International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 13(3), February, 2021

Pages: 50-53

Date of Publication: 03-Feb-2021


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Role of Red Cell Distribution Width and Neutrophil: Lymphocyte Ratio in Adults with Sepsis

Author: Pavan MR, Madhav H Hande, JayakumarJeganathan, Meenakshi Shetty, Chakrapani M

Category: Healthcare

Abstract:Introduction: Sepsis is a significant contributor to morbidity and mortality in admitted patients. A large number of markers have been studied as biomarkers for sepsis. Most of them are either expensive or lack good sensitivity and specificity. Objective: In this study, we want to evaluate the role of simple blood tests such as Red cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR) in the evaluation of the severity of sepsis cases. Methods: 173 sepsis patients were included in this ICU cross-sectional study. Red cell distribution width and neutrophil-lymphocyte ration were measured at admission. Both these parameters were compared with quick sequential organ failure assessment (qSOFA) score. They were also compared with the outcome of patients. Results: The mean RDW was 14.455 and it showed a significant correlation with qSOFA score and outcome of sepsis patients. An RDW of 15.050 was found to predict the worse outcome with a sensitivity of 82.4% and specificity of 74.7%. The mean NLR was 5.1645 and it also correlated with qSOFA score in sepsis patients. An NLR of 3.22 predicted worse outcome but only with the sensitivity of 66.2% and specificity of 65.7%. Conclusion: RDW and NLR both showed good correlation with sepsis outcome. However, RDW had a better sensitivity and specificity in predicting worse outcomes in sepsis.

Keywords: Neutrophil lymphocyte ratio, Outcome, Red cell distribution width, Sepsis, Severity, Intensive care unit

Full Text:

Introduction

Sepsis continues to be a major cause of morbidity and mortality in Intensive Care Units (ICU) despite the better understanding of its pathophysiology in recent years. Bloodstream infections are an important cause of serious morbidity and mortality and the incidence of sepsis is reported up to 30% in patients admitted in the intensive care units.1,2 Since sepsis is a heterogenous process with various manifestations, severity levels and cellular processes involved, a definitive biomarker that could aid in the diagnosis, staging, prognosis, and response to intervention has been difficult to determine. Scores such as APACHE II score on admission are associated with high mortality.3 Researchers have proposed more than a hundred different molecules as useful biomarkers of sepsis. C?reactive protein (CRP) and Procalcitonin (PCT) have been frequently used in the evaluation of the severity of sepsis and deciding the duration of therapy in ICU patients. Nevertheless, they are expensive and have insufficient predictive value for an individual.4 Since the definition of the new criteria was published, qSOFA score and SOFA score have been used to predict severity of sepsis and related in-hospital mortality for patients in the emergency department or the ICU.5 Red cell distribution width (RDW) is routinely done as a part of the routine blood count. Various studies have shown that it may be used as a prognostic marker in hypertension, coronary artery disease, stroke, and acute kidney injury. It has also been shown to correlate with all-cause mortality and nutritional status. 6 Total White blood cell (WBC) count is recognised as an important systemic inflammation marker. Leucocytosis has also been shown to independently predict all?cause mortality. Previous studies have also shown relative lymphocytopenia and neutrophilia in patients with sepsis. In critically ill patients the “neutrophil-lymphocyte ratio” (NLR) is a simple, rapid and inexpensive novel marker of inflammation and stress. It has also been found to have predictive value in patients with suspected bacteraemia in medical emergencies; and also found to be associated with short-term and long-term clinical outcomes in critically ill patients.7 With this background, the current study aims to study the relationship between RDW and neutrophil: lymphocyte ratio with the severity of illness in patients admitted to medical ICUs with sepsis has been undertaken.

MATERIALS AND METHODS

The study design was a cross-sectional study. The study type was an analytical study. It was done in an ICU in a tertiary care centre in South India. Permission from the local ethics committee was obtained. Informed consent was obtained from all participants.

Inclusion criteria: All participants who were more than 18 years and diagnosed to have sepsis in ICU and in whom blood sampling was done within 24hrs of admission were included in the study.

Exclusion criteria: Immunosuppressed patients such as HIV infection, cancer or patients receiving immunosuppressive therapy, patients with haematological disorders and pregnancy.

Sample size was estimated using the formula n= 2(Zα +Zβ)2 x σ2 / d2where Zα =1.96 at 95% confidence interval, Zβ = 1.28 at 90% power, σ = SD and d=mean difference. With 95% confidence level and 90% power the sample size came to 180. Sampling strategy followed was convenient sampling.  Adult patients presenting to ICU diagnosed as sepsis as per 2016 Sepsis – 3 guidelines2, were considered for the present study. Basic demographic data, comorbidities, source of a new infection, presenting vital signs were recorded as per the proforma. Patients were stratified according to Q-SOFA scoring. q-SOFA score and SOFA score were calculated on the fifth day of admission to ICU, to assess the progress of the patient.

Blood samples were collected at the time of admission for the following tests: Complete blood counts with RBC indices. Blood urea, serum creatinine and serum electrolytes. Liver function test (LFT), coagulation studies (INR, aPTT), Serum glucose, Blood culture and other cultures (e.g., of sputum, stool, urine, wounds, catheters, prosthetic implants, epidural sites, pleural or peritoneal fluid). Arterial blood gas (ABG). Chest x-ray, ECG was performed as per protocol. Other investigations as appropriate were carried out such as lumbar puncture, echocardiogram  (trans-thoracic or trans-oesophageal), ultrasound scan, CT chest or abdomen. RDW was measured at admission to ICU. The RDW is a measure of variability or red blood cells in size. It may be elevated due to ineffective production or increased destruction of red blood cells. This happens usually in inflammation and infections.  Neutrophil to lymphocyte ratio (NLR) was determined by dividing the absolute neutrophil count by the absolute lymphocyte count.  The patients were followed to check their condition whether SOFA score improved or worsened. The patient outcome on Day 5, including mortality, was recorded.

Statistical Methods

Data was entered and analyzed by using statistical software- Statistical Package for Social Sciences (SPSS) Version 17.0. Descriptive statistics like proportions, mean (standard deviation) and median (IQR) was used for expressing the results. For qualitative data Chi-square test and ANOVA was applied and P < 0.05 was considered as a statistically significant association.

Results

A total of 173 patients were included in the study. Males formed 62.4% of the subjects. Majority of the patients with sepsis were over 50 years of age. Pulmonary infections (38.2%) were the most common source of infection in the majority of sepsis cases, followed by tropical infections (27.2%). Table 1 shows the organisms responsible for sepsis. Gram-negative sepsis was the most common cause of sepsis in the study population. Dengue fever, detected by dengue IgM positivity, was the most common individual cause of sepsis in the study population. No organisms could be isolated in around 23.7% of the cases. Hypertension (41.6%) and Diabetes (41%) were the most common co-morbidities present in this study. Outcomes on day 5: 43% of the patients improved, 39% of the patients worsened and 18% of the patients died. RDW was found to be between 14.2 and 15.2 in the majority (59%) of patients with sepsis in the study group. Most of the patients belonged to qSOFA score of 3 (41%). 36% of the patients had a qSOFA score of 2 and 23% of the patients belonged to qSOFA score of 1. As the RDW increased the qSOFA score also increased as shown in Table 2. It was statistically significant. As seen in Table 3 patients with high RDW had poorer outcome and it was statistically significant. ROC was plotted for RDW vs outcome: The area under the curve was found to be 0.834, which implied RDW was a good test to predict the outcome. An RDW of 15.050 was found to predict the worse outcome with a sensitivity of 82.4% and specificity of 74.7%. It was found in the study that as the q SOFA score increases, median NLR increases as seen in Table 4. ROC was plotted for NLR vs Outcome. The area under the curve was found to be 0.663, which showed that NLR was only a fair test to predict the outcome. An NLR of 3.22 predicted worse outcome with the sensitivity of 66.2% and specificity of 65.7%.

Discussion

In this study, 173 patients who were admitted to the ICU, diagnosed as sepsis as per the 2016 Sepsis – 3 guidelines, were studied. Respiratory infections were the most common source of sepsis, and this was by previous studies.8  However, tropical/non localised diseases such as dengue fever, leptospirosis and malaria had a much higher incidence in our study population, this might be explained by the endemicity of these diseases to this region. Hypertension and diabetes mellitus were the most common comorbidities seen in this study. In another study of sepsis in India, 28% of those patients had diabetes and 16.5% of the patients had hypertension.9 In our study mortality rate was 18%. In another study by Pandya et al. they found a mortality rate of 28% in sepsis patients.10 In our study there was a good correlation between RDW and qSOFA score. RDW correlated well with the APACHE II score in sepsis patients.11 In our study RDW correlated well with the outcomes and as the RDW increased the outcome of the patients worsened. In another study, RDW not only predicted short term mortality but also had a good correlation with the 4-year mortality rate.12 In our study an RDW greater than 15.050 predicted a worse outcome. In the study by Jandial A, they found that an RDW greater than 17.3 showed significant correlation with mortality in sepsis patients.11In our study the median NLR showed a reasonable correlation with the qSOFA score. As the median NLR increased the clinical outcome of the patient worsened. De Jager et al. observed NLR as a better predictor of severity and outcome in bacteremia than conventional markers.13  In our study NLR of 3.22 predicted worse outcome in sepsis patients however it was not as strong a predictor as the RDW.  Martins EC in their study showed that the cutoff point of 5.0 for the NLR was associated with a high risk for sepsis.14

Conclusion

We found that RDW correlated well with qSOFA score in sepsis patients and offered a clinically reliable cut off for prognostication of sepsis. We determined such a cut off to be 15.050 above which the outcome was bad.  But we found Neutrophil lymphocyte ratio to be of limited clinical value as it lacked a discernible cut off and had a weak association with clinical outcome.

Ethical clearance: Taken from the institutional local ethics committee before the start of the study. (IEC KC MLR 09-17/167)

Source of funding: Self

Conflict of interest: Nil

Acknowledgement: Authors acknowledge the immense help received from the scholars whose articles are cited and included in references to 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.

References:

  1. Singer M, Deutschman CS, Seymour CW. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016;315(8):801–810.

  2. Anamika V, Ramavtar S, Pooja G, Mrityunjay K. Bloodstream infections in Intensive care unit patients: A single centre retrospective study of the distribution and antibiotic resistance pattern in clinical isolates. Int J Cur Res Rev 2012;4(12):154-162.

  3. Bhadade RR, DeSouza RA, Harde MJ, Prarthana P. Prospective evaluation and mortality outcome of nosocomial infections in medical intensive care unit at Tertiary care teaching centre in Mumbai. Int J Cur Res Rev 2013;5(19):26-40.

  4. Lichtenstern C, Brenner T, Bardenheuer HJ, Weigand MA. Predictors of survival in sepsis: what is the best inflammatory marker to measure? Curr Opin Infect Dis 2012;25(3):328-336.

  5. Freund Y, Lemachatti N, Krastinova E. Prognostic Accuracy of Sepsis-3 Criteria for In-Hospital Mortality Among Patients With Suspected Infection Presenting to the Emergency Department. JAMA 2017;317(3):301–308.

  6. Patel KV, Ferrucci L, Ershler WB. Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med 2009;169(5):515–523.

  7. Salciccioli JD, Marshall DC, Pimentel MA. The association between the neutrophil-to-lymphocyte ratio and mortality in critical illness: an observational cohort study. Crit Care 2015;19(1):13.

  8. Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, Moreno R, Carlet J, Le Gall JR, Payen D. Sepsis in European intensive care units: results of the SOAP study. Crit Care Med 2006;34(2):344-353.

  9. Anand AK, Kumar N, Gambhir IS. Clinicomicrobiological profile of the Indian elderly with sepsis. Ann Trop Med Public Health 2016;9:316-320.

  10. Pandya H, Pabani N, Shah K, Yadav R, Patel P, Raninga J. Study of various prognostic factors for sepsis patients requiring intensive medical care with special emphasis on APACHE II score in prognostication. J Integr Health Sci 2015;3:14-22.

  11. Jandial A, Kumar S, Bhalla A. Elevated Red Cell Distribution Width as a Prognostic Marker in Severe Sepsis: A Prospective Observational Study. Indian J Crit Care Med 2017;21(9):552–562.

  12. Han YQ, Zhang L, Yan L. Red blood cell distribution width predicts long-term outcomes in sepsis patients admitted to the intensive care unit. Clinica Chimica Acta. 2018;487:112-116.

  13. deJager CP, van Wijk PT, Mathoera RB. Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit. Crit Care 2010;14(5):2-8.

  14. Martins EC, Silveira LDF, Viegas K. Neutrophil-lymphocyte ratio in the early diagnosis of sepsis in an intensive care unit: a case-control study. Razãoneutrófilo-linfócito no diagnósticoprecoce de sepseemunidade de terapiaintensiva: um estudo de caso-controle. Rev Bras Ter Intensiva 2019;31(1):64–70.

Announcements

Dr. Pramod Kumar Manjhi joined Editor-in-Chief since July 2021 onwards

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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


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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.



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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

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