PurposeRespiratory conditions remain a source of morbidity globally. As such, this study aimed to explore factors associated with the development of airflow obstruction (AFO) in a rural Indian setting and, using spirometry, study whether underweight is linked to AFO.MethodsPatients > 35 years old attending a rural clinic in West Bengal, India, took a structured questionnaire, had their body mass index (BMI) measured, and had spirometry performed by an ancillary health care worker.ResultsIn total, 416 patients completed the study; spirometry was acceptable for analysis of forced expiratory volume in 1 second in 286 cases (69%); 16% were noted to exhibit AFO. Factors associated with AFO were: increasing age (95% confidence interval (CI) 0.004–0.011; P = 0.005), smoking history (95% CI 0.07–0.174; P = 0.006), male gender (95% CI 0.19–0.47; P = 0.012), reduced BMI (95% CI 0.19–0.65; P = 0.02), and occupation (95% CI 0.12–0.84; P = 0.08). The mean BMI in males who currently smoked (n = 60; 19.29 kg/m2; standard deviation [SD] 3.46) was significantly lower than in male never smokers (n = 33; 21.15 kg/m2 SD 3.38; P < 0.001). AFO was observed in 27% of subjects with a BMI <18.5 kg/m2, falling to 13% with a BMI ≥18.5 kg/m2 (P = 0.013). AFO was observed in 11% of housewives, 22% of farm laborers, and 31% of cotton/jute workers (P = 0.035).ConclusionIn a rural Indian setting, AFO was related to advancing age, current or previous smoking, male gender, reduced BMI, and occupation. The data also suggest that being under-weight is linked with AFO and that a mechanistic relationship exists between low body weight, smoking tobacco, and development of AFO.

P120 Figure 1 Total number of non-infective COPD and asthma admissions following eruption of Eyjafjallajokull to Perth Royal Infirmary. Introduction Spirometry remains the cornerstone in the diagnosis of Chronic Obstructive Pulmonary Disease (COPD). Little is known regarding the determinants and prevalence of COPD in rural India. We undertook a population-based study in Howrah District, West Bengal,India at a community-based primary care clinic of a voluntary organisation to test the feasibility of spirometric estimation of the prevalence of COPD. Methods Spirometry was performed on all adults >35 years attending the clinic. Questionnaire data (capturing respiratory symptoms, occupation, tobacco smoking history, indoor stove use) were gathered for each subject. All spirometric data were examined by an independent UK-based clinical scientist. Results Spirometry was performed in 315 patients over 3 months; 18% (58/315) of measurements were deemed good quality as per ERS guidelines; 45% (143/315) had the correct shaped curve; hence 64% (201/315) of all spirometries were deemed adequate for FEV 1 analysis. Poor quality traces were noted in 36% (n¼114) and hence were excluded from analysis. Of the adequate spirometries (n¼201, mean age 51 years (SD 12.1); 39% male), 84 (42%) were normal, 102 (51%) exhibited mild airflow obstruction, 12 (6%) moderate airflow obstruction and 3 (1.5%) severe airflow obstruction according to British guidelines. Difference in FEV 1 % predicted between never/ex smokers and current smokers was significant (p¼0.029). Indoor stove use was ubiquitous in this population and did not correlate with FEV 1 percent predicted. Conclusion In a rural Indian setting, valid spirometry can be obtained in two-thirds of adult patients attending a community clinic with 58% of patients in this sample exhibiting at least mild REFERENCES

Congenital tuberculosis is a rare disease. It usually presents with respiratory distress, fever and organomegaly. We report a case of congenital tuberculosis presenting with ascites only.DOI: http://dx.doi.org/10.3126/jcmsn.v10i1.12766 Journal of College of Medical Sciences-Nepal, 2014, Vol.10(1); 37-40