Article|International Journal of Current Research and Review

Search Articles

Track manuscript

Full Html

IJCRR - 8(1), January, 2016

Pages: 09-15

Print Article Download XML Download PDF

CORRELATION OF DISEASE DURATION, SMOKING PACK YEARS AND FEV1% PREDICTED WITH BAEP PARAMETERS IN PATIENTS OF COPD

Author: Rupali Parlewar, Rubiya Shaikh

Category: Healthcare

Abstract:COPD is a progressive disease associated with an amplified chronic inflammatory response to noxious particles or gases in the airways and lungs. It is characterized by airflow limitation that is not fully reversible. Long term exposure to lung irritants that damages the lungs and airways usually is the cause of COPD. Worldwide, the most commonly encountered risk factor for COPD is tobacco smoking. The early detection of auditory impairment can be possible by recording of BAEP in patients of COPD. Study includes 100 individual, all males with the age group of 40-60 yrs. were divided in two groups, study group (n=50) and controls (n=50). Study group includes patients of COPD, as per gold criteria and those had a duration of COPD for more than 5 years with stable course of disease. Controls are age & sex matched normal healthy adults. Spirometry was done in patients to confirm the diagnosis of COPD and the severity of airflow limitation. And BAEP recording was done. Latencies of wave I, II, III, IV, V and Interpeak latencies I-III, III-V, I-V of right ear had a statistically non-significant positive correlation with disease duration. There were increase in right ear latencies of wave I, II, III, IV, V and Interpeak latencies of I-III, III-V, I-V along with increase in smoking pack years indicating a positive correlation with p value < 0.05 showing a statistical significance. Also statistical significant (p value < 0.05) negative correlation between post-bronchodilator FEV1% predicted value and right ear latencies of wave I, II, III, IV, V &Interpeak latencies of I-III, III-V, I-V ; indicating prolongation of latencies of BAEP with reduction in FEV1% predicted. The progressive chronic hypoxemia leads to development of tissue hypoxia and decreases the cerebral perfusion; also it slows the nerve conduction in auditory pathways which causes prolongation of latency. The contents of tobacco smoke in addition to hypoxemia lead to hypoxia. Therefore smoking pack years and decreased FEV1% predicted value definitely have impact on BAEP.

Keywords: BAEP, Latencies, Interpeak latencies, FEV1 % predicted value, Smoking pack years, Disease duration, Hypoxia

Full Text:

INTRODUCTION
Chronic Obstructive Pulmonary Disease (COPD), a common preventable and treatable disease, is characterised by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Exacerbations and comorbidities contribute to the overall severity in individual patients (1). The term COPD is commonly used to refer the related conditions emphysema and chronic bronchitis (2).The recently published GOLD report (2014) used the term emphysema and chronic bronchitis for diagnosis of COPD, but they are not included in definition. Because chronic bronchitis defined as the presence of cough and sputum production for at least 3 months in each of 2 consecutive years, is not necessarily associated with airflow limitation. Emphysema, defined as destruction of the alveoli, is a pathological term that is sometimes (incorrectly) used clinically and describes only one of several structural abnormalities present in patients with COPD and can also be found in subjects with normal lung function (1). Long term exposure to lung irritants that damages the lungs and airways usually is the cause of COPD. Worldwide, the most commonly encountered risk factor for COPD is tobacco smoking(3,4,5). Studies show that approximately 80-90% of patients with COPD have been smoking and approximately 15% of all smokers will develop COPD (6). Non-smokers may also be at risk for developing COPD as a consequence of passive smoking, indoor and outdoor air pollution or occupational dusts and chemicals(7,8). COPD risk is related to the total burden of inhaled particles a person encounters over their lifetime (9).

1) Tobacco smoke includes cigarette, bidi, pipe, cigar and other types of tobacco smoking.

2) Indoor air pollution from the burning of biomass fuel used for cooking and heating in poorly vented dwellings, a risk factor that particularly affects women in developing countries (10).

3) Occupational dusts and chemicals are risk factors when the exposures to them are sufficiently intense and prolonged (7,11).

4) Outdoor air pollution also contributes to the lungs’ total burden of inhaled particles, although it appears to have a relatively small effect in causing COPD (1).

5) Genetic factors- The genetic risk factor that is best documented is a severe hereditary deficiency of alpha-1 antitrypsin (12).

These indicators are not diagnostic themselves, but the presence of multiple key indicators increases the probability of a diagnosis of COPD. Spirometry is required to make a clinical diagnosis of COPD; the presence of a post-bronchodilator FEV1 /FVC < 0.70confirms the presence of persistent airflow limitation and thus of COPD. Spirometry (meaning measuring of breath) is the most common of the pulmonary function tests measures how much air can breathe out (volume) and how fast can blow air out (flow)(13). COPD is often associated with clinical manifestations that include metabolic abnormalities, weight loss, muscle weakness and wasting, anxiety, depression(14), Osteoporosis, Cardiovascular diseases like Corpulmonale(15), Atherosclerosis, ischemic heart disease and stroke(16). Many of the systemic co-morbidities associated with COPD have been related to systemic inflammation (17). There is rapidly growing body of evidence indicating that the pulmonary disease observed in patients with COPD is also associated with systemic inflammation(18). COPD is associated with systemic inflammation, recognized as a risk factor for its systemic complications. Hypoxemia triggers oxidative stress and inflammation in COPD patients (19).

The existing medical literature suggests that hypoxemia results in peripheral nerve damage by harming the vasonervosum. In the early stages of ischemia, mechanisms to reduce peripheral neuropathy are activated, but these become insufficient over time and obvious neuropathy is inevitable in chronic hypoxemia (20). There are some studies showing that auditory receptors are affected from hypoxia (21,22). The early detection of auditory impairment can be possible by recording of BAEP in patients of COPD. Brainstem auditory evoked potentials (BAEPs) are the potentials recorded from the ear and vertex in response to a brief auditory stimulation to assess the conduction through the auditory pathway up to the midbrain (23). BAEP is a far field recording of the synchronized response of a large number of neurons in auditory pathway. The use of the BAEP has been well documented both from a neurological and audio logical stand point (24).

BAEP is a simple, non-invasive procedure to detect early impairment of acoustic nerve and CNS pathway, even in the absence of specific symptoms. Therefore Correlation of disease duration, smoking pack years and FEV1 % predicted with BAEP parameters done in patients of COPD.

MATERIALS AND METHODS
The present study was conducted in the Department of Physiology and Department of Pulmonary Medicine in Grant Government Medical College and J.J Hospital, Mumbai. Before commencement of study, approval was taken from the Institutional Ethical Committee.

The study design involved 100 individuals which can be divided in two groups. Group I –Diagnosed patients of COPD as per GOLD criteria, after applying inclusion and exclusion criteria were accepted for study (n=50) Group II –Age and sex matched normal healthy adults (n=50). In addition, spirometry was done to confirm the diagnosis of COPD and the severity of airflow limitation was determined by GOLD gradation criteria (post-bronchodilator FEV1 /FVC ratio less than 70%, consistent with airflow limitation that is not fully reversible,GOLD criteria).

The evaluation was done in following stages -

1) A written informed consent was taken from all participants of this study.

2) A detailed history-taking and thorough clinical exami- nation was done.

3) Spirometric test was performed in both groups and diagnosis of COPD was confirmed in cases

4) BAEP recording was done. Among COPD patients, those had a duration of COPD for more than 5 years with stable course of disease, having a regular follow up for 1 year with no hospitalization for COPD related illness in preceding 6 months were included in study group. All COPD patients in study were males and had smoking history. They were having moderate to severe airflow limitation. The subjects who met the criteria were selected for the study. The study and control group were selected as per inclusion and exclusion criteria. Spirometry test was done in study group with the help of MEDGRAPHICS Body Plethysmographmachine.

Inclusion criteria for selection of COPD patient -

1. Males with age group of 40-60 years.

2. On spirometric test, patients having post-Bronchodilator FEV1 % predicted valueless than 80% with FEV1 / FVC ratio <0.70.

3. Patients with normal auditory function tests.

Inclusion criteria for controls

1. Normal healthy male individuals with age group of 40-60 years.

2. Subjects having no addiction (Non-smokers).

3. Subjects having normal hearing.

Exclusion criteria for both

1. Patients of COPD in acute exacerbation.

2. Subjects having any clinical neuropathy.

3. Subjects having hearing loss.

4. Subjects suffering from another acute/ chronic medical disorder like hypertension, diabetes mellitus, malignancy, leprosy, tuberculosis.

5. Subjects with history of addiction to alcohol, drug abuse.

6. Subjects with history of drug intake known to cause central neuropathy e.g. Reserpine, Phenytoin, Alphamethyldopa, Nitrofurantoin.

7. Subjects who had history of taking ototoxic drugs e.g. Gentamycin, Amikacin, Streptomycin, Kanamycin and Quinine.

Evoked Potential study(26) Pre-test preparation-
The skin was prepared by mild abrading and degreasing by Nu-Prep gel. Standard cup electrodes were used. The electrodes were placed on their respective sites using electrode paste as per 10-20 international system of electrode placement. The tests were carried out in a quiet room. EMGand EP digital neurophysiological system software, Neuro-MEPw version 3.0, 64.0 was used to conduct evoked potential tests.

Brain stem auditory evoked potential Recording -
All the techniques of recording, machine settings and instruments were maintained uniformly throughout the study. Patients were made to lie down comfortably on couch and were asked to close their eyes and relax. BAEPs are obtained using monaural (one ear at a time) stimulation.

Electrode placement - Active electrodes (Mi , Mc ) - over mastoid processes Reference electrode (Cz ) - at vertex Ground electrode (Fz ) - at forehead in midline Montage consisting of the following derivations was used for BAEP recordingChannel 1: Vertex - ipsilateral mastoid process (Cz - Mi ) Channel 2: Vertex - contralateral mastoid process (Cz -Mc ) The following machine setting was used throughout the study.

1) Stimulus - Monaural auditory stimulus in the form of clicks were delivered through TDH-39P headphone at a rate of 10 per second (10 Hz) with the alternating polarity. The click stimuli at an intensity 100 dB SPL was given to the stimulated ear (ipsilateral) and masking sound (white noise) of 60 dB SPL to non-stimulated, contralateral ear through the headphone. Stimulus duration was 0.1 milliseconds. Responses to 2000 click stimuli were averaged for 10 milliseconds.

2) Filter- Low and High band pass filter was set at 100 Hz and at 3000 Hz respectively.

3) Impedance - The electrode impedance was kept below 5 kΩ The signals picked up by these electrodes were filtered, averaged, amplified and displayed on the computer monitor. Two trials of recording were done and wave forms were super imposed to check for reproducibility. Parameter studied: BAEP waveforms from each ear with absolute latencies of I, II, III, IV, V waves and Inter peak latencies (IPLs) of I-III, III-V, I-V were considered for comparison among COPD patients and controls.

Statistical analysis:
The results were expressed as mean and standard deviation for each variable, separately for right and left side. Unpaired (independent) t-test was used for intergroup comparisons in the healthy volunteers group and the COPD group, p-value of 0.05 or less has been considered as statistically significant. Correlation between disease duration, smoking pack years and FEV1 % predicted with BAEP and VEP parameters were done. All statistical analyses were carried out with the help of SPSS version 20.0 software.

DISCUSSION
In the present study, mean age group of COPD patients was 52.92 ± 3.93 years with disease duration of 10.82 ± 2.89. All were smokers with smoking pack year index 31.04 ± 6.6. On spirometric findings, all COPD patients were having post-bronchodilator FEV1 /FVC ratio less than 0.7, a GOLD diagnostic criteria of COPD. COPD patients were having moderate to severe airflow obstruction (grade 2 and 3) as per GOLD gradation of severity of airflow limitation with mean post-bronchodilator FEV1 % predicted value 47.73 ± 8.13. There were no clinical signs and symptoms of peripheral neuropathy in study group. Correlation of patient’s characteristics with BAEP and VEP parameters was given in table no. 1-5. Present study found that there was non-significant correlation between disease duration and BAEP parameters while there was significant correlation of BAEP parameters with smoking pack years and severity of airflow obstruction. Similar findings are present in some studies Vijay Kumar et al (27) (1996), Hafez et al (28) (2009), NesrienShalabietal(29) (2012). Vijay Kumar(27) (1996) studied BAEP in tobacco smokers and found latency of wave I and wave III were significantly prolonged. They concluded that abnormal BAEP findings were due to nicotine and toluene of smoke. Hafez et al(28) (2009) found positive correlation of BAEP & VEP with disease duration, smoking pack years & PaCO2 . Their study showed negative correlation with spirometric indices. NesrienShalabi(29) (2012) found latencies of wave I,III,V of BAEP had significant negative correlation with FEV1 , FEV1 / FVC and these latencies were positively correlated with smoking index. Gupta et al (30) (2008) in their study found 65% of COPD patients had abnormalities in one or more BAEP variables. They hypothesized that the abnormal BAEP findings are due to brainstem hypoxia which increases with the severity of COPD. As COPD patients in their study were heavy smokers, they had given the possibility of the contents of cigarette smoke leading to BAEP abnormalities. In addition to chronic hypoxemia and hypercapnia, other associated factors in patients with COPD, including tobacco smoking; malnutrition; and drugs used in COPD treatment, may be possibly associated with neuropathy seen in COPD patients.

CONCLUSION
The progressive chronic hypoxemia leads to development of tissue hypoxia and decreases the cerebral perfusion; also it slows the nerve conduction in auditory pathways which causes prolongation of latency. The contents of tobacco smoke in addition to hypoxemia lead to hypoxia. Therefore smoking pack years and decreased FEV1% predicted value definitely have impact on BAEP.

ACKNOWLEDGEMENT
Authors acknowledge the immense help received from the scholars whose articles are cited and included in the references of this manuscript. 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. Global Initiative for Chronic Obstructive Lung Disease - Global Strategy forthe Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. Updated 2014. P 1-11. available from http.//www.goldcopd.org.

2. DM Mannino. Epidemiology and Evaluation of COPD. Hospital Physician 2001;p 22-31.

3. Edwin K, Siverman, Frank E. Speizer. Risk factors for the development of chronic obstructive pulmonary disease. Medical clinics of North America. 1996; 80 (3): 501-22.

4. Laniado-Laborín R. Smoking and chronic obstructive pulmonary disease (COPD).Parallel epidemics of the 21 century. Int J Environ Res Public Health. 2009Jan;6(1):209-24.

5. Decramer M, Janssens W, Miravitlles M. Chronic obstructive pulmonary disease. Lancet. 2012; 379 (9823):1341-51.

6. Maarten Fischer, Margreet Scharloo, John Weinman, Ad Kaptein. Illness perceptions and treatment beliefs in pulmonary rehabilitation for patients with COPD, Chapter 2 Respiratory rehabilitation. Psychological management of physical disabilities: A practitioner’s guide. London: Brunner Routledge; 2007. pp. 124-48 available from URL: https://openaccess.leidenuniv.nl

7. Devereux G. ABC of chronic obstructive pulmonary disease. Definition, epidemiology and risk factors. BMJ. 2006;332(7550):1142-4.

8. Rennard, Stephen. Clinical management of chronic obstructive pulmonary disease.2013;2ndedition.New York: Informa Healthcare. p 23.

9. Goldman, Lee. Goldman’s Cecil medicine. 2012; 24th ed. Philadelphia: Elsevier/Saunders. p. 537.

10. Kennedy SM, Chambers R, Du W, Dimich-Ward H. Environmental and occupational exposures: do they affect chronic obstructive pulmonary disease differently in women and men? Proc Am Thorac Soc. 2007 Dec;4(8):692-4.

11. Kant S, Gupta B. Role of lifestyle in the development of chronic obstructive pulmonary disease: a review. Lung India. 2008 Apr;25(2):95- 101.

12. Stoller J K, Aboussouan L S. Alpha 1-antitrypsin deficiency. Lancet 2005;365:2225-36.

13. National Heart, Lung and Blood Institute. National Institute of Health. How Is COPD Diagnosed? p 3. Available from http:// www.nhlbi.nih.gov/Health/Health-topics/copd/

14. Hanania NA, Mullerova H, Locantore NW et al. Determinants of depression in the ECLIPSE chronic obstructive pulmonary disease cohort. Am J RespirCrit Care Med 2011; 183:604-11.

15. Weitzenblum E, Chaouat A. Corpulmonale. Chron respire Dis. 2009; 6(3):177-85.

16. Curkendall SM, Lanes S, de Luise C stang MR, et al. Chronic obstructive pulmonary disease severity and cardiovascular outcomes. Eur J Epidemiol. 2006; 21: 803-13.

17. Agusti A, Faner R. Systemic inflammation and comorbidities in chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2012; 9(2): 43-6.

18. Pepys MB, Hirschfield GM. C-reactive protein: a critical update. J Clin Invest 2003; 111 (12): 1805-12.

19. G.L. Snider. Understanding of inflammation in chronic obstructive pulmonary disease: the process begins. Am J Respir Crit Care Med. 2003; 163: 1045-46.

20. Pfeifer G, Knuze K, Bruch M, et al. Polyneuropathy associated with chronic hypoxemia: Prevalence in patients with chronic obstructive pulmonary disease. J Neurol. 1990; 237: 230-3.

21. Fowler B, Banner J, Pogue J. The slowing of visual processing by hypoxia. Ergonomics 1993; 36: 727-35.

22. Deecke L, Goode RC, Whitehead G et al. Hearing under respiratory stress: latency changes of the human auditory evoked response during hyperventilation, hypoxia, asphyxia and hypercapnia. Aerosp Med 1973; 44: 1106-11.

23. Mishra UK, Kalita J. Brainstem Auditory Evoked Potential. Clinical Neurophysiology. 2nd ed. Chapter 9.Churchill Livingstone, Elsevier. p 329-46.

24. Charles W Cummings. Otolaryngology Head and Neck Surgery. Volume 5, 4th ed. Elsevier Mosby. 2009; 3470-97.

25. Koul PA. Chronic obstructive pulmonary disease: Indian guidelines and the road ahead. Lung India 2013; 30:175-177.

26. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. American Thoracic Society. Am J Respir Crit Care Med. 1995; 152 (5 Pt 2):S77-121.

27. Vijay Kumar, O. P. Tondon. Brainstem auditory evoked potentials (BAEPs) in tobacco smokers. Indian J Physiol Pharmacol. 1996; 40(4): 381-4.

28. Hafez M R, Maabady M H, Aboelkheir O I, Elsheikh R M. Chronic obstructive pulmonary disease and its relation to impairment of visual and brainstem auditory evoked potentials. AAMJ. 2009; 7:3.

29. Nesrien Shalabi, Mohamed Abdel El-Salam, Fatma Abbas. Brain-stem auditory evoked responses in COPD patients. Egyptian Journal of Chest Diseases and Tuberculosis. 2012; 61: 313- 21.

30. Gupta PP, Sood S, Atreja A, Agarwal D. Evaluation of brain stem auditory evoked potentials in stable patients with chronic obstructive pulmonary disease. Ann Thorac Med. 2008;3(4):128- 34.

Announcements

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

COPE guidelines for Reviewers

SCOPUS indexing: 2014, 2019 to 2021

Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award:

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

Women Researcher Award:

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

Emerging Researcher Award:

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

Best Article Award

A study by Dorothy Ebere Adimora et al. entitled \"Remediation for Effects of Domestic Violence on Psychological well-being, Depression and Suicide among Women During COVID-19 Pandemic: A Cross-cultural Study of Nigeria and Spain\" is awarded Best Article of Vol 14 issue 23

A study by Muhas C. et al. entitled \"Study on Knowledge & Awareness About Pharmacovigilance Among Pharmacists in South India\" is awarded Best article for Vol 14 issue 22

A study by Saurabh Suvidha entitled \"A Case of Mucoid Degeneration of Uterine Fibroid with Hydrosalphinx and Ovarian Cyst\" is awarded Best article of Vol 14 issue 21

A study by Alice Alice entitled \"Strengthening of Human Milk Banking across South Asian Countries: A Next Step Forward\" is awarded Best article of Vol 14 issue 20

A study by Sathyanarayanan AR et al. entitled \"The on-task Attention of Individuals with Autism Spectrum Disorder-An Eye Tracker Study Using Auticare\" is awarded Best article of Vol 14 issue 19

A study by Gupta P. et al. entitled \"A Short Review on \"A Novel Approach in Fast Dissolving Film & their Evaluation Studies\" is awarded Best Article of Vol 14 issue 18.

A study by Shafaque M. et al. entitled \"A Case-Control Study Performed in Karachi on Inflammatory Markers by Ciprofloxacin and CoAmoxicillin in Patients with Chronic Suppurative Otitis Media\" is awarded Best Article of Vol 14 issue 17

A study by Ali Nawaz et al. entitled \"A Comparative Study of Tubeless versus Standard Percutaneous Nephrolithotomy (PCNL) \? A Randomized Controlled Study\" is awarded Best Article for Vol 14 issue 16.

A study by Singh R. et al. entitled \"A Prospective Study to Find the Association of Astigmatism in Patients of Vernal Keratoconjunctivitis (VKC) in a Tertiary Health Care Centre in India (Vindhya Region MP)\" is awarded Best Article for Vol 14 issue 15

A Study by Humaira Tahir et al. entitled "Comparison of First Analgesic Demand after Major Surgeries of Obstetrics and Gynecology between Pre-Emptive Versus Intra-Operative Groups by Using Intravenous Paracetamol: A Cross-Sectional Study" is awarded Best Article for Vol 14 issue 14

A Study by Monica K. entitled "Risk Predictors for Lymphoma Development in Sjogren Syndrome - A Systematic Review" is awarded Best Article for Vol 14 issue 13

A Study by Mokhtar M Sh et al. entitled "Prevalence of Hospital Mortality of Critically Ill Elderly Patients" is awarded Best Article for Vol 14 issue 12

A Study by Vidya S. Bhat et al. entitled "Effect of an Indigenous Cleanser on the Microbial Biofilm on Acrylic Denture Base - A Pilot Study" is awarded Best Article for Vol 14 issue 11

A Study by Pandya S. et al. entitled "Acute and 28-Day Repeated Dose Subacute Toxicological Evaluation of Coroprotect Tablet in Rodents" is awarded Best Article for Vol 14 issue 10

A Study by Muhammad Zaki et al. entitled "Effect of Hemoglobin Level on the Severity of Acute Bronchiolitis in Children: A Case-Control Study" is awarded Best Article for Vol 14 issue 09

A Study by Vinita S & Ayushi S entitled "Role of Colour Doppler and Transvaginal Sonography for diagnosis of endometrial pathology in women presenting with Abnormal Uterine Bleeding" is awarded Best Article for Vol 14 issue 08

A Study by Prabhu A et al. entitled "Awareness of Common Eye Conditions among the ASHA (Accredited Social Health Activist) Workers in the Rural Communities of Udupi District- A Pilot Study" is awarded Best Article for Vol 14 issue 07

A Study by Divya MP et al. entitled "Non-Echoplanar Diffusion-Weighted Imaging and 3D Fiesta Magnetic Resonance Imaging Sequences with High Resolution Computed Tomography Temporal Bone in Assessment and Predicting the Outcome of Chronic Suppurative Otitis Media with Cholesteatoma" is awarded Best Article for Vol 14 issue 06

A Study by Zahoor Illahi Soomro et al. entitled "Functional Outcomes of Fracture Distal Radius after Fixation with Two Different Plates: A Retrospective Comparative Study" is awarded Best Article for Vol 14 issue 05

A Study by Ajai KG & Athira KN entitled "Patients’ Gratification Towards Service Delivery Among Government Hospitals with Particular Orientation Towards Primary Health Centres" is awarded Best Article for Vol 14 issue 04

A Study by Mbungu Mulaila AP et al. entitled "Ovarian Pregnancy in Kindu City, D.R. Congo - A Case Report" is awarded Best Article for Vol 14 issue 03

A Study by Maryam MJ et al. entitled "Evaluation Serum Chemerin and Visfatin Levels with Rheumatoid Arthritis: Possible Diagnostic Biomarkers" is awarded Best Article for Vol 14 issue 02

A Study by Shanthan KR et al. entitled "Comparison of Ultrasound Guided Versus Nerve Stimulator Guided Technique of Supraclavicular Brachial Plexus Block in Patients Undergoing Upper Limb Surgeries" is awarded Best Article for Vol 14 issue 01

A Study by Amol Sanap et al. entitled "The Outcome of Coxofemoral Bypass Using Cemented Bipolar Hemiarthroplasty in the Treatment of Unstable Intertrochanteric Fracture of Femur in a Rural Setup" is awarded Best Article Award of Vol 13 issue 24

A Study by Manoj KP et al. entitled "A Randomized Comparative Clinical Trial to Know the Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block Against Multimodal Analgesia for Postoperative Analgesia Following Caesarean Section" is awarded Best Article Award of Vol 13 issue 23

A Study by Karimova II et al. entitled "Changes in the Activity of Intestinal Carbohydrases in Alloxan-Induced Diabetic Rats and Their Correction with Prenalon" is awarded Best Article of Vol 13 issue 22

A Study by Ashish B Roge et al. entitled "Development, Validation of RP-HPLC Method and GC MS Analysis of Desloratadine HCL and It’s Degradation Products" is awarded Best Article of Vol 13 issue 21

A Study by Isha Gaurav et al. entitled "Association of ABO Blood Group with Oral Cancer and Precancer – A Case-control Study" is awarded Best Article for Vol 13 issue 20

A Study by Amr Y. Zakaria et al. entitled "Single Nucleotide Polymorphisms of ATP-Binding Cassette Gene(ABCC3 rs4793665) affect High Dose Methotrexate-Induced Nephrotoxicity in Children with Osteosarcoma" is awarded Best Article for Vol 13 issue 19

A Study by Kholis Ernawati et al. entitled "The Utilization of Mobile-Based Information Technology in the Management of Dengue Fever in the Community Year 2019-2020: Systematic Review" is awarded Best Article for Vol 13 issue 18

A Study by Bhat Asifa et al. entitled "Efficacy of Modified Carbapenem Inactivation Method for Carbapenemase Detection and Comparative Evaluation with Polymerase Chain Reaction for the Identification of Carbapenemase Producing Klebsiella pneumonia Isolates" is awarded Best Article for Vol 13 issue 17

A Study by Gupta R. et al. entitled "A Clinical Study of Paediatric Tracheostomy: Our Experience in a Tertiary Care Hospital in North India" is awarded Best Article for Vol 13 issue 16

A Study by Chandran Anand et al. entitled "A Prospective Study on Assessment of Quality of Life of Patients Receiving Sorafenib for Hepatocellular Carcinoma" is awarded Best article for Vol 13 issue 15

A Study by Rosa PS et al. entitled "Emotional State Due to the Covid – 19 Pandemic in People Residing in a Vulnerable Area in North Lima" is awarded Best Article for Vol 13 issue 14

A Study by Suvarna Sunder J et al. entitled "Endodontic Revascularization of Necrotic Permanent Anterior Tooth with Platelet Rich Fibrin, Platelet Rich Plasma, and Blood Clot - A Comparative Study" is awarded Best Article for Vol 13 issue 13

A Study by Mona Isam Eldin Osman et al. entitled "Psychological Impact and Risk Factors of Sexual Abuse on Sudanese Children in Khartoum State" is awarded Best Article for Vol 13 issue 12

A Study by Khaw Ming Sheng & Sathiapriya Ramiah entitled "Web Based Suicide Prevention Application for Patients Suffering from Depression" is awarded Best Article for Vol 13 issue 11

A Study by Purushottam S. G. et al. entitled "Development of Fenofibrate Solid Dispersions for the Plausible Aqueous Solubility Augmentation of this BCS Class-II Drug" is awarded Best article for Vol 13 issue 10

A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09

A Study by Mardhiah Kamaruddin et al. entitled "The Pattern of Creatinine Clearance in Gestational and Chronic Hypertension Women from the Third Trimester to 12 Weeks Postpartum" is awarded Best Article for Vol 13 issue 08

A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07

A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness

A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health

A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06

A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia

A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05

A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04

A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03

A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02

A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01

A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24

A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23

A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22

A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21

A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20

A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19

A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18

A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17

A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16

A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15

A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020

A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"

A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13

A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for Vol 12 issue 12

A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for Vol 12 issue 11

A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for Vol 12 issue 10

A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for Vol 12 issue 09

A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for Vol 12 issue 08

A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for Vol 12 issue 07

A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20

A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR

A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13

A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR

A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR.

A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award

A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award

RSS feed

IJCRR

CORRELATION OF DISEASE DURATION, SMOKING PACK YEARS AND FEV1% PREDICTED WITH BAEP PARAMETERS IN PATIENTS OF COPD

RSS feed

ABOUT US

Useful links

Useful links

Contact