Filarial pleural effusion without peripheral blood or pleural fluid eosinophilia.

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.

Prevalence and etiological profile of chronic obstructive pulmonary disease in nonsmokers.

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.

Does 'weight reduction' help all adult snorers?

BACKGROUND: Obesity is now a global epidemic. Obese people are at higher risk of snoring. Weight reduction could influence the prevalence of snoring. Present study tried to find out, whether weight reduction is of benefit in all adult snorers. MATERIALS AND METHODS: It is a cross sectional study, on 349 subjects (196 males and 153 females). They and their spouses were asked for snoring habits. Their neck circumference, height and weight was measured and Body mass index (BMI) was calculated, and they were classified into low normal, high normal, pre-obese and obese BMI groups. Prevalence rates of snoring in different groups were compared, to find out any statistically significant difference, between them. RESULTS: Statistically significant difference, in prevalence rates of snoring was found, when obese and pre-obese group were compared with normal BMI group, separately. No significant difference was found in prevalence rates, when comparison was made between obese and pre-obese group. Difference in prevalence of snoring, was also not significant, when comparison was made between low normal and high normal BMI groups. Neck circumference of snorers was significantly more than the neck circumference of non-snorers in all BMI groups. Gender wise difference, in prevalence of snoring was also not significant. CONCLUSION: Body mass index target needs to be set at 25 kg/m(2), in weight reduction programmes, to achieve clinically relevant response in a snorer. There is no need to put extra emphasis, on further reduction of BMI. Weight reduction, is not helpful in all adult snorers, especially those with normal BMI, where other causes of snoring, like fat around upper airways, need to be considered.