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 - 12(13), July, 2020

Pages: 51-55

Date of Publication: 06-Jul-2020


Print Article   Download XML  Download PDF

Challenges of Pre-analytical Variables in Conventional Cytogenetics - A University Teaching Hospital Experience

Author: Vidya Jha, Ajeesh G.A., Akhil K.S.

Category: Healthcare

Abstract:Introduction: Conventional Cytogenetics is an essential tool for the diagnosis of a neoplastic or premalignant condition and provides important prognostic and therapeutic information. The rate of unsuccessful karyotyping in hematological malignancies is reported between 10-20%.
Objective: To analyze the relationship between pre-analytical variables and associated failures with conventional karyotyping in hematological neoplasms.
Material and Methods: 1020 samples with suspected hematological malignancies received in the department of Cytogenetics from January 2018 to December 2019 were included in the study. Pre-analytical variables assessed included time from collection to sample processing, type of sample, diagnosis and sample cellularity. Statistical analysis was performed using Chi-square test to verify associations of variables with karyotyping.
Results: 86 (12%) out of 720 samples that were processed in less than 24 hours of time of collection showed an unsuccessful KT while 57/300 samples (19%) that were processed beyond 24 hours failed to yield any metaphase (p-value 0.003). 31/79 PVB (39%) and 112/941 BM (12%) were unsuccessful (p-value < 0.001). 15/287 (06%) acute myeloid leukemia cases, 64/156 (41%) acute lymphoblastic leukemia cases, 12/109 (11%) myelodysplastic syndrome, 6/34 (18%) MDS/MPN cases, 11/338 (03%) MPN cases and 35/96 (36%) from the others category did not yield any metaphase for analysis (p value 0.015. 24/819 (03%) samples with cellularity >7 x 103/\?l and 119/201 (59%) samples with low cellularity being ≤7 x 103/\?l were unsuccessful (p-value

Keywords: Pre-analytical variables, Karyotyping, Cytogenetics, Hematological malignancies

Full Text:

Introduction

The World Health Organization (WHO) classification of tumors of the hematopoietic and lymphoid tissues incorporates cytogenetic and molecular genetics abnormalities.1

Hematologic neoplasm is listed in the top ten malignancies worldwide and also one of the leading causes of mortality in patients with cancer. Almost 9% of all cancer cases diagnosed in a year are hematological malignancies.2,3 Identification of clonal aberrations yields support in diagnosing malignant/premalignant diseases as well as gives important information regarding prognosis and therapy.4,5 Therefore, conventional cytogenetic analysis is mandatory in the evaluation of suspected acute leukemia. It is one of the essential tools for classification of hematological malignancies, prognostication and treatment.6,7 It is also seen that unsuccessful conventional karyotyping has a prognostic implication in hematological malignancies.8,9,10

The rate of unsuccessful karyotyping in hematological malignancies is reported between 10-20%. Successful karyotyping is affected by number of factors like nature of sample, time to process, collection method, cellularity of sample and processing methods.11 The present study aims to analyze the relationship between pre-analytical variables and associated failures with conventional karyotyping in hematological neoplasms.

Material and methods

The archives of department of Cytogenetics were retrospectively reviewed from January 2018 to December 2019. Of the 4300 cytogenetic case records reviewed over a period of 2 years, 1020 samples of bone marrow and blood with suspected hematological malignancies were received over a period of 2 years. Along with clinical history and examination, peripheral blood counts, marrow morphology and immunophenotyping was done to come to a diagnosis. Molecular tests like JAK2 mutation, Ph chromosome etc. were done, wherever required. Final diagnosis was made based on WHO criteria.1 Bone marrow samples were cultured for 17 and 24 hours without mitogenic agents and harvested following standard protocols.7 The slides were air-dried and stained with G-Banding using Trypsin and Giemsa (GTG-banding). Twenty metaphases were analyzed and karyotypes were described according to the International System for Human Cytogenetic Nomenclature criteria.12

Pre-analytical parameters

The following pre-analytical variables were noted:

  1. Time from sample collection to initiation of processing in lab (more or less than 24 hours)

  2. Material type (bone marrow or peripheral venous blood)

  3. Sample cellularity (>7 or ≤7 x 103/µl)

  4. Patient’s diagnosis (AML. ALL, MDS, MPN, CLL, MDS/MPN)

Statistical analysis was performed using Chi-square test to verify associations of variables with karyotyping. The data were analyzed using IBM SPSS software (Version 21). The level of significance for the statistical tests was 5% (p-value < 0.05).

Results

Out of the 4300 cases received in Cytogenetics lab over a period of 2 years, 1020 samples with hematological malignancies were found. The mean patient age was 46 years (range 1 month – 84 years). There were 612 (60%) males and 408 (40%) females with a male : female ratio of 1.5. The diagnosis of 1020 cases as per the WHO criteria was as follows: myeloproliferative syndrome 338 (33%), acute myeloid leukemia 287 (28%), acute lymphoid leukemia 156 (15%), myelodysplastic syndrome 109 (11%), MDS/MPN 34 (03%) and Others like plasma cell disorder, chronic lymphoid leukemia etc 96 (09%).

Out of the 1020 samples, there were 941 (92%) bone marrow (BM) specimen and 79 (08%) peripheral venous blood (PVB) specimens.  720 (71%) samples had culture set up in less than 24 hours from their time of collection. 819 (80%) samples had cellularity more than 7x103/µl.

143 (14%) samples out of 1020 failed to yield any metaphase on culture that precluded any cytogenetic analysis. The pre-analytical variables associated with unsuccessful or failed karyotype (KT) are shown in table 1. 86 (12%) out of 720 samples that were processed in less than 24 hours of time of collection showed an unsuccessful KT while 57/300 samples (19%) that were processed beyond 24 hours failed to yield any metaphase (p-value 0.003). 31/79 PVB (39%) and 112/941 BM (12%) were unsuccessful (p-value <0.001). 15/287 (06%) AML cases, 64/156 (41%) ALL cases, 12/109 (11%) MDS, 6/34 (18%) MDS/MPN cases, 11/338 (03%) MPN cases and 35/96 (36%) from the Others category did not yield any metaphase for analysis (p-value 0.015). 24/819 (03%) samples with cellularity >7 x 103/µl and 119/201 (59%) samples with low cellularity being ≤7 x 103/µl were unsuccessful (p-value <0.001).

DISCUSSION

Cytogenetic analysis remains of the essential tools for classification of hematological malignancies, prognostication and treatment. WHO criteria for diagnosis of hematological malignancies includes cytogenetic abnormalities. However, despite its relevance, sometimes G-banding karyotyping fails to give results due to technical difficulties that yield poor mitotic index.1

In the present study, 143/1020 (14%) samples did not yield any metaphase for analysis and therefore were categorized as Unsuccessful karyotyping (UK). This UK's rate lies between the accepted range of UK reported in literature in case of hematological malignancy (10–20%).6,11 As per the guidelines, a minimum of 20 metaphases must be analyzed in the absence of any abnormality. It will help in excluding presence of 14% any abnormal clone with 95% confidence.13 The remaining 877 samples, 810 (92.4%) yielded 20 metaphases, 35 samples (4%) had 10-20 which were categorized as 'Incomplete karyotype' and 32 (3.6%) had less than 10 metaphases which were labeled as 'Insufficient karyotype'. 

In our lab, 88% of the samples (634/720) processed within 24 hrs of its time of collection were successful. We had a higher success rate with samples processed in less than 24 hrs (86/720, 12% UK) when compared to those that were processed after 24 hrs (57/300, 19%).  Unlike the work done by Santos and his coworkers, it was statistically significant (p-value 0.003).6 As per the literature, it is recommended to send a sufficient quantity of BM (0.5–1 ml minimum), preferably within 24 h after aspiration (best is as soon as possible) to the Cytogenetics laboratory.  Care should be taken to avoid delays in transport and exposure to extreme temperatures. Use of transport medium is also strongly recommended to minimize drying-out of the sample and to maintain the viability of the cells.4,14,15

For hematological malignancies including myeloma the specimen of choice for analysis is bone marrow. Peripheral venous blood should be used only if there is a significant level of circulating disease.16 In our study, we found that unsuccessful Karyotype was seen at a higher rate in PVB (39%) when compared to BM (12%).  The nature of sample - PVB and BM showed a statistically significant difference (p-value <0.001) in the outcome of metaphase yield where PVB was found to be associated with UK. This is in concordance to reports published by other authors.6,17 PVB may yield informative results when the circulating blast cell percentage is higher than 10% and should be considered as an alternative where a BM sample or culture has proved inadequate. It is inappropriate for all diagnoses, like MDS, MPD (except chronic granulocytic leukemia and myelofibrosis) or pancytopenic AML.6,15 In cases of dry tap, for example myelofibrosis aspiration of BM is often unsuccessful because of considerable fibrotic changes and replacement of hemopoietic cell clusters onto reticulin and collagen fibers. In the study by Lozynskyy and his coworkers, BM and PVB samples from patients with myelofibrosis with cytogenetic analysis of unstimulated PVB samples culture was unsuccessful in all 10 patients due to either insufficient quantity or quality of mitotic division. When they set up cell cultures of PVB leukocytes stimulated in vitro with G-CSF all 31 patients resulted in good metaphase with successful karyotyping.18 PVB may be used for hematological malignancies keeping in mind that the abnormal clone may not be identified in such specimens as frequently as in bone marrow.14 BM samples that have been contaminated with blood during aspiration might lack an adequate number of spontaneously dividing cells. Care should be taken to avoid hemodilution of the sample. For this reason, it is important that the cytogenetics laboratory receive the first few milliliters of the bone marrow tap.4,19

In our study, the incidence of UK was highest (41%) for acute lymphoblastic leukemia followed by 18% in MDS/MPN and 6% in AML. Santos et al. reported a higher UK rate in AML (13.3%) and MDS (16.4% ).6 In their study, Medeiros and his coworkers have reported an UK incidence in AML as 10% and that it is related to poor prognosis.8 They have stated that UK occurs more commonly in older patients, predicts poor response to chemotherapy, and should be considered a high-risk feature. UK is seen in 6–7% of patients with MDS, mainly where marrow is fibrotic or hypocellular.20 Study of FISH with MDS cases with G-banding failure done by Yang and his coworkers did not identify abnormalities with poor prognosis and none of the patients had features of high risk MDS by morphologic criteria suggesting that this finding is associated with indolent forms of MDS.9 This was, in contrast, to study by Cervera and coworkers who reported that unsuccessful conventional karyotyping in MDS was associated with worse survival compared to normal karyotyping.10 In the 'Others' category, most of myeloma cases failed to grow due to low dividing capacity of plasma cells.

As per literature, a concentration of 1 million cells per ml of medium is optimal and most laboratories suspend the sample in 5-10 ml growth medium.6,21 Low cellularity was seen in 20% of the samples received in our lab. Out of them, 59% (119/201) showed UK as compared to 3% with high cellularity. This was found to be statistically significant. Similar results were reported by Santos and coworkers who reported association of low cellularity with higher frequency of UK.6  As per the guidelines if cellularity is low, a culture of lower volume should be set up in order to maintain the cellular concentration.21,22 At least two different cultures are recommended, using two different media or two different culture times. Although insufficient or poor-quality samples can sometimes fail to provide enough mitotic divisions, the high-count samples are most likely to fail completely. It is due to the fact that majority of these cells are incapable of division, and their presence inhibits the few remaining cells that can divide.23 High cellularity was associated with 3% UK in our study. Out of the 3% of UK seen in samples with high cellularity, we found that highly cellular PVB had more failure rate (33%) than BM with higher cellularity (2.5%). This is similar to findings of Santos et al who reported UK in 3.9% of BM with high cellularity and 41.9% in PVB with high cellularity.6

Conclusion

Conventional cytogenetics provides support for a malignant or premalignant hematological condition and provides important prognostic and therapeutic information. It is helpful in predicting initial response to therapy, duration of remission and survival. Pre-analytical parameters impact the success of conventional cytogenetics. As per the present study, unsuccessful conventional karyotyping (14% in the present study) is directly related to pre-analytical parameters like time to process, nature of sample and cellularity. Therefore, bone marrow should be preferred for cytogenetics, samples should be transported to lab as soon as possible and correct volume of samples should be used to set up culture in order to get a better success rate. To conclude, the authors believe that collection of an adequate and good quality sample is of paramount importance on which success of karyotyping of hematological malignancies depends.

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.

Financial support - Nil

Conflict of interest - Nil

References:

  1. Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood 2016; 127: 2391–2405  doi:10.1182/blood-2016-03-643544.

  2. Prakash G, Kaur A, Malhotra P, Khadwal A, Sharma P, Suri V, et al. Current role of genetics in hematologic malignancies. Indian J Helmitol Blood Transfus 2016;32:18-31.

  3. Siegel R, Ward E, Brawley O, Jemal A (2011) Cancer statistics,2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin 61(4):212–236

  4. Rack, K.A., van den Berg, E., Haferlach, C. et al. European recommendations and quality assurance for cytogenomic analysis of haematological neoplasms. Leukemia 33, 1851–1867 (2019). https://doi.org/10.1038/s41375-019-0378-z

  5. Mitelman F, Johansson B, Mertens F. Mitelman database of chromosome aberrations and gene fusions in cancer. 2018. http://cgap.nci.nih.gov/Chromosomes/Mitelman

  6. Santos MFM, Oliveira FCAC, Kishimoto RK, Borri D, Santos FPS, Campregher PV et al. Pre-analytical parameters associated with unsuccessful karyotyping in myeloid neoplasm: a study of 421 samples. Braz J Med Biol Res. 2019 Feb 14;52(2): e8194. doi: 10.1590/1414-431X20188194.

  7. Haferlach C, Rieder H, Lillington DM, Dastugue N, Hagemeijer A, Harbott J, et al. Proposals for standardized protocols for cytogenetic analyses of acute leukemias, chronic lymphocytic leukemia, chronic myeloid leukemia, chronic myeloproliferative disorders, and myelodysplastic syndromes. Genes Chromosomes Cancer 2007; 46: 494–499, doi:10.1002/gcc.20433.

  8. Medeiros BC, Othus M, Estey EH, Fang M, Appelbaum FR. Unsuccessful diagnostic cytogenetic analysis is a poor prognostic feature in acute myeloid leukaemia. Br J Haematol 2014; 164: 245–250, doi: 10.1111/bjh.12625.

  9. Yang W, Stotler B, Sevilla DW, Emmons FN, Murty VV, Alobeid B, et al. FISH analysis in addition to G-band karyotyping: utility in evaluation of myelodysplastic syndromes? Leuk Res 2010; 34: 420–425, doi: 10.1016/j.leukres.2009.09.013.

  10. Cervera J, Solé F, Haase D, Luño E, Such E, Nomdedeu B, et al. Prognostic impact on survival of an unsuccessful conventional cytogenetic study in patients with myelodysplastic syndromes. In: Leukemia Research 2009; 33: Abstracts of the 10th International symposium on myelodysplastic syndromes, Patras (Greece) 6–9 May 2009. Abstract number: P030.

  11. Watson MS. Quality assurance and quality control in clinical cytogenetics. In: Dracopoli NC, Haines JL, Korf BR, Morton CC, Seidman CE, Seidman JG, Smith DR (Ed), Current Protocols in Human Genetics. New York: John Wiley; 2007. p 8.2.1–8.2.9.

  12. Shaffer LG, Tommerup N ISCN 2005, an international system for human cytogenetic nomenclature (2005), S. Karger AG, Basel (2005) ISBN 3-8055-8019-3.

  13. Hook EB. Exclusion of chromosomal mosaicism: tables of 90%, 95% and 99% confidence limits and comments on use. Am J Hum Genet. 1977;29:94–97.

  14. Mikhail FM, Heerema NA, Rao KW, Burnside RD, Cherry AM, Cooley LD. Section E6.1-6.4 of the ACMG technical standards and guidelines: chromosome studies of neoplastic blood and bone marrow-acquired chromosomal abnormalities. Genet Med 2016; 18: 635–642, doi: 10.1038/gim.2016.50.

  15. Potter AM, Watmore A. Cytogenetics in myeloid leukaemia. In: Rooney DE and Czepulkowski BH (Ed). Human Cytogenetics: A Practical Approach. Volume 2: Malignancy and Acquired Abnormalities. Second edition. Oxford: IRL Press at Oxford University Press, 1992. p28.

  16. Cherry AM, Slovak ML, Campbell LJ, Chun K, Eclache V, Haase D, et al. Will a peripheral blood (PB) sample yield the same diagnostic and prognostic cytogenetic data as the concomitant bone marrow (BM) in myelodysplasia? Leuk Res. 2012;36:832–40.

  17. Hussein K, Ketterling RP, Hulshizer RL, Kuffel DG, Wiktor AE, Hanson CA, et al. Peripheral blood cytogenetic studies in hematological neoplasms: predictors of obtaining metaphases for analysis. Eur J Haematol 2008; 80: 318–321, doi: 10.1111/j.1600-0609.2007.01021.x.

  18. Lozynskyy RY, Lozynska MR, Hontar YV, Huleyuk NL, Maslyak ZV, Novak VL. Study of cytogenetic abnormalities in G-CSF stimulated peripheral blood cells and non-stimulated bone marrow cells of patients with myelofibrosis. Exp Oncol 2016; 38: 40–44.

  19. Gersen SL and Keagle MB (Ed). The principles of clinical cytogenetics. Second edition. New Jersey: Humana Press, 2005, doi: 10.1385/1592598331.

  20. Stevens-Kroef MJ, Olde Weghuis D, ElIdrissi-Zaynoun N, Van der Reijden B, Cremers EMP, Alhan C, et al. Genomic array as compared to karyotyping in myelodysplastic syndromes in a prospective clinical trial. Genes Chromosomes Cancer 2017; 56: 524–534, doi: 10.1002/gcc.22455.

  21. Arsham MS, Barch MJ, Lawce HJ. The AGT Cytogenetics Laboratory Manual. Fourth edition. Hoboken, New Jersey: Wiley-Blackwell, 2017, doi: 10.1002/9781119061199.

  22. Döhner H, Estey E, Grimwade D, Amadori S, Appelbaum F, et al. Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel. Blood. 2017;129(4):424-447.

  23. Swansbury J. Cytogenetic studies in hematologic malignancies: an overview. In: Swansbury J (Ed). Cancer Cytogenetics: methods and protocols. First edition. New Jersey: Humana press, 2003. p 13–17.

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