International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 13(2), January, 2021

Pages: 43-46

Date of Publication: 16-Jan-2021


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Circulating Serum Total Bilirubin as a Predictor for Hypertension in General Population

Author: E. Keerthika, Siddhartha Sankar Pal, Harini Srinivasamoorthy, R. Surekha, Potla Yasaswi, B. Harini

Category: Healthcare

Abstract:Introduction: Circulating total bilirubin is known to be inversely and independently associated with future risk of cardiovascular disease. However, the relationship of circulating total bilirubin with incident hypertension is uncertain. Objective: We aimed to assess the association of total bilirubin with future hypertension risk. However, data on the relationship between bilirubin and blood pressure are scarce and inconclusive. Methods: We analysed data with a 50 minimal sufficient adjustment set of variables (MSAS) needed to estimate the unconfounded effect of bilirubin on blood pressure and hypertension (systolic/diastolic blood pressure ≥140/90 mmHg or using antihypertensive medication) was identified using the back-door criterion and included in all regression models. Results: In this prospective study, after adjustment for the MSAS variables, systolic blood pressure decreased progressively up to -2.5 mm Hg (p < 0.001) and the prevalence of hypertension was up to 25% lower (P < 0.001) in those with bilirubin ≥1.0 mg/ dl-the highest two deciles-compared with those with 0.1-0.4 mg/dl-the lowest decile. Sensitivity analyses showed these results were unlikely to be explained by residual confounding or selection bias. Conclusion: High serum bilirubin may decrease the risk of hypertension by inactivating and inhibiting the synthesis of reactive oxygen species in vascular cells. Strategies to boost the bioavailability of circulating and tissue bilirubin or to mimic bilirubin's antioxidant properties could have a significant impact on prevention and control of hypertension as well as coronary heart disease.

Keywords: Serum total bilirubin, Cardiovascular disease, Systolic/diastolic blood pressure, Hypertension, Minimal sufficient adjustment set, Regression and antioxidant properties

Full Text:

Introduction

The part of aggravation in cardiovascular infection (CVD) is built up. Oxidative pressure assumes a significant part in atherosclerosis, which is an ongoing fiery reaction to vascular endothelial injury brought about by an assortment of variables advancing incendiary cell section and actuation.1 The acknowledgement of bilirubin as a significant endogenous mitigating and cell reinforcement particle has expanded in late many years. Bilirubin influences atherosclerosis by a few repressing systems, including low-thickness lipoprotein oxidation, vascular smooth muscle cell multiplication, and endothelial dysfunction.

Although elevated blood pressure (BP) is a major cause of cardiovascular diseases in all populations and the leading risk factor for global disease burden,1Our knowledge on risk factors for the development of hypertension is still limited. Serum bilirubin is a powerful antioxidant2 and has been shown to decrease the risk of cardiovascular outcomes in prospective cohort studies.3 Experimental studies in animal models suggest that bilirubin may reduce BP by decreasing vascular oxidative stress,4 and a few epidemiological studies point to an association between bilirubin and BP.

Moreover, the role of oxidative stress in the incidence of hypertension has been questioned, due in part to contradictory findings from epidemiological and clinical studies assessing the benefits of supplementing diets with antioxidants such as vitamins C and E.5 Given the potential clinical and public health significance of this association, in this study, we examined the role of serum bilirubin as a possible risk factor for hypertension. This case-control study will be carried out in the clinical biochemistry laboratory in Saveetha medical college and hospital with 50 hypertension patients and 50 age and sex-matched controls.

Materials and Methods

This study is based on data from November 2019 to July 2020. Participants ≥20 years old were eligible for this study, excluding pregnant women (n=4), individuals without BP data (n=6) with BP data (n=40). Three to four BP measurements were taken following standard procedures6 and the mean of all values, excluding the first one in those with more than one measurement, was used in our analysis. Individuals with an average systolic BP-140 mmHg and/or average diastolic BP-90 mmHg and/or taking prescribed antihypertensive drugs were considered as hypertensives. Serum total bilirubin levels were measured using vitros 5600 automated dry chemistry analysers and reported values were adjusted to make them comparable when needed. This study was approved by the Ethical committee of Saveetha medical college and hospital and its ID number: 020/03/098

Statistical analysis

Estimating the effect of bilirubin:

Excluding those individuals from the analysis would have reduced statistical power and increased the likelihood of selection bias, whereas excluding those variables would have increased the likelihood of residual confounding. 6 In consequence, we used multivariate imputation by chained equations (MICE) to fill out missing values and generated and analysed 50 imputed data sets. Also, the underlying BP, our outcome variable, could not be measured in 70% of the 38% (of total participants) with hypertension, because they were taking antihypertensive drugs.

Excluding these individuals, treating observed BP as underlying BP values, and including treatment as a covariate in the analysis could have resulted in bias.7 To address this problem we considered the measured BP as a right-censored variable and imputed BP values among treated individuals using interval regression. BP was measured in the Physiotherapy department of Saveetha medical college.

Multiple linear and logistic regression were used to estimate the effect of bilirubin on current systolic and diastolic BP and the prevalence of hypertension, respectively. An age-squared term and a gender-by-age interaction term were included in our regression models to account for the nonlinearity in the age-BP relationship and the age-dependent effect of gender on BP and hypertension risk. Also, a term for an abdominal obesity-by-age interaction was included and retained if it was statistically significant.

It is well documented that survival is increased among individuals with higher levels of serum bilirubin, and is decreased among individuals with higher BP. Then we estimated the effect of bilirubin-0.7 mg/dl on hypertension excluding individuals with high values of the simulated collider and compared these estimates with the one obtained from the analysis with all individuals

Results

Our analysis included 50 individuals, with an average age of 50 years, 50% men, 38% hypertensive, and median serum bilirubin of 0.7 mg/dl (range 0.1 to 13.1; Table 1). Individuals with serum bilirubin 0.7 mg/dL had higher serum creatinine and uric acid, but had slightly lower systolic BP and prevalence of hypertension, and were considerably less likely to be African Americans, to have abdominal obesity, to smoke or to drink alcohol regularly.

Multivariate adjusted models showed that systolic BP was lower among individuals with higher serum bilirubin (Table 2). After adjusting for variables in the minimal sufficient adjustment set MSAS, systolic BP decreased progressively with increasing levels of bilirubin, up to -3.4mmHg in those with the highest (1.2 mg/dl) as compared with those with the lowest (0.1–0.4 mg/dl) levels of bilirubin (P<0.001). Systolic BP decreased by 0.41mmHg for each increase of 0.20 mg/dl of bilirubin (P<0.001; Table 2). Also, systolic BP was 1.67mm Hg (P<0.001) lower among individuals with bilirubin -0.7 mg/dl. In contrast, bilirubin-associated changes in diastolic BP were inconsistent, small and statistically non-significant in all models (Table 3).

The prevalence of hypertension decreased progressively with increasing levels of serum bilirubin (Table 4). Indeed, after accounting for variables in the MSAS, the prevalence

of hypertension was 25% lower in individuals with the highest (1.2 mg/dl) as compared with those with the lowest (0.1–0.4 mg/dL) levels of bilirubin (P<0.001), and decreased by 14% among those with bilirubin - 0.7 mg/dl (P<0.001) and 5% per each 0.20 mg/dl increase in bilirubin (P<0.001). A bilirubin level above the median resulted in similar decreases in hypertension prevalence in men and women (P-value: 0.144).

Discussion:

We found that serum bilirubin was inversely associated with systolic BP and with the prevalence of hypertension. Specifically, after adjusting for relevant confounders, systolic BP was 1.67 mmHg lower and hypertension was 14% less likely among individuals with bilirubin -0.7 mg/dl. These inverse associations were also observed when bilirubin was analysed as a continuous and as an interval variable. A significant relationship between bilirubin and diastolic BP was not observed.6,7

Serum bilirubin has previously been shown to be an independent cardiovascular risk factor in prospective cohort studies.8 There are few reports on the association between bilirubin and BP, but most seem to support our findings. In a study among young adults from the Bogalusa study, Madhavan et al. found that bilirubin was negatively and weakly correlated with systolic but not with diastolic BP, after adjustment for age, body mass index, smoking and alcohol intake.9 Also, in crude comparisons in a small group of non-smokers with primary dyslipidaemia, serum bilirubin was significantly lower in those who were hypertensive, regardless of antihypertensive treatment.10 Moreover, Chin et al. conducted a cohort study among 1208 Korean outpatients recruited from a health promotion clinic over 10 years and found that the relative risk of hypertension was 0.71 (P=0.048) in patients with total bilirubin -1.1 mg/dl as compared with those with lower levels, after adjustment for other risk factors.11 However, this was a small study with only 43 new cases in the exposed group and staggered non-planned follow-up evaluations, and the decrease in risk was statistically significant only in women and smokers. In contrast, bilirubin was not associated with BP in a small study (N = 26) among related Amish.

By this prospective study, We have resulted in survival bias because both low bilirubin and high BP are positively associated with increased mortality. However, our sensitivity analysis showed that if survival bias had occurred, the true effect of bilirubin on BP should be slightly stronger than what we have estimated in our study.12-15

Many studies have shown that bilirubin is a powerful antioxidant both in vitro and in vivo.12,13 Bilirubin contributes to 23% of the total antioxidant activity of the five major radical scavenging antioxidants in plasma (albumin, urate, ascorbate, α-tocopherol and bilirubin) in 5-days-old term babies. Moreover, it has been postulated that the main role of bilirubin is inhibiting NADPH oxidase, the enzyme mainly responsible for vascular ROS production. Also, high bilirubin is associated with higher brachial artery flow-mediated vasodilation, an indicator of endothelial function potentially related to the development of hypertension. There are currently no proven interventions to induce safe and persistent increases in bilirubin levels that may lead to important changes in BP. Limited data suggest that smoking cessation,100 vigorous exercises14,15 and weight loss through diet102 could lead to significant short-term increases in serum bilirubin.

Conclusion

Given our findings and those from previous studies, it is reasonable to infer that serum bilirubin has a likely casual effect on BP. However, bilirubin's effects on systolic BP and hypertension were relatively weak, despite its high antioxidant capacity. This suggests that strategies to boost the bioavailability of bilirubin or to mimic its antioxidant properties would have a limited impact on prevention and treatment of hypertension and may partly explain the failure of small controlled trials of antioxidant supplements for prevention and management of cardiovascular diseases. Hence future study will be done with large controlled trials.

Authors acknowledgement: This research was supported/partially supported by Saveetha medical college and hospital. We are thankful to our colleagues who provided expertise that greatly assisted the research.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee by Saveetha medical college and hospital and its ID number:  020/03/098

References:

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  2. Bélanger S, Lavoie JC, Chessex P. Influence of bilirubin on the antioxidant capacity of plasma in newborn infants. Neonatology 1997;71:233–238.

  3. Vítek L, Jirsa M, Brodanová M. Gilbert syndrome and ischemic heart disease: a protective effect of elevated bilirubin levels. Atherosclerosis 2002;160:449–456.

  4. Lin JP, Donnell CJ, Schwaiger JP. Association between the UGT1A128 allele, bilirubin levels, and coronary heart disease in the Framingham Heart Study. Circulation 2006;114:1476–1481.

  5. Pandey N, Gupta S, Yadav RK, Kumar S. Physiological jaundice: role in oxidative stress. Int J Curr Res Rev 2013;5(19):69-80.

  6. Djousse L. Effect of serum albumin and bilirubin on the risk of myocardial infarction (the Framingham Offspring Study). Am J Cardiol 2003;91:485–488.

  7. Levy D. Total serum bilirubin and risk of cardiovascular disease in the Framingham offspring study. Am J Cardiol 2001;87:1196-1200.

  8. Madhavan M, Wattigney WA, Srinivasan SR. Serum bilirubin distribution and its relation to cardiovascular risk in children and young adults. Atherosclerosis 1997;131:107–13.

  9. Pflueger A, Croatt AJ, Peterson TE. The hyperbilirubinemia Gunn rat is resistant to the pressor effects of angiotensin II. Am J Physiol Renal Physiol 2005;288: 552-558.

  10. Zucker SD, Qin X, Rouster SD. Mechanism of indinavir-induced hyperbilirubinemia. Proc Natl Acad Sci 2001; 98: 12671-12676.

  11. Chin HJ, Song YR, Kim HS.  The bilirubin level is negatively correlated with the incidence of hypertension in the normotensive Korean population. J Korean Med Sci 2009;24:S50–56. 

  12. Vera T, Granger JP, Stec DE. Inhibition of bilirubin metabolism induces moderate hyperbilirubinemia and attenuates ANG II-dependent hypertension in mice. Am J Physiol Regul Integr Comp Physiol 2009;297:738-743. 

  13. Papadakis JA, Ganotakis ES. Effect of hypertension and its treatment on lipid, lipoprotein(a), fibrinogen, and bilirubin levels in patients referred for dyslipidemia. Am J Hypertens 1999;12:673–681.

  14. Breimer LH, Mikhailidis DP. Is bilirubin a marker of vascular disease and/or cancer and is it a potential therapeutic target. Curr Pharm Des 2011;17:3644-3655.

  15. Perloff D, Grim C, Flack J. Human blood pressure determination by sphygmomanometry. Circulation 1993;88:2460-2470.

Announcements

Dr. Pramod Kumar Manjhi joined Editor-in-Chief since July 2021 onwards

COPE guidelines for Reviewers

SCOPUS indexing: 2014, 2019 to 2021


Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

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 Dorothy Ebere Adimora et al. entitled \"Remediation for Effects of Domestic Violence on Psychological well-being, Depression and Suicide among Women During COVID-19 Pandemic: A Cross-cultural Study of Nigeria and Spain\" is awarded Best Article of Vol 14 issue 23
A study by Muhas C. et al. entitled \"Study on Knowledge & Awareness About Pharmacovigilance Among Pharmacists in South India\" is awarded Best article for Vol 14 issue 22
A study by Saurabh Suvidha entitled \"A Case of Mucoid Degeneration of Uterine Fibroid with Hydrosalphinx and Ovarian Cyst\" is awarded Best article of Vol 14 issue 21
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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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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