[Features of asthma by age]

It is a problem of public health, its prevalence is estimated at 300 millions people around the world, its clinical features diagnostic and therapeutic are very heterogeneous with age, then constitute a difficult task. This is a retrospective comparative study of 81 asthmatics profile divided into 2G + and G2: those over 65 years [GI] subjects under 65 years [G2]. The female is found in both groups, the average age was 69 ans +/- 14 versus 21 years +/- 10 in 1 and 2. In the personal history, it was noted that in patients under age 65 [group 2] there was more of rhinitis and dermatitis, but less of conjunctivitis and this statistically significant [p

[Facticious hypoglycaemia and diabetes: diagnosis difficulty]

There are many facticious diseases, and their diagnosis is often difficult, facticious hypoglycaemia due to auto-administration of insulin or secondary to insulin secretagogues drugs are probably under estimated. We report the case of a 25 years old woman who presents a particular facticious hypoglycaemia. she pretends to be treated for diabetes with insulin injection for 2 years. We suspect the [facticious diabetes] since she has normal fasting blood glucose level and without hyperglycaemia after her hypoglycaemic episodes, we decided to stop insulin injections, and realize that hypoglycaemia only happen when her husband comes and disappear when she has no visitors. Insulinemia and C-peptide coupled of the blood glucose level in addition to the oral provocated hyperglycemia confirm the diagnosis of facticious hypoglycaemia. the patient denied the insulin injection and we concluded she has a Munchhausen syndrome

[Utilisation of HbAlc in general practice]

Diabetes is a common, costly, and highly morbid chronic illness that requires continuing medical care to prevent acute complications and to reduce the risk of long-term complications. There is no definitive treatment for this disease, and the only way to avoid its complications is to obtion adurable equilibrant glycemic targets. The glycated haemoglobin and especially the HbAlc has become the [gold standard] for assessing and monitoring glycaemic control in patients with type 1 and type 2 diabetes. All laboratories determining HbAlc should use methods certified by the national glycohemoglobin standardisation program diabetes control and complications trial [NGSP/DCCT]. The upper limit of normal for such methods is generally from 4 to 6%. Sometimes, its interpretation should be reviewed because of red blood cells anomalies. Nowadays, HbAlc is recommended for the follow up of the diabetic patients. However, its role as a diabetes screening test or for diagnosis is not conclusively established. Actually, measurements of HbAlc allows clinicians to directly use their laboratory value to estimate future risk of micro and macro vascular complications

[ case of spontaneous pregnancy with Sheehan's syndrome]

Pregnancy in Sheehan syndrome is rare. Pituitary necrosis is sometimes incomplete and some remaining gonadotropic cells may induce ovulations. We report the case of a patient who presented with Sheehan syndrome and received cortisone and thyroxin substitutive therapy but no estrogen-progestogen treatment. One year later, the patient presented with a spontaneous pregnancy which was carried out until term. She delivered a healthy new born who was not breast-fed