Shubhra P Paul - Academia.edu (original) (raw)

Papers by Shubhra P Paul

Northern International Medical College Journal, 2024

Background: Complications from preterm birth are the leading causes of death among children under... more Background: Complications from preterm birth are the leading causes of death among children under 5 years of age, responsible for approximately 1 million deaths in 2015. Three-quarters of these deaths could be prevented with current, cost-effective interventions. Premature infants, particularly those born at <28 weeks of gestation, are at significant risk for reduced bone mineral content (BMC) and subsequent bone disease, variably termed metabolic bone disease (MBD), osteomalacia, osteopenia, or neonatal rickets. Risk of fracture and growth failure increase in the presence of osteopenia in these infants. Early detection of Osteopenia of Prematurity (OOP) may prevent unwanted deaths.

Objectives: To identify biochemical markers of osteopenia in the neonatal period for early detection before the appearance of radiological evidence of osteopenia.

Methods: This prospective observational study was carried out at Dhaka Shishu Hospital (DSH) from July, 2016 to June, 2018. Babies admitted in the Neonatal Intensive Care and Special Care Baby Unit with gestational age <34 weeks and birth weight <2200 gm were included in the study. Purposive sampling technique was used to collect the study data. Blood sample for baseline biochemical markers were collected in 1st week of life, then subsequently at 2 weeks interval up to corrected term age. Wrist radiography was done for to detect radiological osteopenia at 6th week post-natal age and at corrected term age. Then the biochemical parameters are compared with radiological osteopenia.

Result: This study included 84 preterm new born below 34 weeks of gestation and a birth weight below 2200 grams. Radiological evidence of osteopenia of prematurity was found in 34 (40.5%) babies of which 29 (85.3%) were below 32 week and 5 (14.7%) were at or above 32 weeks. Osteopenic infants had significantly (p<0.001) lower birth weight (1318.82 ± 264.23 gm) compared to non-osteopenic infants (1701.40 ± 431.11 gm). Our study showed that the optimal cutoff point for Alkaline phosphatase (ALP) was 352.50 U/L at 3rd week of life, at which sensitivity and specificity were found 82.4% and 80.0% respectively. Serum inorganic phosphate values for the diagnosis of osteopenia was 4.67 mg/dl at 5th week of age. At this level, sensitivity was found to be 68.0%, whereas specificity was 60.0%. Serum calcium of the infants did not show any significant difference when they were enrolled in the study and in the first follow up. But serum calcium level was significantly lower in osteopenic infants compared to nonosteopenic infants in 2nd and 3rd follow up (p<0.05).

Conclusion: High alkaline phosphatase level at 3rd week of life and low serum inorganic phosphate at 5th week of life can be used as a predictor of osteopenia of prematurity.

Dhaka Shishu, Children, Hospital journal, Dec 11, 2022

Background: Recent re-emergence of dengue patient among Bangladeshi children have created a huge ... more Background: Recent re-emergence of dengue patient among Bangladeshi children have created a huge burden in the morbidity and mortality of our children.

TAJ, Mar 8, 2022

Acute pyelonephritis (APN) is the most common bacterial infection involving the upper urinary tra... more Acute pyelonephritis (APN) is the most common bacterial infection involving the upper urinary tract system, including the renal parenchyma and pelvis. Complications of APN include renal abscess, septic shock, and renal impairment, including AKI. At the same time, antibiotic resistance of uropathogens resulted in unfavorable clinical responses in APN. The objective of the study was to evaluate the clinical characteristics of patients with APN and antimicrobial susceptibility of causative bacteria. It was a cross-sectional type of observational study which included 100 diagnosed patients of APN admitted into the department of nephrology, Rajshahi Medical College Hospital, Rajshahi, from January 2018 to December 2018. In both males and females, E. coli was the major causative bacteria (51.1% vs. 48.9%). Renal failure was present in 87% of patients, and among them, AKI was present in 81.6% and CKD in 18.4%). Infection with klebsiella was significantly more common among CKD patients as compared to AKI (p<0.05). Commonly used antibiotic ceftriaxone was found significantly resistant in the case of E. coli (p<0.01) and klebsiella (p<0.05). In the majority of cases (>50%), E. coli was susceptible to nitrofurantoin, amikacin, imipenem, meropenem, and piperacillin-tazobactam. Resistance to antibiotics may complicate the condition. Antibiotic resistance to several commonly used antibiotics TAJ 2021; 34: No-2: 32-42

Scholars journal of applied medical sciences, Dec 18, 2022

Original Research Article Introduction: Breastfeeding provides adequate nutrition for the growth ... more Original Research Article Introduction: Breastfeeding provides adequate nutrition for the growth and development of infant. World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life which should be continued for up to two years. Aim of the Study: The study aimed to assess the exclusive breastfeeding practice and related factors among women admitted to tertiary care hospitals in Bangladesh. Methods: This was a prospective study done at Bangladesh Shishu (Children) Hospital & Institute, and it's a tertiary care hospital. The duration of the study was from 1 st February 2021 to 31 st July 2021. Result: Most of the mothers 214(72.8%) were aged more than 25-35 years and most of the infants 97(33%) were aged 3-4 months. Most of the mothers 213(72.4%) were housewife. Normal vaginal delivery was done in 98(29.84%) cases and caesarean section was done in 196(70.16%) cases. Majority of mothers 199(68%) practiced mixed feeding and in 95(32%) cases exclusive breast feeding was practiced. It is found that both exclusive breast feeding 68(23.1%) and mixed feeding 128(43.5%) were high in cesarean section delivery which is statistically significant (P < 0.04). More infant was sick in mixed feeding group 199(68%) than exclusive breast feeding 95(32%) group. Majority of the mothers 113(59.2%) believed that they do not have enough milk. 98(33.3%) mothers don't like breastfeed the baby. 76(25.9%) mothers believed that formula is better than breastfeeding and 48(16.3%) mothers had lack of knowledge about exclusive breastfeeding. Conclusion: In this present study, the practice of mixed feeding is seemed to be high.

Malaysian Journal of Paediatrics and Child Health

Objective: Not only has COVID-19 caused unprecedented changes in every sphere of human lives, but... more Objective: Not only has COVID-19 caused unprecedented changes in every sphere of human lives, but it has also simultaneously triggered a wide range of psychological problems within the community. Naturally, parents are prone to being anxious about their children amidst this pandemic. This becomes particularly serious when their children are being affected and hospitalized due to exposure to COVID-19, leading to increased anxiety and depression. Our study aims to assess the level of anxiety and depression and the predictor factors for depression and anxiety among the parents of hospitalized COVID-19-infected children. Method: This cross-sectional study incorporated 160 parents of COVID-19 infected children who were admitted to Mugda Medical College Hospital, Dhaka Shishu (Children) Hospital, and Kurmitola General Hospital between April 2020 and October 2020. Result: The study has revealed that among the 160 participants, every one in five parents (19.37%) was suffering from moderate ...

TAJ: Journal of Teachers Association

Background: Research is the integral part of post-graduation course curriculum. If steps are not ... more Background: Research is the integral part of post-graduation course curriculum. If steps are not taken at an early stage by medical postgraduates who will walk in the path of research in future, the quality of research and its application may be compromised. Students had variable perceptions towards research. The findings of this study could provide insights to improve research training. Objectives: The aim of this study was to assess knowledge and to find out attitude to biomedical research of the post-graduate medical students in Bangladesh. Materials & Methods: This cross-sectional type of descriptive study was carried out in the community Medicine Department of Rajshahi Medical College over a period of 12 months from January to December 2020 among the post-graduate students of different medical colleges. Approval from the Ethical Review Committee (ERC) was obtained prior to the commencement of the study. Purposive sampling technique was used. Pre-designed, validated, structured...

Ibrahim Cardiac Medical Journal, 2019

Background & objective: With rapid improvement of socioeconomic condition of developing countries... more Background & objective: With rapid improvement of socioeconomic condition of developing countries in the last two decades, a rapid change in the nutritional behaviour and activity of adolescents is evident leading to increased prevalence of overweight and obesity among them. The present cross-sectional survey was undertaken to evaluate the dietary and exercise behavior of the adolescents studying in rural secondary schools. Methods: This study was conducted in the Department of Community Medicine, Rajshahi Medical College, Rajshahi from April-May 2019. Data were collected from secondary schools of Puthia. A total of 535 students from two secondary schools participated in the study. In order to ensure an equal representation from both sexes we chose one boys‟ and one girls‟ schools. Every alternate students of those schools from class VI-X were then included in study as respondents. Weight and height of the selected students were first taken followed by interview. Result: In the pres...

International Journal of Contemporary Pediatrics

Background: Retinopathy of prematurity (ROP) is a potentially blinding disease affecting the reti... more Background: Retinopathy of prematurity (ROP) is a potentially blinding disease affecting the retinas in premature infants. In the treatment procedure of ROP, oxygen inhalation as well as the SpO2, PaO2, FiO2 levels analysis are some major concerns.Methods: This was a prospective COHORT study which was conducted at the special care baby unit (SCABU) and intensive care unit (ICU) of Dhaka shishu (children) hospital, Dhaka, Bangladesh from July 2012 to December 2014. Total one hundred (100) neonates of both sexes were finalized as the study population. Data were processed and analyzed using statistical software SPSS version 17, EPI info 7.Results: We found statistically significant risk for ROP, RR 3.48 (2.61-4.64) but there was no risk associated with FiO2 (24-32) % or 33-40 % in inhaled air. SpO2 (95-99) % was present in 25 (78.13%) of ROP (positive) neonates and 16 (23.53%) in ROP (negative) neonates. The difference was statistically significant (p<0.05) between the groups and RR...

Centre for Medical Education Journal , 2022

Background: COVID-19 caused unprecedented changes in every sphere of life and simultaneously trig... more Background:
COVID-19 caused unprecedented changes in every sphere of life and simultaneously triggered a wide variety of psychological problems. Parents are naturally prone to be anxious about their children amidst this pandemic situation; when their children are affected by Covid-19 and hospitalized, their anxiety and depression are increased.
Purpose:
To assess the level of anxiety and depression among the parents of hospitalized COVID-19 infected children.
Method:
This cross-sectional study was conducted on 160 parents of Covid-19 infected children of Mugda Medical College Hospital, Bangladesh Shishu Hospital & Institute and Kurmitola General Hospital from April 2020 to October 2020. Detail history was taken from all the study subjects. Results were presented by appropriate tables and figures.
Results:
The study found that among the 160 participants, every one in five parents (19.37%) were suffering from moderate to severe anxiety, while 43.1% of parents were suffering from moderate and moderately severe depression. More than fifty per cent of the respondents were suffering from minimal anxiety (54.38%) and 43.8% of parents were suffering from minimal depression. City dwellers were more prone to developing both anxiety and depression.
Conclusion:
Many parents of hospitalized COVID-19 infected children were suffering from moderate to severe anxiety and depression. They need to be addressed and provide appropriate support.

International Journal of Contemporary Pediatrics, 2021

Evaluation of modified nitrite test for diagnosing urinary tract infection in pediatrics N. Aravi... more Evaluation of modified nitrite test for diagnosing urinary tract infection in pediatrics N. Aravind Babu

Background: Number of pediatric rheumatologic diseases (RD) are increasing globally as well as na... more Background: Number of pediatric rheumatologic diseases (RD) are increasing globally as well as national level. Among these several diseases are responsible for long term morbidity and disability.

Background : Kawasaki disease (KD) is an acute, febrile, self-limiting vasculitis of the medium-a... more Background : Kawasaki disease (KD) is an acute, febrile, self-limiting vasculitis of the medium-and small-sized arteries of unknown etiology. Recently its incidence is increasing worldwide. Objective : The aim of this study was to evaluate its presenting symptoms, clinical features and laboratory tests for the diagnosis of complete and incomplete KD in children. Materials & Methods : Medical records of 20 children with KD admitted in Dhaka Shishu Hospital from January, 2011 to December 2014, were reviewed. Demographic features, diagnostic clinical features of KD, and additional clinical findings including arthritis and/or arthralgia, gastrointestinal symptoms, respiratory symptoms and central nervous system symptoms were recorded for each patient. Besides, available laboratory findings collected on admission before Intravenous Immunoglobulin (IVIG) administration were reviewed. The diagnosis of complete and incomplete KD was made using the American Heart Association (AHA) recommendations. Results : About two-thirds of the children (65%) were 30-60 months, 20% were < 30 months and 15% were 60 or above 60 months old with mean age being 42 months. Over half (55%) of the children were female and 50% affected in summer season. Of the five principal signs, polymorphous skin rash was predominant (90%), followed by changes in oral mucosa or lip (85%), conjunctival hyperemia (75%), cervical lymphadenopathy (70%) and changes in distal extremities and gastrointestinal symptoms (each 65%). Majority of the children had raised WBC (75%), raised ESR (95%), increased platelet count (70%) and elevated CRP (75%). Uveitis was a predominant complication (45%), followed by facial paralysis (30%) and neurosensory hypoacusia (20%). Cardiovascular complications were less commonly found (30%). Neither age nor sex was found to be associated with type of Kawasaki disease (p = 0.450 and p = 0.535 respectively). Sixty percent of the patient fulfilled the criteria of complete KD and the rest incomplete KD. However, cervical lymphadenopathy and changes in distal extremity were significantly common in complete KD than those in incomplete KD (p = 0.019 and p = 0.05 respectively). Conclusion : In this study 60% of the patient fulfilled the criteria of complete KD and the rest incomplete KD.

Background: Perinatal asphyxia is the commonest cause of neonatal morbidity and mortality. It can... more Background: Perinatal asphyxia is the commonest cause of neonatal morbidity and mortality. It can affect almost all the organ systems of body due to oxygen deficiency at tissue level. Thyroid is the second most vascular organ in the body. As a result, it cannot be escaped from such an oxygen related insult. Objective: To evaluate how perinatal asphyxia impacts on thyroid function in term newborn. Methods: It is a cross sectional study which was conducted in Department of Neonatology of Dhaka Shishu Hospital (DSH) from January2017 to December2017. The sample size was 50. Among them, 25 in each group namely study group (asphyxiated neonates) and control group (full term healthy neonates). Blood sample from all the neonates were collected at 18-24 hours after birth. A semi structured, interview based, peer-reviewed data collection sheet was prepared. Data regarding socio-demographic, clinical and biochemical outcome profile were recorded, compiled, edited and analyzed using SPSS version 23. The results were presented as tabular form. Results: Mean birth weight in asphyxiated and control groups were 2920±276.8 gm and 3123±179.3 gm respectively. In the initial group, the mean gestational age of babies was 38.07±0.68 weeks which was exactly 38.3±0.69 weeks in the later group. Blood gas analysis of arterial blood expressed pH and PaO 2 had statistically significant differences (p = 0.35 and 0.003 respectively) though PaCO 2 and base deficit showed no statistically significant differences (p = 0.53 and p = 0.37 respectively). Statistically significant difference was found between asphyxiated and control neonats, thyroid status especially in FT4 and TSH (p= <0.0001 and 0.003 respectively). Conclusion: Perinatal asphyxia shows significant impact in alteration of TSH and FT4 level at 18-24 hours after birth.

Background: Retinopathy of prematurity (ROP) which is also known as retrolental fibroplasia is a ... more Background: Retinopathy of prematurity (ROP) which is also known as retrolental fibroplasia is a vasoproliferative disorder that affects premature infants. Despite of major advancement in management, it continues to be a leading cause of childhood blindness throughout the world. As there had been very few studies conducted here and very few information regarding this disease are available we conducted this study. Aim of the study: The aim of this study was to evaluate the effect of supplemental Oxygen on development of retinopathy of prematurity. Methods: This was a prospective cohort study which was conducted at the Special Care Baby Unit (SCABU) and Intensive Care Unit (ICU) of Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh during the period from July 2012 to December 2014. In total One Hundred and Twenty (120) 0-28 day's old neonates of both sexes possibilities of ROP were finalized as the study population. Data were processed and analyzed using statistical software SPSS version 17, EPI info 7. Result: In this study, thirty (36.59%) neonates got oxygen up to 72 hours did not developed ROP. Only one 1(2.63%) ROP (+ve) neonates received oxygen for 73 to 120 hours. Those who received oxygen for duration of 170-218 hours and >218 hours developed ROP, RR was 2.01 [1.17-3.48] and 4.67 [2.71-8.03] respectively and (p<0.05). On the other hand, five neonates (13.16%) of ROP (+ve) got percentage of oxygen in inhaled air (41-60)% and this concentration was found statistically significant risk for ROP, RR 3.48 [2.61-4.64] but there was no risk associated with FiO2 (24-32)% or 33-40% in inhaled air. SpO2 (95-99) % was present in 29 (76.32%) of ROP (+ve) neonates and 19 (23.17%) in ROP (-ve) neonates. Conclusion: The practice of providing oxygen and blood transfusion are often lifesaving, a more judicious approach to the use of such therapies may help to reduce the problem of ROP. Inappropriate supplementation of oxygen may not correct hypoxia or may lead to hyperoxia. Both the conditions are injurious to neonatal health. During oxygen therapy, SpO2 value and more precisely the PaO2 value on neonate should be maintained within a target range. The finding of this study should be explored in the future.

Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

TAJ: Journal of Teachers Association, 2022

Northern International Medical College Journal