International Journal of Current Research and Review
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IJCRR - 5(3), February, 2013

Pages: 14-22

Date of Publication: 18-Feb-2013


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POLYCHLORINATED DIBENZO P DIOXINS AND FURANS- A REVIEW

Author: D. J. Mukesh Kumar, D. Deepika, B. Srinithya, P. T. Kalaichelvan

Category: General Sciences

Abstract:Polychlorinated dibenzo p dioxins and furans are considered as the highly toxic pollutants among the organic pollutants emitted from various industries as byproducts. They are almost found in all the section of the global ecosystem. They can persistent in the environment and with stand for a long period of time and considered to be accumulated in the food web. This review paper describes about the different sources of emission of this organic compound from the environment. Various remediation methods for the reduction of PCDD/PCDF from the environment were also discussed in this paper.

Keywords: Persistent organic pollutants, Dioxins, Toxic equivalent factor, Sources

Full Text:

INTRODUCTION
Persistent organic pollutants (POPs) are the most dangerous pollutants released by human activity into the environment. Persistent organic pollutants have been released as unwanted byproducts from industries for decades. In current days, these POPs reveals few unusual characteristics like Persistence iREMEDIATION/REDUCTION OF PCDD/PCDFn environment, Bio-accumulation, and can travel to a long distance. They also cause adverse health effects to both humans and animals since it is highly toxic and persistent in the environment (GEF, 2009) There are various types of persistent organic pollutants; they are short listed into 12 compounds which also include polychlorinated dibenzo-pdioxin and polychlorinated dibenzofurans (PCDD/PCDF). Some forms of carbon such as coal, charcoal, graphite, inactivated amorphous carbon can generate PCDD/PCDF. The generation of PCDD/PCDF from these carbon sources is due to the degeneration and deformation of graphite structures. (Physician Consensus Statement, March 1998) The polychlorinated dibenzo-p-dioxin (PCDD) has 75 derivatives and polychlorinated dibenzofurans (PCDF) have 135 derivatives which are commonly referred to ‘dioxins’ (Kutz et al., 1999). These 210 individual derivatives of PCDD and PCDF have been emitted from both thermal and industrial processes. Characteristics of Higher chlorinated PCDD/PCDF (Kutz et al., 1999).

  • Less soluble in water
  • Low volatile
  • Absorb strongly to surfaces

MODE OF TRANSFER TO ENVIRONMENT
Terrestrial food chain
Air→plants/soil→cattle→milk/meat→man PCDD/PCDFs are less lipophillic, poor water soluble and hence bind to the granular particles such as soil and sediments. They might also accumulate in adipose tissues of organisms. They are accumulated on plant surfaces through deposition (wet/dry) of chemicals which adhere to the particles present in the atmosphere and also by diffusive transport which transfers gaseous chemicals in the air to the plant surfaces. Some amounts of PCDD/PCDFs rested on soil, move back to the environment by resuspending less chlorinated congeners (Kutz et al., 1999).

Release to air
Release of PCDD/PCDFs into air is either by stationary or diffused sources. Stationary source: This particularly involves industrial activities such as production and manufacturing processes. Diffused or dispersed source- which mostly relates to products containing PCDD/PCDFs. Some of the processes which release PCDD/PCDFs into air are:

1. Combustion processes

2. Metal processing operations

3. Drying and baking operations

4. Thermal processes

Even though the development of many technologies have tried to decrease and control the levels of emission of PCDD/PCDFs into air, it is more important to prevent the shifting of emission from one media to another (Environment and Social Development Organization, 2005) Release to water Dumping of wastes, applying pesticides directly, discharge of waste water runoff from contaminated sites result in release of PCDD/PCDFs into water (Environment and Social Development Organization, 2005) Release to land Direct application of contaminated products and deposition of PCDD/PCDFs through environmental process are the ways of releasing PCDD/PCDFs into land (Environment and Social Development Organization, 2005)

MODE OF ACTION
PCDDs and PCDFs are collectively called as dioxins which enter into human cell by using Aryl hydrocarbon (Ah) receptor which is generally present in the cell. The two main remarkable things about aryl hydrocarbon receptor are:

1. Even after 30 years of research, scientists do not know why it is present in the cell. Ah receptor’s normal ligand and its function are yet unknown.

2. Every species above invertebrates has the Ah receptor.

TOXIC EQUIVALENT FACTOR (TEF)
Toxic equivalent factor (TEF) was developed to rank the toxicity level of individual Dioxins. Toxicity equivalent factor helps to represent increasing toxicities of complex PCDD/PCDF mixtures and are expressed as a single Toxic equivalent quantity value (Kutz et al., 1999). Polychlorinated Biphenyls toxicity equivalents are similar to 2, 3, 7, and 8,-TCDD and concentration of PCDD/PCDFs congeners are expressed through TEFs which helps us to know risk levels. It is used to evaluate human health risks posed by PCDD/PCDF mixtures by using TCDD (Tetra Chloro dibenzo p dioxin) as an index chemical (Risk Assessment Forum., 2010). To apply TEF method, dose-response function must be known since toxicity of index chemical gives scaling factor for each Dioxin like compounds (DLC) and this when multiplied with environmental exposure concentration gives individual PCDD and PCDF dose equal to index chemical dose. TEF values are determined by correlating the ratio of molar dose of Tetrachloro dibenzo-p-dioxin to produce 50% effect to that of chemical which is to be tested to produce 50% effect. The TEC (TCDD Equivalent Concentration) can be known by multiplying the TEF value of an individual dioxin to the concentration of that derivative in the tissue sample (Michael et al., 1996). Then the total TEC can be obtained by summing up all the TEC values of each congener. TEQ can be calculated by using the following equation (Otto Hutzinger et al., 2000) TEQ = ((PCDDi × TEFi) n ) + ((PCDFi × TEFi) n )

EXPOSURE AND HEALTH RISK ASSESSMENT
Exposure of PCDD/PCDFs into the environment affects the people severely. They were exposed to these compounds by inhaling them from air, eating plants and animals which are accumulated by high concentration of PCDD/PCDFs. These compounds alter the endocrine functions which end up infertility disorders, pregnancy problems. These are due to the strong resemblance/correspondence of the dioxin structure to the sex and steroid hormones. It also causes inflection in thyroid and testosterone levels in plasma, attenuating neurological effects and reduced glucose tolerance (WHO, 1996) Human carcinogenesis was predicted by study which was done based on human exposures by gathering an occupational group who differ in the order of magnitude of accumulation of PCDDs in tissues more than background levels (McGregor et al., 1998). A study explains the quantitative information about dose-response relationship. The dose-response relationship is considered to be important (McGregor et al., 1998). From the data collected in 1997, based on the results of single cohort studies done on small number of workers exposed to contaminated herbicides or on the basis of animal carcinogenicity, the results were not consistent and no assessment of PCDD/PCDFs were made (McGregor et al., 1998). In humans, dioxins carried to newborn can be determined by plasma concentrations where it stays in blood and onto the new born (Farland., 2003). As drug-receptor complex results in biological response similarly plasma concentrations can result in human exposure data whereas for animals Physiologically-Based Pharmacokinetic models are used to provide reasonable values (Farland., 2003). The exposure of PCDD/PCDF to humans occurs through intake of animal as a major source of food. Several countries have characterized Tolerable Daily Intake (TDI) of PCDD/PCDF depending on No Observed Adverse Effect Level (NOEAL) acquired from animal tissues (Kulkharni et al., 2007). A Tolerable Daily Intake for TCDD at 10pg/kg was established by WHO in 1990, based on TCDD induced liver cancer in rats. WHO highlighted that if the average intake over a long periods is not exceeded, then the TDI expresses a Tolerable Daily Intake for lifetime exposure and that irregular excursions above TDI would have no health effects. The range of TDI is the equal to the typical/average daily intake by all passages of emission to PCDD/PCDFs estimated as TEQs. WHO suggested that TDI is not applicable to breastfed newborns as the approach of TDI is in accordance with the dose absorbed throughout the lifespan (WHO, 1996). In addition to this, another consultation reported that even though for many concerns, humans might be less sensitive than animals, there are still some ambiguities remain regarding animal to human susceptivities. Moreover there are many dissimilarities occur in half lives for destruction of different TEQ compound mixtures. A combined uncertainty factor of 10 was proposed in order to account for all such ambiguities. By applying this uncertainty factor of 10, a TDI (Tolerable Daily Intake) range was developed (Otto Hutzinger et al., 2000).

PCDD/PCDFs SOURCES
Incineration sources
Incineration is the waste treatment process that involves the burning of the organic substances which are present in the waste materials. They are been treated at high temperature which transfers the waste in Ash or flue gas. The incinerator units are categorized into

? Municipal Waste Combustors (MWC),

  • Medical Waste Incinerators (MWI),
  • Hazardous Waste Incinerators (HWI),
  • Boilers and Industrial Furnaces (BIF),
  • Cement kilns (CK),
  • Biomass Combustors (BC).

i. Municipal waste incinerators
Municipal incineration is the most expensive technique. They involve skilled working and maintenance of the incineration, this technique is commonly being adopted by the developed companies The flue gases of Municipal solid waste incinerators are responsible for the emission of PCDD/PCDFs (Kim et al., 2001). The presence of dioxins and their precursors in municipal solid waste were observed to be around 50ng I-TEQ/kg (Abad et al., 2002). Some municipal waste incinerators include a. Mass Burn Refractory-Wall, b. Mass Burn Water Wall, c. Refused Derived Fuel, d. Modular Starved Air, e. Modular Excess Air f. Rotary Water Wall (Thomas et al., 1995)

ii. Hospital waste incinerators
Hospital wastes like used syringes, needles, test tubes, bandages, cell cultures, plastics, human anatomic remains, wastes contaminated with viruses, bacteria, fungi etc were not disposed in a proper way and hence the incineration (combustion) of high chlorinated wastes emit PCDD/PCDFs (Stanmore et al., 2000). Hospital waste incinerators are smaller and less organized than municipal waste incinerators and so they may be less functioned than municipal waste incinerators (Thomas et al., 1995)

iii. Sewage sludge incinerators
Sewage sludge incinerators are used mostly to burn dewatered sewage sludge which are also a main source of emitting PCDD/PCDFs (Fullana et al., 2004) Due to improper land filling and recycling, restriction to sea disposal has led to the usage of incinerators which emit PCDD/PCDFs into the environment (Kulkharni et al., 2007).

iv. Hazardous waste incinerators
The toxic compounds released from chemical processes are referred as hazardous wastes. These compounds can be carcinogenic, mutagenic, explosive, inflammable, oxidizing, corrosive and highly toxic based on their kinds. The incineration for such hazardous wastes is termed as hazardous waste incinerators. Such incineration process is also a source of emission of PCDD/PCDFs (Karademir et al., 2004). Food chain designing is used to figure out the emission of hazardous wastes to plants and animal tissues (Aykan Karademir., 2003)

Thermal and combustion processes
High temperature and combustion processes are considered to be the major source of emitting PCDD/PCDFs into the environment. Thermal processes are applicable to municipal, medical and chemical waste incineration. Iron, steel, nickel and magnesium are also produced in high temperature combustion processes. The main sources of PCDD/PCDFs to the atmosphere are flue gases released from thermal processes (Grzegorz Wielgosi?ski., 2010).

i. Thermal degradation of commercial products
Thermal processecing of commercial products are also responsible for the emission of PCDD/PCDFs. Combustion of PCBs produces polychlorinated dibenzo furans and burning of PVCs also lead to congeners of PCDD/PCDFs (Rajagopalan et al., 2004).

ii. Coal and wood burning
 In non industrial processes, several studies have shown that the PCDD/PCDFs are present in the emission as well as in ash/soot from wood fires. While comparing coal fired utilities to wood burning, the emission of PCDD/PCDFs is very less, even though they are larger in size, and they also affect very large areas (Kulkharni et al., 2007).

iii. Cement kilns
Another major source of PCDD/PCDFs is cement kilns, which vary widely in their emission patterns and quantities. The variations may be because of many factors, which include kiln’s model, performing conditions, fuels and unrefined materials fed into it. Hazardous wastes like PCDD/PCDFs are produced during the combustion of varied mix of fuels including petroleum coke, coal, refinery distillation ends and other supporting fuels in kilns. Industrial sources i. Metal treatment and processing industries Copper smelting and electric arc furnaces in steel processing, which are also a high temperature processes emit PCDD/PCDFs (Rajagopalan et al., 2004). ii. Paper and pulp industries During pulp bleaching, the phenol present in the pulp reacts with chlorine and chlorinated compounds which results in emission of PCDD/PCDFs under high pressure and temperature conditions (Rajagopalan et al., 2004) iii. Photochemical processes In photochemical dechlorination, the higher chlorinated PCDD/PCDFs are converted to lower chlorinated congeners. For instance, hepta, hexa, penta, and tetra congeners are produced from the photochemical dechlorination of octa chlorinated dibenzo dioxins and octa chlorinated dibenzo furans (Rajagopalan et al., 2004) Reservoir sources The accumulation of PCDD/PCDFs in soils, sediments, organic matter, landfills sites and vegetation is mainly due to their persistent and hydrophobic nature (Kjeller Lo et al., 1995) PCDD/PCDF reservoirs where they are already present either as products or in the environment. They are not intentionally present but are from other sources. The main feature of reservoir sources is that they have the capability of releasing PCDD/PCDFs into the environment again. As a by-product they can be released into three mediaair, water, land as product and waste (Environment and Social Development Organization, 2005)

REMEDIATION/REDUCTION OF PCDD/PCDF
Remediation As PCDD/PCDFs are carcinogenic, understanding the pathway of their contamination is of more concern. Mostly the toxic PCDD/PCDFs are accumulated in soils and sediments which have their source from reservoirs. The estimated amount of soil polluted with PCDD/PCDFs was 500,000 tons, which needs remediation (Johnson., 2008). i. ex situ remediation technique Ex situ is the offsite convertion, in this the remediation technique are not directly located in the particular contaminated product. Ex situ thermal process is used to transport the contaminants from soil to vapor phase. It is achieved by three steps: Soil conditioning, thermal treatment, exhaust gas purification. In soil conditioning, the soil is broken into smaller granular particles and they are sieved in preparation for thermal treatment, which increases the heat supply to the soil and evaporation of pollutants occurs and finally the contaminants are transferred to the gas phase (Koning et al., 2000). The methods which come under ex situ remediation are: composting, Land farming, biopilling and bioreactor processing. This process degrades petroleum hydrocarbons (TPH), polycyclic aromatic hydrocarbons (PAH), benzene, toluene, ethylbenzene, xylenes (BTEX), phenol compounds, PCDD/PCDFs etc (Koning et al., 2000). ii. In situ remediation techniques This technique is applicable only for specific type of soils, which include high permeable and low organic content homogenous soils. It is suitable for removing pollutants that can be deprived in lower temperature. In this process a steam air is introduced into the soil at 60-100?C. The steam-air mixture must be controlled in this temperature range, since pollutants must not be transferred to ground water. After the injection of steam air mixture into the soil, the volatile and non volatile contaminants move from soil to vapor phase.

Treatment of fly ash
PCDD/PCDFs are formed generally during combustion of organic matter in the presence of chlorine, where flyash is the residue and results in major environmental pollution. (Nam et al., 2008) found that PCDD/PCDFs in flyash can be degraded by Sphingomonas wittichii strain RW1. From a study in 2005, it was identified that the 75.5% of PCDD and 83.8% of 2,3,7,8-TCDD were eliminated from flyash by degradation and adsorption on viable and non viable cell biomass (Nam et al., 2008) From a study of 2008, a biocatalyst was introduced to degrade PCDD/PCDFs, through a combination of mix of 4 bacterial and 5 fungal strains. 68.7% of PCDD and 66.8% of 2, 3, 7, 8- TCDD were degraded by the biocatalyst. It was confirmed that, an extracellular non specific enzyme named oxidases could degrade highly stable PCDDs and lignin in fly ash (Nam et al., 2008). Sorption / desorption of PCDD/PCDFs Cyclodextrin are sugar molecules which are bound together in a ring. They are produced from starch in the means of enzymatic conditions. These are widely used in chemical industries and environmental engineering. Cyclodextrin (CD) was used for degrading PCDD/PCDFs, which are present in soil and water. There are five classes of cyclodextrins commonly. They are, (1) α-cyclodextrin (ACD), (2) β-cyclodextrin (BCD), (3) hydroxypropyl-α-cyclodextrin (HPACD), (4) hydroxypropyl-β-cyclodextrin (HPBCD), and (5) hydroxypropyl-γ-cyclodextrin (HPGCD). Among these, the efficient CDs in removing the contaminants are hydroxypropyl-β-cyclodextrin (HPBCD), α-cyclodextrin (ACD), β-cyclodextrin (BCD) (Cathum et al., 2010). CDs are first made to trap (bound) to PCDD/PCDFs in soil and water. The initial concentration of unbound PCDD/PCDFs was monitored. After a certain period of days, CDs would remove PCDD/PCDFs present in soil and water. And the highest efficiency of removing all congeners of PCDD/PCDFs is 96%, which is achieved by hydroxypropyl-β-cyclodextrin (HPBCD). Following to that, α-cyclodextrin (ACD) has an efficiency of 45% and β- cyclodextrin (BCD) has an efficiency of 50% in removing PCDD/PCDFs. The CDs were selected based on the diameter of the molecular void and functional groups present in it (Cathum et al., 2010). Thermal desorption Many PCDD/PCDF contaminated sites are treated by thermal desorption method. It is a separation process, in which heat is used to separate hydrocarbons from contaminated soils. Equipment is designed for thermal desorption called thermal desorber. It supplies enough heat to the contaminant soil, due to which the constituents are evaporated and separated from the soil (Kulkharni et al., 2007).

Bio degradation
Anaerobic reductive dechlorination (ARD) and aerobic dioxygenation are the two methods which have been studied for microbial degradation of PCDD/PCDFs (Field, Chang., 2008). In anaerobic reductive dechlorination, the hydrogen molecules replace the chlorine molecules (Mohn., 2008). In biodegradation process the reduction of toxic compounds are done by means of micro organisms. The micro organisms reduce Persistent Organic Pollutants (POPs) especially dioxin and dioxin like compounds by oxidation and cleavage of aromatic rings in presence of oxygen (Chang., 2008). The genes involved in anaerobic dechlorination and aerobic angular dioxygenation called as dioxin detoxification genes (DDGs) are accountable for reducing toxicity of PCDD/PCDFs. Pseudomonas and Sphingomonas (RW1) are efficient strains for oxidizing PCDD/PCDFs (Chang ., 2008). Lower chlorinated congeners are reduced under aerobic conditions and higher chlorinated congeners are reduced under anaerobic conditions. Intermediate products are formed during aerobic and anaerobic processes are less equal or more toxic than the original pollutants (Kao et al., 2000).

Destruction of PCDD/PCDFs by Carbon Nanotubes
Carbon NanoTubes can be seen as smooth and flat graphite sheets that have been deformed, so that carbon atoms twist in a helical manner to form a tiny tube (Baughman et.al., 1999). They are of two types namely single walled carbon nanotubes (SWCNT) and multi walled carbon nanotubes (MWCNT). The characteristics of CNTs are high surface area, interstitial space with a cluster of nanotubes, electron mobility, electrical conductivity, (Dai et al., 2002) mechanical properties , (Saridara et al., 2005) like chemical and thermal stabilities. Thus Carbon NanoTubes are used to carry catalysts that help in destruction of dioxins (Lina Zhou et al., 2010). As dioxins have high melting and boiling point, the estimation of adsorption isotherms is difficult. A technique was developed, which depends on Temperature Programmed Desorption (TPD) to study adsorption isotherm of dioxins (Yang et al., 1999). From a study, it was identified that doped graphene and doped nanotubes are efficient in disruption of dioxins (Kang ., 2005). Vanadia – tungsta – titania catalysts are more effective than noble metal catalysts to reduce the concentration of dioxins below 0.1ng TEQ/Nm3 (Lina Zhou et al., 2010). The adsorption and absorption of carbon nanotubes only transfer the contaminants from gas phase to solid or liquid phase, but the catalysts alone cause the elimination of dioxin totally (Yoshikawa et al., 2004).

FUTURE ASPECTS AND CONCLUSION
As PCDD/PCDFs are highly toxic and more persistent, understanding about the source of contamination is essential. PCDD/PCDFs are emitted from various sources like industrial sources, reservoir sources, combustion sources and incineration sources. These POPs affect human health adversely; especially it causes infertility, endocrine disruption, modulation of sex and thyroid hormones. To summarize, biodegradation is most effective reduction method for converting toxic PCDD/PCDFs into non toxic and harmless compounds. In future, the destruction of gas phase PCDD/PCDFs contaminants by adsorption and catalytic destruction using Carbon Nano Tubes can be a promising method to reduce the PCDD/PCDF contamination.

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A study by Alice Alice entitled \"Strengthening of Human Milk Banking across South Asian Countries: A Next Step Forward\" is awarded Best article of Vol 14 issue 20
A study by Sathyanarayanan AR et al. entitled \"The on-task Attention of Individuals with Autism Spectrum Disorder-An Eye Tracker Study Using Auticare\" is awarded Best article of Vol 14 issue 19
A study by Gupta P. et al. entitled \"A Short Review on \"A Novel Approach in Fast Dissolving Film & their Evaluation Studies\" is awarded Best Article of Vol 14 issue 18.
A study by Shafaque M. et al. entitled \"A Case-Control Study Performed in Karachi on Inflammatory Markers by Ciprofloxacin and CoAmoxicillin in Patients with Chronic Suppurative Otitis Media\" is awarded Best Article of Vol 14 issue 17
A study by Ali Nawaz et al. entitled \"A Comparative Study of Tubeless versus Standard Percutaneous Nephrolithotomy (PCNL) \? A Randomized Controlled Study\" is awarded Best Article for Vol 14 issue 16.
A study by Singh R. et al. entitled \"A Prospective Study to Find the Association of Astigmatism in Patients of Vernal Keratoconjunctivitis (VKC) in a Tertiary Health Care Centre in India (Vindhya Region MP)\" is awarded Best Article for Vol 14 issue 15
A Study by Humaira Tahir et al. entitled "Comparison of First Analgesic Demand after Major Surgeries of Obstetrics and Gynecology between Pre-Emptive Versus Intra-Operative Groups by Using Intravenous Paracetamol: A Cross-Sectional Study" is awarded Best Article for Vol 14 issue 14
A Study by Monica K. entitled "Risk Predictors for Lymphoma Development in Sjogren Syndrome - A Systematic Review" is awarded Best Article for Vol 14 issue 13
A Study by Mokhtar M Sh et al. entitled "Prevalence of Hospital Mortality of Critically Ill Elderly Patients" is awarded Best Article for Vol 14 issue 12
A Study by Vidya S. Bhat et al. entitled "Effect of an Indigenous Cleanser on the Microbial Biofilm on Acrylic Denture Base - A Pilot Study" is awarded Best Article for Vol 14 issue 11
A Study by Pandya S. et al. entitled "Acute and 28-Day Repeated Dose Subacute Toxicological Evaluation of Coroprotect Tablet in Rodents" is awarded Best Article for Vol 14 issue 10
A Study by Muhammad Zaki et al. entitled "Effect of Hemoglobin Level on the Severity of Acute Bronchiolitis in Children: A Case-Control Study" is awarded Best Article for Vol 14 issue 09
A Study by Vinita S & Ayushi S entitled "Role of Colour Doppler and Transvaginal Sonography for diagnosis of endometrial pathology in women presenting with Abnormal Uterine Bleeding" is awarded Best Article for Vol 14 issue 08
A Study by Prabhu A et al. entitled "Awareness of Common Eye Conditions among the ASHA (Accredited Social Health Activist) Workers in the Rural Communities of Udupi District- A Pilot Study" is awarded Best Article for Vol 14 issue 07
A Study by Divya MP et al. entitled "Non-Echoplanar Diffusion-Weighted Imaging and 3D Fiesta Magnetic Resonance Imaging Sequences with High Resolution Computed Tomography Temporal Bone in Assessment and Predicting the Outcome of Chronic Suppurative Otitis Media with Cholesteatoma" is awarded Best Article for Vol 14 issue 06
A Study by Zahoor Illahi Soomro et al. entitled "Functional Outcomes of Fracture Distal Radius after Fixation with Two Different Plates: A Retrospective Comparative Study" is awarded Best Article for Vol 14 issue 05
A Study by Ajai KG & Athira KN entitled "Patients’ Gratification Towards Service Delivery Among Government Hospitals with Particular Orientation Towards Primary Health Centres" is awarded Best Article for Vol 14 issue 04
A Study by Mbungu Mulaila AP et al. entitled "Ovarian Pregnancy in Kindu City, D.R. Congo - A Case Report" is awarded Best Article for Vol 14 issue 03
A Study by Maryam MJ et al. entitled "Evaluation Serum Chemerin and Visfatin Levels with Rheumatoid Arthritis: Possible Diagnostic Biomarkers" is awarded Best Article for Vol 14 issue 02
A Study by Shanthan KR et al. entitled "Comparison of Ultrasound Guided Versus Nerve Stimulator Guided Technique of Supraclavicular Brachial Plexus Block in Patients Undergoing Upper Limb Surgeries" is awarded Best Article for Vol 14 issue 01
A Study by Amol Sanap et al. entitled "The Outcome of Coxofemoral Bypass Using Cemented Bipolar Hemiarthroplasty in the Treatment of Unstable Intertrochanteric Fracture of Femur in a Rural Setup" is awarded Best Article Award of Vol 13 issue 24
A Study by Manoj KP et al. entitled "A Randomized Comparative Clinical Trial to Know the Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block Against Multimodal Analgesia for Postoperative Analgesia Following Caesarean Section" is awarded Best Article Award of Vol 13 issue 23
A Study by Karimova II et al. entitled "Changes in the Activity of Intestinal Carbohydrases in Alloxan-Induced Diabetic Rats and Their Correction with Prenalon" is awarded Best Article of Vol 13 issue 22
A Study by Ashish B Roge et al. entitled "Development, Validation of RP-HPLC Method and GC MS Analysis of Desloratadine HCL and It’s Degradation Products" is awarded Best Article of Vol 13 issue 21
A Study by Isha Gaurav et al. entitled "Association of ABO Blood Group with Oral Cancer and Precancer – A Case-control Study" is awarded Best Article for Vol 13 issue 20
A Study by Amr Y. Zakaria et al. entitled "Single Nucleotide Polymorphisms of ATP-Binding Cassette Gene(ABCC3 rs4793665) affect High Dose Methotrexate-Induced Nephrotoxicity in Children with Osteosarcoma" is awarded Best Article for Vol 13 issue 19
A Study by Kholis Ernawati et al. entitled "The Utilization of Mobile-Based Information Technology in the Management of Dengue Fever in the Community Year 2019-2020: Systematic Review" is awarded Best Article for Vol 13 issue 18
A Study by Bhat Asifa et al. entitled "Efficacy of Modified Carbapenem Inactivation Method for Carbapenemase Detection and Comparative Evaluation with Polymerase Chain Reaction for the Identification of Carbapenemase Producing Klebsiella pneumonia Isolates" is awarded Best Article for Vol 13 issue 17
A Study by Gupta R. et al. entitled "A Clinical Study of Paediatric Tracheostomy: Our Experience in a Tertiary Care Hospital in North India" is awarded Best Article for Vol 13 issue 16
A Study by Chandran Anand et al. entitled "A Prospective Study on Assessment of Quality of Life of Patients Receiving Sorafenib for Hepatocellular Carcinoma" is awarded Best article for Vol 13 issue 15
A Study by Rosa PS et al. entitled "Emotional State Due to the Covid – 19 Pandemic in People Residing in a Vulnerable Area in North Lima" is awarded Best Article for Vol 13 issue 14
A Study by Suvarna Sunder J et al. entitled "Endodontic Revascularization of Necrotic Permanent Anterior Tooth with Platelet Rich Fibrin, Platelet Rich Plasma, and Blood Clot - A Comparative Study" is awarded Best Article for Vol 13 issue 13
A Study by Mona Isam Eldin Osman et al. entitled "Psychological Impact and Risk Factors of Sexual Abuse on Sudanese Children in Khartoum State" is awarded Best Article for Vol 13 issue 12
A Study by Khaw Ming Sheng & Sathiapriya Ramiah entitled "Web Based Suicide Prevention Application for Patients Suffering from Depression" is awarded Best Article for Vol 13 issue 11
A Study by Purushottam S. G. et al. entitled "Development of Fenofibrate Solid Dispersions for the Plausible Aqueous Solubility Augmentation of this BCS Class-II Drug" is awarded Best article for Vol 13 issue 10
A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09
A Study by Mardhiah Kamaruddin et al. entitled "The Pattern of Creatinine Clearance in Gestational and Chronic Hypertension Women from the Third Trimester to 12 Weeks Postpartum" is awarded Best Article for Vol 13 issue 08
A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07
A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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