Papers by Nuzhat Choudhury
Journal of Family Medicine and Primary Care
Euroasian Journal of Hepato-Gastroenterology
Background and aim: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndr... more Background and aim: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has induced a sense of panic around the world as the disease is highly contagious and has been spreading in full swing during last 5 months causing millions of COVID-19 patients and hundreds of thousands of deaths. Bangladesh, a country of 170 million people, is not an exception regarding COVID-19; it has reported several thousand COVID-19 patients with several hundred of deaths. This observational study has been planned to assess the scope and limitation of management strategy against COVID-19 patients in a medical college hospital of Bangladesh with available drugs in a real-life situation. Materials and methods: All patients in this cohort (N: 33) were positive for SARS-CoV-2 by polymerase chain reaction (PCR) and they attended the hospital with variable presenting symptoms those ranged from cough and fever to respiratory distress and pneumonia. As per the protocol, the patients were regularly evaluated for several parameters of COVID-19-related pathology. Before discharge, they were checked for SARS-CoV-2 for 2 consecutive times. The management strategy included standard of care (SoC) and administration of hydroxychloroquine and azythromycin, available in Bangladesh. Results: Out of total 33 patients, 1 patient died at day 4 day after admission. Two patients developed severe complications and were referred to tertiary hospital in Dhaka (2 and 3 days after admission), the capital of Bangladesh, where they recovered and were discharged from hospital after being SARS-CoV-2 negative. The rest 30 patients were discharged from the medical college hospital after being negative for SARS-CoV-2 in two subsequent assessments and improvement of their COVID-related symptoms. The average hospital stay of these patients was 14.5 days with a range of 10-24 days. Conclusion: It seems that most of the COVID-19 patients may be adequately managed by standard of care management with drug support. However, early diagnosis and hospitalization with adequate care may be important variables for better survival. These factors may be properly ensured if the patient burden remains at a palatable level in forthcoming days in Bangladesh.
Bangladesh Medical Research Council Bulletin
Retinopathy of Prematurity (ROP) is a potentially avoidable cause of irreversible blindness or se... more Retinopathy of Prematurity (ROP) is a potentially avoidable cause of irreversible blindness or severe visual impairment in many infants born premature. The global incidence of premature birth has been reported to be 11.1 per 100 livebirths in 2010. The present communication share the experience and lessons learnt during a Neonatologist-Ophthalmologist Retinopathy of Prematurity (NO-ROP) campaign and ROP situation analysis in Bangladesh. A weeklong workshop was organised in May 2016 in Dhaka for the paediatricians and ophthalmologists of the country involved in ROP care. This included a programme to train the attendees on basic to advanced ROP care. Finally, a half day session was organised for the government stakeholders, non government organisations, obstetricians, neonatal and child health care providers and ophthalmologists to assess the level of awareness, the gaps and any obstacles for an effective ROP care in the country. Besides, two neonatal units were visited to assess the ...
Euroasian Journal of Hepato-Gastroenterology
Background: Chronic liver disease (CLD) is common in Bangladesh; however, a major bulk remains as... more Background: Chronic liver disease (CLD) is common in Bangladesh; however, a major bulk remains as cryptogenic CLD as they remain devoid of known pathological agents leading to have a check of Kayser-Fleischer (K-F) rings for possible Wilson's disease (WD) and many of these patients develop complications such as cirrhosis of liver and hepatocellular carcinoma. However, there remains considerable proportions of CLD patients with undefined etiology (cryptogenic CLD) and these patients cannot be provided effective therapy based on etiological factors. Here, the proportion of WD among cryptogenic CLD patients in Bangladesh has been evaluated to improve the management of CLD and reduce complications. Materials and methods: A total of 941 patients with cryptogenic CLD [negative for hepatitis viruses, alcohol, nonalcoholic fatty liver disease (NAFLD), drug, and autoimmunity] were enrolled in the study. To assess if they have been suffering from WD, the levels of copper in 24-hour urine were evaluated. Definitive WD was diagnosed when 24-hour urinary copper output was >100 μg and strongly indicative WD patients excreted >40 μg of copper in 24 hours. Results: Out of 941 patients with cryptogenic CLD, 212 patients were diagnosed as definitive WD and 239 patients as strongly indicative WD on the basis of 24-hours copper excretion. The age distribution ranging of the patients varied from 1 year to 90 years. There was a male predominance. Considerable numbers of WD patients had previous history of jaundice. Kayser-Fleischer rings were mostly uncommon and detected in five patients with WD only. Discussion: Wilson's disease is not a rare entity in Bangladesh; rather, it seems to be fairly common among CLD patients. A country-wide epidemiological survey should be conducted for diagnosis of WD in Bangladesh to provide a proper management strategy for these huge numbers of WD patients. In fact, most of the WD patients are unaware of their diagnosis and the general physicians are equally unaware of diagnosis and management of WD.
Khyber Medical University Journal, May 23, 2012
Khyber Medical University Journal, Oct 15, 2011
Although first described in the early 1900s, the pathogenesis of Wilson's disease was identified ... more Although first described in the early 1900s, the pathogenesis of Wilson's disease was identified in the mid-1900s. It is an inherited error of copper metabolism that predominantly presents with hepatic and/or neurological manifestations. Hepatic form of Wilson's disease can have varied presentations from acute hepatitis to liver cirrhosis and end stage liver disease necessitating liver transplantation. In addition to the liver and brain other organs like eyes, kidneys and bones are frequently involved. Although infrequent, Wilson's disease is not rare in Neuromedicine, Hepatology and Ophthalmology practices. Chelation therapy remains the mainstay of treatment and several copper chelating agents are now available.
Bangabandhu Sheikh Mujib Medical University Journal
Journal of Ophthalmic Inflammation and Infection, 2014
Background: Ocular tuberculosis (TB) can affect nearly every ocular tissue, leading to a variety ... more Background: Ocular tuberculosis (TB) can affect nearly every ocular tissue, leading to a variety of vision-threatening clinical manifestations. The goal of this study is to estimate the degree, duration, and causes of visual impairment in eyes affected by ocular TB. Results: This was a retrospective study of patients diagnosed as ocular TB based on polymerase chain reaction (PCR) for Mycobacterium tuberculosis complex. We applied the World Health Organization definition of visual impairment (VI) to affected eye(s), instead of better-seeing eye. Best-corrected visual acuity (BCVA) of <6/18 and ≥6/60 in the affected eye was classified as moderate VI and <6/60 and ≥3/60 as severe VI. Data collected included presenting and final BCVA of affected eyes and the worst BCVA during the study period. Sixty-one eyes of 40 patients were analyzed. Twenty-five patients (52.1%) had bilateral disease. The mean worst BCVA and mean final BCVA (logMAR) were 1.26 ± 0.87 and 0.61 ± 0.85, respectively, and their difference was highly significant (p < 0.0001, Friedman test). The median worst and final BCVA results were 1.30 (range 0.0 to 3.0) and 0.20 (range 0.0 to 3.0), respectively. The mean duration of follow-up was 98.34 ± 81.81 weeks. Moderate and severe VIs were seen in 14 (22.9%) and 12 (19.7%) eyes, respectively, during the course of follow up. Twenty eyes (32.8%) had BCVA of <3/60. Moderate VI or worse was most commonly seen in eyes with multifocal serpiginoid choroiditis (n = 6; 100%), retinal vasculitis (n = 25; 80.6%), and panuveitis (n = 12; 80%). The mean duration of visual loss was 25.2 ± 42.37 weeks (median 6.43 weeks, range 0 to 206.42 weeks). Vitreous hemorrhage, complicated cataract, and macular scarring were the common causes of VI.
Journal of Ophthalmic Inflammation and Infection, 2014
Background: Ocular tuberculosis (TB) can affect nearly every ocular tissue, leading to a variety ... more Background: Ocular tuberculosis (TB) can affect nearly every ocular tissue, leading to a variety of vision-threatening clinical manifestations. The goal of this study is to estimate the degree, duration, and causes of visual impairment in eyes affected by ocular TB.
Bangladesh Journal of Medicine, 2015
Journal of ophthalmic inflammation and infection, 2014
Polymerase chain reaction (PCR) assay can be a useful method for definitive diagnosis in paucibac... more Polymerase chain reaction (PCR) assay can be a useful method for definitive diagnosis in paucibacillary infections such as ocular tuberculosis (TB). In this study, we have evaluated factors affecting PCR outcomes in patients with clinically suspected ocular TB. Patients with clinically suspected ocular TB were investigated by PCR of aqueous or vitreous samples. Three control groups were also tested: group 1 included culture-proven non-tuberculous endophthalmitis, group 2 culture-negative non-tuberculous endophthalmitis, and group 3 patients undergoing surgery for uncomplicated cataract. PCR targeted one or more of following targets: IS6110, MPB64, and protein b genes of Mycobacterium tuberculosis complex. Multiple regression analysis (5% level of significance) was done to evaluate the associations between positive PCR outcome and laterality of disease, tuberculin skin test (TST)/interferon-gamma release assay (IGRA), chest radiography, and type of sample (aqueous or vitreous). The m...
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Papers by Nuzhat Choudhury