International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - Vol 03 Issue 01, January, 2011

Pages: 04-10

Date of Publication: 30-Nov--0001


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CLINICAL PROFILE AND HAEMATOLOGICAL INDICES OF CLINICALLY DIAGNOSED EARLY NEONATAL
SEPTICAEMIA: A STUDY CONDUCTED IN TEACHING INSTITUTE ATTACHED TO RURAL HOSPITAL OF
WARDHA DISTRICT

Author: Gargi D. Mudey, Neelima S. Tankhiwale, Abhay Mudey

Category: Healthcare

Abstract:In India, neonatal infections occurs in 10.97 to 27 per thousand live births and is the leading cause of neonatal mortality accounting for one quarter to nearly half of all neonatal deaths. A detailed clinical profile of 155 early onset neonatal infections was carried out prospectively for 12 months. Almost 70% babies had associated risk factors. Refusal to feed, respiratory distress, lethargy, restlessness, irritability, hypothermia and fever were the most common presenting features in that order. Blood culture was positive in 71(68.93%) cases. Klebsiella pneumoniae was the most frequently isolated pathogen (61.97%). CRP positivity, increased micro-ESR concentration and associated thrombocytopenia were present in statistically significant number of cases. It can be concluded from the findings of the study that some routine inexpensive
laboratory tests will help in the early diagnosis of neonatal septicaemia.

Keywords: Early onset neonatal septicaemia, Clinical profile, Neonatal infections, Laboratory investigations

Full Text:

INTRODUCTION

Neonatal septicaemia is a clinical syndrome of bacteremia characterized by systemic signs and symptoms in the first month of life, it encompasses systemic infections of newborn including meningitis, pneumonia, arthritis, osteomyelitis and urinary tract infections[1] . In India, neonatal infections occurs in 10.97 to 27 per thousand live births and is the leading cause of neonatal mortality accounting for one quarter to nearly half of all neonatal deaths[2,3] . Early onset neonatal septicaemia (EOS) usually presents within the first 72 hours of life [4,5] . A remarkable feature of the clinical manifestations of early neonatal septicaemia is non-specificity of symptoms which creates difficulty in diagnosis of infections in the early stage [6] . The associated risk factors for earlyonset sepsis include low birth weight and prematurity. Resuscitation at birth, particularly if it involves endotracheal intubation, insertion of an umbilical vessel catheter, intravenous fluids,

blood products, and those babies who stay in hospital for more than 48 hours are at increased risk of bacterial infection [7,8] . Blood culture remains an important investigation in diagnosing neonatal septicaemia but it has its limitations. In routine practice minimum of 48 hours are required to isolate, identify and determine antimicrobial susceptibility of bacteria [1] . Changing pattern of organisms causing neonatal septicaemia and the frequent emergence of resistant bacteria are causing difficulty in the treatment [9]. The present study was carried out with objectives of finding out the foetal risk factors, common clinical presentations and laboratory findings in neonates those were admitted in NICU with suspected neonatal infections.

MATERIAL AND METHODS

This is a prospective study done at NICU of Acharya Vinoba Bhave rural hospital, Sawangi (M) Wardha. Study period was from September 2009 to August 2010. 155 neonates in whom clinical diagnosis of early neonatal infections was established were selected for the study. Details of these cases were recorded in a separate proforma including obstetric risk factors, history of labor, birth weight, gestational age, day of onset and subsiding of symptoms, presenting clinical features, complications and duration of hospital stay. Blood culture, C-reactive protein (CRP) estimation, micro-ESR(erythrocyte sedimentation rate), total leucocytes count, platelet count and peripheral blood smear for toxic granules, band cells, cytoplasmic vacuolations were done in all the cases. Statistical analysis was done using the statistical software SPSS 13.0

RESULTS

Among 155 neonates with early onset infections, 99 were males whereas 56 were females. Thus male to female ratio in this group was 1.7:1. Associated risk factors were studied in all the cases. Among 155 neonates 96(61.93%) were preterm, 102(65.81%) were low birth weight. 72(46.45%) neonates had mild to moderate birth asphyxia and required active resuscitation. In 15 (9.68%) cases there was history of instrumentation or invasive procedures. 9(5.81%) cases were on ventilator. Presenting sign and symptoms recorded in all the 155 cases are shown in Table I. Refusal to feed, respiratory distress, lethargy, restlessness, irritability, hypothermia and fever were the most common presenting features in that order. Blood culture was positive in 71(68.93%) cases. Among these Klebsiella pneumoniae was the most frequently isolated pathogen (61.97%), followed by Staphylococcus aureus (11.26%), Escherichia coli (8.45%), Enterobacter species (7.04%), Citrobacter freundii (4.23%), Acinetobacter species (4.23%) and Klebsiella oxytoca (2.82%). Blood count and peripheral blood smear findings recorded in all 155 cases are shown in Table II. CRP positivity, increased micro-ESR concentration and associated thrombocytopenia in early onset neonatal infections were statistically significant findings.

DISCUSSION

Early onset neonatal infections is observed more common in males with male/female ratio ranging from 1.4:1 to 3.1:1[5,7,10,11,12]. The male/female ratio in this study was 1.7:1. In the present study prematurity, low birth weight, birth asphyxia, history of instrumentation and ventilators were observed in neonates with early onset neonatal infections (EOS) whereas similar findings were quoted by I Roy et al, Shahsanam Gheibi et al and Meenu Singh et al in which they were reported prematurity, low birth weight and birth asphyxia to be the commonest risk factors associated with EOS [13,14,15] . The most common presenting features in the present study were refusal to feed, respiratory distress, lethargy, restlessness, irritability, hypothermia and fever in that order. The same findings were also observed by some researchers[2,8,15,16] . Blood culture positivity in EOS as reported by various reporters ranges from 22.9% to 85.99% [7,9,10,13,17,18,19,20,21] whereas in the present study blood culture positivity rate in EOS was observed in 68.93% cases, this finding correlates well with the findings of K. Chugh et al, Khanal B et al and Nalini Agnihotri et al. Various researchers have reported incidence of Klebsiella species between 13-60% in their studies [7,9,13,21]. In the present study Klebsiella pneumoniae was the most frequently isolated pathogen (61.97%) which is very close to the findings of K. Chugh et al where they reported Klebsiella sp. in 77.3% of EOS group [20] . Alistair G. S. Philip et al [22] in the study of 376 cases of neonatal septicaemia reported positive CRP in 64(17.02%) cases, Pradip Kumar Das et al [23] reported positive CRP in 251/310(80.9%) cases, R. S. Jaswal et al [2] in the study of 50 cases reported positive CRP in 50% cases of EOS, SS Ahmed et al [24] in the study of 60 neonates found that 70% cases of EOS were CRP positive, Mustafa S et al [25] in the study of 50 cases reported CRP positive in 58 % cases of EOS whereas CRP was positive in 99/210(47.14%) cases in the study of Reza Ghotaslou et al [26]. The present study finding of CRP positive in 75/155(48.39%) cases of EOS corroborates with the findings of R. S. Jaswal et al and Reza Ghotaslou et al. The present study finding of increased micro-ESR in 59(38.06%) in EOS cases correlates well with the finding of R. S. Jaswal et al where they reported increased microESR in 48% of cases of EOS. SS Ahmed et al reported thrombocytopenia in 63.3% cases, K.V Shyamala et al in the study of 103 cases reported thrombocytopenia in 72 (69.9%) cases. Torkaman M et al in the retrospective study observed in 56.6% EOS. Thrombocytopenia in the present study i.e. 42 (27.10%) in EOS was present in less number of cases when compared with other researchers. Leukocytosis observed in the present study i.e. 19(12.26%) cases in EOS was present in less number of cases when compared with other researchers like SS Ahmed et al (53.3%) and Archana Devi and Pushpa et al (50%). On the other hand present study finding of leucopenia in 13 (8.39%) EOS cases correlates with the finding of Alistair G. S. Philip et al (9.84%) and Jain NK et al (10%). Band cell count (>20%) or toxic granules or cytoplasmic vacuolation in the present study 11(7.10%) in EOS was present in less number of cases when compared with other researchers Alistair G. S. Philip et al (27.39%) and Jain NK et al (34.4%). The present study findings of CRP positivity, increased micro-ESR concentration and associated thrombocytopenia in cases of neonatal septicaemia were statistically significant findings.

SUMMARY AND CONCLUSION

Early onset neonatal septicaemia is more common among males. Prematurity, low birth weight, birth asphyxia was the common foetal risk factors found to be associated with EOS. Commonest clinical presentations were refusal to feed, respiratory distress and lethargy whereas commonest causative agent in the present study was Klebsiella pneumoniae. Positive CRP, increased micro-ESR and thrombocytopenia were found in statistically significant number in EOS. From the above summery it can be concluded that CRP, micro-ESR and platelet count estimations will help in the early diagnosis of neonatal septicaemia. These tests will be of great use in cases where antibiotics are started before collection of blood for blood culture. As these tests are inexpensive and readily available these can be of help in hospitals where blood culture facilities are not available.

References:

1. John P. Cloherty, Eric C. Eichenwald, Ann R. Stark: Manual of neonatal care: Sixth edition : Lippincott Williams and Wilkins: 2007; Page No.274-300

2. R.S. Jaswal, R.K. Kaushal, Asha Goel and Kushla Pathania: Role of C-reactive protein in deciding duration of antibiotic therapy in neonatal septicaemia: Indian Pediatrics 2003; 40: Page 880-883.

3. David Osrin, Stefania Vergnano and Anthony Costello: Serious bacterial infections in newborn infants in developing countries: Current opinion in infectious diseases 2004; 17: 217-224.

4. Samuel P. Gotoff : Infections of the neonatal infants: Nelson's Textbook of Pediatrics: 16th edition: 2000; Chapter 105: Page No. 538-552

5. Jain NK, Jain VM, Maheshwari S: Clinical profile of neonatal sepsis: Kathmandu University Medical Journal: 2003; 1(2): 117-120.

6. Kenneth C. Iregbu, Olufumilayo Y. Elegba, Iretiola B. Babaniyi: Bacteriological profile of neonatal septicaemia in a tertiary hospital in Nigeria: African Health Sciences 2006; 6(3): 151-154.

7. Kurien Anil Kuruvilla, Swati Pillai, Mary Jesudason and Atanu Kumar Jana: Bacterial profile of sepsis in a neonatal unit in south India: Indian Pediatrics 1998; 35:851-858

8. NNF: The National Neonatology Forum www.nnfi.org

9. Shashikala S. Tallur, A. V. Kasturi, Shobha D. Nagdir and B.V.S. Krishna: Clinico-bacteriological study of neonatal septicaemia in Hubli: Indian Journal of Pediatrics: 2000; 67(3): 169-174.

10. Jia-Horng Jiang, Nan-Chang Chiu, Fu-Yang Huang, Hsin-An Kao,Chyong-Hsin Hsu, Han-Yang Hung, Jui-Hsing Chang, ChunChih Peng: Neonatal sepsis in the neonatal intensive care unit: Characteristics of early versus late onset: The Journal of Microbiology, Immunolology and Infection: 2004; 37: 301-306.

11. AH Movahedian, R Moniri , Z Mosayebi: Bacterial culture of neonatal sepsis: Iranian Journal of Public Health, 2006; 35(4) : 84-89.

12. S. P. Khatua, A.K. Das, B.D. Chatterjee, S. Khatua, B. Ghose and A. Saha: Neonatal septicaemia: Indian J Pediatrics 1986; 53: 509-514.

13. I Roy, A Jain, M Kumar, S K Agarwal: Bacteriology of neonatal septicaemia in a tertiary care hospital of northern India: Indian Journal of Medical Microbiology: 2002; 20 (3):156-159.

14. Shahsanam Gheibi, Zahra Fakoor: Coagulase negative staphylococcus; The most common cause of neonatal septicemia in Urmia, Iran: Iran Journal of Pediatrics: Sep 2008; 18(3): 237- 243

. 15. Meenu Singh, Anil Narang, and O. N. Bhakoo: Predictive perinatal score in the diagnosis of neonatal sepsis: Journal of Tropical Pediatrics 1994; 40: 365-368.

16. Piyush Gupta, Murali M V, MMA Faridi Kaul P B, Ramachandran VG, Talwar : Clinical profile of Klebsiella septicemia in neonates: Indian Journal of Pediatrics: 1993; 60(4): 565-572.

17. Shrestha P, Das BK, Bhatta NK, Jha DK, Das B, Setia A, Tiwari A: Clinical and bacteriological profiles of blood culture positive sepsis in newborns: Journal Nepal Pediatric Society 2006; 27(2) : 64-67.

18. Nalini Agnihotri, Neelam Kaistha and Varsha Gupta: Antimicrobial susceptibility of isolates from neonatal septicemia: Jpn Journal of Infectious Diseases 2004; 57:273- 275.

19. Khanal B, Shariff M, Deb M :Neonatal septicaemia: A hospital based study in eastern Nepal: Journal of Nepal Medical Association 2004; 43: 231-234

20. K.Chugh, B. B. Agrawal, V.K. Kaul and S.C. Arya: Bacteriological profile of neonatal septicaemia: Indian Journal Pediatrics 1988; 55: 961-965

. 21. Dr. Rizwan Waseem, Dr. Muhammad Khan, Dr. Tahira S. Izhar, Prof. Dr. Abdul Waheed Qureshi: Neonatal Sepsis: Professional Medical Journal: December 2005; 12(4): 451-456 22. Allistair G. S. Philip and Jean R. Hewitt: Early diagnosis of neonatal sepsis: PEDIATRICS 1980; 65(5):1036-1041

23. Pradip Kumar Das, Kaberi Basu, P Chakraborty, P K Bhowmik: Clinical and bacteriological profile of neonatal infections in metropolitan city based medical college nursery: Journal Indian Medical Association 1999; 97(1): 3-5

24. SS Ahmed, Maka Chowdhury, MM Hoque, D Begum, Asmnu Ahmed: Role of intravenous immunoglobulin (IVIG) as an adjuvant in the treatment of neonatal sepsis in preterm babies: Journal of Bangladesh College of Physicians and Surgeons 2006; 24(3): 97-104.

25. Mustafa S, Farooqui S, Waheed S and

Mahmood K: Evaluation of Creactive protein as early indicator of blood culture positivity in neonates: Pak Journal Medical Science: January-March 2005; 21( 1): 69-73.

26. Reza Ghotaslou, Ziaadin Ghorashi and Mohammad-Reza Nahaei: Klebsiella pneumonia in neonatal sepsis: A 3-year-study in the pediatric hospital of Tabriz, Iran: Jpn. Journal of Infectious Diseases: 2007; 60: 126-128.

27. K.V. Shyamala, N.K. Sabbalakshmi, K. Raghuveera: Role of platelet count and CRP level in gram negative versus gram positive bacterial sepsis in low birth weight neonates: Journal of Chinese Clinical Medicine 2010; 5(8): 474-479.

28. Torkaman M, Afsharpaiman S H, Hoseini M J, Moradi M, Mazraati A, Amirsalari S, Kavehmanesh Z: Platelet count and neonatal sepsis: A high prevalence of Enterobacter spp.: Singapore Medical Journal 2009; 50(5) : 482-485.

29. Archana Devi and Pushpa: A comparative study in sepsis and normal neonates -A microbiological perspective: Journal Medical sciences 2008; 8: 515-518.

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

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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 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 situs slot and Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh et al. situs slot "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 situs slot 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 situs slot et al entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09
Late to bed everyday? You may die early, get depression situs slot
Egg a day tied to lower risk of heart disease situs slot
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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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