International Journal of Current Research and Review
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IJCRR - 9(9), May, 2017

Pages: 37-45

Date of Publication: 15-May-2017


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Study of Adventitious Lung Sounds of Paediatric Population using Artificial Neural Network Approach

Author: Sibghatullah I. Khan, Vasif Ahmed

Category: Technology

Abstract:Objectives: Human lung sounds are important indicators of underlying lung pathology. The prime objective of this work is to classify normal and adventitious lung sounds in paediatric population using spectral features and artificial neural networks.
Material and Method: 3M Littmann 3200 electronic stethoscope was used to record the lung sounds. After pre-processing ten spectral features were extracted. For classification, comparative performance of different artificial neural networks is studied and GFF neural network with calculated optimum parameters is selected.
Results: For testing data Out of 49 normal subjects 48 were classified successfully and out of 52 pathological subjects 48 were classified successfully. The classification sensitivity and specificity obtained is 92.30% and 97.95% respectively.
Conclusion: Early diagnosis of lung disorder is important especially in childhood so that further progress of the disease could be prevented. New approach to detect adventitious lung sounds is being proposed utilizing electronic stethoscope as a recording device. Combination of spectral features and artificial neural networks has provided classification accuracy of 95.12%.

Keywords: Lung disease, Adventitious lung sounds, Spectral features, Artificial neural networks

Full Text:

INTRODUCTION

Human lung sounds play an important role in diagnosis of underlying respiratory pathology. Traditionally medical doctors used to auscultate the lung sounds with the conventional stethoscope. This approach is quite common, but is subjected to some concerns like, for the novice doctors it is difficult to distinguish between different categories of adventitious lung sounds due to unavailability of any objective reference. Moreover, the misdiagnosed adventitious lung sounds of paediatric population may lead to adulthood repository disease such as COPD.

Respiratory disorders, if diagnosed early in childhood, could be cured with proper antibiotics. To sum it up, it is very important to diagnose adventitious lung sounds in the paediatrics population due to their inability to communicate effectively about their health problems and lack of research in this category. This problem is more severe in the developing countries like India where majority (70%) of the population resides in the rural regions where appropriate medical facilities are not easily available due to distant geography and due to the shortage of trained medical practitioners. 

There are estimated 6.4 million deaths [1] due to lung disease globally and in India it accounts for 11% of all the deaths [2]. Respiratory disorders are the second most cause of mortality in India after Heart related disease. The aim of this study is to address the issue by employing signal processing techniques in analysis of paediatric lung sounds to categorize them in normal and adventitious category. Now-a-days commercialization of electronic stethoscope with various inbuilt features opens a wide opportunity for the researchers in the biomedical field. Littmann is most trusted brand in the stethoscope market since many years. 3M Littmann traditional models were the most popular amongst the doctors especially amongst the pulmonologists and cardiologists. 3M Littmann 3200 Electronic stethoscope is used to record the lung sounds of subjects which was not utilized for lung sound recording and analysis purpose by previous researchers.

The paper has been organized into four sections. The second section presents review of some research done in past. Section three describes materials and method which includes data acquisition, feature extraction and classification. Finally Section four presents results and fifth describes conclusion.

LITERATURE REVIEW

Table A provides some of the research work done in the past for automated objective analysis of lung sounds.

 

From table 1, it is noted that lot of research is done and still going on relating the automatic/computerized analysis of adventitious lung sounds and many signal processing techniques have been employed. The majority of the research carried out was for the adult population and vast non-uniformity is observed in the data acquisition methods, Some researchers have utilized lung sound training tapes where as some of them have used data from online resources. In spite of this, majority of the researchers have used the data which was acquired using microphones, microphones embedded with stethoscope or sensor jackets. There are in fact, very few researchers who have used data recorded from paediatric population. Also no one till date has utilized the electronic stethoscope model 3200 by 3M Littmann with the feature of ambient noise reduction. So there exists tremendous scope to study the lung sounds of paediatric population for objective analysis and for classification.   

MATARIALS AND METHODS

A] Data Acquisition

For data acquisition, 3M Littmann 3200 electronic stethoscope was used .3M Littmann electronic stethoscope is been chosen because of its ambient noise reduction capability, larger bandwidth (0-2000 Hz) and facility to record in extended mode which provides maximum bandwidth as compared to traditional stethoscope which provides only two modes i.e. Bell and Diaphragm. Also 3M Littmann is most popular and trusted brand among medical practitioners. Also its fidelity for heart sound recording has been tested in our precious study [32].

The stethoscope has the Bluetooth connectivity with PC with the help of ‘StethAssist’ software provided by Littmann. One complete recoding of 60 sec is transmitted to PC simultaneously during auscultation through Bluetooth interface. The file is then exported in ‘.wav’ format (16 bit PCM sampled at 4000 Hz). Recordings were made on PC running Windows 8 operating system with AMD quad core processor with 4 GB ram. The recording setup is shown in figure 1.

All lung sound recordings were made after obtaining approval from concerned authorities and in accordance with medical ethics. The mean age of children selected for recording is 2 years ± 1 year, with almost equal gender distribution. The recordings were carried out at renowned child hospitals having Paediatrician with more than 15 years of experience in Nagpur city and in the towns of Pusad and Digras (Vidharbha region of Maharashtra State India).

B] Sorting and Pre-processing

The recordings were labelled according to the disease and sorted according to the quality. Here quality means the absence of hospital noise. The noise in the data was mainly due to crying and movement of child subjects. So after sorting, almost 50% of the data was discarded due to high amount of noise content. Total 540 recording were recorded out of which only 253 recording were selected of which 127 include adventitious lung sounds such as wheezing, crackles, grunting, crepitations and harsh breath sounds. For categorizing normal lung sounds, 126 recordings were selected including the lung sounds of the subjects having common acute cough and cold.

The pre-processing stage involves filtering, DC removal, segmentation and normalization. Below 100 Hz the auscultation sounds are dominated by heart sounds, it is necessary to remove this unwanted signals by means of suitable filtering which will not only remove the noise but will also preserve the basic nature of lung sounds for higher frequencies. Different digital filters were designed and tested by varying order of filter and window types, and finally 7th order Chebyshev type I IIR filter with cut-off frequency of 100 Hz is selected after observing time and frequency domain characteristics of filtered signal. Filter designing is done using MATLAB 2008b licensed version. After successful filtering of all the recordings, two breath cycles from each recording is extracted manually using WAVEDIT software. Each segmented recording is relabelled and saved for analysis. Segmented sounds are then amplitude normalized in the range of ±1.These pre-processed sounds was then used for feature extraction and classification.

C] Feature Extraction:

By observing time and frequency domain description (spectrum) of all the cases of normal and adventitious lung sounds, it was observed that time domain analysis would not help good classification because of similarity in shape of time domain statistical parameters. The previous studies related to time domain analysis of lung sounds also do not reflect encouraging results in terms of accuracy. So, frequency domain analysis is carried out using spectral features which were extensively used in automatic speech recognition systems [33-34]. Total ten spectral features were extracted consisting of Spectral centroid, Spectral crest, Spectral decrease, Spectral flatness, Spectral flux, Spectral roll off, Spectral skewness, Spectral kurtosis, Spectral Slope and Spectral spread.

Brief definition of spectral features is given below

  1. Spectral Centroid

It is the centre of gravity of spectrum. It is defined as

Spectral centroid basically represents the location of concentration of spectral energy. Low values of spectral centroid indicate presence of lower frequency components and vice versa.

2.Spectral Crest Factor

It is a measure of tonalness of the signal. It is the ratio of maximum of the magnitude spectrum to the sum of all bins in the magnitude spectrum. It is defined as

Where n is the block length. In this study the complete segmented signal (two breath cycles) were considered as single block. Low values of spectral crest factor indicates flat spectrum where as high values indicates a sinusoidal. Spectral crest factor is zero for the blocks having zero energy (silence).

3.Spectral Decrease

The spectral decrease measures the steepness of the decrease in the spectral envelope over frequency. It is defined as

The value of spectral decrease is a value S.Dec≤1. A lower value of spectral decrease indicates concentration of the spectral energy at bin 0.

  1. Spectral Flatness

The spectral flatness is the ratio of geometric mean and arithmetic mean of the magnitude spectrum, it is defined as

The value of spectral flatness is greater than 0.The upper value depends on the maximum spectral magnitude. Non-flat spectrum tends to have lower values of S.F where as flat spectrums results in higher values of S.F.

  1. Spectral Flux

The spectral flux measures the amount of change in spectral shape. It is defined as the average difference between successive STFT frames

The value of spectral flux lies in the range 0 ≤ S.F A with A representing maximum possible spectral magnitude. Low values of A represents steady input signals.

  1. Spectral Kurtosis

The Kurtosis is referred to the ratio of   fourth central movement of a variable to the fourth power of standard deviation. The spectral kurtosis measures how much the distribution of spectral magnitude resembles the Gaussian distribution. It is defined as

Spectral kurtosis represents peakedness of the signal. For spectrum having peaks, its value will be higher. Again one complete segmented signal is used as input to calculate spectral kurtosis.

  1. Spectral Roll off

It is the measure of concentration of spectrum. It is defined as the frequency below which certain percentage (In this study 95%) of the magnitude distribution of the spectrum is concentrated. If mth DFT coefficient corresponds to the spectral roll off of the ith frame then

C is the adapted percentage which is 95% in our case. To normalize spectral roll off frequency it is divided by the FL (total length of the band). So it will have values between 0 and 1, where 1 corresponds to the maximum frequency of signal (fs/2).This parameter actually describes the distribution and shape of the spectrum i.e. narrower spectrum yields lower values where as wider spectrum results in higher values of spectral roll off.

  1. Spectral Skewness

The Spectral skewness is a measure of symmetry of distribution of the spectral magnitude around their arithmetic mean. It is defined as

It indicates the amount of non similarities between spectral magnitudes i.e. for flat like spectrums it has a very low value, where as for fluctuating spectrum its value is high.

 

  1. Spectral Slope

      The spectral slope is similar to the spectral decrease which measures the slope of the spectral shape. It is calculated using a linear approximation of the magnitude spectrum. In the presented form, the linear function is modelled from the magnitude spectrum. It is calculated with the following equation

 

 

  1. Spectral Spread

It is defined as the second central moment of the spectrum. To calculate it deviation from the spectral centroid is taken

 

To normalize SS in the range [0,1], it is divided by the factor (fs/2) ,where 1 corresponds to maximum frequency of signal (fs/2).

All ten spectral features are calculated for each segmented recording. The calculations were performed in Matlab R2008b Licensed version using toolbox available [34]. For 126 normal subjects the dimension of feature matrix is 126*10 and for 127 Pathological subjects the feature matrix dimension is 127*10. By observing both the feature matrices it is concluded that they are not linearly separable, so classification based of artificial neural network has been employed.

C] Classification:

Neurosolutions (Neuro Dimension Inc.USA) 5.07 was used to implement different NN based classifiers on lung sound recordings which are represented by feature vector containing 10 different elements. This paper explores the Multilayer Perceptron (MLP), Generalized feed forward (GFF) and Modular Neural networks for classification purpose.

In the first stage all the network classifiers were tested for different topologies i.e. by varying number of hidden layers and processing elements (PEs) and by changing transfer function and learning rules. Performance measures such as mean square error (MSE), minimum absolute error, maximum absolute error, mean absolute error (MAE), correlation coefficient and classification accuracy were calculated for different classifiers. After observing performances of all the possible combination of transfer functions and learning rules with varying processing elements in hidden layers, it was decided to use network having one hidden layer with six processing elements in it.

Table I provides comparative performances in terms of minimum MSE for MLP, GFF and MNN, where as table II provides their performance in terms of minimum absolute error, maximum absolute error, correlation coefficient and classification accuracy on testing data.

From tables I and II it is concluded that GFF outperforms MLP and MNN in terms of performance measures. The classification accuracy attained by GFF for normal and adventitious lung sound is 90.90% and 91.22% respectively. So in order to optimize GFF for improved accuracy, network is trained by different combinations of transfer functions and learning rules. Table III and IV illustrates the comparative performance of the network for various combinations of transfer functions and learning rule

From the table III it is observed that tanh, which is a non linear transfer function performs better than other transfer functions. This might be due to high degree of non linear separability in the data. So in the next stage of network development, different learning rules such as Step, Momentum, Conjugate gradient (CG), Levenberg Marquardt (LM), Quickprop (QP), Delta bar delta (DBD) were used along with Tanh as a transfer function. Table IV shows comparative performances in terms of Mean square error (MSE), Mean absolute error (MAE), Correlation coefficient  and classification accuracy for different learning rules.

Maximum classification accuracy and correlation coefficient value was obtained by the tanh- CG combination. The computed value of MSE and MAE is also minimum for this combination. All the performances were calculated for testing data.

From Table III and IV it is evident that GFF with tanh as transfer function with Conjugate gradient as a learning rule performs better than other transfer function-learning rule combinations. The final specifications of the network after carrying out trials can now be defined as follows:

 

  1. Network: Generalized feed forward NN
  2. Stopping condition: 3000 Epochs
  3. Conscience rule: L2 Norm
  4. Number of hidden layer: 01
  5. Number of PEs in hidden layer: 06
  6. Hidden Layer Transfer function: Tanh          
  7. Hidden layer learning rule: Conjugate gradient
  8. Output layer: Transfer function: Tanh
  9. Output layer Learning Rule: Conjugate gradient                                                                                                                                                                                             

    RESULTS

    Table IV shows the results using GFF neural network in terms of performance measures such as MSE, MAE, Correlation coefficients and classification accuracy. The sensitivity of neural network for all the ten features is shown in figure 2. For testing data of 49 subjects belonging to normal category, 48 were classified successfully and for Subjects belonging to pathological category out of 52, 48 were successfully classified. The sensitivity and specificity for conducted study is 92.30% and 97.95% respectively leading to the overall accuracy of 95.12%.

    CONCLUSIONS

    A new approach to preliminary detect adventitious lung sounds in paediatric population has been proposed in this study. Features representing spectral characteristics were calculated for each recording and subsequently different artificial neural network topologies involving MLP, GFF and MNN have been tested by varying number of hidden layers, PEs, transfer functions and learning rules. It has been concluded that GFF with one hidden layer and with 6 PEs in it incorporating tanh as transfer function with Conjugate gradient as learning rule is the most optimum neural network for this application. The overall accuracy obtained is 95.12%. The work can be further extended to classify different categories of adventitious lung sounds for detecting specific disease after suitable increase in the subjects recordings pertaining to each disease.

    ACKNOWLEDGEMENTS

    We acknowledge the valuable support received from Shri J. S. Naik, President Janata Shikshan Prasarak Mandal,  Pusad, Dr. H. B. Nanvala, Principal Babasaheb Naik College of  Engineering Pusad and  Dr. N. P. Jawarkar, Head Department of Electronics and Telecommunication Engineering B. N. College of Engg. Pusad. We also convey our thanks to Dr. N. A. Charniya, Dr. S. N. Dandare and Prof Vijay Agrawal  for their help and support during this study. We also thank Dr. Mohibul Haque (Paediatrician, Nagpur), Dr. Arif Ahmed  (Paediatrician, Pusad), Dr. V.K. Deshpande  (Paediatrician,  Digras), Dr. Adanaul Haque Khan and Dr Anwar Siddiqui Nagpur for their help, guidance and support during auscultation recording of lung sounds. 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.

    Source of Funding: None

    Conflict of Interest: None

    Abbreviation

    Chronic Obstructive Pulmonary Disease (COPD)

    Infinite Impulse Response filter (IIR-Filter)

    Spectral centroid (SC)

    Spectral crest factor (SCr)

    Spectral decrease (S.Dec)

    Spectral flatness (SF)

    Spectral flux (SFx)

    Spectral roll off (S.Roff)

    Spectral skewness (S.Skw)

    Spectral kurtosis (SK)                                                                                                                                                 

  10.  

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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
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A study by Alice Alice entitled \"Strengthening of Human Milk Banking across South Asian Countries: A Next Step Forward\" is awarded Best article of Vol 14 issue 20
A study by Sathyanarayanan AR et al. entitled \"The on-task Attention of Individuals with Autism Spectrum Disorder-An Eye Tracker Study Using Auticare\" is awarded Best article of Vol 14 issue 19
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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.
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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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