International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - Vol 05 Issue 14, July, 2013

Pages: 36-43

Date of Publication: 29-Jul-2013


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EVALUATION OF PORTAL SITE HEALING WITH CLOSURE AND WITHOUT CLOSURE AFTER ARTHROSCOPIC PROCEDURE- A RANDOMIZED PROSPECTIVE STUDY

Author: Kiran S Patil, Haridas M Somayaji, Santhosh S Nandi, Deepesh Daultani, Mallikarjun Ithli

Category: Healthcare

Abstract:Objective: To compare the two methods of management of the arthroscopic portal sites. Background: The methods of managing the Arthroscopy Portals are not standardized. The options are to close with the use of Non Absorbable Sutures or leave it open with sterile simple dressing. This study compares the two methods of management. Material and Methods: We present the outcome of 70 knee Arthroscopies carried out over a period of 24 months in Shri. B. M. Patil Medical College, Bijapur which were chosen alternatively into two groups one with simple sutures other with simple dressings. Outcome measures adopted were level of pain, redness, localised swelling, superficial infection, appearance of the wound after healing. Any observations were reported by an independent observer who was blinded with method of management. Results: No patient was lost during follow up. There was significant difference in the two groups with regards to the redness, swelling, severity of the pain and cosmesis.34% patients developed redness in suture group while only 5% patients developed redness in simple dressing group. 28% patients developed mild to moderate swelling in suture group while only 2% patient developed mild swelling in simple dressing group. 5% patients developed minimal superficial infection in suture group while no patients developed such complication in simple dressing group. Regarding the scar appearance 71% were happy in sutured group while 97% were happy in simple dressing group. Fifteen patients in suture group suffered mild to moderate pain while five patients suffered mild pain in simple dressing group. There was no long term complication in any patients. Conclusion: From our findings we suggest that it is preferable to leave arthroscopy portals open with simple dressing.

Keywords: Arthroscopy, portal sites, portal closure.

Full Text:

INTRODUCTION
Knee arthroscopy is a minimally invasive surgical procedure performed to diagnose and treat intra-articular knee problems. The portals are created with a No. 11 blade incising the skin, subcutaneous tissue, and capsule.[1]. Under normal circumstances two portals are sufficient for most arthroscopic operations.[2]. Although rare, issues with portal healing may occur in association with arthroscopic knee procedures. [3]. Most wound problems are of minor severity and can be treated conservatively. Suturing of the wounds is not necessary and use of a sterile adhesive tape or leaving the wounds open is adequate. The portal wound complication rate was approximately 10% using either method.[1]. Very few studies have been carried out regarding this portal site management. Here we carried out a single blind, prospective randomised study comparing the two methods of portal site management either sutured or just covered by simple sterile dressing.

MATERIAL AND METHODS
This study was performed in B.L.D.E.U’s medical college hospital and research centre, Bijapur and included patients who went arthroscopy of the knee joint by a single surgeon during the period from July 2010 to June 2012 over a period of 24 months. Inclusion criteria were all adult patients underwent arthroscopy of the knee joint either for diagnostic or therapeutic procedures with not more than 5mm stab incision for each portals. Exclusion criteria were procedure requiring longer incision [more than 5mm]; premorbid conditions like diabetes mellitus, septic arthritis. Single surgeon carried out all the procedures and 5mm stab incision made for each portal. Procedure carried out using tourniquet. Ringer lactate used as lavage solution. Portal sites either closed with mattress suture with 2-0 ethilon suture material or by covering the wound with simple sterile dressing. Supportive Jones bandage was given. Wounds were inspected at the end of 2nd, 5th, 8th postoperative day by an independent observer [nursing staff] who was not present during the surgical procedure and dressed. Sutures were removed at the end of 12-14th postoperative day. Any problems at this time were reported by the same independent observer. Patients were discharged after suture removal or wound is healed. All the patients followed up after 6 week interval for routine check up as outpatient basis. Same independent observer attended even during the follow up period. Severity of the pain (using visual analog scale [4]), redness, localised swelling, and superficial infection with respect to discharge were notified by the independent observer. Patients were asked about the appearance of the scar after healing with which they were satisfied or not. When the pain was present it was asked whether the pain is from portal site or deep inside. Problems related to the original pathology were not taken as to restrict our documentation related to portal sites only. Statistical methods Pilot study was conducted and 35 patients for each group were taken as sample size and p value of less than 0.05 was taken for significance. Z value, percentage were used as diagnostic statistical tests to evaluate the results.

RESULTS
Totally seventy patients were studied by choosing alternatively into each group. There were 23 males [65.71%] in each group and average age is 34.7 years [range- 20-59]. Table 1 gives the common indication for the arthroscopic procedure carried out. All the patients had 2 portals each which accounts to 70 portals for each group. No patient was lost in follow up. Mean operating time was 45.14 minutes for suture group and 43.14 minutes for simple dressing group [table-4]. There was significant difference in the two groups with regards to the redness and swelling. Twelve [34%] patients developed redness in suture group while only two [5%] patients developed redness in simple dressing group. Ten [28%] patients developed mild to moderate swelling in suture group while only one [2%] patient developed mild swelling in simple dressing group. Two [5%] patients developed minimal serosanguinous discharge suggesting superficial infection in suture group while no patients developed such complication in simple dressing group[table-2 aandb]. Suture removal was delayed by week for these patients and portal site healed by 4th week with regular dressing and oral antibiotics. All the portal sites in both the groups healed completely by 4 weeks without any complications. However regarding the scar appearance satisfaction twenty five [71%] were happy in sutured group while thirty four [97%] were happy in simple dressing group [table-2 

aandb]. This shows the significant difference with respect to the cosmetic result. Severity of the pain assessed using VAS [4] were more with the patients who are sutured [table-3]. Fifteen patients [42.85%] in suture group suffered mild to moderate pain while five patients [14.28%] suffered mild pain in simple dressing group. However there was no long term complication in any patients with respect to the portal sites in both groups. But there was highly significant difference in the overall complication rate [p value less than 0.001; z value=2.52] favouring the simple dressing group [2.28%] over suture group [19.42%][table-5]. DISCUSSION Our results indicate that leaving arthroscopy portals open is an acceptable method of wound closure. This study suggests that open management of arthroscopy portals results in high patient level satisfaction. Hussein et al in their study reported that there were no major or long term complications with portal site healing and concluded that leaving knee arthroscopy wounds open is an acceptable method of management, which concurs with our study. And furthermore, although the use of suture material for closure of knee arthroscopy portals has decreased, many surgeons continue to use adhesive tape, assuming this is superior to leaving them open. And we conclude that there is no significant difference between the two methods of treatment either with adhesive tape or simple sterile dressing. [5]. There was a difference in the patients who perceived pain using VAS [4]. Fifteen patients in suture group suffered mild to moderate pain while five patients suffered mild pain in simple dressing group. Among these eight patients scored scale4 in sutured group where as only two patients scored scale 4 in open group. The patients scored 4 or more had either redness or swelling or both. According to Michael J Strobel, joint swelling may persist for some time after arthroscopy [6]. The pain would have been probably attributed to the distension of soft tissues or local tissue reaction due to retention of the secretion. As retention is more after closure, more number of patients in sutured group perceived pain even in number and in intensity [table-3]. There was a significant difference in the redness and swelling which were more in sutured group [table-2a and2b]. This would have been attributed to the effusion and local tissue reaction which was more in sutured group due to fluid retention. Two [5%] patients developed superficial infection in suture group while no patients developed such complication in simple dressing group. An analysis by SMALL of more than 10,000 arthroscopic operations showed infection rate of 12.1% which includes both superficial and deep [6]. This concludes that infection rate is minimal in our study and bacterial colonization of the suture track is the reason for superficial infection in suture group. Gristina AG, ET AL observed that colonizing bacteria are enveloped in a copious exopolysaccharide glycocalix, protects the bacteria from host defence factors and accounts for their persistence on the suture surfaces until they are removed with the sutures. [7] Scars of open group appeared cosmetically better than scars of sutured group.[table-3b.]. However there were no problems with the healing in any group. As christosis k states, following the arthroscopy unobstructed healing is a rule. Uncommon cases of synovial fistula were seen and reported rate is 0.0117%-0.61% [1]. Bhattacharyya M, ET AL, states that the method portal site management with adhesive tape was associated with a reduced potential for infection, faster renewal of tensile strength, greater cost effectiveness, and better cosmetic effects comparing with suture closure.[8]. We also state the similar result with simple dressing for the portal site management.

The method of management employed has implications on time saved in theatre including a reduced tourniquet time [table-4], and on cost. Tourniquet time should be minimized to prevent possible deep vein thrombosis and ischemic neurovascular changes [9]. The price of the suture material is saved and also the cost and time of removal of sutures either at outpatients, or by the practice nurse. If portals were left open then patients would not need to attend for removal of sutures and could simply have one follow up appointment at outpatients. This cost increases if more expensive sutures or staplers are used and further outpatient episodes are required for suture removal. In a study by Zempsky WT, et al, lowest average cost per laceration for sutures were $24.11[10]., Even though we have not come across any needle stick injury, percutaneous needle stick injury is one of the major risk factors in the transmission of hepatitis C, hepatitis B and HIV among healthcare workers. The commonest clinical activity to cause the needle stick injury was blood withdrawal (55%), followed by suturing (20.3%) [11]. It is pertinent to develop surgical techniques to avoid needle stick injuries among healthcare workers. Even though this study is a controlled trial, observations like severity of pain and appearance of scar are subjective variables leading to the chances of bias. However we tried to minimize these by keeping same independent observer who is not a part of team during surgical procedure for all the patients.

ACKNOWLEDGEMENT
We are thankful to the patients who allowed us to conduct this study. We are also thankful to the statistician Dr.Madagi who helped us in statistical analysis. No financial assistance of any sort was received from any source for this study.

CONCLUSION
The present study shows that managing the arthroscopic portal with simple sterile dressing has an advantage over the suturing the portals. We propose that all normal sized arthroscopy portals can be left open and covered with simple dressings. This would not only lead to high patient satisfaction with the appearance of their wounds, but also save time and money which is an ever important consideration today; prevents the possible needle stick injuries and reduces the burden on our health services.

References:

1. Christos K. Yiannakopoulos, MD: Diagnosis and Treatment of Postarthroscopic Synovial Knee Fistulae: J Knee Surg. 2007; 20:34-38. 2. Michael J.strobel .Knee joint –general part. In:manual of arthroscopic surgery.1st edition. ISBN 978-81-8489-082-2.Springer;2009. p57. 3. Robert J Meislin, Jeffrey Halbrecht . Avoiding and managing complications associated with arthroscopic knee surgery.In:Complications in Knee and Shoulder Surgery . ISBN: 978-1-84882-202- 3 .Springer;2009 p171, 4. Warden V, Hurley AC, Volicer L. Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) scale.Journal of the American Medical Directors Association 2003;4:9-15. 5. Hussein R, Southgate GW. Management of knee arthroscopy portals. Knee. 2001 Dec;8(4):329-31. 6. Michael J.strobel .Knee joint –general part. In:manual of arthroscopic surgery.1st edition. ISBN 978-81-8489-082-2. Springer;2009. p73. 7. Gristina AG, Price JL, Hobgood CD, Webb LX, Costerton JW. Bacterial colonization of percutaneous sutures. Surgery. 1985 Jul;98(1):12-19.

8. Bhattacharyya M, Bradley H. Intraoperative handling and wound healing of arthroscopic portal wounds: a clinical study comparing nylon suture with wound closure strips. J Perioper Pract. 2008 May;18(5):194-6, 198. 9. Barry B. Phillips . Arthroscopy of the Lower Extremity .In: Canale and Beaty: Campbell's Operative Orthopaedics, 11th ed. ISBN: 978- 0-8089-2361-9 MOSBY ELSEVIER 2008.p2812. 10. Zempsky WT, Zehrer CL, Lyle CT, Hedbloom EC. Economic comparison of methods of wound closure: wound closure strips vs. sutures and wound adhesives. Int Wound J. 2005 Sep;2(3):272-81. 11. Sumathi Muralidhar, Prashant Kumar Singh*, R.K. Jain, Meenakshi Malhotra and Manju Bala Needle stick injuries among health care workers in a tertiary care hospital of India Indian J Med Res 131, March 2010, pp 405- 410.

List of abbreviations
VAS- Visual Analog Score. mm- Millie Metre. p value- Probability value z value- Relative deviate value


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

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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 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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