International Journal of Current Research and Review
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IJCRR - 13(5), March, 2021

Pages: 188-190

Date of Publication: 03-Mar-2021


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Morphologic Pattern of Upper Gastrointestinal Tract Lesions - Endoscopic Biopsy Analysis

Author: Rajesh Kothari, Sanjay Agrawal, Vineeta Kothari

Category: Healthcare

Abstract:Introduction: A diagnostic technique that visualizes the upper portion of the gastrointestinal tract up to the duodenum is the upper gastrointestinal endoscopy. It is a proven model of investigation and plays a crucial role in the precise detection and treatment of a wide variety of upper gastro-intestinal conditions in conjunction with biopsy. Objectives: To study the Morphological pattern of lesions of the upper gastrointestinal tract from the endoscopic biopsies. Methods: The present research was performed with endoscopic biopsies of the upper gastrointestinal tract over two years in the pathology department of a tertiary care hospital. Results: In 828 patients, biopsy materials were collected from various levels of the upper gastrointestinal tract. This included 288 biopsies from the oesophagus (35%), 84 from the gastric junction of the oesophagus (10%), 444 from the stomach (54%) and 12 from the small intestine (2%). There were 280 (34%) cases that were non-neoplastic, while 548 (66%) were neoplastic. Histopathology revealed gastritis of varying grades (27%) as the inflammatory lesion most frequently diagnosed, while the most frequently diagnosed malignant lesion was squamous cell carcinoma (37 %). Conclusion: A strong correlation between endoscopic and histological diagnosis was shown in this research. It further indicates that the predominant site of upper gastro-intestinal malignancy is the oesophagus.

Keywords: Upper gastro-intestinal malignancy, Biopsy, Endoscopy, Histopathology

Full Text:

INTRODUCTION

The oesophagus, stomach and duodenum from the upper gastrointestinal tract. Symptoms of trouble swallowing, stomach discomfort, vomiting and hematemesis are usually present in patients with upper gastrointestinal system diseases.1,2 One of the most common sites for neoplasms, particularly malignant tumours, is the upper gastrointestinal tract. A diagnostic technique that visualizes the upper portion of the gastrointestinal tract up to the duodenum is the upper gastrointestinal endoscopy.3 It is a proven method of researching and treating a wide variety of upper gastrointestinal conditions. As the main form of diagnosing upper gastrointestinal disease, it has replaced upper gastro-intestinal radiography.4,5 First used in 1968, the upper gastro-intestinal flexible fibre-optic endoscope proved to be a significant advance in gastro-intestinal tract lesion diagnosis. A convenient technique and current gold standard for reliable objective evaluation of patients with upper gastrointestinal tract symptoms is endoscopic biopsy accompanied by histopathological review.6 It is used not only to diagnose malignant & inflammatory lesions, but also to track the path, nature of the disease, therapy response, and early complication detection. This is reflected by a growing trend in the upper gastrointestinal tract to receive mucosal biopsies.7,8 Endoscopic screening can detect gastric mucosal lesions at an early stage particularly atrophy, intestinal metaplasia and dysplasia to prevent the progress of lesions to invasive cancer.9,10 Oesophageal & gastric cancers are the most prevalent cancers found in men, according to the National Cancer Registry, while oesophageal cancer ranks third among women after breast and cervix carcinoma.11

MATERIALS AND METHODS

The present research was performed for two years in the Department of Pathology. We obtained a total of 828 biopsy materials from different levels of the upper gastrointestinal tract during this two year study period. A flexible fibre-optic upper gastrointestinal endoscope was used to obtain the biopsy materials. Endoscopic tests and biopsies were carried out in patients of both sexes over 12 years of age with upper gastrointestinal symptoms. All patients involved in this study received informed consent. Using standardized proforma, relevant history and clinical information were documented. Both biopsy samples were counted for tissue fragments and immediately placed in 10% neutral formalin, accompanied by traditional processing & embedding of tissue. There were five micron thick parts cut & slides prepared. Each segment was stained and studied with Haematoxylin and Eosin stain. To observe H.Pylori, additional segments were stained with Giemsa. Wherever possible, Alcian blue stain to observe intestinal metaplasia and Periodic Acid Schiff (PAS) stain were performed. According to the WHO classification of the gastrointestinal tumour and tumour like symptoms, lesions were diagnosed.

RESULTS

Of the 828 cases ( Table 1), 540 (65 %) were men and 288 (35 %) were women with a 1.9:1 ratio of male to female. The age group of patients ranged from 15 years to 85 years in the current study and the highest number of cases were identified in the 40-60 year age group, representing a total of 40 % of the study population, followed by 60-80 years (34 %), 20-40 years (19 %) and the lowest incidences (4 %) in 10-20 years. Of the 828 endoscopic biopsies, 444 were gastric biopsies (54 %), 288 were oesophageal biopsies (35 %), 84 were oesophagus-gastric junction biopsies (10 %) and about 12 were duodenal biopsies (1 % ). There were 280 (34%) cases that were non-neoplastic, while 548 (66%) were neoplastic. 272 (50 %) of the 548 neoplastic cases were from the oesophagus, 192 (35 %) were from the stomach, and 84 (15 %) were from the oesophagus-gastric junction. Gastritis was found to be the most frequently diagnosed inflammatory lesion by histopathology (27 %), while squamous cell carcinoma (37 %) was the most frequently diagnosed malignant lesion. 272 cases of the 288 oesophageal lesions were malignant. Squamous cell carcinoma has been noted in 272 oesophagus biopsies and 34 oesophagus-gastric junction biopsies. Of these cases, 33% were well-differentiated squamous cell carcinoma, 63% were moderately differentiated squamous cell carcinoma, and 5% were poorly differentiated squamous cell carcinoma. In the stomach, two cases showed hyperplastic polyp, two cases of foreign body granuloma, & 220 specimens with varying grades of gastritis were noted. Adenocarcinoma has been noted in 190 stomach biopsies and 50 oesophagogastric junction biopsies. Nonspecific duodenitis was demonstrated in 2 cases by endoscopic biopsies involving the upper two sections of the duodenum, villous atrophy in 2 cases and duodenal ulcer in 6 cases.

DISCUSSION

The typical site is the stomach, preceded by the oesophagus, for upper gastrointestinal endoscopic biopsy. The most frequent presenting symptom was dysphagia among patients with oesophageal malignancy. The most prominent signs of gastric malignancy have been dyspepsia and weight loss.12Oesophageal and gastric cancers are the most common cancers found in men, according to the National Cancer Registry, while oesophageal cancer is ranked 3rd among women after breast & cervix carcinoma. Most of the patients identified were male (66 %) and 40 % were in the 4th to 6th decade of life. A similar finding was also observed by Shennak et al5 which they attributed to the greater degree of exposure of male subjects to different risk factors and greater attendance of male patients to the outpatient department of the hospital as compared to the female patients. Between the 40-60 age groups, a predominance of upper gastrointestinal tract diseases was observed, which showed a similar pattern to other studies published. The majority of oesophageal lesions have been described as malignant.13 These findings are comparable to research performed by Memon F et al.8 The bulk (54 %) of the cases involved gastric biopsies. Of the 444 cases, in line with other research, 180 cases of gastric malignancies were histopathologically diagnosed as gastric adenocarcinoma. While there is a comparatively lower incidence of gastric carcinoma in India than in other countries, there has been a high incidence in Southern India. As with other research, Antrum was the most common location for gastric carcinoma, followed by the body of the stomach. Chronic gastritis was the most common lesion among the non-neoplastic lesions (14 %), which is comparable to the study conducted by Khandige.14 Just 12 patients were diagnosed with a histopathological endoscopic biopsy involving the first two sections of the duodenum. Of these, six patients were diagnosed with duodenal ulcer, two with celiac disease, followed by two with non-specific duodenitis.14-17

CONCLUSION

Useful information is provided by biopsy sampling of the upper gastrointestinal mucosa during diagnostic endoscopy. In the present research, several non-neoplastic and neoplastic lesions have been identified across a wide spectrum of age & size distribution. The most common location for upper endoscopic biopsy in our sample was from the stomach, and it further indicates that the primary site of upper gastrointestinal malignancy is the oesophagus and the common histological form is squamous cell carcinoma. Owing to limited biopsy specimens, handling and processing items, weaknesses in diagnostic interpretation are sometimes encountered. However, to establish a definitive diagnosis, several bits of endoscopic biopsies from irregular looking mucosa are recommended. In addition to detecting upper gastrointestinal mucosal lesions at an early stage, endoscopic biopsies can detect changing trends in the spectrum of lesions, in particular atrophy, intestinal metaplasia and dysplasia, to avoid the progression of these lesions to invasive cancer. We, therefore, conclude that without biopsy, endoscopy is incomplete and hence the combination of both the techniques offers a strong diagnostic method for improved treatment of patients.

Acknowledgement

The author acknowledges the immense help received from the scholars whose articles are cited and included in references to this manuscript. The author is 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.

Conflict of Interest: Nil

Source of Funding: Nil

References:

1. Black M. Endoscopic interpretation normal and pathologic appearance of the gastrointestinal tract. Raven Press New York 1984;1:13-15.

2. Karish R. A study on histopathologic spectrum of upper gastrointestinal tract endoscopic biopsies. Int J MedRes Health Sci2013;2(3):418-424.

3. Suvakovic Z. Improving the detection rate of early gastric cancer requires more than open access gastroscopy: a five-year study. Gut 1997;41(3):308-313.

4. National Cancer Registry Programme. First All India Report 2001-2002. Vol 1. Indian Council of Medical Research. Bangalore, India. 2004.

5. Shennak M. Upper gastrointestinal diseases in symptomatic Jordanians: A prospective study. Ann Saudi Med 1997;17(4):471-474.

6. Paymaster J. Cancer of the gastrointestinal tract in western India. Cancer 1968;21:279-287.

7. Khar H. Endoscopic and histopathological evaluation of 306 dyspeptic patients. Pak j Gastroenterol 2003;17:4-7.

8. Memon F. Upper gastro-intestinal endoscopic biopsy; the morphological spectrum of lesions. ProfesMed J 2015;22(12):1574-1579.

9. Fuchs C. Gastric Carcinoma. New EnglJ Med 1995;333(1):32-36.

10. Kelley J. Gastric cancer: Epidemiology and risk factors. J ClinEpidemiol2003;56:1-9.

11. Dicken B. Gastric Adenocarcinoma – Review and considerations for future directions. AnnlSurg2005;241(1):27-39.

12. Gajalakshmi V. An independent survey to assess the completeness of Registration: Population-based cancer registry, Chennai, India. Asian PacJ Cancer Prev2001;2:179-183.

13. Marson B. Gastrointestinal pathology. 2nd edn, Black Well Scientific Publications, London, 1998:l48-151.

14.Khandige S. The Conceding of Upper Gastro-intestinal Lesion Endoscopic Biopsy: A Bare Minimum for Diagnosis. IntJ SciRes 2015;4(2):264-266.

15. Fenoglio-Preiser C. Gastric carcinoma. In: WHO Classification of Tumours - Pathology and Genetics of Tumours of the Digestive System. Hamilton SR and Aaltonen LA (Eds), IARC Press: Lyon, France, 2000: 38-52.

16. Cherian J. Carcinoma of the oesophagus in Tamil Nadu (South India): 16-year trends from a tertiary centre. J GastrointesLiver Dis2007;16(3):245-249.

17. Abilash SC. Gastric carcinoma and Diagnosis. Sch J Appl Med Sci 2016;4(5E):1807-1813.

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One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

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This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

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‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

A study by 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
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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
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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
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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
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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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