Seema Patrikar | Armed Forces Medical College, Pune, India (original) (raw)

Papers by Seema Patrikar

International journal of research in medical sciences, Jun 29, 2024

Medical journal, Armed Forces India, Aug 1, 2023

Medical journal, Armed Forces India, Nov 1, 2020

Medical journal, Armed Forces India, Apr 1, 2022

BackgroundThe Indian Armed Forces, on entry, vaccinates all cadets and recruits with varicella va... more BackgroundThe Indian Armed Forces, on entry, vaccinates all cadets and recruits with varicella vaccine for the prevention of varicella. This health technology assessment (HTA) report puts forth evidence for HTA of varicella vaccination in the Armed Forces in various domains namely clinical, societal, ethical, economic, and legal.MethodsThe policy question under each domain has been developed according to best-practice methods for HTA. The costs included were hospitalization cost due to varicella infection; training lost cost; the varicella vaccine cost; cost of the side effects of vaccine; and the outbreak investigation cost. The incremental cost-effectiveness ratio (ICER) for varicella cases averted and man-days saved, and quality-adjusted life years (QALYs) gained due to varicella vaccination strategy were calculated.ResultsEvidence suggests a reduction of 81% in hospitalization rates with 19392 man-days saved per 1 lakh population due to varicella vaccination strategy. The ICER for varicella cases averted is estimated to be Rs 56732/- per case averted and Rs 5687/- per man-day saved. QALYs gained due to two-dose varicella vaccination strategy is estimated to be 1152 per 1 lakh population with cost per QALY gained Rs 95735/-.ConclusionThe study showed a large reduction in hospitalizations and consequently man-days lost after the introduction of the vaccination strategy. The QALYs was another aspect of importance brought out by this study. Thus, a two-dose vaccination strategy for varicella-zoster virus (VZV) for the Armed Forces trainees is a cost-effective policy.

Medical journal, Armed Forces India, Jul 1, 2019

PubMed, Oct 6, 2005

Objectives: The impact of hepatitis C virus (HCV) infection on the success of renal transplant is... more Objectives: The impact of hepatitis C virus (HCV) infection on the success of renal transplant is controversial. We assessed the effect of HCV infection on graft and patient survival in renal allograft recipients. Methods: We retrospectively analyzed medical records of renal allograft recipients who were transplanted between June 1990 and March 2004. Patients were divided into those positive and negative for anti-HCV antibody. Graft and patient survival were compared between the groups. Results: Of 126 patients studied (median age 34.5 years, range, 16-60; 111 men), 35 were positive for anti-HCV antibody. In seven patients, the antibodies were detected for the first time after renal transplant. Mean patient and graft survival duration in the anti-HCV negative group was longer (55 [SD 2] months [95% CI, 51-58]) than in the anti-HCV positive group (50 [SD 4] months [95% CI, 43-58]) (p< 0.05). Twenty-two patients died - 8 (22.8%) in the anti-HCV positive group and 14 (15.3%) in the negative group. In the anti-HCV positive group, infections were the cause of death in 5 patients and 3 patients died of liver cell failure. In the anti-HCV negative group, corresponding figures were 13 and one. Conclusion: HCV infection is a bad prognostic indicator for patient and graft survival duration in renal transplant recipients. Infections are the commonest cause of death in renal transplant recipients.

Medical journal, Armed Forces India, Jul 1, 2015

Background: Neonatal birth weight is a powerful predictor of infant growth and survival and mater... more Background: Neonatal birth weight is a powerful predictor of infant growth and survival and maternal factors like poor knowledge and insufficient dietary intake are significant risk factors. Other preventable determinants like pre pregnant BMI <18.5, low gestational weight gain (GWG) and anemia are also associated with low birth weight. This study was carried out to identify the impact of these maternal factors with risk of low birth weight (LBW). Methods: A longitudinal study was carried out on 124 booked antenatal cases at a tertiary care center. A validated protocol containing socio demography, food frequency and anthropometry was administered at the 3rd trimester. Birth weight of the newborn was noted after delivery. Results: 26.28% children had low birth weight (<2500 g), 14.6% mothers were thin (BMI < 18.5), 55.3% mothers had a weight gain of less than 9 kgs and 45.5% were anemic. 81.81% mothers with BMI >18.5 and 28.92% women who were educated till high school had a baby with LBW. Most mothers consumed milk and vegetables daily and a few consumed non vegetarian foods but quality and quantity of food were grossly inadequate. GWG levels and Hb levels were significantly different in different birth weight groups and also were significantly associated with low birth weight. Conclusion: Quality and quantity of maternal dietary intake during pregnancy, even in normal weight mothers (BMI > 18.5), are important determinants of birth weight. Nutritional counseling for mothers during the antenatal period is the cornerstone for healthy mother and healthy child.

Medical journal, Armed Forces India, Oct 1, 2018

Background: Knowledge of normal variation and measurements on a chest radiograph is essential to ... more Background: Knowledge of normal variation and measurements on a chest radiograph is essential to interpret any abnormality. There is paucity of information about normal measurement ranges and variations in young adolescents, particularly from Indian subcontinent. The aim of this study was to analyze certain normal variations on screening chest radiographs of healthy Indian adolescents and the objectives were to measure/assess (1) degree of inspiration, (2) cardiothoracic ratio (CTR), (3) presence of gastric fundic bubble, (4) fundocupolic distance, (5) presence of splenic flexure, (6) difference in height of diaphragmatic domes and (7) effect of inspiration on the CTR. Methods: Digital chest radiographs obtained during routine medical examinations for all consecutive medical graduate aspirants in the year 2016 at a medical college, were analyzed for the above mentioned parameters using DICOM viewing software. Result: A total of 558 chest radiographs were analyzed. The mean age of the subjects was 18.50 (SD = 1.002) (range: 17-22 years). There were 497 (89.1%) male and 61 (10.9%) female. Degree of inspiration was at 5th, 6th, 7th and 8th ribs in 29 (5.1%), 259 (46.4%), 264 (47.3%) and 6 (1%) respectively. Mean maximum transverse cardiac diameter, internal thoracic diameter, CTR were 1153.22 AE 120.01, 2935.24 AE 224.86 and 0.39 AE 0.03 respectively. Females had slightly higher CTR (0.40 AE 0.035) as compared to the males (0.39 AE 0.032) (p = 0.009). Gastric fundic bubble was visualized in 91% subjects. Mean fundo-cupolic distance was 8.75 AE 8.00. Mean value for difference in the level of two domes of diaphragm was 15.28 AE 5.38.

Medical journal, Armed Forces India, Oct 1, 2015

Journal of Cancer Research and Therapeutics, 2014

The objective is to assess the utility of the p63 and α-methylacyl CoA racemase (AMACR) in resolv... more The objective is to assess the utility of the p63 and α-methylacyl CoA racemase (AMACR) in resolving suspicious foci in prostatic needle biopsy and transurethral resection of prostate (TURP) specimens. A total of 470 cases are selected. These included 310 TURP specimens, 157 needle biopsies and 03 radical prostatectomy specimens. All the cases are reviewed and divided into three categories. Benign (370), cases with suspicious foci (40 cases) and malignant (60 cases). Immunohistochemistry (IHC) was carried out using monoclonal AMACR and p63 antibodies in the 40 suspicious cases along with positive and negative controls. This study showed AMACR had a sensitivity of 95%, specificity of 92.5%, whereas p63 had a sensitivity of 90%, specificity of 100%. All the 40 suspicious cases were resolved using a combination of morphology and IHC expression p63 and AMACR. In 13 (32.5%), of the 40 suspicious cases there was change of diagnosis based of morphology, clinical details and staining with p63 and AMACR, In the 11 cases (11/40), diagnosis was changed from the benign to malignant. In one case benign to high grade prostatic intraepithelial neoplasia (1/40) and in one case from malignant to benign (1/40). This change was statistically significant with P value of 0.013. Combination of p63 and AMACR is of great additional value in combating the morphologically suspicious cases and should be used on case to case basis especially in prostatic needle biopsies and small foci lesions.

Indian Dermatology Online Journal, 2022

Background: Psoriasis is a common, T-cell-mediated disease, affecting 0.44–2.8% of the general po... more Background: Psoriasis is a common, T-cell-mediated disease, affecting 0.44–2.8% of the general population in India. It is associated with a higher risk of cardiovascular disease possibly due to chronic inflammation. Those patients with severe psoriasis are at a higher risk of death due to cardiovascular disease. The use of scoring tools may help the care providers to assess cardiovascular risks in these patients. Aims: The aim of this study was to assess the cardiovascular risks in patients with severe psoriasis using the commonly used risk-assessment tools (Framingham risk score [FRS] and Pooled cohort equations [PCE]) and to understand the utility of these tools in practice. Methods: It is a case-control study performed in the dermatology outpatient department of a tertiary care center during the study period from January to December 2020. Consenting adults with chronic plaque psoriasis and psoriasis area and severity index (PASI) more than 10 were included in the study. The FRS and PCE risk scores were calculated for the patients and age- and sex-matched healthy controls. Results: A total of 213 patients were assessed and 30 patients were excluded. Of the 183 patients, 152 patients were assessed using FRS and 135 patients using PCE. Equal number of age- and sex-matched healthy controls were also assessed. The mean age of the patients assessed using the FRS and PCE was 47 ± 10.9 and 52.84 ± 8.9 years, respectively. The mean age of the controls was 45.52 ± 8.7 and 51.76 ± 8.1 years in the FRS and PCE groups, respectively. The male to female ratio was 1.92:1 and 2:1 in the FRS and PCE risk-score groups, respectively. The mean PASI score was 16.45 ± 7.88 and 15.6 ± 7.6 in the two groups, respectively. The 10-year risk estimate using FRS in the patients ranged from 0 to 26.9%. The mean and median estimates were 4.95 ± 5.7 and 2.8%, respectively, while 2.65 ± 4.7 and 0.8% in the controls (P = 0.001). The 10-year risk estimate in the patients using the PCE risk score ranged from 0.3 to 39.6%. The mean and median estimate in the patients was 8.17 ± 9.9 and 5.2%, respectively while they were 5.68 ± 7.5% and 2.6% in the controls (P = 0.024). The agreement between the FRS and PCE was found to be poor (Ϗ, 0.049). There was no statistically significant correlation of PASI to either the PCE risk score (P = 0.498) or FRS (P = 0.630). Limitations: A small sample size, and study in a tertiary care center may have resulted in sampling bias. Conclusion: Psoriasis is associated with a higher risk of cardiovascular disease. These tools may help a dermatologist in the primary prevention of cardiovascular disease. It can also help in the awareness of the increased risk of cardiovascular disease in patients.

Journal of Cranio-maxillofacial Surgery, Dec 1, 2016

Purpose: Lateral displacement of fracture zygomaticomaxillary complex (ZMC) can cause significant... more Purpose: Lateral displacement of fracture zygomaticomaxillary complex (ZMC) can cause significant increase in orbital volume leading to enophthalmos. The aim of this study was to radiologically evaluate the efficacy of sphenozygomatic (SZ) suture fixation for restoration of orbital volume after elevation of the temporalis in cases of fracture ZMC where the fixation of zygomatic arch (ZA) was deemed necessary through latero-posterior approach. Materials & methods: 43 operated cases of fracture ZMC using 4-point fixation were divided into two groups. Group I (n ¼ 24) cases had undergone reduction and fixation of SZ suture as fourth point of fixation by elevating temporalis muscle using hemicoronal approach. Group II (n ¼ 19) cases had undergone reduction and fixation of Infraorbital (IO) rim as fourth point of fixation using preseptal transconjunctival approach. Both the groups were analyzed separately and compared for restoring the increased orbital volume on CT. Results: Difference in the pre-surgical orbital volume of both the groups was found to be statistically insignificant [p ¼ .678]. In group I, the average bony orbital volume significantly reduced by 3.6 cc from 25.5 cc to 21.9 cc [p ¼ .000] post-surgically. In group II, the average bony orbital volume reduced by 1.5 cc from 25.6 cc to 24.1 cc post-surgically There was a significant difference in the reduction of the increased orbital volume among the 2 groups (Group I: 3.6 cc, group II: 1.5 cc). The amount of reduction was more and statistically significant [p ¼ .000] in the group I than group II. Conclusion: SZ suture fixation is reliable in reducing fractures ZMC and restoring the increased orbital volume where the fixation of zygomatic arch (ZA) was deemed necessary through latero-posterior approach.

Medical journal, Armed Forces India, Sep 1, 2022

Medical journal, Armed Forces India, Jul 1, 2023

Medical journal, Armed Forces India, 2009

Background: Disorders of visual acuity are known to affect the learning abilities of school child... more Background: Disorders of visual acuity are known to affect the learning abilities of school children. Various authors have reported varying prevalence in India and abroad. Methods: A rapid, community based survey was conducted to assess the prevalence of disorders of visual acuity among adolescent school children in three schools in Pune Cantonment. A sample of 236 children studying in six sections were examined after random selection by a two stage sampling technique ensuring representation to each of the classes. Visual acuity was assessed for all the children available in the selected section on the date of survey. A questionnaire based study of the knowledge and attitude of the parents of the 50 affected children was also conducted. Result: 50 children (25 males and 25 females) were found to have errors of refraction, resulting in prevalence rate of 21.19% with confidence intervals of 15.97% to 26.40%. Conclusion: The study highlights significantly high prevalence of uncorrected errors of visual acuity among adolescent school children as well as the need for instituting IEC activities aimed at improving the general lack of appreciation of the seriousness of the problem by the parents and consequent neglect of urgent corrective measures.

Journal of Cranio-maxillofacial Surgery, Feb 1, 2023

International journal of reproduction, contraception, obstetrics and gynecology, Nov 23, 2017

Background: Permanent sterilization is a preferred method of contraception worldwide. In spite of... more Background: Permanent sterilization is a preferred method of contraception worldwide. In spite of popularization of temporary methods, it is used by 2/3 rd of married women using any contraception. It has a low incidence of complications and failure rate and is cost-effective. Various socio-demographic factors play a role in acceptability of this method. It has an important role in controlling the total fertility rate. Methods: A retrospective record based analysis was done in armed forces personnel undergoing permanent sterilization operation over 11 years between 2005-2015 in a tertiary care institute. Analysis of trends in method choices of surgery, and comparison of the variables determining these choices was done. Year wise total fertility rates was calculated and the trend over 11 years was analyzed. Results: Permanent sterilization operations were performed in 2121 couples over the 11 years period. Of total operations, 1823 (85.95% with 95% confidence interval = 84.42, 87.38) were done in females and 298 (14.05% with 95% confidence interval = 12.62, 15.58) in males. Female sterilization acceptance ranged between 71.6% to 91.6% and male sterilization between 8.4%-28.4% with an increasing trend towards male sterilization acceptance over the years. Total fertility rate declined from 2.3 to 2.09 in 11 years. Conclusions: Increase in literacy rate of both the partners can positively impact the male involvement in permanent sterilization and control of TFR. This would help to stabilize India's population growth. Also, a decline in son preference can be beneficial for decline in fertility rate.

$Research paper thumbnail of Retroseptal transconjunctival approach for fractures of the zygomaticomaxillary complex: a retrospective study$

British Journal of Oral & Maxillofacial Surgery, 2018

We designed a retrospective study to evaluate the efficacy of retroseptal transconjunctival appro... more We designed a retrospective study to evaluate the efficacy of retroseptal transconjunctival approaches in the management of fractures of the zygomaticomaxillary complex (ZMC). The patients were from a single institution, and had had three-point fixation of fractures of the ZMC between 2008 and 2016. A total of 77 patients (56 men and 21 women with a mean (range) age of 28 (18-54) years), were divided into two groups. Group I (n = 51) had had reduction and fixation of the infraorbital rim using a retroseptal transconjunctival approach. In group II (n = 26) the same approach had been used with lateral canthotomy and inferior canthlolysis for both the infraorbital rim and the zygomaticofrontal region. We analysed the association of both approaches with the outcomes of reduction, fixation, and complications. Suboptimal results were found in 13 patients in group I and one in group II (p = 0.017). There were also three patients with trichiasis and two with entropion in group I, and one each of both complications in group II. There was only one patient with a malopposed lateral canthus in group II. All 26 patients in group II had no perceptible scar along the extended line of incision. The risk of a suboptimal outcome was reduced by 20% (relative risk = 0.8) in group II. The retroseptal transconjunctival approach with lateral canthotomy and inferior cantholysis is safe, aesthetic, and effective in the management of fractures of the ZMC.

Medical journal, Armed Forces India, Jul 1, 2008

Background: Male Preference is well known phenomena world wide from ancient ages. A descriptive s... more Background: Male Preference is well known phenomena world wide from ancient ages. A descriptive study was carried out to assess the attitude of women towards birth of son, use of contraception methods and sex determination methods in rural village Kasurdi in Pune district. Methods: Univariate analysis was carried out by considering each factor determining sex preference separately as well as using a Logistic Regression Model. Adequacy of fit of the model has also been tested. Result and Conclusion: Out of 110 respondents interviewed, 62.7% felt that male child is necessary in the family. Univariate analysis revealed that sex of first child, concern undergone for second pregnancy with regards to sex of the child, number of children in family and type of family were significant factors contributing to the son preference. The analysis under the logistic regression model revealed that sex of the first child and concern undergone in second pregnancy with respect to the sex of the second child are the most dominating and significant factors in the causation of son preference. The difference between family sizes when compared with the sex of first child was statistically significant signifying that if the first child is a male then it hardly matters whether the second child is male or female, but if the sex of first child is female then the families land up with bigger family size. On an average most of the respondents favour two children with an equal share of male and female children.

medRxiv (Cold Spring Harbor Laboratory), Jun 29, 2020

Novel coronavirus (COVID-19) rapidly spread from China to other parts of the world. Knowledge of ... more Novel coronavirus (COVID-19) rapidly spread from China to other parts of the world. Knowledge of incubation period and reproduction number is important in controlling any epidemic. The distribution of these parameters helps estimate the epidemic size and transmission potential of the disease. We estimated incubation period and reproduction number of COVID-19 for India utilizing data reported by Ministry of Health and Family Welfare (MoHFW), Government of India (GOI) and data in public domain. The mean incubation period seems to be larger at 6.93 (SD=±5.87, 95% CI: 6.11-7.75). and 95 th percentile estimate for best fit normal distribution is 17.8 days. Weibull distribution, the best fit for the reproduction number estimated pre lockdown reproduction number as 2.6 (95% CI=2.34-2.86) and post lockdown reduced to 1.57 (95% CI=1.3-1.84) implying effectiveness of the epidemic response strategies. The herd immunity is estimated between 36-61% for R 0 of 1.57 and 2.6 respectively. All rights reserved. No reuse allowed without permission.