per cent of women included in the study had MNM events at the time of admission and 81 per cent were referred from lower facilities. Level one and two delays were reported by 52.6 and 32.5 per cent of women, respectively. Level three delay at referral centres and at tertiary hospitals was reported by 69.7 and 48.2 per cent of women, respectively. The findings of this study suggest that MNM-R should be undertaken at all tertiary hospitals in India as per GoI guidelines to identify gaps based on three-delay model. These hospitals should implement interventions as per the identified gaps with emphasis on strengthening the infrastructure, facilities and manpower at the first-referral units.

Outcomes of laparoscopic versus robotic-assisted resection of T4 rectal cancer: propensity score-matched analysis of a national cancer database.

T4 rectal cancer is a challenging condition owing to the highly invasive nature of the tumour that may compromise R0 resection. The present study aimed to assess the outcomes of laparoscopic versus robotic-assisted resection of non-metastatic T4 rectal adenocarcinoma. This was a retrospective propensity score-matched analysis using the National Cancer Database between 2010 and 2019. Patients with pathological T4 non-metastatic rectal adenocarcinoma who underwent laparoscopic or robotic-assisted resection were compared and a propensity score-matched analysis was performed in a 1:1 manner. The main outcome measures were conversion to open surgery, mortality, readmission, resection margins, and overall survival. After propensity score matching, 235 patients were included in each group. There were 260 (55.3 per cent) men and 210 (44.7 per cent) women, with a mean (s.d.) age of 61 (13.2) years. Patients in the robotic group had a statistically significantly lower conversion rate (8.9 per cent versus 17.9 per cent; P = 0.006), shorter median duration of hospital stay (5 versus 6 days; P = 0.007), higher overall survival rate (56.2 per cent versus 43.4 per cent; P = 0.007), and a longer median survival (60.8 versus 43.2; P = 0.025). There were no significant differences between the two groups with regard to positive resection margins, examined lymph nodes, 30-day and 90-day mortality rates, and 30-day readmission rate. Robotic resections of T4 rectal cancer were associated with a significantly lower conversion rate and shorter duration of hospital stay than laparoscopic resections. The two approaches were comparable with regard to positive resection margins, short-term mortality, and readmission.

Navigating parenthood in the surgical profession: mixed-methods study.

Significant barriers exist to surgeons being good parents and parents being good surgeons, and these barriers are heightened for women. Considering the gender balance now present in postgraduate medical schools, it is critical that these barriers are overcome if surgery is to attract and retain applicants. This study aimed to investigate patterns of parenthood in surgery, explore associated attitudes and experiences, and identify barriers and solutions within an Australian and New Zealand context. Surgeons and trainees were invited to participate in a survey and focus groups. Quantitative results were described, and textual responses and focus group transcriptions were analysed thematically. There were 261 survey respondents (62.8 per cent women, 37.2 per cent men) and six focus groups (34 participants). Of the survey respondents, 79.6 per cent of women and 86.5 per cent of men had children. Women were more likely to time childbirth around training or work, and most respondents without children attributed this to their career. Tensions between parenthood and surgery engendered guilt for surgeon-parents. Parenthood was often the 'elephant in the room' in training and employment discussions. Breaking the silence around parenthood and surgery made it more acceptable, normalising positive behaviour changes. The major barrier to parenthood and surgery was the lack of flexible training opportunities. Participants called for top-down establishment of mandated, stand-alone, permanent part-time training positions. Many barriers to parenthood in surgery are created by rigid workplace and professional structures that are reflective of male-dominated historical norms. A willingness to be flexible, innovative and rethink models of training and employment is central to change.

Faithfulness without sexual exclusivity: gendered interpretations of faithfulness in rural south-western Uganda, and implications for HIV prevention programmes

This article explores gendered meanings of both faithfulness and sexual exclusivity within intimate long-term relationships, and the implications for HIV prevention messaging. In 2011–12, in-depth interviews were conducted with a random sample of 50 men and women (52 per cent women) in long-term relationships in rural Uganda. Confirming prior research, we found that a double standard exists for sexual exclusivity, where men define faithfulness to mean strict sexual exclusivity by their wife, but women defined it as being for both partners. However, both men and women defined fidelity to imply continued support. Fidelity was perceived to be intact if a man continued to provide material support, despite not being sexually exclusive. These findings highlight the limitations of HIV prevention strategies that emphasise faithfulness, where faithfulness is not synonymous with sexual exclusivity.

Prosocial Personality as a Predictor of Burnout in Spanish Social Workers

Abstract The aim of this study is to establish the link between burnout and prosocial personality and discover how prosocial personality influences burnout. A single-group ex post facto prospective descriptive design questionnaire was created incorporating socio-demographic data, the Maslach Burnout Inventory and Penner’s Prosocial Personality Battery. The study involved 442 members of professional social workers’ associations in Spain, comprising 91.1 per cent women and 8.9 per cent men, with ages ranging from twenty-four to sixty-three years. The results showed that social responsibility is significantly lower and personal distress is higher in emotional exhaustion and depersonalisation, whilst the personal accomplishment variable correlates positively with the positive variables of prosociality and negatively with personal distress. Social responsibility, perspective-taking, self-reported altruism, prosociality factor 1 (other-oriented empathy) and prosociality factor 2 (helpfulness) were found to be significantly higher amongst professionals without burnout, while personal distress predominates in professionals with burnout. The study also found that personal distress and mutual concerns moral reasoning are risk factors for burnout, whilst perspective-taking is a protective factor. It was concluded that prosociality acts as a protective factor against burnout—a novel idea of great importance when developing prevention programmes to alleviate this problem amongst professionals.

Evaluation of the Desire to Avoid Pregnancy Scale in the UK: a psychometric analysis including predictive validity

ObjectivesTo evaluate the psychometric performance, including predictive validity, of a UK version of the Desire to Avoid Pregnancy (DAP) scale.DesignProspective cohort study for psychometric evaluation.SettingUK.ParticipantsWomen in the UK aged 15...

Influence of patient sex on outcomes after pancreatic surgery: multicentre study.

Recent findings support the hypothesis of sex-related differences in inflammatory and immunological responses to trauma. The aim of this study was to address sex-specific aspects in patients who underwent pancreatic surgery. This retrospective study used data from the German StuDoQ registry. Patients who underwent pancreatic surgery between 2010 and 2020 were stratified according to procedure (pancreatic head resection, distal pancreatectomy (DP), total pancreatectomy (TP)). Each cohort underwent propensity score matching (PSM) with the co-variables BMI, ASA, age, coronary heart disease (CHD), diabetes, hypertension with medication, and histology to level the distribution of co-morbidities between men and women. The main outcomes were morbidity and mortality. The total cohort consisted of 10 224 patients (45.3 per cent women). Men had higher ASA grades, and more often had CHD, diabetes, and hypertension with medication. Women had fewer overall complications (57.3 versus 60.1 per cent; P = 0.005) and a lower mortality rate (3.4 versus 4.9 per cent; P < 0.001). Rates of pancreatic surgery-specific complications, such as clinically relevant postoperative pancreatic fistula (POPF) (grade B/C: 14 versus 17 per cent; P < 0.001), delayed gastric emptying (grade B/C: 7.8 versus 9.2 per cent; P = 0.014), and postpancreatectomy haemorrhage (grade B/C: 7.1 versus 9.0 per cent; P < 0.001), were also lower in women. After PSM, 8358 patients were analysed. In the pancreatic head resection cohort (5318 patients), women had fewer complications (58.6 versus 61.4 per cent; P = 0.044), a lower in-hospital mortality rate (3.6 versus 6.1 per cent; P < 0.001), and less often had clinically relevant POPF (11.6 versus 16.2 per cent; P < 0.001). After DP, the clinically relevant POPF rate was lower in women (22.5 versus 27.3 per cent; P = 0.012). In the TP cohort, men more often developed intra-abdominal abscess requiring drainage (5.0 versus 2.3 per cent; P = 0.050). Women had favourable outcomes after pancreatic surgery.

Psychometric Examination of the Freshman Stress Questionnaire Using a Sample of Social Work Students in Spain during the Covid-19 Pandemic

Abstract The teaching–learning model implemented in Spanish universities as a result of the Covid-19 pandemic has generated a scenario of academic uncertainty amongst Spanish students. In the case of the Social Work degree, this apprehension appears to be linked to the heavy emotional load related to the theoretical–practical curricular contents of the degree. In this sense, the Freshman Stress Questionnaire (FSQ) has presented adequate levels of reliability and validity for its use on a population of Spanish university students; however, there is as yet no psychometric studies for its use on social work students. This study sought to analyse the psychometric properties of the FSQ using a sample of social work students. The sample comprised 732 students at three Spanish universities doing a social work degree (88.3 per cent women, 11.7 per cent men) with an average age of 21.51 years (standard deviation (SD) = 3.58). The results obtained from the exploratory factor analysis and confirmatory factor analysis revealed that the FSQ maintained the structure of four correlated factors and suitable reliability values for each dimension. The results of the factor invariance analysis indicate that the FSQ remains stable up to the level of metric invariance for the variable age. Results are discussed with available theory.

Socio-economic well-being of rural women in Dehradun district: An investigative method

In India, like other developing countries, rural women make generous contributions to the nation’s economy by earning directly or saving money indirectly. This study aims to explore rural women’s economic freedom and socio-economic well-being through various indicators like financial liberty, mobility freedom, family affairs, self-esteem and ownership-related factors. An investigation, in both a qualitative and a quantitative manner, was undertaken. For this purpose, the identification of women from four rural areas of Dehradun district – Mazri Grant, Dhakrani, Chharba and Misraspatti – for data collection and survey was done. A total of 848 women responded to the survey conducted using a combination of random and purposive sampling techniques by being in touch with the pradhan of a particular village. Forty-one per cent of respondents belong to the 18–24 age group category. About 55.2 per cent of respondents were involved in economic activities like farming, stitching, weaving, handicraft, service and nursing and caring. Of that 55.2 per cent, 84.9 per cent women are agreeing to have financial liberty at home. This investigative study reveals a positive relationship between financial liberties and working women, as well as a positive correlation (0.151) between rural women’s interest in art-craft work and mobility freedom. Women inclining towards art-craft have a high self-esteem, which promotes sustainability in their lives through art-craft workmanship. The study’s goals are to identify the rural women’s economic status through identified indicators and to offer recommendation keeping in purview the women’s demography, educational qualifications and available government schemes.

Pathways to change: Three decades of feminist research and activism to end violence against women in Nicaragua

ABSTRACT This paper presents the results of nearly three decades of partnership between feminist researchers and activists to prevent violence against women and girls (VAWG) in Nicaragua. A household survey conducted in 1995 in León, the country’s second-largest city, revealed that 55 per cent of women had experienced lifetime physical intimate partner violence (IPV), and 27 per cent had experienced IPV in the last 12 months. The study results were instrumental in changing domestic violence laws in Nicaragua. A follow-up study in 2016 found a decrease of 63 per cent in lifetime physical IPV and 70 per cent in 12-month physical IPV. This paper examines possible explanations for the reduction, including the policy reforms resulting from feminist advocacy. We compare risk and protective factors for physical IPV, such as changes in women’s attitudes towards violence, their use of services, and knowledge of laws, using data from both the 1995 and 2016 surveys, as well as three waves of Demographic and Health Surveys. We conclude that the decline in IPV can be partially attributed to the efforts of the Nicaraguan women’s movements to reform laws, provide services for survivors, transform gender norms, and increase women’s knowledge of their human rights.

Postnatal Care of Mothers: Knowledge, Nutritional Status and Utilization of Postnatal Care Services

The enabling environment for safe motherhood depends on the acumen of skilled health personnel and the availability of adequate health-care facilities, equipment, and medicines and emergency care when needed. The goal three of SDG aims at reducing the global maternal mortality ratio to less than 70 per 100,000 live births. In view of this, a study was conducted to study the knowledge, nutritional status and utilization of postnatal care services by the nursing mother and to develop intervention module to enhance mother’s knowledge on postnatal care on a sample of 200 mother-infant dyads in Dharwad district of Karnataka state. The tools used for the study were a self-structured questionnaire to study the knowledge about care during puerperium, MUAC was measured to assess the nutritional status of lactating women and Aggarwal socio-Economic Status scales were administered [1]. Edinburgh Postnatal Depression Scale was used to study the presence of postpartum depression among mothers [2]. The results revealed that most of the mothers had moderate (66.50 %) anaemia and 7.00 per cent had severe anaemia. Only 42 per cent women had normal nutritional status whereas 31.50 per cent were in moderate under-nutrition category and 10 per cent were in severe undernutrition category Maternal knowledge in four dimensions of public health, breastfeeding and nutrition, contraceptive methods and infant care was low to moderate. An intervention on postnatal care of mother was developed and was tested for its efficacy. The intervention to mothers significantly increased their knowledge on care during puerperium. The results indicate a need for family-based intervention to improve postnatal care of mother for safe motherhood.

An integrated multidisciplinary model of care for addressing comorbidities beyond reproductive health among women with polycystic ovary syndrome in India.

Polycystic Ovary Syndrome (PCOS) is becoming an area of global and national health concern. It requires a life cycle approach from adolescence to menopause. To comprehensively address the wide spectrum of this disorder, a multidisciplinary model of care was established for women with PCOS in a government setting in India with an objective to screen and manage multifaceted manifestations of PCOS and to diagnose and treat associated comorbidities such as metabolic syndrome, dermatologic manifestations and psychological issues. A model of integrated multidisciplinary PCOS clinic was implemented for services and research at ICMR-National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai Maharashtra, India. This is a one-stop holistic centre for managing menstrual, cosmetic, infertility, obesity, metabolic and psychological concerns of women affected with PCOS. Two hundred and twenty six women diagnosed with PCOS using the Rotterdam criteria were screened for metabolic comorbidities with anthropometry, ultrasonography, hormonal and biochemical tests and for psychological problems. Analysis was performed using SPSS version 19.0. Mean body mass index (BMI) was 26.1 kg/m2, higher for Asians. Hirsutism was observed in 53.6 per cent of women. Metabolic syndrome was seen among 35.3 per cent and non-alcoholic fatty liver in 18.3 per cent. Psychological issues such as anxiety and depression were identified in majority of the women 31.4 per cent of women could achieve pregnancy at the end of one year of multidisciplinary management. The results of the present study suggest that an integrated multidisciplinary approach led to the early identification and treatment of comorbidities of PCOS, especially metabolic syndrome. There is hence an urgent need to implement multidisciplinary PCOS clinics in government health facilities.

Women’s Empowerment Index in Cassava: An Innovative Tool for Gender Mainstreaming

Analysis of women’s empowerment in cassava was done among farm women and farmers who are involved in cassava cultivation in Kanyakumari district of Tamil Nadu. Snowball sampling technique was employed for collecting data using semi-structured interview schedule from 50 women and 50 men farmers involved in cassava cultivation. The women empowerment index in cassava was used for estimating the domains of empowerment and gender parity index. Results revealed that cassava women farmers were more empowered than their household male counterparts in the domains of community leadership and time allocation. Whereas, male farmers were more empowered than their female counterparts in production decision making, access to productive resources and control over use of income. It was found that the overall women empowerment score was 0.83 with 28 per cent of women in disempowered category.

Impact of Migration on Women Empowerment: A Situational Analysis of North-Bihar

The study was conducted during 2018-2019 to explore the impact of male migration innorth-Bihar in empowering women in different domain of household decisions. Five domainsnamely agricultural production, asset creation, health care, educational decision of childrenand leadership were considered and women empowerment indices were computed for eachdomain. The result revealed that migration of male member adequately empowered only29.44 per cent of women. Larger proportion of women respondents (43.89%) were foundunder moderately empowered category and 29.67 per cent were observed still under lowempowerment group. Women were adequately empowered in studied area to take decisionsrelated to health care, education and agricultural production. The decision to purchase andsale of assets still was under the jurisdiction of male counterpart as the patriarchal systemstill dominated. The role of women in decision making in all the farm activities, fromselection of crops to the sale of farm produce, showed comparatively more moderateempowerment indices. The paper concludes that the women are empowered to varyingextent in situation of male migration from their native places.

State of Domestic Violence Against Ever Married Women In Nepal

This study entitled “State of Domestic Violence Against Ever Married Women In Nepal” was carried out on secondary data of Nepal Demographic and Health Survey (NDHS), 2016. This study tried to identify outline of domestic violence against of ever married Women in Nepal. It has looked into the domestic violence such as physical, emotional, sexual and any kinds, of age 15-49 years of ever married women with respect to different socio-economic and demographic variables. The finding let out that physical violence increases sharply with age, from 17.7 per cent among women age 15-24 to 24.8 per cent among age 30 and above. About 36 per cent of women have experienced physical violence on other caste &amp; ethnicity followed by Dalit (31.7%), Janajaties (20.4%) and Brahmin &amp; Chhetri (12.2%). This study has assessed that experience of emotional violence is higher in middle class family in rural areas. Finding revealed that there is strong relation between experience of domestic violence and education level. Higher educated women were less exploited from any kinds of domestic violence in comparison to women with low level of education.

Sexual and reproductive health needs assessment and interventions in a female psychiatric intensive care unit.

To assess the sexual and reproductive health (SRH) needs of women admitted to a psychiatric intensive care unit (PICU), and acceptability of delivering specialist SRH assessments and interventions in this setting. Within a quality improvement framework, staff were trained, a clinical protocol developed and clinical interventions made accessible. Thirty per cent of women were identified as having unmet SRH needs and proceeded to a specialist appointment, representing a 2.5-fold increase in unmet need detection. Forty-two per cent of women were assessed, representing a 3.5-fold increase in uptake. Twenty-one per cent of women initiated SRH interventions, of which 14% had all their SRH needs met. Staff, patients and carers highlighted the acceptability and importance of SRH care, if interventions were appropriately timed and patients' individual risk profiles were considered. Barriers to access included lack of routine enquiry, illness acuity and impact of the COVID-19 pandemic. SRH needs for PICU admissions are greater than previously realised. Providing a nurse-led SRH assessment is acceptable, feasible and beneficial for PICU patients.

Tubal patency assessment using sequential transvaginal ultrasound and hysterosalpingo-foam sonography after methotrexate treatment for tubal pregnancy

Research questionWhat is the efficacy of sequential two-dimensional transvaginal ultrasound (2D-US) and hysterosalpingo-foam sonography (HyFoSy) after methotrexate (MTX) treatment for tubal pregnancy among patients who desire a future pregnancy? DesignA prospective trial conducted between May 2019 and November 2020. Patients who had a suspected tubal ectopic pregnancy diagnosed by ultrasound and treated by MTX were included. These patients underwent sequential transvaginal 2D-US assessment of the pelvic organs and a complementary HyFoSy for tubal patency. The primary outcome was tubal obstruction in the affected side. ResultsA total of 360 women underwent sequential transvaginal 2D-US assessment of the pelvic organs and a complementary HyFoSy for tubal patency. Of these, 40 (11.1%) women fulfilling the inclusion criteria were enrolled. In six out of 40 (15%), hydrosalpinx of the affected tube was found during the initial transvaginal ultrasound examination and were excluded from further investigation. In the remaining 34 (85%) patients, HyFoSy was carried out. Tubal block was found in 10 out of 34 (29.4%) patients. Of these, eight out of 34 (23.5%) and two out of 34 (5.9%) had a proximal block of the affected tube and bilateral proximal obstruction, respectively. Hysterosalpingography confirmed the tubal obstruction in all the affected cases. No procedure-related complications were documented. ConclusionsForty per cent of women who were treated by MTX for tubal pregnancy were diagnosed with tubal obstruction. We recommend that sequential transvaginal ultrasound and HyFoSy become part of routine follow-up for these women, thus offering them timely referral to the appropriate specialist.

The use of objective adherence measures targeting four placebo microbicide delivery forms in the Quatro Clinical Crossover Study

AbstractBackgroundAdherence to topical microbicides for HIV prevention has been a challenge for women using them and those developing novel products. The Quatro Clinical Crossover Study investigated user preference and acceptability of four different placebo‐based vaginal delivery forms among young African women. The objective of this sub‐study was to test the ability of objective adherence measures in assessing placebo product usage.MethodsA total of two hundred women from Zimbabwe and South Africa used placebo vaginal gel, insert, and film once per week, with or without sex, for 1 month and an intravaginal ring continuously for one month (Months 1–4). Women then chose their preferred product and used it with sex each week during Month 5. Women self‐collected vaginal swabs after using the gel, insert and film. Collected vaginal swabs and used intravaginal rings were analysed for placebo‐based adherence measures using spectroscopy and excipient‐based analyses to determine product use. Vaginal insertion and semen exposure was determined using previously developed and published adherence biomarkers. Intravaginal rings were extracted for residual excipient (glycerin) and penetrated bioanalytes.ResultsBoth methodologies showed that women used gel the most during Months 1–4 (75% by excipient methods, 85% by spectroscopy). The methodologies also determined that nearly all swabs from both sites were vaginally inserted, and 51–86% had detectable placebo product. Semen was detected in more swabs collected during Month 5 from women in Zimbabwe than the swabs from women in South Africa, and most of those swabs had placebo product present as well. The majority of women used the ring for the required four weeks. Sixty‐eight per cent of women who used the ring for the required 4 weeks increased to 78% during Month 5.ConclusionThis sub‐study demonstrated how these objective placebo‐based measures of adherence determined product use of various microbicide delivery forms.

The primary empty Sella: An endocrine study on 36 cases

Introduction: The term primary empty sella (PES) makes reference to the herniation of the subarachnoid space within the sella turcica in patients with no history of pituitary tumor, surgery or radiotherapy. Materials and Methods: We studied 36 patients; 27 females and 9 males. The mean age at diagnosis was 50, 4 years [21-80 years]. Most diagnoses were made by magnetic resonance imaging (n = 32). The anterior pituitary function was evaluated by basal hormonal measurements. Then, we had compared two groups of patients: G1(n=17), who had a pituitary disorder, and G2 (n=10), patients without hormonal disease, in order to determine risk factors for endocrine dysregulation in PES. Results: The reasons for ordering pituitary scans were: headaches (65%), visual disturbances (32%) and neurological symptoms in 8% of cases. Sixty-six point five per cent of women were multiparous. Diabetes, obesity and hypertension were found in 19.45 %, 11 % and 19.45 % of the studied population respectively. Hyperprolactinemia was present in 17.24 % of patients. Fifty-five percent of our patients had some degree of hypopituitarism. We didn’t find any correlation in our study, between pituitary insufficiency and age, gender, weight, parity nor post-partum hemorrhage. Failure of lactation was significantly associated with a hormonal disorder. On the other hand, headache was negatively correlated with hormonal effects in PES. Conclusion: PES was most commonly found in middle-aged multiparous women. In most patients, PES is a heterogeneous condition that ranges from hypopituitarism to various degrees of isolated GH deficiency, and which needs careful endocrine assessment, treatment and follow-up.