Causes of short stature identified in children presenting at a tertiary care hospital in Multan Pakistan

To determine the frequency of common causes of short stature in children presenting to the Children's Hospital and the Institute of Child Health, Multan. This cross sectional study was done in Pediatric Endocrinology department, the Children's Hospital and the Institute of Child Health, Multan, from March to September, 2011. One hundred and sixty nine children with short stature presenting to the outpatient department meeting inclusion criteria were recruited after taking an informed consent. The detailed history, physical examination including anthropometric measurements and relevant investigations were recorded. Causes of short stature [outcome variable] were recorded on a predesigned proforma for final analysis. The common causes of short stature identified were; familial short stature [FSS] 36 cases [21.3%], hypothyroidism 29[17.2%], growth hormone deficiency [GHD] 18[10.7%], insulin dependent diabetes mellitus [IDDM] 16[9.5%] and constitutional delayed growth and maturation [CDGM] 11[6.5%] cases. This was followed by primary malnutrition 8[4.7%], celiac disease 6[3.6%], Turner syndrome 5[3%] cases and unknown syndromes 4[2.4%] followed by other rare causes. Common causes of short stature identified in this study were endocrine diseases followed by normal variant short stature [NVSS], while nonendocrine causes were the least

Current concepts in central giant cell granuloma

Central Giant Cell Granuloma is a nonneoplastic intraosseous lesion, and constitutes a common nonodontogenic pathology to occur in the jaws. It is characterized histologically by cellular fibrous tissue containing multiple foci of haemorrhage, aggregations of multinucleated giant cells, and occasionally, trabeculae of woven bone. Various theories brand it from being a 'reactive' to hamartomatous to a neoplastic lesion. It has now been hypothesized that it is the mononuclear spindle shaped cell which controls the proliferative activity of this lesion, as opposed to the more frequently seen giant cell. It has an increased predilection for mandible and females, in younger age groups. Various radiological and histopathological differential diagnoses should be considered in case of giant cell lesions. Some of the lesions are thought to display a markedly 'aggressive' behaviour and a clinically 'aggressive' model of CGCG has been proposed. Smaller, 'nonaggressive' tumours generally respond very well to conservative enucleation or curettage but recurrence is seen to be common with 'aggressive' lesions. Various medical therapies including injections of intra lesional steroids, subcutaneous calcitonin and interferon have been proposed for the treatment of 'aggressive' lesions