International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - Vol 10 Issue 12, June, 2018

Pages: 08-11

Date of Publication: 22-Jun-2018


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A Case Report of Cytomegalovirus Esophagitis in an Immune-competent Patient

Author: Dosieah Pooja, Jagessar Sabreen, Zhang Zhenyu

Category: Healthcare

Abstract:Cytomegalovirus (CMV) esophagitis usually occurs in immunocompromised individuals. Cases of Cytomegalovirus esophagitis in immunocompetent patients have not been reported yet in China. This report is mainly based on a case study and the relevant literature review to summarize the clinical manifestations, endoscopic characteristics, diagnosis and treatment of cytomegalovirus
esophagitis in immunocompetent patients.

Keywords: Cytomegalovirus, Esophagitis, Immune competent, Literature review

Full Text:

Cytomegalovirus (CMV) can cause various kinds of diseases in the human body, such as encephalitis, retinitis, hepatitis, pneumonia and so on [1,2,3]. Cytomegalovirus gastroenteritis
is rare, but esophagitis is the second most common gastrointestinal manifestation of cytomegalovirus (CMV) infection after colitis [4]. It usually occurs in patients with immunodeficiency, such as HIV infection, history of organ transplantation, long-term history of renal dialysis, and long-term use of immunosuppressant [5].

There is currently growing proof of CMV infection in immunocompetent patients [6,7,8]. Here, we present a case of CMV esophagitis in an immunocompetent patient, who presented with severe progressive chest pain and dysphagia. The patient was successfully treated with ganciclovir. This positive outcome has been added to an updated review of the literature relating to CMV esophagitis in immunocompetent hosts.

Case Presentation
A 71-year-old male patient was admitted to the hospital on April 15, 2016 following 20 days of progressive chest pain and dysphagia. After eating, he constantly had difficulty swallowing, but had no symptoms like nausea and vomiting, melena, cough and sputum, chills or fever.

Upon referral, the patient underwent esophagogastroduodenoscopy (EGD), shown in Figure 1, which revealed a rough esophageal mucosa, scattered multiple ulcers were visible about 30-36cm from the incisor teeth, covered with a thin white coating, surrounded by slightly hyperemic peripheral mucous membrane which was altogether diagnosed as multiple esophageal ulcers. The patient had a history of hypertension, cerebral infarction, but no oral antiplatelet drugs. After admission, for acid suppression and mucosal protection, symptomatic and supportive care was given. There was no obvious abnormality in the blood routine examination, urine test, Biochemistry examination, tumor marker, blood transfusion test, anti nuclear antibody, anti neutrophil cytoplasmic antibody, enhanced CT of the chest and abdomen. Other laboratory results showed: Cytomegalovirus IgM antibody (-), cytomegalovirus IgG antibody (+), cytomegalovirus DNA (-), EB virus early antigen IgG (-), EB virus shell antigen IgA (-), EB virus nuclear antigen IgA (-). Colonoscopy results revealed colorectal polyps, which was then treated with EMR (Endoscopic Mucosal Resection). Postoperative pathology results showed tubular adenoma of the sigmoid colon and rectum with glandular low-grade intraepithelial neoplasia. A high-grade intraepithelial neoplasia was found in the focal point. Gastroscopic pathology (Shown in Figure 2) revealed esophageal ulcers and more inflammatory cell infiltration with granulation tissue, scattered macrophages, multiple inflammatory cell infiltration in the middle of squamous epithelium. Immunohistochemistry (shown in Figure 3) revealed HSV-1 (-), CMV (+). After treatment, the patient’s symptoms were slightly improved. On April 22, another gastroscopy was performed. As shown in Fig. 4, 6-8 shallow ulcers were seen at a distance of 30-36 cm from the incisors, and the size varied from 0.4cm to 0.4cm to 0.6x0.6cm. The boundary was well defined and clear. The base was smooth
and the mucosa between the lesions was normal. After the first endoscopic immunohistochemistry, CMV was found positive.

DISCUSSION
The cytomegalovirus (CMV) belongs to the herpes virus family and DNA virus and can be infected through placenta, contact, injection, blood transfusion, or organ transplantation. Once a person has CMV infection, he or she always carries the virus for life. Cytomegalovirus esophagitis usually occurs in immunocompromised patients, such as HIV infection, organ transplantation, long-term use of immunosuppressive patients, etc. The older age of onset may be due to the weakening of immunity of older patients and the decrease of resistance [9], and more basic diseases of the elderly, such as chronic obstructive pulmonary disease, hypertension, diabetes, etc. Some medicines used to treat underlying diseases may damage the digestive tract and are more susceptible to cytomegalovirus infection.

In patients with normal immune function, cytomegalovirus esophagitis mainly presents with chest pain, swallowing pain, hematemesis, and melena, as well as patients with weight loss, difficulty in swallowing, etc. Cytomegalovirus esophagitis in immunocompetent patients and immunodeficient patients showed similar clinical symptoms, which is consistent with previous reports [10]. Endoscopic manifestations of esophageal mucosal erosion, ulcers, erosions and
ulcers often occur in the lower esophagus, but also occur in the upper esophagus. Ulcers are often multiple, and can also be solitary. The borders of ulcers are smooth and the base is
knife-cut or coated with a small amount of white moss.

The key to the diagnosis of cytomegalovirus esophagitis is the discovery of cytomegalovirus inclusion bodies in the nucleus of the biopsy tissue. Since cytomegalovirus often infects fibroblasts and endothelial cells, cytomegalovirus inclusion bodies are easily found on the base of ulcers. Therefore, biopsy specimens should be taken from the base of ulcers, which can increase the detection rate of inclusion bodies [11,12]. There are also opinions that biopsies should be taken from the edge of the ulcer and multinucleated giant cells or nuclear inclusions can be found [13]. Positive cytomegalovirus immunohistochemistry is considered the “gold
standard” for the diagnosis of cytomegalovirus esophagitis [14]. In addition, serological tests, PCR methods for the detection of DNA, serum, or urine culture are important auxiliary diagnostic methods [15].

The treatment of cytomegalovirus esophagitis, the most widely used is the intravenous infusion of ganciclovir, treatment for at least 2-3 weeks [16], for ganciclovir intolerance, can be considered with foscarnet sodium [17]. Antiviral therapy is particularly important for patients with immunodeficiency. In the study done, (shown in table 1) 9 patients with normal immune function and 7 patients were treated with ganciclovir. However, it is worth noting that another 2
patients were cured with supportive treatment alone.

In summary, although cytomegalovirus esophagitis is rare in patients with normal immune function, when esophageal ulcers and diffuse erosions are detected by gastroscopies,
the possibility of cytomegalovirus esophagitis must be considered when the cause of common esophagitis is excluded. Cytomegalovirus related tests should be performed, especially pathological examination. Once diagnosed, antiviral treatment may be considered. However,
whether antiviral treatment must be necessary, further studies are still needed.

CONCLUSION
In conclusion, we have portrayed our perceptions of one immune competent patient with CMV esophagitis and have checked on nine detailed cases. This data demonstrates that CMV esophagitis can cause critical morbidity, even in immune competent patients, and support leading substantial examinations to decide the clinical helpfulness of ganciclovir
treatment.

ACKNOWLEDGEMENT
I would like to extend my gratitude to my professor, Dr. Zhang Zhen Yu and my colleague Dr Tan Lu Xuan for encouraging me and helping me in writing this article.

I am also grateful to all the authors, editors and publishers of all those articles, journals and books from where the literaturefor this article has been reviewed and discussed.
Source of Funding: No funding
Conflict of Interest: No conflict of interest.

References:

1. Goodgame RW. Gastrointestinal Cytomegalovirus Disease. Ann Intern Med. 1993;119:924–935.
2. Wenshi T. Changes of miRNA levels in peripheral blood before and after treatment in patients with hepatitis syndrome caused by human cytomegalo virus [J]. Chinese Journal of Gastroenterology and Hepatology, 2016, 25 (2):178-180.
3. Dong W U, HongY, Yue L I, et al. Clinical features of pulmonary abnormalities associated with inflammatory bowel disease [J]. Chinese Journal of Gastroenterology and Hepatology, 2016, 25 (10):1132-1135.
4. Wang H W, Kuo C J, Lin W R, et al. The clinical characteristics and manifestations of cytomegalovirus esophagitis [J]. Dis Esophagus, 2016, 29 (4):392-9.
5. Patel N C, Caicedo R A. Esophageal infections: an update[J]. Curr Opin Pediatr, 2015, 27 (5):642-8.
6. T. G. Wreghitt E. L. Teare O. Sule R. Devi P. Rice. Clinical Infectious Diseases, Volume 37, Issue 12, 15 December 2003, Pages 1603–1606,
7. Rafailidis PI, Mourtzoukou EG, Varbobitis IC, Falagas ME. Severe cytomegalovirus infection in apparently immunocompetent pa- tients: a systematic review. Virol J 2008; 5: 47.
8. Limaye AP, Leisenring WM, Boeckh M. Reactivation of Cytomegalovirus Infection in Critically Ill Immunocompetent Patients— Reply. JAMA. 2008;300(20):2367–2368. doi:10.1001/
jama.2008.697
9. Akin S, TufanF, BahatG, et al. Cytomegalovirus esophagitis precipitated with immunosuppression in elderly giant cell arteritis patients[J]. Aging Clin Exp Res, 2013, 25 (2): 215-8.
10. Demir D, Doganavsargil B, Sarsik B, et al. Is it possible to diagnose infectious oesophagitis without seeing the causative organism? A histopathologicalstudy[J]. Turk J Gastroenterol, 2014, 25 (5):481-7.
11. Kanda K, Kume K, YoshikawaI, et al. Cytomegalovirus esophagitis with massive upper GI hemorrhage [J]. Gastrointest Endosc, 2004, 59 (6):741-3.
12. Sharaf R N, Shergill A K, Odze R D, et al. Endoscopic mucosal tissue sampling [J]. Gastrointest Endosc, 2013, 78 (2):216-24.
13. O’Rourke A. Infective oesophagitis: epidemiology, cause, diagnosis and treatment options[J]. Curr Opin Otolaryngol Head Neck Surg, 2015, 23(6):459-63.
14. Ozaki T, YamashitaH, KanekoS, et al. Cytomegalovirus disease of the upper gastrointestinal tract in patients with rheumatic diseases: a case series and literature review[J]. Clin Rheumatol, 2013, 32 (11):1683-90.
15. Reggiani B L, LosiL, Di Gregorio C, et al. Cytomegalovirus infection of the upper gastrointestinal tract: a clinical and pathological study of 30 cases[J]. Scand J Gastroenterol, 2011, 46(10):1228-35.
16. Ahuja N K, Clarke J O. Evaluation and Management of Infectious Esophagitis in Immunocompromised and Immunocompetent Individuals [J]. Curr Treat Options Gastroenterol, 2016, 14(1):28-38.
17. BacigalupoA, Boyd A, Slipper J, et al. Foscarnet in the management of cytomegalovirus infections in hematopoietic stem cell transplant patients [J]. Expert Rev Anti Infect Ther, 2012,
10(11):1249-64.

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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.

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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.

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‘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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