RESUMEN
Allgrove syndrome is a rare autosomal recessive disorder characterized by classic triad of Achalasia cardia, Alacremia and ACTH-resistant adrenal insufficiency. Although Addison's disease is the essential component but various combinations of other major findings are often seen involving nervous system. Patients generally present with adrenal insufficiency diagnosed during an inter-current illness. Other clinical features such as alacremia, dysphagia with recurrent vomiting may precede adrenal insufficiency for some time. Here, we present case of a 5 year old boy who presented with complaints of recurrent vomiting and dysphagia. In last admission tendency towards low blood sugar was noticed and there was some concern about pigmentation of lips. This paper highlights early features of this syndrome and the importance to include Allgrove syndrome in the presence of any of two features, progressive dysphagia Alacremia or symptoms of primary adrenal insufficiency
RESUMEN
To determine the smoking patterns of medical students of 4th year MBBS. A cross-sectional survey. Lahore Medical and Dental College [LMDC], Lahore, Pakistan. From November to December 2006. The 50 medical students of 4th year MBBS, who were current smokers. A structured questionnaire was used to collect the data. Descriptive statistics was determined in terms of percentages. In present study, 48% students started smoking between 14-17 years of age, 34% started to smoke between ages 18-21 years and 18% of them had been smoking for past 4-6 yrs. Main reason to commence smoking included curiosity [27%], need to look glamorous [22%], peer pressure [16%] and stress relieving [10%]. When probed about numbers of cigarettes smoked daily, the response of majority was that 32% of students admitted to smoking 1 -5 cigarettes, similar number admitted to smoking 6-10 cigarettes, and 30% of students smoked more than 20 cigarettes. Among the respondents, 41% had a brother who was a smoker and 37% had a father who was a smoker. More than half the respondents [58%] said that their parents were unaware of their smoking habit. Regarding awareness about the medical hazards of smoking, 31% of students named cancer, 29% mentioned heart disease, 18% were familiar with COPD and only 7% referred to stroke. The main concerns of respondents regarding smoking were fear of being discovered by their parents [22%], psychological dependence [20%] and physical dependence [18%]. Only 50% of students tried to quit smoking, using hypnosis and substitutes like nicotine gum and nicotine patches. Tobacco smoking among medical students is alarming. These findings not only raise concerns for the future health of our medical students but also their credibility and effectiveness as health promoters for population at large