International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 4(17), September, 2012

Pages: 80-84

Date of Publication: 14-Sep-2012


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DRUG- RESISTANCE PROFILE OF NEW PTB PATIENTS WITH OR WITHOUT HIV INFECTION

Author: Niladri Sekhar Das

Category: Healthcare

Abstract:Tuberculosis is the commonest opportunistic infection in persons infected with human immunodeficiency virus (HIV). HIV is the most powerful risk factor for reactivation of latent tuberculosis infection to active disease. Emergence of drug resistant isolates of M. tuberculosis (Mtb) highlights the need for continuous monitoring of drug resistance to anti tuberculosis drugs. The aim of our study was to see the anti tubercular drug resistance profile of M.tb in HIV seropositive and seronegative patients. Material and methods- We enrolled 100 new pulmonary tuberculosis (PTB) patients. This study was carried out at Department of Microbiology MGIMS, Sevagram, Wardha Maharashtra from 2007-2009. For every patient staining and culture was done from sputum sample by conventional method. After the identification of isolates as M.tb drug sensitivity testing was done. HIV antibody status was identified in every patient by using rapid and ELISA test. Results were analyzed using SPSS software. Results: There were 8 patients who were HIV seropositive out of total 35 culture positive cases. No resistant patterns were detetected in case of HIV +ve patients with TB infection. Out of 27 HIV seronegative cases with TB infection, 4 cases showed mono-resistant to streptomycin. No multi drug resistant (MDR) strain was detected neither in HIV positive nor in HIV negative cases. Conclusion: HIV infection may not be associated with drug resistant tuberculosis. However due to high prevalence of HIV\?TB infection in the country, monitoring of drug resistance in M. tuberculoisis isolates needs prioritization to ensure success in national tuberculosis control programme.

Keywords: Human immunodeficiency virus (HIV), Pulmonary tuberculosis (PTB), Mycobacterium tuberculosis (Mtb), Multi drug resistant (MDR)

Full Text:

INTRODUCTION
Tuberculosis (TB) is one of the most serious diseases that physicians have recognized and grappled with through the millennia due to its high risk of person to person transmission, morbidity, and mortality. Currently there are 9.2 million new cases of tuberculosis every year with 1.7 million deaths occurring worldwide1 . Despite the discovery of the tubercle bacillus more than a hundred years ago, and all the advances in our knowledge of the disease made since then, tuberculosis still remains one of the major health problems facing mankind, particularly in developing countries. In India each year, 1.9 million new cases of TB occur in the country, of which about 0.8 million are infectious new smear positive pulmonary TB cases2 . The situation is expected to worsen due to the emergence of multi-drug resistant tuberculosis (MDRTB).

Development of drug resistance in M. tuberculosis isolates may adversely impact the management of the disease. Inadequate therapies and indiscriminate use of antibiotics causes such emergence of multi drug resistant bacilli and HIV/AIDS pandemic resulting in accumulation of pool of individuals who are more susceptible to TB have worsened the TB scenario. A High HIV seroprevalence among newly diagnosed TB patients has been reported in India.3, 4 . On the global situation of drug resistance in M.tb , first comprehensive study was conducted by the Research and Surveillance unit, Global TB Programme, WHO5 and was observed that, the rates of acquired resistance were invariably higher than primary resistance for each drug and multi drug resistance was more common when resistance was acquired rather than when it was primary. The increasing prevalence of multidrug resistance in several parts of the world including India has been one of the major reasons for declaring tuberculosis control as a global emergency by WHO6,7 . Several outbreaks of MDR-TB showed the importance of continuous monitoring of drug resistance for treatment of TB patients and initiating adequate public health measures. The present study was undertaken with the objective of comparing the anti TB drug resistance profile of MTB isolates in new PTB patients with or without HIV infection.

MATERIAL AND METHODS:
Among 100 suspected tuberculosis patients study was done at Microbiology Laboratory in MGIMS, Sevagram between 2007 to 2009 with due permission from the institutional ethical committee. Sputum was collected from each individual, smear was made and staining was done by Ziehl–Neelson method. For isolation rest of the sample was decontaminated by NALC-NaOH method8 and inoculation was done on 2 LJ slopes. LJ bottles were observed weekly till the colonies grew sufficiently for identification whereas negative LJ culture was noted if there was no growth after incubation at 370 c for 8 wks. Isolates were identified later by conventional biochemical methods9 After the identification of the strain as MTB, drug sensitivity testing was performed against 1st line drugs by LJ proportion method described by Canetti et al 1969 10. For Drug sensitivity testing stock and working concentration of drugs were made according to Guidelines of TRC manual 200611. The concentration of drugs used were Streptomycin 4 µg/ml, INH 0.2 µg/ml, Rifampicin 40 µg/ml and Ethambutol 2 µg/ml. Before drug sensitivity testing by LJ proportion method, drug containing LJ slopes was made. At first preparation of standard suspension 11 and dilution was made. 0.1 ml of each of the two bacterial dilutions, 10–3 mg/ml and 10–5 mg/ml were inoculated on two slopes of LJ medium without drug and one slope of medium with drug. The standard strain of M.tuberculosis, H37Rv was tested with each batch of sensitivity testing. All the LJ slopes for DST were placed in the incubator at 37 °C. Reading and reporting of the LJ slopes were done according to the reference10 Detection of HIV status in every patient was done by rapid method (TRIDOT) using serum which was collected in a plain bulb. If any sample was found to be positive by rapid method, confirmation was done by ELISA (Vironostika) confirmed by second ELISA at NARI Pune.

RESULTS:
We got 35 total MTB isolates no NTM (Non tubercular mycobacterium) was isolated. Among 35 MTB isolates 87.9 percent (29/33) from smear positive and 9 percent (6/67) from smear negative patients were obtained. Of these 8 isolates were HIV seropositive and 27 HIV seronegative (Table no 1). Among the 35 total MTB isolates, monoresistant was found with Streptomycin that was 11.4% only in HIV seronegative patients (Table no 1). Resistance to any 1st line drug was seen (7/35), in 20% isolates. Drug resistance to at least one drug was found in (7/27), 25.9% isolates in HIV seronegative cases whereas no resistant strain was isolated even for a single drug in HIV+ve cases however in HIV seropositive cases we got (8/8), 100% isolates sensitive to all four drugs. The prevalence of polyresistance (resistance to two or more drugs, but not both isoniazid and refampicin) was found to be (3/27), 11.11% only in HIV seronegative with TB infective patients. Neither individual drug resistance nor the MDR or polyresistance was found to differ significantly in the HIV infected and uninfected TB patients.

DISCUSSION
Emergence and spread of drug resistance in M.tuberculosis is a serious threat to tuberculosis control programme because patients with drug resistance bacilli respond less readily to therapy than those with sensitive bacilli, resulting in preferential spread of the drug resistant bacilli in the community. Drug resistance develops either due to infection with a resistant strain, or as a result of inadequate treatment such as when a patient is exposed to a single drug, or because of selective drug intake, poor compliance, use of inappropriate non-standardized treatment regimens, irregular drug supply, poor drug quality, or rarely erratic absorption of medications 12 . Though the development of drug resistance in India was noted since the beginning of the chemotherapeutic era, it was based on clinical perception and several isolated reports, which failed to give an idea of the national situation as a whole. In this direction the first definite step was taken in 1965-67, when the ICMR conducted two surveys to estimate the prevalence of drug resistance13 . In this study resistance to Isoniazid ranged from 11-20 per cent, to Streptomycin 8- 20 per cent and to both drugs 4-11 per cent. The second study showed resistance to Isoniazid from 15-69 per cent, to Streptomycin 12-63 per cent and to both drugs from 5-58 per cent. However these studies were carried out in the pre-Rifampicin era. Subsequently after about two decades (1980?s), 11 other studies from different parts of the country reported similar resistance to Isoniazid and Streptomycin like those in the earlier studies with the notable exception of Rifampicin resistance being observed in 10 of the 11 publications and the level of MDRTB in all the centers was observed but it was less than 5 per cent. According to third Global Report total prevalence of drug resistance among new cases in India (Wardha) was 19.8% and MDR was 0.5 %. Several small surveys conducted across the country have shown the prevalence rates of MDR-TB in the country at around 3% among new cases, and 12% among retreatment cases. A large scale population based survey in the states of Gujarat and Maharashtra has also indicated similar resistance levels (new- 3% and retreatment- 12- 17%) 13. We found that prevalence of resistance to isoniazid and streptomycin was 0 and 11.4 percent and that to both drugs were 2.8%. The issue of whether infection with HIV is a risk factor for drug resistant tuberculosis still remains unanswered since results of some studies supported this hypothesis while some did not. A study conducted in newyork city 14 revealed that HIV infected TB patients were significantly more likely to develop resistance to at least one drug and MDR than those without HIV infection. No significant difference was found in drug resistance between HIV seropositive and HIV seronegative tuberculosis patients in our study, which is in accordance with the findings from other studies in Europe 15, 16 . In conclusion, we didn?t find any kind of drug resistance in anti-tubercular drug especially in case of HIV seropositive cases. In view of the conflicting results from other studies and high prevalence of HIV-TB in our country, we feel that time to time monitoring of anti-tuberculosis drug resistance pattern in TB patients in general and HIV seropositive tuberculosis patients in particular would provide important data, which may be crucial for the control of tuberculosis.

 

References:

1. Global tuberculosis control: surveillance, planning, financing: WHO report 2008. Geneva: World Health Organization (WHO/HTM/TB/2008.393).

2. TB India 2008. RNTCP Status Report.

3. Paranjape R S ,Tripathy SP, Menon PA, Mehendale SM, khatavkar P, Joshi DR.et al. Increasing trend of HIV seroprevalence among pulmonary tuberculosis patients in Pune, India .indian J Med res 1997;106: 207- 11

4. Tripathy S, Joshi DR, Mehendale SM , Menon P, Joshi AN, Ghorpade SV, et al.Sentinel surveillance for HIV infection tuberculosis patients in India. Indian J tuberc 2002; 49: 17-20.

5. Cohn DL, Bustreo F, Raviglione MC. (1997). Drug resistant tuberculosis: review of the worldwide situation and the WHO/IUATLD global surveillance project. Clin Infect Dis 1997; 24(1): 121-130.

6. Anti tuberculosis drug resistance in the world. The WHO/ WATLD global project on anti tuberculosis surveillance .Geneva,Switzerland;1997.WHO/TB/97.229.

7. Anti tuberculosis drug resistance in the world ,report No.2.WHO/CDS/TB/2000.278

8. Procedure for isolation and identification of mycobacterium CDC manual1975.

9. Laboratory services in tuberculosis control .Part 3-Culture /WHO/98.258,1998.

10. Canetti, G., Fox, W., Khomenko, A., Mahler, H.T., Menon, N.K., Mitchison, D.A., et al. Advances in techniques of testing mycobacterial drug sensitivity, and the use of sensitivity tests in tuberculosis control programmes. Bulletin of the World Health Organisation, 1969. 41, 21-43.

11. Bacteriological methods and Laboratory diagnosis of Tuberculosis TRC Chennai 2006.

12. Behera D. Drug Resistant Tuberculosis In India – Is it a matter of concern? Ind J Tuberc 2007; 54:105-109.

13. Multi-drug resistant and Extensively drug resistant TB in India, Consensus statement on the problem, prevention, management and control, From the consultative meeting of national experts organized by the TB Research Centre, ICMR, Govt. of India, on 14-15 September 2007.

14. Gordin FM, Nelson ET,Matts JP, Cohn DL, Ernst J,Benator D,et al. The impact of human immunodeficiency virus infection on drug resistant tuberculosis . Am J.Respir Crit care Med 1996; 154: 1478-83.

15. Migliori GB, Centis R, Fattorini L, Besozzi G, Saltini C, Scarparo C, et al. Mycobacterium tuberculosis complex drug resistance in Italy. Emerg Infect Dis 2004;10:752-3

16. Shafer RW, Chirgwin KD, Glat AE, Dahdouh MA, Landesman SH, Suster B. HIV prevalence , immunosuppression , and drug resistance in patients with tuberculosis in an area endemic for AIDS.AIDS 1991;5:399-405.

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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 Dorothy Ebere Adimora et al. entitled \"Remediation for Effects of Domestic Violence on Psychological well-being, Depression and Suicide among Women During COVID-19 Pandemic: A Cross-cultural Study of Nigeria and Spain\" is awarded Best Article of Vol 14 issue 23
A study by Muhas C. et al. entitled \"Study on Knowledge & Awareness About Pharmacovigilance Among Pharmacists in South India\" is awarded Best article for Vol 14 issue 22
A study by Saurabh Suvidha entitled \"A Case of Mucoid Degeneration of Uterine Fibroid with Hydrosalphinx and Ovarian Cyst\" is awarded Best article of Vol 14 issue 21
A study by Alice Alice entitled \"Strengthening of Human Milk Banking across South Asian Countries: A Next Step Forward\" is awarded Best article of Vol 14 issue 20
A study by Sathyanarayanan AR et al. entitled \"The on-task Attention of Individuals with Autism Spectrum Disorder-An Eye Tracker Study Using Auticare\" is awarded Best article of Vol 14 issue 19
A study by Gupta P. et al. entitled \"A Short Review on \"A Novel Approach in Fast Dissolving Film & their Evaluation Studies\" is awarded Best Article of Vol 14 issue 18.
A study by Shafaque M. et al. entitled \"A Case-Control Study Performed in Karachi on Inflammatory Markers by Ciprofloxacin and CoAmoxicillin in Patients with Chronic Suppurative Otitis Media\" is awarded Best Article of Vol 14 issue 17
A study by Ali Nawaz et al. entitled \"A Comparative Study of Tubeless versus Standard Percutaneous Nephrolithotomy (PCNL) \? A Randomized Controlled Study\" is awarded Best Article for Vol 14 issue 16.
A study by Singh R. et al. entitled \"A Prospective Study to Find the Association of Astigmatism in Patients of Vernal Keratoconjunctivitis (VKC) in a Tertiary Health Care Centre in India (Vindhya Region MP)\" is awarded Best Article for Vol 14 issue 15
A Study by Humaira Tahir et al. entitled "Comparison of First Analgesic Demand after Major Surgeries of Obstetrics and Gynecology between Pre-Emptive Versus Intra-Operative Groups by Using Intravenous Paracetamol: A Cross-Sectional Study" is awarded Best Article for Vol 14 issue 14
A Study by Monica K. entitled "Risk Predictors for Lymphoma Development in Sjogren Syndrome - A Systematic Review" is awarded Best Article for Vol 14 issue 13
A Study by Mokhtar M Sh et al. entitled "Prevalence of Hospital Mortality of Critically Ill Elderly Patients" is awarded Best Article for Vol 14 issue 12
A Study by Vidya S. Bhat et al. entitled "Effect of an Indigenous Cleanser on the Microbial Biofilm on Acrylic Denture Base - A Pilot Study" is awarded Best Article for Vol 14 issue 11
A Study by Pandya S. et al. entitled "Acute and 28-Day Repeated Dose Subacute Toxicological Evaluation of Coroprotect Tablet in Rodents" is awarded Best Article for Vol 14 issue 10
A Study by Muhammad Zaki et al. entitled "Effect of Hemoglobin Level on the Severity of Acute Bronchiolitis in Children: A Case-Control Study" is awarded Best Article for Vol 14 issue 09
A Study by Vinita S & Ayushi S entitled "Role of Colour Doppler and Transvaginal Sonography for diagnosis of endometrial pathology in women presenting with Abnormal Uterine Bleeding" is awarded Best Article for Vol 14 issue 08
A Study by Prabhu A et al. entitled "Awareness of Common Eye Conditions among the ASHA (Accredited Social Health Activist) Workers in the Rural Communities of Udupi District- A Pilot Study" is awarded Best Article for Vol 14 issue 07
A Study by Divya MP et al. entitled "Non-Echoplanar Diffusion-Weighted Imaging and 3D Fiesta Magnetic Resonance Imaging Sequences with High Resolution Computed Tomography Temporal Bone in Assessment and Predicting the Outcome of Chronic Suppurative Otitis Media with Cholesteatoma" is awarded Best Article for Vol 14 issue 06
A Study by Zahoor Illahi Soomro et al. entitled "Functional Outcomes of Fracture Distal Radius after Fixation with Two Different Plates: A Retrospective Comparative Study" is awarded Best Article for Vol 14 issue 05
A Study by Ajai KG & Athira KN entitled "Patients’ Gratification Towards Service Delivery Among Government Hospitals with Particular Orientation Towards Primary Health Centres" is awarded Best Article for Vol 14 issue 04
A Study by Mbungu Mulaila AP et al. entitled "Ovarian Pregnancy in Kindu City, D.R. Congo - A Case Report" is awarded Best Article for Vol 14 issue 03
A Study by Maryam MJ et al. entitled "Evaluation Serum Chemerin and Visfatin Levels with Rheumatoid Arthritis: Possible Diagnostic Biomarkers" is awarded Best Article for Vol 14 issue 02
A Study by Shanthan KR et al. entitled "Comparison of Ultrasound Guided Versus Nerve Stimulator Guided Technique of Supraclavicular Brachial Plexus Block in Patients Undergoing Upper Limb Surgeries" is awarded Best Article for Vol 14 issue 01
A Study by Amol Sanap et al. entitled "The Outcome of Coxofemoral Bypass Using Cemented Bipolar Hemiarthroplasty in the Treatment of Unstable Intertrochanteric Fracture of Femur in a Rural Setup" is awarded Best Article Award of Vol 13 issue 24
A Study by Manoj KP et al. entitled "A Randomized Comparative Clinical Trial to Know the Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block Against Multimodal Analgesia for Postoperative Analgesia Following Caesarean Section" is awarded Best Article Award of Vol 13 issue 23
A Study by Karimova II et al. entitled "Changes in the Activity of Intestinal Carbohydrases in Alloxan-Induced Diabetic Rats and Their Correction with Prenalon" is awarded Best Article of Vol 13 issue 22
A Study by Ashish B Roge et al. entitled "Development, Validation of RP-HPLC Method and GC MS Analysis of Desloratadine HCL and It’s Degradation Products" is awarded Best Article of Vol 13 issue 21
A Study by Isha Gaurav et al. entitled "Association of ABO Blood Group with Oral Cancer and Precancer – A Case-control Study" is awarded Best Article for Vol 13 issue 20
A Study by Amr Y. Zakaria et al. entitled "Single Nucleotide Polymorphisms of ATP-Binding Cassette Gene(ABCC3 rs4793665) affect High Dose Methotrexate-Induced Nephrotoxicity in Children with Osteosarcoma" is awarded Best Article for Vol 13 issue 19
A Study by Kholis Ernawati et al. entitled "The Utilization of Mobile-Based Information Technology in the Management of Dengue Fever in the Community Year 2019-2020: Systematic Review" is awarded Best Article for Vol 13 issue 18
A Study by Bhat Asifa et al. entitled "Efficacy of Modified Carbapenem Inactivation Method for Carbapenemase Detection and Comparative Evaluation with Polymerase Chain Reaction for the Identification of Carbapenemase Producing Klebsiella pneumonia Isolates" is awarded Best Article for Vol 13 issue 17
A Study by Gupta R. et al. entitled "A Clinical Study of Paediatric Tracheostomy: Our Experience in a Tertiary Care Hospital in North India" is awarded Best Article for Vol 13 issue 16
A Study by Chandran Anand et al. entitled "A Prospective Study on Assessment of Quality of Life of Patients Receiving Sorafenib for Hepatocellular Carcinoma" is awarded Best article for Vol 13 issue 15
A Study by Rosa PS et al. entitled "Emotional State Due to the Covid – 19 Pandemic in People Residing in a Vulnerable Area in North Lima" is awarded Best Article for Vol 13 issue 14
A Study by Suvarna Sunder J et al. entitled "Endodontic Revascularization of Necrotic Permanent Anterior Tooth with Platelet Rich Fibrin, Platelet Rich Plasma, and Blood Clot - A Comparative Study" is awarded Best Article for Vol 13 issue 13
A Study by Mona Isam Eldin Osman et al. entitled "Psychological Impact and Risk Factors of Sexual Abuse on Sudanese Children in Khartoum State" is awarded Best Article for Vol 13 issue 12
A Study by Khaw Ming Sheng & Sathiapriya Ramiah entitled "Web Based Suicide Prevention Application for Patients Suffering from Depression" is awarded Best Article for Vol 13 issue 11
A Study by Purushottam S. G. et al. entitled "Development of Fenofibrate Solid Dispersions for the Plausible Aqueous Solubility Augmentation of this BCS Class-II Drug" is awarded Best article for Vol 13 issue 10
A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09
A Study by Mardhiah Kamaruddin et al. entitled "The Pattern of Creatinine Clearance in Gestational and Chronic Hypertension Women from the Third Trimester to 12 Weeks Postpartum" is awarded Best Article for Vol 13 issue 08
A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07
A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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