Akhil Deepika
National Institute of Mental Health and Neurosciences
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Publication
Featured researches published by Akhil Deepika.
Journal of Head Trauma Rehabilitation | 2013
Akhil Deepika; Ashok Munivenkatappa; Bhagavatula Indira Devi; Dhaval Shukla
Background:The importance of isolated traumatic subarachnoid hemorrhage (SAH) in relation to functional outcome in patients with mild traumatic brain injury (TBI) has not been frequently studied. The aim of this study was to compare the impact of isolated SAH with normal computed tomographic (CT) scan on outcome of patients with mild TBI. Methods:This is a retrospective study of clinical records and CT scans of all patients with mild TBI (Glasgow Coma Scale score ≥13) evaluated from January 1, 2010, to March 15, 2010, at our institution. The patients were divided into 2 groups: isolated SAH and normal CT scan. The telephonic Glasgow Outcome Scale–Extended, Rivermead Post-Concussion Symptoms Questionnaire (RPCSQ), and Rivermead Head Injury Follow-up Questionnaire (RHFUQ) scores were used to assess outcome after 1 year of injury. Independent sample t test in SPSS was used to assess difference in outcome. Results:A total of 1149 patients with mild TBI were evaluated during study period. Among them, 34 (2.9%) patients had isolated SAH. Twenty-eight patients were male and 6 were female, with a mean age of 36.5 years. Subarachnoid hemorrhage was cortical in 19 (55.9%) patients, interhemispheric in 3 (8.8%) patients, Sylvian fissure in 2 (5.9%) patients, and basal cisternal in 1 (2.9%) patient. Nine (26.5%) patients had SAH at multiple locations. The mean RPCSQ and RHFUQ scores for patients with isolated SAH were 1.38 ± 2.40 and 1.11 ±3.305, respectively. The mean RPCSQ and RHFUQ scores for patients with normal CT scans were 0.40 ± 1.549 and 0.533 ± 1.59, respectively. There was no significant difference in the outcome scores between the SAH and the normal CT scan groups (RHFUQ, P = .45; RPCSQ, P = .248). Conclusion:In our study sample of patients with mild TBI, there is no difference in outcome of patients with isolated SAH compared with those with normal CT scans 1 year after injury.
Autonomic Neuroscience: Basic and Clinical | 2015
Akhil Deepika; Manish Joseph Mathew; S. Arun Kumar; Bhagavatula Indira Devi; Dhaval Shukla
Paroxysmal sympathetic hyperactivity (PSH) is a condition in which there is extreme autonomic dysregulation leading to multiple episodes of sympathetic hyperactivity. Its occurrence after traumatic brain injury (TBI) in pediatric population is a neglected scenario. In our series, all pediatric patients with moderate and severe head injuries were studied and those patients who developed PSH were monitored for the PSH episodes. Four children out of 36 cases of pediatric severe traumatic brain injury developed features of PSH. Admission GCS of 3 children were 4/15 and 1 child was 6/15 and each of them had an ICU stay of more than 2 weeks and a poor DRS score at discharge. The presence of PSH is known to produce poorer outcome in terms of overall mortality, time needed for recovery, chances of developing infections, etc. which was also seen in these cases presented here. Though some studies have provided guidelines for the management of PSH like symptomatic management and use of drugs like clonidine, bromocriptine, benzodiazepines, and gabapentin, strict management guidelines are not established and exact incidence in pediatric population is not determined.
Journal of Pediatric Neurosciences | 2013
Ashok Munivenkatappa; Akhil Deepika; Vasuki Prathyusha; Indira Devi; Dhaval Shukla
Introduction: Children have non specific symptoms after mild head injury (MHI). It is difficult to define indication of CT scan among them. We aimed at identification of predictors of CT scan findings after MHI. Materials and Methods: Children aged ≤12 years with GCS 13-15 after head injury were retrospectively evaluated for their clinical and CT scan findings during January to March 2010. The variables used for detection of abnormal (positive) CT scan were age, gender, cause of injury (road traffic accident, fall, and assault), loss of consciousness, vomiting, ear or nose bleed, seizure, and GCS score. Results: A total of 133 children were included in study. Sixty nine (51.9%) children had abnormal CT findings. There was no statistical difference in patients with normal vs abnormal CT scan for presence of any of the variables evaluated. Conclusion: An abnormal CT scan cannot be reliably ruled out in a child with MHI based on symptoms; hence a policy of liberal CT scan based on clinical acumen is advisable.
Neurology India | 2017
Subir Dey; Jagathlal Gangadharan; Akhil Deepika; J. Keshav Kumar; Rita Christopher; Shruthi Shimoga Ramesh; B. Indira Devi; Dhaval Shukla
Objective: To study the acute phase serum biomarkers in patients with mild traumatic brain injury (mTBI) and to correlate them with short term cognitive deficits. Materials and Methods: This is a prospective observational study conducted at a tertiary care center for neurotrauma. The participants included patients with mTBI (n = 20) and age, gender, and education-status matched healthy controls (n = 20). In both the groups, the serum concentrations of biomarkers ubiquitin C terminal hydrolase (UCH-L1) and S100 calcium-binding protein B (S100B) were measured. Both the groups underwent neuropsychological tests. The serum tests were done in the acute stage after injury and the neuropsychological tests were done 3 months after injury. Results: There was no significant increase in the serum S100B and UCH-L1 levels in patients with mTBI. Patients with mTBI had significant cognitive deficits at 3 months after injury, which was suggestive of involvement of diffuse areas of the brain, in particular, the premotor, prefrontal, and medial inferior frontal lobes and the basitemporal region. The correlation of biomarkers with cognitive deficits in patients with mTBI was found in the following domains: working memory, verbal learning, verbal fluency, and visual memory. Conclusion: The serum biomarkers of mTBI have a correlation with selective domains of neuropsychological outcome.
Journal of Neurosciences in Rural Practice | 2016
Akhil Deepika; Dhaval Shukla
model can perform better that what an experienced human can predict. As the authors mentioned, the data set from two different time points is a drawback. As with IMPACT model, the authors’ model is also based on the patient population over many years, which can have a potential to decrease accuracy as the care may have improved over years. Finally, the authors do not convince that a prognostic model based on simple variables is utilizable. The IMPACT model is indeed based on simple variables, which are routinely used in practice for management of severe TBI, the only difference is that the number of variables is more.
Neurology India | 2017
Satyakam Baruah; Akhil Deepika; Dhaval Shukla; Bhagavatula Indira Devi; Veeramani Preethish-Kumar; Talakad N. Sathyaprabha
Objective: To objectively document autonomic dysfunction in the affected arm with traumatic brachial plexus injury (TBPI) using quantitative sudomotor axon reflex test (QSART). Materials and Methods: Patients with TBPI presenting to the neurosurgical outpatient department from August 2013 to November 2014 were included in the study. The QSART was administered to each patient with prior informed consent detailing the procedure. A total of 20 patients with TBPI were included in the study. The age, sex, mode of injury, date of injury, side of injury, and type of injury (pan brachial plexus vs preserved distal function) were recorded. The presence of any pain was also recorded. The injuries were also grouped as preganglionic and postganglionic injuries based on clinical, electroneuromyography (ENMG) and magnetic resonance imaging (MRI) findings. The results of the test for the affected and normal limb were recorded and analyzed with appropriate statistical tests to determine any significant differences. Results: The study included 20 patients, with their age ranging from 15 to 50 years. Out of the 20 patients, one was female and the rest 19 were males. Seven (35%) of the injuries were complete (pan brachial plexus) and 13 (65%) were incomplete (preserved distal function). All patients had preganglionic TBPI. There was no evidence of any statistically significant difference between the affected and normal arm for total sweat volume (P = 0.20) and latency period (P = 0.42). However, the average mean values for the same were lower in the affected arm as compared to the normal. The baseline sweat output (P = 0.010), however, was significantly lower in the affected arm as compared to the normal arm. Conclusion: QSART has demonstrated reduced baseline sweat output in the affected arm in patients with TBPI. This indicates the presence of autonomic dysfunction in the injured arm.
Acta Neurochirurgica | 2015
Akhil Deepika; A. R. Prabhuraj; Amrit Saikia; Dhaval Shukla
Acta Neurochirurgica | 2016
Manish Joseph Mathew; Akhil Deepika; Dhaval Shukla; Bhagavatula Indira Devi; Venkatapura J. Ramesh
Journal of Neurosurgical Anesthesiology | 2014
Akhil Deepika; Madhusudan Reddy; Dhaval Shukla
Journal of Neurotrauma | 2018
Akhil Deepika; Bhagavatula Indira Devi; Dhaval Shukla; Talakad N Sathyaprabla; Rita Christopher; Shruthi Shimoga Ramesh