International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - Vol 08 Issue 04, February, 2016

Pages: 13-18

Date of Publication: 21-Feb-2016


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HISTOMORPHOLOGICAL SPECTRUM OF SKIN ADNEXAL TUMORS AT A TERTIARY CARE HOSPITAL - A RETROSPECTIVE STUDY

Author: Nirali Amin, Smita Shah, Shreedhan Prajapati, Hansa Goswami

Category: Healthcare

Abstract:Background: Skin adnexal tumors (SAT) are a large and diverse group of benign and malignant tumors which exhibit morphological differentiation towards one of the different types of adnexal epithelium present in normal skin: pilosebaeceous unit, eccrine and apocrine. The aim of this study was to recognize various histomorphology of skin adnexal tumors, their frequency, age and site distribution. Methods: It was a retrospective study of 50 cases of skin adnexal turmors, diagnosed on histopathological examination over a period of 3 years (January 2012 to December 2014) in the Department of Pathology, B.J. Medical college, Ahmedabad. Histopathological examination was done on Formalin fixed, Paraffin embedded tissue sections stained with Haematoxylin and Eosin. Special histochemical stains like PAS stain and Reticulin stain were also used, wherever required. Results: Skin adnexal tumors were most common in the age group of 31 to 40 years (38%, 19/50). Male to female ratio was 1:1.27. The head and neck region was the most common site affected (60%) with 32% cases located on the face. 98% cases were benign and only a single case (2%) was malignant. The sweat gland tumors formed the largest group involving 70% of cases followed by hair follicle tumors followed by sebaceous gland tumors. Nodular hidradenoma was the most common benign tumor. Sebaceous carcinoma was the only malignant adnexal tumor reported in our study. Conclusion: Skin adnexal tumors are relatively rare. Benign adnexal tumors are far more common than their malignant counterparts. There is slight Female preponderance. Face is the commonest site for occurrence of SATs. Nodular hidradenoma is the most frequently encountered tumor among all SATs. Histopathological examination is mandatory in their diagnosis as they have very wide spectrum and frequency of differentiation along different lines in the same lesion.

Keywords: Skin adnexal tumor, Nodular hidradenoma, Sebaceous carcinoma, PAS stain

Full Text:

INTRODUCTION Skin adnexal tumors (SAT) are a large and diverse group of benign and malignant neoplasms which exhibit morphological differentiation towards one of the three different types of adnexal epithelium present in normal skin: pilosebaeceous unit, eccrine and apocrine [1]. SAT may display more than one line of differentiation (hybrid/composite tumors), rendering precise classification of these neoplasms difficult [1]. These tumors are derived from multipotential undifferentiated cells present within the epidermis or its appendgeal structures.

Adnexal tumors arising from the skin are usually missed clinically as most of the SATs present as asymptomatic papules or nodules. Anatomic location, number and distribution of lesions provide important clue but histopathology is invaluable in confirmation of the diagnosis. Diagnosis of skin adnexal tumors is possible by performing an elliptical skin biopsy, submitting for haematoxylin and eosin (HandE) staining and histochemistry.

Most SAT are benign, but a malignant counterpart of every SAT has been described [1]. Malignant skin adnexal tumors are rare, locally aggressive and have the potential for nodal involvement and distant metastasis with a poor clinical outcome. Therefore establishing a diagnosis of malignancy in SAT is important for therapeutic and prognostic purposes [1]. The aim of the current study was to recognize various histomorphology of skin adnexal tumors, their frequency, age and site distribution.

MATERIALS AND METHODS The data for this retrospective study was obtained from Department of Pathology of a tertiary care hospital, from January 2012 to December 2014. The tumors were subjected to meticulous gross and microscopic examination. The histopathological examination was done on formalin fixed paraffin embedded tissues. Haematoxylin and Eosin stained sections were examined and few special stains like PAS and reticulin were performed wherever required. Age and gender prevalence, comparison of clinical diagnosis, site of involvement with biopsy diagnosis were done.

RESULTS During the study period, 50 adnexal tumors of skin were diagnosed on histopathological examination (Table 1). Benign adnexal tumors constituted 98% (49/50) cases and only one case of malignant adnexal tumor (2%) was noted. In the present study, skin adnexal tumors were observed in all age groups ranging from 3 to 80 years (Table 2). However, the highest incidence was observed in the age group of 31-40 years followed by age groups 11-20 years and 41-50 years. The Male: Female ratio was 1:1.27. The head and neck region was the most common site affected followed by lower limb and upper limb (Table 3). In head and neck region, face was the most common site followed by scalp.

The neck region was least affected site. The sweat gland tumors formed the largest group involving 70% of cases followed by the hair follicle tumors, followed by sebaceous gland tumors. Amongst the benign tumors, nodular hidradenoma was the most common tumor representing 16% of all cases. A single case of Sebaceous carcinoma was the only malignant adnexal tumor reported in our study.

Benign tumors were observed in age ranging from 3-80 years and a single case of sebaceous carcinoma was noted in a person at 42 years of age. Sweat gland tumors were all benign and included nodular hidradenoma, chondroid syringoma, eccrine spiradenoma, syringocystadenoma papilliferum, eccrine poroma, hidradenoma papilliferum, syringoma, cylindroma, tubular adenoma and ceruminous adenoma.

Among 3 sebaceous gland tumors, 2 were benign and the remaining one was malignant. Sebaceous naevus was the only benign lesion encountered in this study. Sebaceous carcinoma was seen in 1(2%) patient. All hair follicle tumors in this study were benign and included trichofolliculoma, trichoepithelioma, pilomatrixoma and proliferating trichelemmal tumor. Comparison of observations from the present study and other published studies is shown in Table 4.

DISCUSSION Adnexal tumors of the skin, though rare have been recognised from the later part of 19th century [4]. We also observed that adnexal tumors of skin appear to be relatively uncommon tumors. They are thought to have a genetic basis. Mendelian inheritance and P53 mutations are important contributing factors [3]. The histogenesis of these tumors are from either primary epithelial germ cells or pluripotential cells or cells of pre-existing structure [5]. Skin adnexal tumors have a wide range of age distribution. In our study, commonest age group was 31-40 years and Male: Female ratio was found to be 1:1.27; Head and neck region was the most common site of occurrence.

All these findings were consistent with the results with the study by Radhika et al [5]. Incidence of benign tumors was more as compared to malignant cases. This finding was consistent with other studies. Benign tumors showed smooth borders, absence of ulcers, presence of adnexae and absence of necrosis. The occurrence of benign tumors in our study was 98% and 2% (Only one case) was malignant. Nair et al observed that tumors of sweat gland differentiation were most common followed by hair follicle tumors and then sebaceous glands tumors [6].

The present study showed similar results with sweat gland tumors constituting the largest group (70%), followed by hair follicle tumors (24%) and sebaceous gland tumors (6%). Nodular hidradenoma (Figure 1) was the most frequently encountered benign sweat gland tumor in the present study. Similar observations were reported by Radhika et al [5]. Histopathologically most of these tumors are circumscribed and solid with few showing cystic change. Tumor is composed of varying sizes of tubules and papillary projections lined by inner cuboidal and outer myeoepithelial cell layer. Solid portions of the tumor show nodules comprised of clear and polygonal cells [2].

Chondroid syringomas usually present as well circumscribed lobulated masses centered in deep dermis or subcutaneous fat, with prominent chondroid or myxoid stroma, tubulo-alveolar structures lined by epithelial- myoepithelial cell bilayer, ducts lined by single layer of epithelium, nests of polygonal cells and sometimes keratinous cysts. (Figure 2) Syringomas are characterized histologically by interweaving nests, cords and small cysts that are located in the upper half of the dermis. They are enmeshed in a dense collagenous stroma without any epidermal contact.

The ducts of syringoma are composed of 1- 2 layers of cuboidal cells rarely showing clear cell change. Tadpole appearance is quite common in syringoma (Figure 3). Syringocystadenoma papilliferum (Figure 4) is a rare adnexal neoplasm. We observed 4 cases in our study. Microscopically there are papillary projections with squamous epithelial lining and ductal invaginations. These ductal structures are lined by inner columnar and outer cuboidal cells [2]. Cylindroma (Figure 5), Hidradenoma papilliferum (Figure 6) and Ceruminous adenoma were the least common sweat gland tumors in the present study accounting for single case of each. Cylindroma is a benign basaloid tumor that has a mosaic architecture.

They are solitary or multiple. Histologically these are circumscribed non encapsulated dermal nodules composed of islands and cords of basaloid cells surrounded by a thick hyalinized, Periodic acid-Schiff (PAS) positive basement membrane. Not a single case of malignant sweat gland tumor was observed in the present study. Sebaceous naevus was the common sebaceous gland tumor observed by us. However this tumor was not documented in other published studies [4]. Sebaceous nevus histologically consists of zones of epidermal hyperplasia with small foci of sebaceous glands, miniature hairs and minimal numbers of ducts or glands.

In the present study we reported only one case of malignant adnexal tumor- sebaceous carcinoma. Microscopically, sebaceous carcinoma revealed irregular epithelial lobules with an infiltrative growth pattern in the dermis. Lesional cells demonstrated marked cytologic atypia, mitotic activity and focal sebaceous differentiation (Figure 7). In pilomatrixoma, the histopathological hallmark is that of basaloid lobules which are contiguous with eosinophilic ghost cells or shadow cells (Figure 8).

Dystrophic calcifications are usually present. Trichoepithelioma histologically is a symmetric lesion that contains a mixture of epithelial elements ranging from hair germs associated with capillary mesenchymal bodies to small horn cysts, to lace like reticular basaloid structures to mature hairs. Tricofolliculoma and Proliferating trichelemmal tumor were observed as single case of each in our study. Malignant hair follicle tumors were not observed in this study.

CONCLUSION We conclude that skin adnexal tumors are relatively rare. Benign adnexal tumors are far more common than their ma lignant counterparts. Sweat gland tumors are most common among all skin adnexal tumors. There is slight Female preponderance. Head and neck are frequent sites for occurrence of these tumors, among which face is the commonest site. Nodular hidradenoma is the most frequently encountered tumor among all skin adnexal tumors. Skin adnexal tumors cannot be diagnosed on clinical grounds only and histopathological diagnosis plays a major role in diagnosing these tumors.

References:

1. K O Alsaad, N AObaidat, D Ghazarain, Skin adnexal neoplasms-part 1: An approach to tumors of pilosebaceous unit, J Clin Pathol 2007; 60: 129:44

2. W Klein, E Chan, J T Seykora, Tumors of epidermal appendages,DE Elder (Ed) Lever’s Histopathology of the Skin9thedn. Philadelphia, PA: Lippincott Williams and Wilkins, 2005, 867-926.

3. Perez MI, Robins P, Biria S, Roco J, Siegel E, Pellicer A. P53 oncoprotein expression and gene mutations in some keratoacanthomas. Arch Dermatol 1997;133:189-93.

4. M K Reddy, A J Veliath, S Nagarajan, A L Aurora, A clinicopathological study of adnexal tumors of skin, Indian J Med Res 75, 1982, 882-9

5. K Radhika, B V Phaneendra, N Rukmangadha, M K Reddy A biopsy confirmed skin adnexal tumors: experience at a tertiary care teaching hospital, Journal of Scientific Research, 2, 2013, 132-138

6. P S Nair, A clinico-histopathological study of skin appendageal tumors, Indian Journal of Dermatology,Venerology and Leprology, 74 (550), 2008

7. Kartha CC, Shankar SK, Bhuyan UN. Benign mixed tumor of skin–a histopathologic study of 7 cases. Indian J Pathol Microbiol 1980;23:1-6

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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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