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Background and Objective: Tobacco smoking is an established risk factor for chronic obstructive pulmonary disease (COPD). Current evidence suggests that non‑tobacco‑related risk factors vary geographically and are less understood than smoking. This study aims to compare the risk factors, symptoms, and clinical features of smoking (S‑COPD) and non‑smoking (NS‑COPD) in a COPD population. Materials and Methods: In this retrospective cross‑sectional study, 489 COPD patients were screened. Data on socio‑demographics, smoking and medical history, other risk factors, symptoms, and clinical characteristics including COPD Assessment Test (CAT) score, and Modified Medical Research Council (mMRC) Dyspnea Scale were examined. Results: Of the total selected 416 COPD patients, 35.34% were NS‑COPD while 64.66% were S‑COPD. S‑COPD was predominant in males, whereas NS‑COPD was predominant in females (P < 0.0001). In NS‑COPD, biomass fuel exposure was a major risk factor (P < 0.0001), and 61% of subjects had a biomass fuel exposure index of >60. In bivariate and multivariate analyses, no risk factors were correlated with forced expiratory volume in 1 second (FEV1 )% predicted, while among clinical features, duration of illness (P = 0.001) was correlated with lower values of FEV1 in the multivariate table of S‑COPD. In the multivariate analysis, biomass fuel exposure (P = 0.039) and CAT score (P < 0.0001) were correlated with FEV1 (%) in NS‑COPD. Conclusion: Biomass fuel exposure is a substantial risk factor for NS‑COPD and was correlated with FEV1 (%) predicted. In addition, the CAT score correlated with disease severity in patients with NS‑COPD. The development of COPD in non‑smokers is being recognized as a separate phenotype and it should be managed according to risk factors. [ABSTRACT FROM AUTHOR]

Background: Oxidant-antioxidant imbalance forms a prime component in pathogenesis of chronic obstructive pulmonary disease (COPD). Studies of oxidative stress markers in South Asians were sparse. Methods: One hundred and eighty COPD patients and eighty healthy nonsmokers were enrolled in the study. Serum malondialdehyde (MDA) and iron levels were estimated for oxidative stress. Three antioxidant markers evaluated-catalase, superoxide dismutase (SOD), and serum copper. Patients on antioxidant therapy and with sepsis and chronic illness were excluded from the study. Results: The mean age of COPD patients was 59.29 ± 10.3 years. Serum levels of MDA and iron were significantly higher in COPD patients compared to controls (5.21 ± 1.9 vs. 0.71 ± 0.29 nmol MDA/ml, P = 0.0001 and 69.85 ± 85.49 vs. 79.32 ± 24.39 μg/dl, P = 0.0001, respectively). Mean level of all antioxidant enzymes catalase, SOD, and copper were significantly diminished in cases when compared to control population (P = 0.001). Levels of MDA and iron were found to be significantly elevated in higher Global Initiative for Chronic Obstructive Lung Disease (GOLD) classes (III, IV) when compared to lower GOLD Classes (I, II). The levels of serum antioxidants were significantly depleted in higher GOLD grades too. COPD patients who were male and smoked had significantly higher levels of oxidants and depleted antioxidant levels compared to female and nonsmoking compatriots. Serum MDA levels negatively correlated with forced expiratory volume 1 s and forced vital capacity (r = -0.19 and r = -0.21, P ≤ 0.01). The presence of a cough significantly correlated with higher levels of MDA and iron (P = 0.001). The levels of MDA negatively correlated with SOD and catalase levels. Conclusion: Oxidative markers (MDA and iron) are higher whereas antioxidants (catalase, copper, and SOD) are significantly reduced in patients of COPD. Serum MDA levels correlate with lung functions and disease severity. [ABSTRACT FROM AUTHOR]

Massive pleural effusions are commonly caused by malignancy, parapneumonic effusion, and tuberculosis. Parasitic infections are rare causes of massive pleural effusion. Echinococcosis or hydatid disease is a major public health problem in poor hygienic environments. The liver and lungs are the most frequently involved organs. Pulmonary disease appears to be more common in younger individuals. Echinococcus multilocularis causes alveolar echinococcosis, which accounts for <5% of all cases of hydatid liver disease and less frequently lung disease. Here, we present an unusual case of multilocular pulmonary hydatid cysts mimicking massive pleural effusion in a 25-year-old young male. [ABSTRACT FROM AUTHOR]