 i their parents could not provide written consent for them; ii they were lost to follow up; iii they could not perform clonidine stimulation tests CST or insulin tolerance test ITT due to a medical contraindication e.g. cardiac disorder, seizure disorder; iv they had received GH therapy in the past; v they were known to have pituitary diseases, hypothyroidism, hypogonadism or discovered to have panhypopituitarism or vi they have malnutrition, diabetes mellitus, liver disease, or other chronic illnesses. 