Background:Tobacco smoking has been recognized as the most important risk factor for chronic obstructive pulmonary disease (COPD) for a long time, but recent studies have shown that nonsmokers also contribute to a significant proportion of COPD. This study was performed to find out the proportion of nonsmoker individuals among COPD patients and to determine various etiologies in nonsmoker COPD patients.Materials and Methods:This study was an observational cross-sectional study conducted in Department of Pulmonary Medicine, MLN Medical College, Allahabad. A total of 200 COPD patients, aged >18 years of either gender with COPD, diagnosed by clinical and spirometric criteria (GOLD guideline) were included in the study.Results:Of the 200 COPD patients, the proportion of nonsmoker patients was 56.5%, and the smoker was 43.5%. Among 113 nonsmoker COPD patients, maximum number of patients (69.03%) belonged to low socioeconomic status but most important and statistically significant risk factor was exposure to biomass smoke (53.98%), other significant risk factors were treated pulmonary tuberculosis (32.74%), and long-standing asthma (14.16%). Risk factors that were not statistically significant were occupational exposure (9.73%), exposure to outdoor air pollution (3.54%), and lower respiratory tract infection during childhood (1.77%). The patients who were exposed to more than one risk factors, developed COPD at an earlier age.Conclusions:This study revealed that nonsmokers contribute a significant proportion of COPD patients. Multiple risk factors other than smoking also play a major role in the development of COPD, particularly exposure to biomass smoke, treated pulmonary tuberculosis, and long-standing asthma.

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Lymphatic filariasis is a tropical parasitic disease and is endemic in India. It is present in various forms but its manifestation as pleural effusion is rare. Here, we describe a case of 58-year-old male who presented with complaint of left side chest pain and breathlessness. He was investigated and diagnosed as a case of left side pleural effusion due to filariasis, with peripheral blood lymphocytosis but without peripheral blood or pleural fluid eosinophilia. Our case foregrounds that filariasis can present with peripheral blood lymphocytosis and without peripheral blood or pleural fluid eosinophilia.

BACKGROUNDTobacco is one of the major causes of disease and death in India, accounting for nearly 0.9 million deaths every year. The prevalence of SLT use among adult men in India increased from 24% in 1995 to 33% in 2009, whereas the prevalence of smoking reduced from 35% to 24% during the same period. Several studies have demonstrated the association between smoking and the risk of pulmonary TB, relapse of TB and mortality due to TB and poor tuberculosis treatment outcome. Little data exist on the prevalence and patterns of SLT use among patients with TB in India. The objective of present study to assess the association between the tobacco chewing and pulmonary tuberculosis with respect to prevalence and mycobacterium tuberculosis bacilli load. MATERIALS AND METHODSA descriptive study was conducted among 257 pulmonary TB patients between January 2017 and June 2017 attending Department of Respiratory Medicine, MLN Medical College, Allahabad. Using a structured interview schedule, retrospective smoking and smokeless tobacco use data were collected at the diagnosis. RESULTSTotal 257 pulmonary tuberculosis patients enrolled in our study, of which 178 (69.2%) ever users of any form of tobacco in lifetime and 140 (54.4%) patients were current users of any form of tobacco at the time of the survey. Among the tobacco users, 42 patients were exclusive smokers, 68 were exclusive SLT users and 30 of them used both forms of tobacco. The prevalence of tobacco chewing and smoking was 48.5% and 30% respectively at the time of diagnosis. Among tobacco chewers, the AFB smear grading was 2.9% scanty positive, 23.5% were 1+, 38.2% were 2+ and 35.2% were 3+ respectively.