International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
logo
slider
slider
slider
slider
Bootstrap Slider

Indexed and Abstracted in: Crossref, CAS Abstracts, Publons, Google Scholar, Open J-Gate, ROAD, Indian Citation Index (ICI), ResearchGATE, Ulrich's Periodicals Directory, WorldCat (World's largest network of library content and services)

Search Articles

Track manuscript

Full Html

IJCRR - 9(18), September, 2017

Pages: 14-17

Print Article   Download XML  Download PDF

Prevalence of Inducible Clindamycin Resistance of Staphylococcus aureus in Hospitalized Patients in Tertiary Care Hospital

Author: Smita S. Damke, Shahin Vishani, Ramesh P. Fule

Category: Healthcare

Abstract:Background: Methicillin resistant Staphylococcus aureus (MRSA) has emerged as one of the most common pathogen isolated from patients with very few drugs available for their treatment. Clindamycin is a good alternative optional drug for the treatment of these infections. In vitro routine testing may fail to detect such resistance. Thus it is important to detect such resistance by simple D test.
Material and Methods: 300 staphylococcal isolates where isolated from clinical samples by conventional microbiological methods. Of these 208(69.33%) were identified as Staphylococcus aureus. Methicillin resistance and inducible clindamycin resistance was detected by cefoxitin disk diffusion method and D test as per CLSI guidelines respectively.
Results: 135 (64.9%) were MRSA and 73 (35.09%) were Methicillin sensitive Staphylococcus aureus (MSSA), 45(21.63%) isolates showed inducible clindamycin resistance, 19(9.1%) showed constitutive clindamycin resistance, 112(53.84%) showed MS phenotype whereas 32(15.38%) were erythromycin sensitive. Inducible clindamycin resistance and constitutive clindamycin resistance was higher in MRSA than in MSSA (25.92%, 11.11% and 13.69%, 5.47% respectively).
Conclusion: D test should be done as routine test in all Microbiology laboratory for detection of true resistance of clindamycin among staphylococcal isolates.

Keywords: MRSA, Inducible clindamycin resistance, D test

Full Text:

Introduction

Staphylococcus aureus infections are a major cause of morbidity and mortality worldwide. The increasing prevalence of Methicillin resistant Staphylococcus aureus (MRSA) infections especially with the spread of resistant strain in the community (1,2) pose a challenge to physician in terms of the use of alternative antibiotic agents. Although clindamycin has been considered an acceptable option for patients with community acquired MRSA infections, reports on high rates of clindamycin resistant community-acquired MRSA strains are limiting its use(2).

Antimicrobial resistance in S. aureus has become an ever increasing problem among hospitalized patients, persons in long term care facilities and ambulatory outpatients. This has led to the renewed interest in the use of macrolide-licosamide streptogramin B (MLSB) to treat S. aureus infection with clindamycin being preferred agent due to its excellent pharmacokinetic properties (3). Clindamycin is frequently used to treat skin and bone infection because of its tolerability, cost, oral forms and excellent tissue penetration and the fact that it accumulates in abscesses and no renal dosing adjustment are needed(4). Good oral absorption makes it an important option in outpatient therapy as follow-up after intravenous therapy. Clindamycin is good alternative for the treatment of both methicillin resistant and susceptible staphylococcal infections (5).

However wide spread use of MLSB antibiotics has led to an increase in number of Staphylococcal strain acquiring resistance to MLSB antibiotics (6). The most common mechanism of such resistance is target site modification mediated by erm genes which can be expressed either constitutively (constitutive MLSB phenotype) or inducibly (inducible MLSBphenotype). Strains with inducible resistance to clindamycin are difficult to detect in routine laboratory as they appear erythromycin resistance and clindamycin sensitive in vitro when not placed adjacent to each other. In such cases, in vivo therapy with clindamycin may select constitutive erm mutants leading to clinical therapeutic failure.

In vitro, staphylococcus aureus isolates with constitutive resistance are resistant to both erythromycin and clindamycin whereas those with inducible resistance are resistant to erythromycin but appears to be sensitive to clindamycin (iMLSB). These isolates, when used along with clindamycin, erm mutants for constitutive resistance emerge, which leads to failure in treatment(7). This resistance goes undetected by Kirby Bauer method however, it is detected by simple D test. The result is observed as a flattening zone in the area between erythromycin and clindamycin disc, in a shape of 'D' which indicates inducible clindamycin resistance.

Thus the present study was carried out to find the prevalence of inducible clindamycin resistance of S. aureus by very simple method of detecting inducible clindamycin resistance in hospitalized patients by performing D test.

Material and methods

This study was a prospective study over a period of six months from July 2014 to December 2014 in the department of Microbiology attached to the tertiary care hospital in central India. After obtaining ethical clearance a total of 300 isolate of staphylococcus from various clinical specimen like pus, wound swabs, sputum, throat swabs, suction tips, aspirates, blood and urine were tested. Isolates were identified upto species level by conventional methods such as Gram stain, growth on mannitol salt agar, slide and tube coagulase test, DNAse test and by biochemical tests (8).

The isolates were subjected to susceptibility testing by Kirby bauer disc diffusion method on Mullier Hinton agar plate using erythromycin (15ug), clindamycin (2ug), linozolide (30ug), rifampicin (5ug), cotrimaxazole (30ug), ciprofloxacin (5ug), gentamycin (30ug), tetracycline (30ug), penicillin (10ug), nitrofurantoin (10ug) and norfloxacin (300ug)(for urinary isolates only). The results were interpreted as per CLSI guidelines. Methicillin resistance was detected by cefoxitin disc diffusion method.

To detect inducible clindamycin resistant, 15 ug erythromycin and 2ug clindamycin discs were placed on Mullier Hinton plate that had been inoculated with staphylococcal isolates. The disc were placed at a distance of 15 -20 mm edge to edge from each other. Plates were incubated overnight at 37o C. A positive D test was taken as flattening of the zone of inhibition around clindamycin disc proximal to erythromycin disc (D shaped zone of inhibition) and was defined as inducible MLSB resistance (Figure 1). Strains that were resistant to both erythromycin and clindamycin were defined as exhibiting constitutive MSLB resistant and those that were resistant to erythromycin and sensitive to clindamycin were MS phenotype.

Results

In the present prospective study, a total of 300 isolates of Staphylococcus were studied. Among these 208 (69.33%) were found to be coagulase positive Staphylococcus aureus and 92 (30.66%) were coagulase negative staphylococcus. Of 208 staphylococcus aureus isolates, 135(64.9%) were methicillin resistance staphylococcus aureus (MRSA) while 73 (35.09%) were methicillin sensitive staphylococcus aureus (MSSA).

In the present study, inducible clindamycin resistance i.e. positive D test in MRSA was found to be in 35(25.92%) isolates and 10 (13.69%) isolate showed D test positive in MSSA. Strains showing resistance to both clindamycin and erythromycin i.e. exhibiting constitutive MSLB (cMLSB) resistance were found to be 15 (11.11%) in MRSA isolates and 4 (5.47%) in MSSA. Isolates showing resistance to erythromycin and sensitivity to clindamycin, termed as MS phenotypes was found to be 70 (51.85%) in MRSA and 42 (57.83%) in MSSA(Table 1) (Figure1).Thus in the present study, higher incidence of resistance was found to be in methicillin resistance staphylococcus aureus whereas higher incidence of sensitivity was found in methicillin sensitive staphylococcus aureus.

Discussion

There is a growing concern about the rapid rise in resistance of S. aureus to antimicrobial agents (9). In India, the importance of MRSA as a problem has been recognized relatively late (10). The prevalence of MRSA varies in different parts of India and is not uniform. This variation in prevalence may be because of several factors like study design, population and geographical distribution, differential clonal expression, drug pressure in community, health care facilities available in the hospital, implementation and monitoring of infection control committee, rationale antibiotic usage which varies from hospital to hospital. MRSA is a major cause of nosocomial infection worldwide. Serious endemic and epidemic MRSA infections occur globally as infected and colonised patients in the health care settings are the reservoirs.

Emergence of MRSA has left us with very little therapeutic options to treat staphylococcal infections. In the present study, a total of 300 staphylococcal isolate, the prevalence of S. aureus was found to be 208 (69.33%) isolates were coagulase positive and out of this 135(64.9%) were MRSA and 73(35.09%) were MSSA. Similar results were found by Borge et al (11) and Dar et al(12) having the prevalence rate of MRSA as 65% and 54.85% respectively.

The determination of antimicrobial susceptibility of a clinical isolate is often crucial for optimal antimicrobial therapy of infected patients. This is particularly important considering the increase of resistance and the emergence of multidrug resistant organisms. There are only few options available for treatment of MSSA and MRSA infections, with clindamycin being one of the good alternatives(5). However, clindamycin resistance can develop in staphylococcal isolates with inducible phenotype, and from such isolates, spontaneous constitutively resistant mutants have arisen both in vitro testing and in vivo during clindamycin therapy(13).

In the present study, of the total coagulase positive staphylococcal isolates inducible clindamycin resistance was found to be 45 (21.63%), of this 35 (25.92%) were from MRSA and 10(13.69%) from MSSA. The study report by Dardichandran Kaur(14), Gadepalliet(6), Pal et al(15) and Lt. Col. Mahima Lall(16) showed prevalence of inducible clindamycin resistance as 21.12%, 21%, 24.63% and 20.3% respectively. The study by Deotale et al(3)reported 27.6% iMLSB in MRSA, whereas Yilmaz et al(13) found inducible resistance of 24.4%in MRSA and 14.8% in MSSA; Gadepalli et al(6) showed it to be 30% in MRSA and 10% in MSSA, while Mohamed Rahabar et al(17) reported 22.6% in MRSA and 4% in MSSA. In another study Schreckenberger et al(18) and Levin et al(19) showed higher percentage of inducible resistance in MSSA as compared to MRSA, 7-12% in MRSA and 19-20% in MSSA; 12.5% MRSA and 68% MSSA respectively.

In our study, constitutive resistance was observed to be 19(9.1%) isolates, in which 15 (11.11%) from MRSA and 4 (5.47%) from MSSA. Other studies reporting constitutive MLSB differ in their prevalence as Sireesha et al(20) reported 10% and Deotale et al (3) reported 3.6%. Results near about similar to our study were observed in the studies by Gurdale Yilmaz et al(13) showed 14.8%; Ciraj et al (21)15.3% and Sireeshaet al (20) 18%.

Prabhu K et al (22) observed that percentage of inducible resistance and constitutive resistance were higher in MRSA as compared to MSSA which is in concordance with our present study.

Conclusion

The true sensitivity to clindamycin can only be judge after performing the D test on erythromycin resistant isolates. The use of D test in routine laboratory will help us in advising the clinicians regarding the use of clindamycin in superficial skin and soft tissue infections, as clindamycin should not be used for clindamycin induced resistant staphylococcus i.e. D test positive while it can be the drug of choice in case of D test negative isolates. Thus microbiological laboratories should report Saureus isolates exhibiting inducible MLSB as clindamycin resistant.

Acknowledgment: Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.

Source of Funding / Support: Nil

Conflict of Interest: Nil

Table 1: Distribution of resistance pattern of S. aureus

iMLSB

cMLSB

MS phenotype

Erythromycin sensitive

MRSA (n=135)

35(25.92%)

15 (11.11%)

70 (51.85%)

15(11.11%)

MSSA(n= 73)

10 (13.69%)

4 (5.47%)

42 (57.83%)

17(23.28%)

Total (n=208)

45(21.63%)

19(9.1%)

112(53.84%)

32(15.38%)

(MRSA-methicillin resistant staphylococcus aureus; MSSA- methicillin sensitive staphylococcus aureus; iMLSB- inducible macrolide-licosamide streptogramin B; cMLSB - constitutive macrolide-licosamide streptogramin B)

References:

  1. Gorak EJ, Yamada SM, Brown JD. Community-acquired methicillin-resistant Staphylococcus aureus in hospitalized adults and children without known risk factors. Clin Infect Dis 1999; 29: 797-800.
  2. Daum RS. Clinical practice. Skin and soft-tissue infections caused by methicillin-resistant Staphylococcus aureus. N Engl J Med 2007; 357: 380-90.
  3. Deotale V, Mendiratta DK, Raut U, Narang P (2010) Inducible clindamycin resistance in Staphylococcus aureus isolated from clinical samples. Indian J Med Microbiol 28:124-126
  4. Kasten MJ (1999) Clindamycin, metronidazole, and chloramphenicol. Mayo Clin Proc 74:825-833
  5. Fiebelkorn KR, Crawford SA, McElmeel ML, Jorgensen JH. Practical disc diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase negative Staphylococci. J Clin Microbiol 2003;41:4740-4.
  6. Gadepalli R, Dhawan B, Mohanty S, Kapil A, Das BK,Chaudhry R. Inducible clindamycin resistance in clinical isolates of Staphylococcus aureus. Indian J Med Res 2006;123:571-3.
  7. Mukesh Patel, Ken B. Waites, Stephen A. Moser, Gretchen A. Cloud and Craig J. Hoesley, 2006. Prevalence of Inducible Clindamycin Resistance among Community- and Hospital- Associated Staphylococcus aureus isolates: J Clin Microbiol.44( 7), 2481-2484.
  8. Kloos WE, Banerman TL. Staphylococcus and Micrococcus, Chapter 22. In: Manual of clinical microbiology. 7th ed. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, editors. Washington DC: ASM Press; 1999. p. 264-82.
  9. Mulla S, Patel M, Shah L, Vaghela G. Study of antibiotic sensitivity pattern of methicillin-resistant Staphylococcus aureus. Indian J Critical Care Medicine. 2007;11(2):99-101.
  10. Rajaduraipandi K, Mani KR, Panneerselvam K, M, Bhaskar M, Manikandan P. Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus: a multicentre study. Indian J Med Microbiol 2006;24:34-8.
  11. Borg M, Scicluna E, De Kraker M, Van de Sande-Bruinsma N, Tiemersma E, Gur D et al (2006) Antibiotic resistance in the southeastern Mediterrenean-preliminary results from the AR medical project. European surveillance 11(7):639
  12. Dar JA, Thoker MA, Khan JA, Ali A, Khan MA, Rizwan M et al (2006) Molecular epidemiology of clinical and carrier strains of methicillin resistant Staphylococcus aureus in the hospital settings of north India. Ann Clin Microbiol Antimicrobial 5(1):22
  13. Yilmaz G, Aydin K, Iskender S, Caylan R, Koksal I. Detection and prevalence of inducible clindamycin resistance in staphylococci. J Med Microbiol 2007;56:342-5.
  14. Dardi CK, Khare AS. Inducible clindamycin resistance in staphylococcus aureus in a tertiary care rural hospital. I Jou
  15. Pal N, Sharma B, Sharma R, Vyas L. Detection of inducible clindamycin resistance among Staphylococcal isolates from different clinical specimens in western India. J Postgrad Med 2010;56:182-5.
  16. Lt Col Mahima L, Brig Sahni AK. Prevalence of inducible clindamycin resistance in staphylococcus aureus isolated from clinical samples. Med J Armed forces India 2014;70:43
  17. Rahabar M, Hajia M. Inducible clindamycin resistance in Staphylococcus aureus: A cross sectional report. Pak J Biol Sci 2007;10:189-92.
  18. Schreckenberger PC, Ilendo E, Ristow KL. Incidence of constitutive and inducible clindamycin resistance in Staphylococcus aureus and coagulase-negative staphylococci in a community and a tertiary care hospital. J Clin Microbiol 2004;42:2777-9.
  19. Levin TP, Suh B, Axelrod P, Truant AL, Fekete T. Potential clindamycin Resistance in clindamycin-susceptible, erythromycin-resistant Staphylococcus aureus: Report of a clinical failure. Antimicrob Agents Chemother 2005;49:1222-4.
  20. Sireesha P, Setty CR. Detection of various types of resistance patterns and their correlation with minimal inhibitory concentrations against clindamycin among methicillin-resistant Staphylococcus aureus isolates. Indian J Med Microbiol 2012;30:165-9.
  21. Ciraj AM, Vinod P, Sreejith G, Rajani K. Inducible clindamycin resistance among clinical isolates of staphylococci. Indian J Pathol Microbiol 2009;52:49-5.
  22. Prabhu K, Rao S, Rao V. Inducible clindamycin resistance in Staphylococcus aureus isolated from clinical samples. J Lab Physicians 2011;3:25-7.

Announcements

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

COPE guidelines for Reviewers

SCOPUS indexing: 2014, 2019 to 2021


Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

Emerging Researcher Award:

‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

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

List of Awardees

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


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


RSS feed

Indexed and Abstracted in


Antiplagiarism Policy: IJCRR strongly condemn and discourage practice of plagiarism. All received manuscripts have to pass through "Plagiarism Detection Software" test before Toto Macau forwarding for peer review. We consider "Plagiarism is a crime"

IJCRR Code of Conduct: To achieve a high standard of publication, we adopt Good Publishing Practices (updated in 2022) which are inspired by guidelines provided by Committee on Publication Ethics (COPE), Open Access Scholarly Publishers Association (OASPA) and International Committee of Medical Journal Editors (ICMJE)

Disclaimer: International Journal of Current Research and Review (IJCRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal.



ABOUT US

International Journal of Current Research and Review (IJCRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal

Contact

148, IMSR Building, Ayurvedic Layout,
        Near NIT Complex, Sakkardara,
        Nagpur-24, Maharashtra State, India

editor@ijcrr.com

editor.ijcrr@gmail.com


Copyright © 2024 IJCRR. Specialized online journals by ubijournal .Website by Ubitech solutions