International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - Vol 04 Issue 09, May, 2012

Pages: 11-17

Date of Publication: 17-May-2012


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EFFICACY OF TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) IN TREATMENT OF NEUROPATHIC PAIN IN PATIENTS WITH DIABETIC NEUROPATHY

Author: Anjan Desai, Khushbu Desai

Category: Healthcare

Abstract:Introduction: Diabetic Neuropathy is a peripheral nerve disorder caused by diabetes that leads to pain in periphery. Many patients are limited in their physical activity by pain. The study conducted to assess the effect of Transcutaneous Electrical Nerve Stimulation (TENS) application for reduction of pain in patients with diabetic neuropathy. Aim of study: The main objective of this study is to compare the effectof TENS on Diabetic Neuropathy patients in reduction of pain and improving single limb stance. Materials and Methodology: Study Design: An experimental comparative study. Sample Selection: A sample of 30 patients diagnosed as diabetic neuropathy were taken from after giving due consideration to inclusion and exclusion criteria. Sample size: Total 30 including Control Group (Group A): The patients in this group were given therapeutic exercise training only and Experimental Group (Group B): The patients in this group were given treatment with TENS application and therapeutic exercise training. Inclusive Criteria: Patients of diabetic neuropathy affecting unilateral lower limb defined as ? 50% loss of strength and sensation of foot relative to non-affected side and complain of pain duration ? 5 months. Exclusion Criteria: Patients with age group between the 50-60 years and Patients with other pathological conditions of foot i.e. gout, spondylolysthesis, gangrene and spinal disease. Outcome measures: Visual analogue scale and Single limb stance. Results: The subject's parameters calculated by using Paired t test for within group comparison and unpaired t test used for between group comparisons. The mean and standard deviation of the measurement were also calculated. The training induced changes were significantly greater in the experimental group than the control group in Visual analogue scale and Single limb stance. Conclusion: It concluded that the treatment with TENS has good effect on Diabetic Neuropathy patients in reduction of pain and improving single limb stance.

Keywords: Diabetic Neuropathy, Transcutaneous electrical nerve stimulation (TENS)

Full Text:

INTRODUCTION
Diabetes mellitus is clinical syndrome characterized by hyperglycemia due to absolute or relative deficiency of insulin (1); the incidence of diabetes among age increased 90% from 4.8 per 1,000 in 1995-1997 to 9.1 in 2005-2007(2) . Lack of insulin causes the various metabolic imbalances leading to irreversible functional & structural changes in cell body with these of vascular and nervous system being affected the most, among people suffering from diabetes mellitus, 45% of patient will have neuropathy during the course of disease(3) . Diabetic neuropathy is a peripheral nerve disorder cause by diabetes, is characterized by gradual loss of sensations i.e. touch , temperature, vibration with loss of coordination and balance leading to weakness and wasting of muscles of hands and feet(4) . Diabetes changes the way nerve use glucose leading to accumulation of sorbitol & depletion of substance called myoinositol within the nerves.(5) Excessive blood sugar decreases the level of nitric oxide present in the blood leading to constriction of small vessels supplying a nerves contributing to nerve damage. The damaged nerve fiber sends incorrect signals to other pain centers giving rise to Neuropathic pain (6) . The main objective of the treatment is to decrease pain & improve single limb stance with simplify possible regimen. Medical management concentrates on oral hypoglycemic drugs aided by use of non–steroidal anti-inflammatory drug along with exercise and dietary changes. Transcutaneous Electrical Nerve Stimulation (TENS) is a specific therapeutic approach to control the Neuropathic pain in patients with diabetic neuropathy (7). TENS either activates the gate control mechanism or induces the release of endogenous opiate substances to relieve pain (11) . Neurological Rehabilitation programme aim at reducing pain, improve single limb stance, functional mobility, activities of daily living, quality of life and perhaps survival in patients with diabetic neuropathy. Many patients with diabetic neuropathy are limited in their physical activity by pain (12). Subjects undergoing treatment with TENS may be beneficial effect in diabetic neuropathy patient to reduce severity of pain and improving the single limb stance (13) . The study conducted to determine whether the TENS has effective on Diabetic Neuropathic pain.

MATERIALS AND METHODOLOGY
Study Design:
An experimental comparative study.

Materials: Control Group (Group A): Tuning fork, Inch tape, Digital stopwatch, goniometer and TENS.

Sample size:
A total number of 30 patients diagnosed as diabetic neuropathy selected and divided in two groups. The study carried out as before and after study design with control group.

Control Group (Group A):
The patients in this group had given treatment with therapeutic exercise to reduce pain.

Experimental Group (Group B):
The patients in this group had given treatment with TENS application and therapeutic exercise to reduce pain.

Study setting:
The study was conducted on patients diagnosed as diabetic neuropathy, which were referred for physiotherapy management from neurology ward of South Central Railway Hospital, Secunderabad and experiment was conducted at Sri Sai Physiotherapy Clinic, Kothapet, Andhra Pradesh, India.

Duration:
Treatment given for 20 minutes/sessions, 2 sessions /day for 5 days in a week for the both groups for 1 month.

Subject selection criteria:
Inclusion Criteria:
- Diabetic neuropathy affecting unilateral lower limb defined as ≥ 50% loss of strength and sensation of foot relative to non-affected side.
- Complain of pain duration ≥ 5 months.

Exclusion Criteria:
- Age group was between 50-60 years.
- Pathological conditions of foot: gout, spondylolysthesis, gangrene and spinal disease.

Parameters:
Visual Analogue Scale: Visual analogue scale is a most valuable and highly subjective measure mental scale that tries to measure a characteristic or attitude that has to range across a continuum of values. Visual analogue scale used for determine the intensity of pain. The amount of pain that patient feels ranges across a continuum from none to an extreme amount of pain. Operationally a Visual analogue scale is usually horizontal line, 10 cm. in length, encored by word descriptors at each and patient‘s marks on the line that the point that they feel represents their perception of current state. The left side of the line represents no pain. Moreover, the right side represents the worst pain. Visual analogue scale is consistent reliable and easy to use and took less time to administer. Visual analogue scale used before and after to measure effectiveness of treatment and a patient‘s progress. Visual analogue scale is a valid and reliable measure of chronic and acute pain intensity.

Single Limb Stance:
Single limb stance is an objective type of gait variable in which one extremity is in contact with the ground or supporting surface. Foot placed pointing straight forward in relation to reference line in the frontal and sagittal planes. The other leg was flexed 90 degree at hip and knee with both arm hang at side. Patients were instructed to stand as motion less as possible, look straight ahead at the point on wall 65cm. away. Patients informed to be in position until the time they can, with normal time about 60 seconds.

Procedure
Technique of application:
Every session started with 5 minutes assessment of sensation, range of motion and muscle strength. In prone lying position, TENS given with high frequency rectangular pulse shape, Pulse width between 200 to 400 µsec, Pulse rate between 60 to 100 Hz, Intensity between 44 to 60 mA and single channel surface electrode was used.

Group A: Subjects in the control group given only therapeutic exercise program. The total exercises training time was 20 minutes daily for 5 to 6 days in a week with total duration of 4 weeks.

Group B: Subjects in experimental group given treatment with Transcutaneous electrical nerve stimulation along with exercise programme for pain reduction. The total training time was 20 minutes daily for 5 to 6 days in a week with total duration of 4 weeks.

RESULTS
Paired t test used for within group comparison and unpaired t test used for between group comparisons. Within group comparison

 

The Visual Analogue Scale and Single Limb Stance have shown a mean improvement indicating the effect of treatment in Group B patients who had beneficial effects. Exercise only did not show an improvement in a short duration of 4 weeks. The mean improvement in the patient‘s condition measured using visual analogue scale and single limb stance indicating the reduction of pain achieved by treatment in this study. Visual analogue scale had a significant improvement. The ?t? value indicates the significant change in experimental group than the control group. DISCUSSION The study measurements assessed for preexercise and post-exercise sessions of both Group A and Group B. The post exercise parameters assessed by paired ?t? test and the formulated ?t? values were compared with the table values with a degree of freedom 14. The study demonstrated that in diabetic neuropathy patients, treatment with the TENS reduces pain and improves single limb stance. The study conducted with great care to ensure familiarization with the treatment and the length of the training session as prescribed in clinical trials. Diabetic neuropathy contributes to pain and reducing single limb stance (4). The measurement recorded after the treatment period in both the groups has variations. The experimental group, who treated with TENS, had significant variations indicating the reduction of pain and improvement in single limb stance. There have been earlier studies that reported significant reduction in pain by treatment with TENS. (9) The study showed that TENS administration was followed by reduction, but not abolition of pain in lower extremity at all painful sites. Finally, the reduction in pain intensity reported here is typical of that observed in patients with diabetic neuropathy who were treated with TENS (7) . The earlier studies for reduction of pain in diabetic neuropathy had shown that TENS could relive the pain by altering nociceptive

transmission in the dorsal horn of the spinal cord (15). The other mechanism requires that stimulation delivered to the spinal cord segments that innervate the painful area via ventral rami of spinal nerves(17), however also innervate the skin of lower back via dorsal rami. Thus, TENS delivered to the dorsal columns reduced the Neuropathic pain in patients with diabetic neuropathy. CONCLUSION The level of significance of visual analogue scale and single limb stance had shown change after the treatment with TENS and had proved reduction of pain in diabetic neuropathy patients. The calculated ?t? value greater than tabulated ?t? value in parameters, standing that the results are highly significant and so the hypothesis goes in favor of the Experimental hypothesis with the reduction in pain and improvement in single limb stance. Thus the study concluded by rejecting null hypothesis and accepting the experimental hypothesis. The experimental hypothesis of the study states, ?There is a significant reduction in pain and also improvement in single limb stance by treatment with Transcutaneous electrical nerve stimulation application in patients with Diabetic Neuropathy.? ACKNOWLEDGMENTS Authors are sincerely grateful to the god who showered his blessings and his helping hand for our research. Sincerely Authors are thankful to our principal who helped us in every walk of our research and his support. The knowledge he shared and his encouragement helped us a lot. Authors would like to mention special thanks to my entire faculty who were always a standing rock for our great work. Authors are privilege to thank our respected elderly subjects without whom this research was not been possible. Authors heartily thankful to authors, journals and books from where references for this article has been reviewed and discussed.

Conflict of Interest: None

References:

1. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 20: 1183–1197, 1997.

2. State-Specific Incidence of Diabetes among Adults, Participating States, 1995-1997 and 2005-2007. October 31, 2008 / 57(43); 1169-1173.

3. Harrison M., Eastman R. Symptoms of sensory neuropathy in adults with diabetes mellitus. Diabetes care.1993; 16:1446- 1452.

4. Archives of Physical Medicine and Rehabilitation. Volume 77, Issue 9, September 1996, Pages 849–855.

5. Walkins PJ. Natural history of Diabetic neuropathy. Q J Med.1990; 77:1209-1218.

6. Chance P., Lebo R. et al: Motor and Sensory neuropathy in peripheral neuropathy 1981.

7. Kumar D., Diabetic Peripheral Neuropathy: Amelioration of pain with Transcutaneous electrical nerve stimulation. Diabetes care 1997, 20:1702-1705.

8. J B Dingwell and associates study in patients with diabetic neuropathy contribute to pain and reduction in single limb stance. J Neurol.2000; 53:789-793.

9. Mannheimer J.S. Electrode placement technique. In clinical Transcutaneous electrical nerve stimulation 1984; 331-495.

10. Galer BS and associates: Development and preliminary validation of a pain measure specific to Neuropathic pain. Neurology 1997; 48:332-338.

11. Garrison D and Foreman R suggested that there is decreased activity of spontaneous and noxiously evoked dorsal horn cells by Transcutaneous electrical nerve stimulation application. Pain1994; 58:309-315.

12. ANN M. ARING, M.D., Riverside Methodist Hospital, Columbus, Ohio. Am Fam Physician. 2005 Jun 1; 71(11):2123- 2128.

13. Forster E.L. et al: Effect of Transcutaneous electrical nerve stimulation on pain following Diabetic neuropathy. Neurol.106:1343-1348.

14. Wall J C and Scarbrough J: Use of multimemory stopwatch to measure gait parameters. J Ortho Sports Phys Ther. 1997; 25:277.

15. Lamontage A.: electrophysiological studies in diabetic neuropathy. Am. Neurol. 1990; 27:574-578.

16. Walker SC et al: Gait pattern alteration by sensory stimulation in diabetic patient with peripheral neuropathy. Arch Phy Med Rehab.1997; 78:853.

17. Macdonald A. J. R. Transcutaneous electrical nerve stimulation induces spinal electro analgesia and its relief of chronic pain. Physiotherapy 1995; 81:653-61.

18. Walsh D.M., Transcutaneous electrical nerve stimulation: Relevance of stimulation parameters to neurophysiologic and hypo analgesic effect. Am J Phys Med. Rehab.1995; 74:199-206.

19. Nalon M.F.: Difference in electrode used with Transcutaneous electrical nerve stimulation. Phys Ther 1991; 71:746-51.

20. Lee K H, Chung J M. Inhibition of primate spinothalamic tract cell by transcutaneous electrical nerve stimulation.

21. Frampton V: Pain control with the aid of Transcutaneous electrical nerve stimulation. Physiotherapy 1982; 68:76-81.

22. Cauthen Jc. Transcutaneous electrical nerve and peripheral nerve stimulation for chronic pain states. Surg. neurology, 1975; 4: 134-141.

23. Long D M studied the effect of stimulation to the posterior columns of the spinal cord for relief of intractable pain. Surg Neurol.1975; 4:134-141.

24. U.s. Department of health and human services National Institutes of Health. NIH Publication No. 09–3185 February 2009.

25. Archives of Physical Medicine and Rehabilitation. Volume 77, Issue 11, November 1996, Pages 1152–1156

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One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

Emerging Researcher Award:

‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

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 Leow Jun Xian and 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 et al. entitled "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 COLAKOGLU 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 Arpita M. et al 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
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List of Awardees

A Study by Ese Anibor et al. entitled "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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