What justifies a placebo-controlled trial of Varenicline for smoking cessation in patients with COPD?

Correspondence helped to rule out concomitant silicosis in this case. 4 Patients with silicotuberculosis may have resistance to antitubercular medications, and they may need a longer duration of treatment as compared with TB alone 5 ; hence, it is important to recognize concomitant silicosis in the context of this case report. Pleuritic chest pain and pericardial effusion on echocardiogram suggest the diagnosis of pericardial TB, but the authors did not mention this in their fi nal diagnosis. Moreover, steroids should have been added for treatment of pericardial TB in addition to standard anti-TB regimen. 6