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A 43-year-old male using valproic acid (VA) for 2 years for seizure disorder presented with right-sided moderate pleural effusion. Pleural fluid analysis revealed exudative effusion with 42% eosinophils. There was no evidence of haemothorax, pneumothorax, malignancy, and parasitic infections. Suspecting a drug-related event, VA was discontinued. The patient showed clinical improvement with resolution of pleural effusion on chest radiograph three weeks later. VA is a popular drug used for variety of disorders like seizures, migraines, and schizophrenia. There is a paucity of literature on VA-induced pleural effusion. Though a rare phenomenon, clinicians should be aware of such a possibility to avoid erroneous diagnosis. [ABSTRACT FROM AUTHOR]

Context: Irreversible airway obstruction is important sequelae of pulmonary tuberculosis (TB) that might contribute to a significant proportion of chronic obstructive pulmonary disease (COPD). India has the highest TB burden in the world. However, there are limited data on the prevalence and presentation of TB-associated COPD from this region. Aims: This study aims to evaluate the prevalence of TB-associated COPD among COPD patients presenting to a tertiary care hospital. Settings and Design: It was a case-control study conducted in a tertiary care hospital. Subjects and Methods: Stable COPD patients presenting to chest OPD and an equal number of healthy controls were enrolled. COPD patients were subjected to detailed clinical evaluation and lung function test. History of pulmonary TB was evaluated from both groups through self-reporting and/or checking previous records. TB-associated COPD patients were identified and their prevalence and distinguishing features evaluated. Results: Of 74 COPD patients, 24 (32.4%) had previous history of pulmonary TB. The odds of having a previous TB in COPD patients was 3.96 (95% confidence interval: 1.64-9.55; P = 0.002) as compared to controls. Patients with TB-associated COPD were younger (P = 0.02), had lesser pack-years of smoking (P = 0.027) but had more number of hospitalizations (P = 0.01). The airflow limitation was similar in both groups. Conclusions: TB-associated COPD constitutes a significant proportion of COPD patients. It is a distinct clinical entity with preponderance in young. It may be associated with frequent hospitalizations as compared to other COPD patients. [ABSTRACT FROM AUTHOR]