BACKGROUND Although, smoking is the most common risk factor implicated in the causation of chronic obstructive pulmonary disease (COPD), biomass smoke exposure is an important risk factor, especially in women residing in rural areas of developing countries such as India. Comorbidities are prevalent in patients with COPD because of systemic inflammation. The prevalence of comorbidities among biomass smoke-induced COPD has not been widely studied. Aims and Objectives-To assess whether patients exposed to biomass fuel have similar clinical profile and prevalence of comorbidities as smoker COPD or not. MATERIALS AND METHODSThe clinical characteristics and prevalence of comorbidities were compared between 411 male patients with smoker COPD and 288 female patients with biomass smoke-induced COPD. RESULTSThe patients exposed to biomass fuel were all females, were younger, had higher body mass index (BMI) and had less severe disease (higher values of post bronchodilator (BD) forced expiratory volume in the first second (FEV1 %)). The mean age in smoker COPD was significantly higher than in biomass smoke-induced COPD (p < 0.001). The mean BMI was lower in smoker COPD as compared to that in biomass smoke-induced COPD and this difference was statistically significant (p= 0.042). Coronary artery disease (CAD) (13.86% versus 3.81%, p < 0.0001) and systemic hypertension (HTN) (15.32% versus 3.47%, p < 0.0001) were significantly more common in smoker COPD without any other significant differences. Obstructive sleep apnoea (OSA), lung cancer and anaemia were found to be more common in biomass fuel-induced COPD, although not statistically significant. CONCLUSIONCAD and systemic HTN were significantly more prevalent in smoker COPD. KEYWORDSChronic Obstructive Pulmonary Disease, Biomass, Tobacco, Comorbidity. HOW TO CITE THIS ARTICLE: Jangpangi DS, Singh A, Rawat J, et al. A comparison of clinical profile and prevalence of comorbidities among biomass and tobacco smoke-induced COPD patients at a tertiary care centre in North India.

Spontaneous diaphragmatic hernia without any apparent predisposing factor is a very rare condition. We report a case of 28-year-old male who presented with complaints of abdominal pain and gradually increasing breathlessness. Chest radiograph was suggestive of left-sided hydropneumothorax. Diagnosis of diaphragmatic hernia was confirmed by computed tomography. The defect was repaired by open thoracotomy and patient had an uneventful postoperative recovery.

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