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IJCRR - 10(12), June, 2018

Pages: 01-07

Date of Publication: 22-Jun-2018


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Comparison between Laparoscopic High Uterosacralligament Suspension and Laparoscopic Sacrocolpopexy: A Retrospective Study

Author: Jacqueline Miyuna Bakisololo, Wang Huali, Audrey Muntanda Bazolana, Deng Yanjie, Roger Mbungu Mwimba, Yanga Kidiamene, Lokomba Bolamba, Mboloko Esimo, Tesfaldet Habtemariam, Ding Xiao Dan

Category: Healthcare

Abstract:Background: Pelvic organ prolapse is a latent disease that may take origin after injury of the connective tissue. This investigation aims to compare the surgery outcome of the Laparoscopic High Uterosacral ligament suspension (LHULS) and the Laparoscopic Sacrocolpopexy (LSC).
Materials and Methods: This is a retrospective study. Fifty-three participants with pelvic organ prolapse stage ≥II referring to pelvic organ prolapse quantification (POP-Q) system were desirable in this study. Thirty participants underwent LSC, twentythree others experienced the LHULS surgery. The surgery outcomeand patient's satisfaction were assessed by the POP-Q
system, and the pelvic floor questionnaires PFDI-20, PFIQ-7, PISQ-12, respectively. Whitney-Test was utilized to analyze the pre-and post-operative results between groups, while the Wilcoxon signed rank test was used to compare the pre-and postoperative
outcomes.
Result: The POP-Q score improved significantly for both groups postoperatively. LSC was superior to LHULS in the anterior compartment, the postoperative mean for Ba was (2.54 \?0.56 Vs -2.39\? 1.47). The LSC was superior to The LHULS in the posterior compartment as well; Bp(2.50\? 1.96 Vs-2.08\?1.3, P< 0.05). The LHULS had a higher patient satisfaction especially in urinary symptoms (P< 0.05). The LSC has a longer operation time and inpatient day, as well as an extended catheterization time (P< 0.05). Moreover, the LSC has a higher amount of bleeding and a higher occurrence of hysterectomy (P< 0.05).
Conclusion: The LSC technique demonstrated his superiority in anterior and posterior compartment than LHULS. The LHULSsurgery had a higher patient satisfaction for urinary symptoms.The LSC has a longer operation time and in-patient day compared to LHULS.

Keywords: Laparoscopic, Sacrocolpopexy, Uterosacral ligament suspension, Effectiveness

Full Text:

Introduction

Pelvic organ prolapse is a latent disease that may take origin after injury or abnormalities of the connective tissue, Levator ani muscles, nerve, and vessels. Over time, these disturbances will increase and become obvious later in life [1- 4]. The demand for prolapse treatment is increasing as longevity increases. After menopause, the probability to suffer from prolapse is estimated to be as higher as 50 percent [5].

The challenge of surgeons is to care and cure the affected population with different kinds of techniques, provided that those techniques proof their effectiveness. [6]

Abdominal Sacral colpopexy (ASC) has a reputation for being the cornerstone in repairing the vault prolapse [7], furthermore, it has an important place in restoring the multi-compartment pelvic organs herniation [7], and the recurrence protruded organs. The laparoscopic approach has highlighted the increasing benefit of this procedure by magnification and minimal invasion [7]. Studies conducted to compare the laparotomic and the laparoscopic sacrocolpopexy(LSC) concluded that the surgery outcomes were similar with some limitation for both sides. The laparotomic surgery’s and hospitalization time was higher than the laparoscopic approach [7, 8]. The Laparoscopic technique, however, minimizes these issues. Moreover, the manipulation of the gut is less [7]. Nevertheless, the LSC requires an experience [8].

On the other hand, the laparoscopic high uterosacral ligament suspension (LHULS) has shown good anatomic outcome for vault prolapse [9-12]. Interestingly, this procedure does not require any graft, therefore, the concerns about the graft-related complications are dispelled [11]. Furthermore, it has an advantage of better view by magnification and being less aggressive [9].

Materials and Methods

This is a retrospective study. Fifty-three participants with pelvic organ prolapse stage ≥II referring to pelvic organ prolapse quantification system were desirable in this study between April 2014 and May 2017.Thirty participants underwent LSC and twenty-three others experienced LHULS at Dalian Gynecology and Obstetrical (Maternal and child health care) Hospital. The womenwithtroublesome prolapse, and with pelvic prolapse stage equal or greater II were included in this investigation. The smoking women and patients who were not acandidatefor laparoscopic surgery to treat prolapse were excluded. The LSC surgery was done by two gynecologists, one of the two gynecologists also performed the LHULS surgery.  The analysis was done for afollow up of 12months.

Ethical approval

The Ethics committee of Gynecology and Obstetrical (Maternal and child health care) Hospital and Dalian Medical University approved the study.

Patients evaluation

All participants had a complete clinical examination before surgery. The surgery outcome was evaluated by the pelvic prolapse quantification (POP-Q) system, the satisfaction of patients was assessed by the pelvic floor questionnaires including the Pelvic floor distress inventory-20, pelvic floor impact questionnaire-7 and pelvic prolapse incontinence sexual questionnaire-12, respectively PFDI-20, PFIQ-7, PISQ-12. We assessed the intraoperativedetails and surgical complications.

Operation procedure

1. Laparoscopic Sacral Colpopexy

The general anesthesia was used. The patient was placed in the recumbent position, legs flexed and sustained by stirrups. Theskin disinfection, the sterile draping, and urinary catheterization were then performed.Firstly, we placed four trocars on the abdomen. The initial 10mm at the umbilicus, twolateral 5mm trocars at one-third of the umbilical-spinous line at either side, and the last trocar was inserted 4cm ascendant from the left lateral 5mm trocar. A hysterectomy was done when required.The vesicovaginal and the rectovaginal pouchwere opened at the lowest part of the prolapse. Then, the promontory dissection was completed by the incision of the paravertebral peritoneum and the retroperitoneum fat, after identification of the L5-S1, the right ureter, and iliac vein. Hence, the anterior longitudinal ligament was visible. Furthermore, the incision of the peritoneum at the sacral promontory was extended medially. Therefore, the Y-shape mesh was used (monofilament, macroporous polypropylene mesh GYNECARE of U.S.A. and Budd Company of Germany). With two columns of six interrupted sutures,we then sutured the arms of the mesh at the anterior and the posterior compartment. Finally, we attached the mesh on the anterior sacral longitudinal ligament with non-absorbable suture. The peritoneum closure was achieved by a running suture. The patientswere recommended the useof vaginal estrogen cream at least for six months after surgery. And they could start sexual life after three months and encouraged to use

2. Laparoscopic High Uterosacral ligament suspension

Under general anesthesia, we disinfected and covered with sterile clothes the patient which liedin the lithotomy position. We began to insert four trocars in the abdomen, one on the umbilicus of 10mm, two laterals 5mm each and another midway between the umbilicus and the external iliac spine.  Then, we identified the uterosacral ligaments and ipsilateral ureter. We made an incision in the peritoneum between the ligament and the ureter to avoid ureter damage. A non-absorbable suture was placed in running mode through the proximal, middle and distal of either uterosacral Ligament. The uterus sacral ligament was folded and shortened. The shortened uterosacral ligament was sutured at the vaginal part of the cervix (if the uterus is preserved) or to the vaginal cuff (when a hysterectomy has been performed).

The patients were prescribed a vaginal estrogen cream after surgery for a duration of six months and more and attempt sexuality three months later.

Follow up process

After surgery, the patients were reviewed. The surgery outcome and the patient’s satisfaction were assessed as well.  We checked for any bulge, mesh exposure, and urine leakage by the cough test. The subjective outcome was assessed by the valid quality of life questionnaire short form PFDI-20, PFIQ-7, PISQ-12.

Statistics Analysis

The data are described as a mean ± standard deviation, median (range), rate as fitting. The Mann Whitney-Test was utilized to analyze the postoperative results between groups, while the Wilcoxon signed rank test was used to compare the pre-and post-operative outcomes Then, we used the chi-square (Pearson chi-square, continuity correlation, Fisher exact accordingly) for categorical data. We used the IBM SPSS statistics version 21, the p< 0.05 was considered as statistically significant.

Result

The baseline characteristics of the patients are shown in table 1. The LSC group have a high rate of menopaused women than the LHULS group (P=0.01).  There was no difference in age, BMI, and other risk factors.

 Table 2 demonstrates the POP-Q result showing that there was a statically significant amelioration in POP-Q scores, except for the point Ba in LHULS group and for TVL and PB for both LHULS and LSC groups; when comparing the preoperative to postoperative outcomes. The two groups were different in all compartments before surgery, except for Ap, GH, TVL. PB.  The postoperative POP-Q measurement demonstrated a significant difference in mean Aa, which was -2,40±1.3 versus -2.86±0.46 respectively for LSC and LHULS(P=0.04), while the mean postoperative for the point Bpimproved better in LSC compared to LHULS group (-2.50± 1.96 versus -2.08±1.3, P=0.008).The genital hiatus(GH) was greater for LSC group (3.75 ± 1.13 versus 2.78 ± 1.38, P= 0.004).Similarly, the point Ba improved more in LSC group (-2.54 ±0.56 Vs-2.39± 1.47); as shown in table 2. We defined the surgery success as POP-Q Aa, Ba, C, Ap, Bp less than -1. There was no difference in success rate between groups. In all sites, we obtained a success rate of 87% and 87% for both LHULS and LSC respectively. Moreover, no difference was detected in relapse rate (13.33% versus13.04%) for LSC and LHUSL respectively.

The patients' satisfaction assessment is seen in Table 3. The PFDI-20 improved significantly for both groups, except for the CRADI-8 domain. The PFIQ-7 did not improve significantly in all domains for LSC group,while in the LHULS group, there was an improvement for the PFIQ-7 questionnaire in total and for the UIQ-7 domain. For both groups, there was no difference after surgery in CRAIQ-7domain.

The operation’s details and complications are shown in Table 4.  LSC held an extended surgical time than LHULS (177[50-350] versus 115 [70-190], P<0.001), alonger hospitalstays (6[4-9] versus 5[4-7], <0.001), a higher blood loss   50[20-150] versus 30[20-50] ,P<0.001, and a longervesical catheterization (1 [1-2] versus 1 [1 -2]   P= 0.006). Except the difference seen in de novo incontinence 16.7(5/30) versus 0(0/23), P=0.04, there was no difference in dyspareunia, pelvic pain, vaginal infection between the groups after surgery.   The LSC group has a higher rate of hysterectomy than LHULS.    

Discussion

The surgery outcome as assessed by the POP-Q Measurement showed no difference between the groups in thecentral compartment postoperatively.These results are differentto previous reports [13, 14]. This can be explained by the difference of point C before operation among the groups.In our study, the uterine prolapse was more severe in LSC group before surgery. Although the two groups were different in POP-Q score before surgery, indicating that the prolapse in all compartments in the LSC group was more severe than in the LHULS group; Nevertheless, the postoperative outcome for LSC surgery demonstrated his superiority in the anterior and posterior compartment in our study. These foundings are in accordance with a study conducted by Rondini et al detected that LSC was superior in posterior compartment than LHULS [14].Another comparison study between the ASC surgery and the vaginal uterosacral ligament suspension demonstrated that ASC was better in apical compartment than vaginal uterosacral ligament suspension. [15]We did not have a difference in relapse rate that supports a recent study from 2017[16].

In the present analysis, LHULS gave better satisfaction in the PFDI-20 score when compared to LSC. We noticed that neither the patients of LSC group nor those of the LHUSL group were satisfied in the CRADI-8 and CRAIQ-7, thus indicating that the Colorectal-anal symptoms remained the same after both surgeries. A previous study from 2018 that compared the robotic-assisted uterosacral ligament suspension and the robotic-assisted sacrocolpopexy also did not find any statistical significance in bowel function [17].Similarly, a recent study using vaginal uterosacral ligament vault suspension did not find a significant improvement in bowel function [18].

In our study, the LSC group had a longer surgery time, a longer hospital-stay than LHULS group. This is similar to preceding reports [14, 19]. The present study also found that LSC held an extended time of catheterization and high blood loss than LHULS, although none of the patients required a blood transfusion.

 We did not have a postoperative complication in the LHULS group.Our success rate of uterosacral suspension is between arange of the reported result [20].

Our study demonstrates that both LSC and LHULS are effective in the treatment of apical compartment prolapse. Importantly, the LHULS uses anative tissue, thus do not possess any mesh-related complication. Nevertheless, many studies have reported the superiority of LSC to address the more severe prolapse [19]. The risk of mesh erosion with laparoscopic approach range between 0 to 12% [22], thus the benefits of mesh use must always outweigh the risk. The selection of patients for mesh surgery is critical. Moreover, theexperience of the surgeon is the goal of the satisfactory outcomes.

The strength of this study was that all the surgeries were done that by two gynecologists.  We used the POP-Q to assess the treatment outcomes and the valid pelvic floor quality of life questionnaires for patients’ s satisfaction.

The study has several limitations including the small sample size and we did not include the urodynamic study for our patients.

Conclusion

The LSC and LHULS surgeries are safe and effective for the treatment of pelvic organs prolapse.  The LSC technique demonstrated his superiority in anterior and posterior compartment than LHULS. The LHULS surgery had higher patient satisfaction with urinary symptoms.The LSC has a longer operation time and inpatient day, as well as an extended catheterization time.  Moreover, the LSC has a higher amount of bleeding and a higher occurrence of hysterectomy.

Acknowledgment

  • The authors acknowledge the immense help received from the scholars whose articles are cited and included in refer­ences of this manuscript. The authors are also grateful to authors / editors/publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.

  • Dr. Zhao Yue, Dr. Ma Yao, Dr. Jiao Zhou at Dalian Obstetrics and Gynecology (Maternal and child health care) Hospitalaffiliated to Dalian Medical University, Dalian, Liaoning, China.

Conflict of interest

The Authors declare that they have any conflict of interest

Authors contributions

J.Bakisololo Miyuna:  Data conceptualization, collection, interpretation, analysis,and manuscript writing.

Wang. Huali: Data conceptualization, collection, and interpretation.

A. BazolonaMuntanda: Data collection and analysis.

DengYanjie:Data collection and interpretation.

R.MbunguMwimba:Data conceptualization and interpretation.

Yanga Kidiamene:Data conceptualization and interpretation.

Lokomba Bolamba:Data conceptualizationand interpretation.

Mboloko Esimo:Data conceptualization and interpretation.

Tesfaldet Habtemariam: Dataanalysis.

Ding Xiao Dan :Data collection

References:

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[2]. Martin L. Pernoll, M.D. Relaxation of pelvic support, Benson and Pernoll’s Handbook of Gynecology and Obstetrics, 10th edition. New York, Mc Grow-Hill, pp 804-812. 2001

[3]. Barbara L. Hoffman, MD, John O. Schorge, MD, Karen D. Bradshaw, MD, Lisa M. Halvorson, MD, Joseph I. Schffer, MD, Marlene M. Corton, MD. Pelvic organ prolapse, Williams Gynecology 3th edition, New York, McGraw-Hill Education publishing, pp 538-560. 2016

[4]. Tomas L. Griebling. Vaginal pessaries for treatment of pelvic organ prolapse in elderly women, CURR Opin Urol.2016; 26: 201-206.  DOI:10.1097/MOU.0000000000000266

[5]. Maggie F. Wilkins, Jennifer M. Wu, Epidemiology of prolapse. Current of Obstetrics and Gynecology report 2018; 5(2): 119-123

[6].Charles R. Rardin, M.D., Elisabeth A. Erekson, M.D., Vivian W. Sung, M.D., M.P.H., ReneeM. Ward, M.D., and Deborah L. Myers, M.D.Uterosacral Colpopexy at the Time of Vaginal Hysterectomy:Comparison of Laparoscopic and Vaginal Approaches. J Reprod Med. 2009; 54(5): 273–280.

[7]. Elisabetta Costantini, Luigi Mearini, MassimoLazzeri, Vittorio Bini,ElisabettaNunzi, Manuel di Biase and Massimo porena. Laparoscopic versus Abdominal Sacrocolpopexy: A randomized, controlled trial, The Journal of Urology 2016; 196, 159-165. doi.org/10.1016/j.juro.2015.12.089

[8]. S. Manodoro, E. Werbrouck, J. Veldman1, k. Haest, R. Corona, F. Claerhout, et al. Laparoscopic Sacrocolpopexy: review, F, V & V in ObGyn., 2011; 3 (3): 151-158.

[9]. Patrick J. Culligan, MD, John R. Miklos, MD, Miles Murphy, MD, Roger Goldberg, MD, MPH, Carol Graham, MD, Robert D. Moore. The tensile strength of uterosacral ligament sutures: A comparison of vaginal and laparoscopic techniques.ObstetGynecol2003; 101:500–503.  https://doi.org/10.1016/S0029-7844(02)03123-X

[10]. Unger CA, Walters MD, Ridgeway B, et al.Incidence of adverse events after uterosacral colpopexy for uterovaginal and posthysterectomy vault prolapse. Am J ObstetGynecol2015;  212:603. e1 7.http://dx.doi.org/10.1016/j.ajog.2014.11.034

[11]. Rodolfo Milani, Matteo Frigerio, Stefano Manodoro, Alice Cola, Federico Spelzini. Transvaginal uterosacral ligament hysteropexy: a retrospective feasibility study, Int Urogynecol J.  DOI 10.1007/s00192-016-3036-2

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[13].  Lavelle ES, Giugale LE, Winger DG,  Li Wang,  Charelle M Carter-Brooks,  Jonathan P. Shepherd Prolapse recurrence following sacrocolpopexy vs uterosacral ligament suspension: a comparison stratified by Pelvic Organ Prolapse Quantification stage, Am J ObstetGynecol2018; 218(1):  116.e1–116.e5   https://doi.org/10.1016/j.ajog.2017.09.015

[14]. C. Rondini, H. Braun, J. Alvarez, M. J. Urzúa, R. Villegas, C. Wenzel, C. Descouvieres High uterosacral vault suspension vs Sacrocolpopexy for treating apical defects: a randomized controlled trial with twelve months follow-up, Int Urogynecol J. 2015.Doi:10.1007/s00192-015-2666-0

[15]. Gilad A. Filmar& Hilaire W. Fisher & Enrique Aranda & Peter M. Lotze, (2014) Laparoscopic uterosacral ligament suspension and sacral colpopexy: results and complications, Int Urogynecol J. 2014. DOI 10.1007/s00192-014-2407-9

[16]. N. Noor, D. Bastawros, C. U. Eto , S. Iyer, M. E. Florian-Rodriguez , E. Lavelle , et al. Minimally invasive sacrocolpopexy versus vaginal uterosacral ligament suspension: Comparing anatomic outcomes at 1 year.  American Journal of Obstetrics and Gynecology, 2018; 218 (2): S881. https://doi.org/10.1016/j.ajog.2017.12.185

[17]. Kurdoglu M, Unlu S, Antonetti Elford M, Kurdoglu Z, Kilic GS. Short-term results of changes in existing and de novo lower urinary tract symptoms after robot-assisted laparoscopic uterosacral ligament suspension and sacrocolpopexy. Lower Urinary Tract Symptoms. 2018;1–7. https://doi.org/10.1111/luts.12219

[18].W. Andre Silva, MD, Rachel N. Pauls, MD, Jeffrey L. Segal, MD, Christopher M. Rooney, MD,Steven D. Kleeman, MD. Uterosacral Ligament Vault Suspension Five-Year OutcomesObstetrics& Gynecology2006; 108(2): 255-263

[19]. Erin Seifert Lavelle, MD, Lauren Giugale, MD, Daniel G. Winger, Li Wang, Charelle M. Carter-Brooks, MD, Jonathan P. Shepherd, MD, MSc (2017) Prolapse Recurrence Following Sacrocolpopexy Versus Uterosacral Ligament Suspension: A Comparison Stratified by POPQ Stage. American Journal of Obstetrics and Gynecology2017.Doi:10.1016/j.ajog.2017.09.015.

[20]. Rebecca U. Margulies, Mary A.M. Rogers, Daniel M. Morgan (2010) Outcomes of transvaginal uterosacral ligament suspension: systematic review and meta-analysis, American Journal of Obstetrics & Gynecology2010. Doi: 10.1016/j.ajog.2009.07.052

[21]. Cecile A. Unger, MD, MPH, Matthew D. Barber, MD, MHS, Mark D. Walters, MD, Marie Fidela R. Paraiso, MD, Beri Ridgeway, MD, and J. Eric Jelovsek, MD, MMEd. Long-Term Effectiveness of Uterosacral Colpopexy and Minimally Invasive Sacral Colpopexy for Treatment of Pelvic Organ Prolapse Female Pelvic Med Reconstr Surg 2017;23(3): 188–194 DOI: 10.1097/SPV.0000000000000313

[22].Richard K. Lee, Alexandre Mottrie, Christopher K. Payne, David Waltregny.  A Review of the Current Status of Laparoscopic and Robot-assisted Sacrocolpopexy for Pelvic Organ Prolapse, European Urology2014; 65:1128–1137

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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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International Journal of Current Research and Review (IJCRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal

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