The significance of height in boosting self-confidence has prompted some families to seek medical interventions to enhance their children’s stature. One such intervention is hormone therapy using recombinant human growth hormone (rhGH), which has been employed in clinics since 1985, primarily for treating growth hormone deficiency (GHD). Over time, rhGH therapy has been utilized for various conditions where childhood short stature is not solely a result of inadequate growth hormone secretion, such as small for gestational age (SGA) or idiopathic short stature (ISS). In addition to its effects on the skeletal system, growth hormone (GH) also plays a vital role in regulating CARDIOVASCULAR function. There is growing evidence suggesting a correlation between abnormal GH levels—both elevated and deficient—and increased CARDIOVASCULAR morbidity and mortality among patients with GH disorder. Notably, CARDIOVASCULAR complications are not limited to pathological GH levels; even slight increases within the normal range have been linked to increased CARDIOVASCULAR disease (CVD) events in healthy individuals. These findings raise concerns about the potential long-term CARDIOVASCULAR effects of rhGH therapy, especially among children without GH disorders. In this comprehensive review, we summarized recent research findings to provide insights into the physiological and pathophysiological effects of GH on the heart. We aimed to elucidate the long-term side effects of GH therapy and identify associated risk factors.

BACKGROUND: Breast cancer is the most common malignancy in women, with 15–20% being HER2-positive, an aggressive subtype treated with Trastuzumab. Despite its survival benefits, Trastuzumab may cause cardiotoxicity, typically monitored by left ventricular ejection fraction (LVEF). This study assessed Trastuzumab’s impact on LVEF and related factors among women with breast cancer in Baghdad. METHODS: This retrospective observational cohort study included 60 women with stage I–III HER2-positive breast cancer treated at Al-Amal National Oncology Hospital between January 2023 and May 2024. Baseline demographic, clinical, and echocardiographic parameters were collected, with follow-up assessments every three weeks during therapy and after the final cycle. Data were analyzed using SPSS version 27. RESULTS: A P-value <0. 05 was considered statistically significant. Mean LVEF declined significantly from 64. 98% ± 5. 50 to 62. 02% ± 6. 91 post-treatment (P < 0. 001). The proportion of patients with impaired left ventricular diastolic function increased from 11. 7% to 26. 7% (P = 0. 003). An LVEF decline of ≥10% was considered clinically meaningful. Traditional risk factors were not associated with LVEF decline, whereas baseline LVDF (OR 10. 80,95% CI: 2. 21–17. 42,P = 0. 007) and post-treatment LVDF (OR 8. 20,95% CI: 1. 74–13. 58,P = 0. 008) were significantly linked to LVEF decline. CONCLUSION: Trastuzumab can cause early cardiac function decline, which is not always detected by LVEF alone. Assessment of left ventricular diastolic function at baseline and during therapy can identify high-risk patients, enabling timely monitoring and management to balance anticancer benefits with cardiotoxic risk.

Background & Objective: Oral examinations or viva is a common mode of assessment for medical students. It is not possible to cover the entire syllabus and students often feel that the “luck factor” plays a major role in deciding their performance. Efforts have been made to address these shortcomings associated with traditional viva exams, mainly by attempting to formulate a format which is both objective as well as structured. With this background, aim of the present study was to create an objective structured viva questions in CARDIOVASCULAR PHYSIOLOGY as a prototype of viva voce in PHYSIOLOGY. Materials & Methods: The study included creation of an Objective Structured Viva Examination (OSVE) question bank in CARDIOVASCULAR PHYSIOLOGY. The first year medical (MBBS) students were randomized by use of random number table and attended all three formats of theory viva (OSVE, traditional & blended) on designated dates and time slots. Feedback was obtained from the participants using standard format and the feedback from faculty involved in the study was collected in a qualitative format at the end of the assessment. Results: There was significant difference in the mean value of marks obtained by the students in the OSVE format when compared to traditional and blended format (p < 0. 05). No correlation was observed between marks scored between the three formats of viva. Student’s feedback revealed that OSVE format was well structured and easy to score marks when compared to other formats. Faculty feedback revealed that OSVE format was less time consuming as compared to the other formats. Conclusion: Since there was no correlation between performance of students in the three formats of viva, each type of viva format can be used as a separate assessment tool for the students. Further studies of this kind can help to reorganize the viva assessment and also can give a platform for innovation of newer assessment method in medical education which can be extrapolated to other streams