International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - Vol 10 Issue 10, May, 2018

Pages: 35-38

Date of Publication: 30-May-2018


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Phylloides Tumor - A Study of Spectrum of its Histomorphological Parameters along with Ki-67 Expression

Author: Manish Gupta, Mustafa Ali

Category: Healthcare

Abstract: Objective: Aim of the study was to evaluate different parameters that are used to categorise phylloides tumor into benign, borderline and malignant type and also to know frequency of Ki-67 expression in different category.
Method: It was a prospective study of two year duration carried out in the department of pathology, King George's medical university and included total 30 cases.
Results: Most of patients in the entire category were more than 35 years of age and also severity of all the parameters increased as tumor spectrum shift from benign to malignant side.
Conclusion: Patient age and tumor size increases as the lesions progress from benign to malignant phyllodes tumor so is the ki-67 expression. Also Ki-67 antigen is a useful adjunct in the diagnosis and prognosis of phylloides tumor.

Keywords: Phylloides, Histomorphology, Ki-67 antigen

Full Text:

INTRODUCTION

Phyllodes tumor which derives from the greek word “phullon” or leaf  are group of biphasic fibroepithelial tumors of  breast of varying malignant potential ranging from benign tumor to fully malignant sarcomas. They were first fully characterized by Johannes Muller in 18381 and constitute 0.3% to 1% of all breast neoplasm. The term cystosarcoma phyllodes was initially described by Muller based on the tumor's “leaflike” projections in to the cystic spaces, sarcomatous stroma and “fleshy” gross appearance. This term has since been discouraged because greater than 70% of these lesion follow a benign course and only rarely exhibit cystic degeneration; phyllodes tumor, coined by the world health organization (WHO) in 1981, is now the preferred term.2 In 2003, WHO divided breast phyllodes tumor in three groups as benign, borderline and malignant, based up on the following criteria3 1. Stromal overgrowth 2. Stromal cellularity 3. Nuclear pleomorphism 4. Mitotic activity 5. Microscopic tumor border (circumscribed or infiltrating). Depending upon the above criteria benign tumors were classified when there was moderate stromal cellularity, mitotic figures were few if any per 10 high power field, well circumscribed border and absence of or mild nuclear pleomorphism. On the other hand malignant phyllodes tumor were diagnosed when they showed extensive stromal overgrowth, marked stromal cellularity, more than 10 mitotic figures per 10 high power field, infiltrating border and marked nuclear pleomorphism. Borderline phyllodes tumors were more atypical than benign but did not fulfil all the criteria of malignancy. All grades of phyllodes tumor have the potential of local recurrence, but the metastasis is mostly identified in borderline and malignant grades. Although a grading system has been set up, the criteria of this system are not rigidly defined and vary widely among the pathologist and it is often difficult to predict the clinical behaviour from the histology alone. In addition to the routine histomorphology, the study of Ki-67 antigen expression may be useful to differentiate benign, borderline and malignant phyllodes tumor and are also helpful in predicting the clinical behaviour.

MATERIAL AND METHODS

It is a prospective study of two year duration that included all the cases diagnosed as phylloides in Department of pathology and then were assessed and compared by histomorphological parameters used in the diagnosis. Finally Immunohistochemistry using Ki-67 was performed and its expression was recorded. Positive tissue control (Lymphoma for Ki-67) and negative control (Omission of primary antibody) were taken.

Hematoxylin and Eosin staining procedure: (Standard protocols were used)

Immunohistochemistry:  (Standard protocols were used)

Primary Antibody Dako, Monoclonal Mouse Antibody Anti-Human Ki-67 Antigen, product code: IS626; Ready-to-use and Anti-Human CD10, Product code: IS648; Ready-to-use)

Interpretation of the Ki-67 immunostaining:

Presence of brown colored end product at the site of target antigen was indicative of positive reactivity. KI-67 antigen is expressed in the nucleus and Ki-67 labelling index is defined as the percentage of cells that showed a positive nuclear stain. At least 1000 stromal cells were counted for this analysis, and all Ki-67 indices were determined by one observer.

Statistical Analysis

The results are presented in Mean±SD (standard deviation), Median and Percentages.  The dichotomous / categorical variables are compared by using Chi-square test. The one way analysis of variance (ANOVA) test is used to compare the continuous variables among the final diagnosis. The Tukey's multiple comparison test is used for pair wise multiple comparison between two groups, if found significant in ANOVA test analysis. The p-value <0.05 is considered as significant. All the analysis is carried out by using SPSS (statistical package for the social sciences) 16.0 version.

RESULTS

In our study out of 30 cases, maximum number of cases belonged to benign phyllodes tumor, 14 cases (47%) whereas Borderline and Malignant phyllodes tumor constituted 9 and 7 cases (30% and 23%) respectively. More than half of the patients in benign phyllodes tumor (57.1%), borderline phyllodes tumor (77.8%) and malignant phyllodes tumor (71.4%) were more than 35 years of age. The age was significantly different among the groups (p=0.02). The post-hoc test revealed that the age was significantly (p=0.01) different between benign phyllodes tumor (31.29±10.30) and malignant phyllodes tumor (45.86±12.98). There was significant difference (p=0.0001) in the tumor size among benign phyllodes tumor (5.57±3.71), borderline phyllodes tumor (10.22±2.86) and malignant phyllodes tumor (16.43±3.99). Majority of cases of benign phylloides showed mild cellularity, borderline cases showed moderate cellularity, while malignant cases had marked cellularity in most of cases. The comparison of atypia among the various category showed that mild atypia was present in 64.3% of benign phyllodes tumor, moderate atypia was in all the patients of Borderline phyllodes tumor and 14.3% in malignant phyllodes tumor. Marked atypia was found in 85.7% in malignant phyllodes tumor. The association between atypia and final diagnosis was statistically significant (p=0.0001). The Mitotic Counts were significantly different in benign phyllodes tumor (1.14±1.09), Borderline phyllodes tumor (4.33±1.00) and malignant phyllodes tumor (10.86±0.69). The Ki-67 labelling index was significantly (p=0.0001) lower in Benign phyllodes tumor (1.71±0.82) compared with Borderline (10.67±6.20) and Malignant phyllodes tumor (18.14±9.26).

DISCUSSION

Our result demonstrated the several findings. Firstly, the mean age of patient in benign, borderline and malignant phyllodes tumor were 31.39, 37.67 and 45.86 years respectively and this difference was found to be statistically significant (p=0.02). Thus the mean age of patient increases as we progress from benign to malignant phyllodes tumor. Similar results were also noted by Tse GM et al 4 and K.S. Kim et al 5 in their studies. Mean tumor size in our study was 5.57, 10.22 and 16.43cm respectively in benign, borderline and malignant phyllodes tumor and this difference was statistically significant. This increasing in tumor size from benign to borderline to malignant phyllodes tumor was also found in the studies done by Tse GM et al and Ili? I, et al.6 Stromal cellularity, atypia and mitotic counts increased as lesions progresses from benign towards malignant category and the difference was statistically significant. Ki Beom Ku et al 7 and Timothy W. Jacobs et al 8 have also mentioned similar findings in their studies. Important finding in our study is that mean Ki-67 labelling index was lower in Benign phyllodes tumor (1.71) compared with Borderline (10.67) and Malignant phyllodes tumor (18.14) and this difference was statistically significant (p=0.0001). There are many studies which support this finding of our study. In one study done by Yu-Jan Chan et al 9 in year 2004, immunohistochemical analysis of 63 phyllodes tumor cases (50 benign and 13 malignant) were done and compared for the positive staining of tumor cell with the tumor grading and clinical outcome. They found that Ki-67 antigen was well correlated with tumor grading. In another study by Nicole Nicosia Esposito et al 10 the mean Ki-67 scores for benign, borderline and malignant phyllodes tumor were 3%, 26% and 32% respectively. Thus Ki-67 was differentially expressed among different tumor grades (p<0.001) but it did not differentiate between borderline and malignant phyllodes tumor (p>0.99). In few other studies by Y Singh et al 11 in 1996 and Umekita Y et al 12 in 1999 have also found the significant difference in the expression of Ki-67 antigen in benign, borderline and malignant phyllodes tumor, thus further supporting the findings of our study.

CONCLUSION

Patient age and tumor size increases as the lesions progress from benign to borderline to malignant. Ki-67 antigen in combination with other histomorphological parameters also increases in severity and helps in predicting the clinical behaviour and in distinguishing the benign, borderline and malignant phyllodes tumor.

ACKNOWLEDGEMENT

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.

Conflict of interest: None

Source of Funding: None

References:

1. Muller J, Ueber den feinen bau unddie furmen der krankhafte Geschwulste. Berlin: G Reimer; 1838; 1: 54-57.

2. Tavassoli FA, Devilee P, et al. Pathology and Genetics of Tumors of the Breast and Female Genital Organs. Lyon, France: International agency for research on cancer; 2003.

3. Fattaneh A, Tavassoli FA, Devilee P. WHO classification of tumors: Tumors of the breast and female genital organs. IARC, Lyon, pp 100-103, 2003.

4. Tse GM, Tsang AK, Putti TC, Scolyer RA, Lui PC, Law BK, Karim RZ, Lee CS. Stromal CD10 expression in mammary fibroadenomas and phyllodes tumors. J Clin Pathol. 2005; 58(2):185-189.

5. K.S. Kim. Correlation of CD10 and EGFR Expression in Phyllodes Tumors of the Breast.  Ann Oncol (2012)23 (suppl 2): ii17-ii24.

6. Ivan Ili?, Pavle Ran?elovi?, Ratko Ili?, Vuka Kati?, Maja Milentijevi?, Ljubinka Veli?kovi?, Miljan Krsti?. An approach to malignant mammary phyllodes tumors detection. Vojnosanit Pregl .2009; 66(4): 277–282.

7. Ki Beom Ku, Mi Ji Bang, Jong Woo Choi, Yoon Sik Lee, Jin Hyun Park, Hyun Ok Kim,  Min Hee Jeong, Hoon Gyu Oh, and Jin Gu Bong. Clinical, Pathologic and Immunohistochemical feature of Phyllodes Tumors of the Breast. J Breast Cancer. 2004; 7(3):185-192.

8. Timothy W. Jacobs, Yunn-Yi Chen, Donald G. Guinee, Joseph A. Holden, Imok Cha, Donald E et al. Fibroepithelial Lesions with Cellular Stroma on Breast Core Needle Biopsy. Are There Predictors of Outcome on Surgical Excision? Am J Clin Pathol 2005;124:342-354.

9. Yu-Jan Chan, Be-Fong Chen, Chin-Long Chang, Tsen-Long Yang, Chi-Chen Fan. Expression of p53 protein and Ki-67 Antigen in Phyllodes Tumor of The Breast. J Chin Med Assoc.2004; 67:3-8.

10. Nicole Nicosia Esposito, Deepak Mohan, Adam Brufsky, Yan Lin, Malathy Kapali, David J. Dabbs. Phyllodes Tumor: A Clinicopathologic and Immunohistochemical study of 30 cases. Arch Pathol Lab Med. 2006; 130:1516–1521.

11. Y Singh, T Hatano, Y Uemura, N Shikata, H Senzaki, K Hioki, A Tsubura. Immunohistochemical profile of phyllodes tumors of the breast. Oncology Reports.1996; 3(4):677-681.

12. Umekita Y, Yoshida H. Immunohistochemical study of MIB1 expression in phyllodes tumor and fibroadenoma. Pathology international.1999; 4 9(9):807-10.

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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 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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