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: 19-24

Date of Publication: 21-Feb-2016


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SPECTRUM OF LESIONS IN URINARY BLADDER -A HISTOPATHOLOGICAL STUDY

Author: Pooja Y. Shah, Monika Nanavati, Ravi G. Patel, Hansa M. Goswami

Category: Healthcare

Abstract:Background: Diseases of the bladder, particularly inflammation (cystitis), constitute an important source of clinical signs and symptoms. Tumors of the bladder are an important source of both morbidity and mortality. Objectives: 1) To study the histopathological features of various lesions in bladder. 2) To study the frequency of different pathological lesions, particularly Papillary Urothelial Neoplasms in urinary bladder. Results: 35 cases of urinary bladder were received. Out of 35 patients, 27 were males and 8 were females with male to female ratio being 3.38:1.The spectrum of pathological lesions included inflammations, metaplastic lesions, cystic lesions and tumors. Out of 35 cases 12(34.28%) were Non neoplastic lesions and 23(65.71%) were Neoplastic lesions. Among the non neoplastic lesions cystitis (41.67%) was the most common finding. Others were non-specific inflammation due to various etiology, hydatid cyst, benign epithelial inclusion cyst and abscess. Most common age groups affected by the neoplastic lesions were 41-50 years and 61-70 years with male to female ratio being 2.29:1. Among the neoplastic lesions 19(82.60%) cases were of urothelial neoplasms, others being Squamous Cell Carcinoma, Poorly Differentiated Carcinoma with Neuroendocrine differentiation and Paraganglioma. Most common Urothelial neoplasm was Non invasive Papillary Urothelial Carcinoma, Low Grade (9 cases). Among all the bladder biopsies received there was no muscle layer in 3 cases (8.3%). Conclusions: Our study has revealed that the bladder tumors are the commonest lesions in the urinary bladder tissues received and Papillary Urothelial Neoplasms were the predominant tumor type.

Keywords: Bladder, Papillary urothelial neoplasms, Paraganglioma.

Full Text:

INTRODUCTION Diseases of the bladder, particularly inflammation (cystitis), constitute an important source of clinical signs and symptoms. Usually, however, these disorders are more disabling than lethal. Neoplasms of bladder pose biologic and clinical challenges [1]. Tumors of the bladder are an important source of both morbidity and mortality. It is the second most common malignancy seen by the urologist[2]. Various risk factors include cigarette smoking, industrial exposure to acrylamine, schistosoma hematobium, cyclophosphamide, artificial sweeteners and long-acting use of analgesics. How these influence to induce cancer is unclear, but a number of cytogenetic and molecular alterations are heterogeneous [3].

In general, the prevalence of bladder tumours in developed countries is approximately 6 times higher compared with that in developing countries. The most common type of bladder cancer in developed countries is urothelial carcinoma, derived from the uroepithelium, which constitutes more than 90% of bladder cancer cases in USA, France or Italy. However, in other regions (e.g. Eastern and Northern Europe, Africa, Asia) the relative frequency of urothelial carcinoma of the bladder is lower [4]. The relative frequency of histological subtype of bladder carcinoma depends on the clinical setting. About 90% of bladder carcinoma reported from the West is transitional cell type. In large series reported from Egypt, squamous cell carcinoma (SCC) accounted for 59– 73% of bilharzial bladder cases which are endemic areas for Schistosoma Haematobium[3].

Objectives:

1) To study the histopathological features of various lesions in bladder. 

2) To study the frequency of different pathological lesions, particularly Papillary Urothelial Neoplasms in urinary bladder.

MATERIAL AND METHODS Source and Method of collection of data: This was a four years (January 2012 to October 2015) retrospective study conducted in histopathology section of Department of Pathology, B.J Medical College, Civil Hospital Ahmedabad, Gujarat from January 2012 to October 2015. All specimens of urinary bladder were included in the study. Patient’s age, sex and other details were retrieved from the request forms manually. The data was analyzed with emphasis on age, sex and histology. The surgical specimens were fixed in 10% formalin. Surgical specimens were examined grossly concerning the size and shape of material and were processed routinely. Light microscopic technique was used for diagnosis. Special stains and immunohistochemistry were applied, where ever required.

RESULTS Out of 35 cases, 12 (34.28%) were non neoplastic lesions and 23 (65.71%) were neoplastic lesions (Table 1). Among the non neoplastic lesions most common lesion was cystitis (41.67%), with 2 cases of cystitis glandularis (metaplasia), 1 of cystitis cystica, 1 of polypoid cystitis and 1 of eosinophilic cystitis. Cases of non specific inflammation constituted 4 cases (33.33 %) of non neoplastic lesions. Among them 2 were associated with trauma,1 with fistula and 1 with diverticulum. Among the other non neoplastic lesions there were Benign Epithelial Inclusion Cyst, Abscess and Hydatid Cyst, 1case (8.33%) of each.

Table 2 shows histopathological spectrum of non neoplastic lesions of urinary bladder. Among the neoplastic lesions most common was Papillary Urothelial Neoplasm 19 cases(82.60%) with 2 cases of Squamous Cell Carcinoma(8.69%),1 case of Poorly differentiated Carcinoma of Neuroendocrine Differentiation (4.35%) and 1 case of Paraganglioma(4.35%)[Table 3]. Among the urothelial neoplasms, most common were Papillary Urothelial Carcinoma, Low Grade with 9 cases(47.36%) [Table 4]. Most common age groups affected by the neoplastic lesions were 41-50 years and 61-70 years with male to female ratio being 2.29:1[Table 5]
 

DISCUSSION Cystoscopy is the primary diagnostic tool in the diagnosis of urinary bladder carcinoma. The histopathological study of the cystoscopic biopsy not only gives the diagnosis but also provides the additional information to the urologist that can have impact on the treatment. Out of 35 patients, 27 (77.14%) were males and 8(22.86%) were females with male to female ratio being 3.3:1.Among the neoplastic lesions out of 23 cases, 16(59.26%) were male and 7(40.74%) were females with male to female ratio being 2.28:1.Similar finding were seen in several studies of cystoscopic biopsy.[5-8] Bladder carcinoma is more common in elderly males. The most common age groups of presentation of neoplastic lesion of the bladder were 41-50 years and 61-70 years, followed by 51-60 years. This is similar to that reported in the existing literature [6,9,10]. Out of 35 cases 12(34.28%) were non neoplastic lesions most common being cystitis. Out of 5 cases of cystitis 2 cases were of Cystitis glandularis and 1 each of cystitis cystica, polypoid cystitis and eosinophilic cystitis.

Out of 4 cases of non specific inflammation 2 were associated with trauma, one with diverticula and another with fistula formation. One case was of Hydatid Cyst in the bladder which was also associated with hydatid cyst of liver and kidney. One case of epithelial inclusion cyst was there in our study.One case of abscess in the muscular wall was also there in our study. Out of 35 cases 23(65.71%) were neoplastic lesions. Among the neoplastic lesions urothelial neoplasms were most common consisting of 19(82.60%) cases. There was no detrusor muscle in 3(15.79%) cases of urothelial neoplasm to assess the muscle invasion. Laishram et al [6] could also assess only 83% cases for invasion and out of that 42.1% cases showed muscle invasion [6].Muscle invasion was seen in 26.31% cases of urothelial neoplasm in study done in Nepal [11].The same study showed 26.7% cases of invasive urothelial carcinoma. Other studies showed 35.8%, 27.2% and 26% of muscle invasion in urothelial carcinoma respectively [7,12,13]. Comparable to these, in our study 26.31% of Urothelial Neoplasms showed muscle invasion. About 70 % of all carcinomas of the urinary bladder are either non- invasive (pTa) or only minimally invasive (pT1) at the time of presentation[14].

Correct histologic grading and tumor staging is crucial for proper and optimal patient management. The corner stone of bladder cancer diagnosis, treatment and staging is a high quality transurethral resection of the bladder tumor (TURBT) [15]. In our study most common urothelial neoplasm were Papillary Urothelial carcinoma,Low Grade consisting 9 cases out of 19 cases with 3 showing lamina propria invasion and in two cases biopsy were inadequate. There were 7 cases of Papillary Urothelial carcinoma, High Grade with 5 cases showing muscularis propria invasion, one showing lamina propria invasion and in one case biopsy was inadequate. In most analysis, less than 10% of low grade cancers invade, but as many as 80% of high grade TCC are invasive [17]. In our study 3 cases were of Papillary urothelial neoplasm of low malignant potential.

As compared to Matalka et al observations, their study showed 40% cases of high grade TCC and 60% of low grade TCC. In our study 47.36% of urothelial neoplasms were Low Grade(Micrograph 2),36.84% were High Grade(Micrograph 3) and 15.79% were with Low Malignant Potential(Micrograph 1). In our study there were only 2 cases of Squamous Cell Carcinoma. In contrast to the studies done in South East Asian countries and Western countries,

Nigeria has squamous cell carcinoma as the most common type of urinary bladder carcinoma. This is because of high frequency of association of squamous cell carcinoma with schstosomiasis [17]. However this pattern has been changing in Egypt in the last few years. There is decline in squamous cell carcinoma and increase in urothelial carcinoma [18]. In India there is only a focus of population infected by Schistosomia haematobium as compared to other countries[19]which explains lower incidence of Squamous cell carcinoma of bladder. Our study showed one case of Poorly Differentiated Carcinoma with Neuroendocrine Differentiation which was confirmed by IHC. Tumor was positive for NSE and negative for Chromogranin.

CONCLUSIONS Our study has revealed that the bladder tumours are the commonest lesions seen in the received specimens of bladder tissue and Papillary Urothelial Neoplasm was the predominant tumour type. Besides, other investigations, cystoscopic bladder biopsies help in the early diagnosis and treatment of various bladder lesions. This study documents a high frequency of urothelial tumor, mostly non invasive papillary urothelial neoplasm, low grade with a male preponderance in the age group above 40 years. Invasion to the muscle layer correlates with high grade tumor. Hence, inclusion of detrusor muscle in the cystoscopic biopsy is very important.

References:

1. Vinay Kumar, Abbas AK, and Fausto N. The lower urinary tract and male genital system. Robbins and Cotran. Pathologic basis of disease. 9th Edition. Philadelphia:Saunders 2004; 1026-1036.

2. Matalka et al. Transitional cell carcinoma of the urinary bladder: a clinicopathological study. Singapore Med J 2008; 49(10): 791.

3. Hasan SM et al. Frequency of transitional cell carcinoma in local suburban population ofkarachi. JLUMHS 2007; 83-85.

4. Beltran AL et al. Infiltrating urothelial carcinoma. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs. IARC Press: Lyon 2004; 93-109.

5. Al- Samawi AS, Aulaqi SM. Urinary bladder cancer in Yemen. Oman Med J 2013; 28: 337-40.

6. Laishram RS, Kipgen P, Laishram S, Khuraijam S, SharmaDC. Urothelial tumors of the urinary bladder in Manipur: ahistopathological perspective. Asia Pacifi c Journal of CancerPrevention. 2012; 13: 2477-9.

7. Viadya S, Lakhey M, KC S, Hirachand S. Urothelial tumors ofthe urinary bladder: a histopathological study of cystoscopicbiopsies. J Nepal Med Assoc 2013; 52: 475-8.

8. Kumar UM, Yelikar BR. Spectrum of lesions in cystoscopicbladder biopsies- a histopathological study. Al Ameen J MedSci 2012; 5: 132- 6.

9. Stepan A, Simionescu C, Margaritescu C, Ciurea R. Histopathological study of the urothelial bladder carcinomas.Current health Science Journal 2013; 39:147-150.

10. Islam AHMT, Mostafa SN, Rahman M, Nahar Z. Role of ultrasound in the evaluation of urinary bladder neoplasm with histopathological correlation. Journal of Teachers Association TAJ 2008; 21:155-9.

11. Nepal Med Coll J 2014; 16(1): 9-12 Cystoscopic bladder biopsies: A histopathological studyPudasaini S,1 Subedi N,2 Prasad KBR,1 Rauniyar SK,1 Joshi BR,2 Bhomi K K 2

12. Biswas RR, Mangal S, Guha D, Basu K, Karmakar D. Anepidemiological study of cases of urothelial carcinoma ofurinary bladder in a tertiary care centre. Journal of KrishnaInstitute of Medical Sciences 2013; 2: 82-8.

13. Gupta P, Jain M, Kapoor R, Muruganandham K,Srivastava A, Mandhani A.Impact of age and gender on the clinicopathological characteristics of bladder cancer. Indian J Urol 2009; 25: 207-10.

14. I. Tosoni .U. Wagner, G Sauter. MEG Coff et al. Clinical Significance of Inter Observer Differences in the Staging and Grading of Superficial Bladder Cancer. BJU International 2000;85:48- 53.

15. Peter J Bostrom, Bas W.G. Van Rhijn, Neil Fleshner et al. Staging and Staging Errors in Bladder Cancer. European Urology Supplements 2010;9:2-9.

16. Mahesh Kumar U and B.R. Yelikar, Spectrum of Lesions in Cystoscopic Bladder Biopsies: A Histopathological study. Al Ameen J Medical Sci 2012;5 (2):132-136.

17. Felix AS, Soliman AS, Khaled H et al. The changing patterns of bladder cancer in Egypt over the past 26 years. Cancer Causes and Control 2008;19: 421-9.

18. Eble JN, Sauter G, Epstein JI, Sesterhenn IA, editors. World Health Organization of tumors- tumors of the urinary system and male genital organs. IARC Press, Lyon, 2004.

19. The global status of schistosomiasis and its control , L. Chitsulo, D. Engels, A. Montresor, L. Savioli, Acta Tropica 77 (2000) 41–51.

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 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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