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Objective: To ascertain the effects of cotton dust on the peak expiratory flow of cotton mill workers in comparison with thehealthy controls who never exposure to the cotton dust. Setting: Outpatient Department of Pulmonology, Nishtar Hospital, Multan.Period: August 2011 to March 2012. Material and methods: A total of 200 male subjects (100 healthy controls and 100 cotton millworkers) who strictly met the inclusion criteria were selected from the OPD. Results: The peak expiratory flow rate (PEFR) (L/min) ofcotton mill workers was significantly lower as compared to the control subjects and this impairment was directly proportional to theduration of exposure to the cotton dust in the mail. Conclusions: It was concluded from the study that the peak expiratory flow rate wasdecreased in the cotton mill workers.

Objective: To determine the frequency of various diseases presenting with pleural effusion. Setting: Department of ChestMedicine, Nishtar Hospital, Multan. Period: March 2010 to September 2010. Material and methods: A total of 100 patients both sexes, morethan 12 years old, with clinically and radiologically confirmed pleural effusion underwent diagnostic thoracocentesis. Pleural fluid wasexamined grossly and for sugar, protein, LDH, total and differential white cell count and malignant cells. Pleural fluid culture and pleural biopsywas done in case of exudative effusion. Results: Tuberculosis was the most common cause (28%) of exudative pleural effusion followed byparapneumonic effusion (25%) and malignant effusion (9%). Congestive cardiac failure (13%) and liver cirrhosis (8%) were the commonestcause of transudative pleural effusion. Renal failure (5%), nephritic syndrome (2%), pancreatitis (2%), systemic lupus erythmatosus (2%) werethe other significant causes of pleural effusion. Conclusion:- Tuberculosis, paraneumonic effusion and malignancies are the common cause ofexudative pleural effusion while congestive cardiac failure, liver cirrhosis and nephritic syndrome are common causes of transudative effusion.