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IJCRR - 13(8), April, 2021

Pages: 171-177

Date of Publication: 25-Apr-2021


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Advances in the Study of Kaposi's Sarcoma in Human

Author: Mohammad Salim

Category: Healthcare

Abstract:Kaposi sarcoma (KS) is a kind of cancer that is widespread all over the world. This is for the first time discovered by Hungarian physician and dermatologist Moritz Kaposi in 1872 as a skin tumor. The name Kaposi sarcoma was coined to honour of the discoverer. Kaposi sarcoma is caused by the Kaposi sarcoma herpesvirus (KSHV). This is soft tissue cancer of blood vessels and lymphatic system developing purplish-red coloured lesions mostly in mouth, face, nose, genitals, and the lower extremities. The KSHV is easily transmitted either sexually or via the act of parturition vertically. There are 4 types of Kaposi's sarcoma distributed globally such as chronic or European, endemic or African, transplant-associated or iatrogenic and AIDS-related or epidemic. Italians using topical steroids are more prone to have this type of cancer. The KSHV has been isolated in almost all cases of Kaposi's sarcoma cancer. KS is composed of spindle shaped cells and inflammatory mononuclear cells. These cells grow faster and survive for a longer period of time. The various stages of Kaposi's sarcoma are maculonodular stage, infiltrative stage, florid stage and disseminated stage. The KSHV has also been found to be associated with two other lymphoproliferative diseases such as primary effusion lymphoma (PEL) and multicentric Castleman's diseases. Kaposi's sarcoma is an outcome of viral infection. As this is not a curable disease, it can often be treated for many years. And, public awareness about KS can only save the lives properly. However, currently, the drug used to treat Kaposi's sarcoma are thalidomide, bevacizumab, and sirolimus.

Keywords: Human Herpes Virus-8, Kaposi Sarcoma, Cancer

Full Text:

INTRODUCTION

Moritz Kaposi was a Hungarian physician and dermatologist who described a kind of skin tumor initially in 1872 that received his name later as Kaposi sarcoma (KS).1 In fact, it was Sternberg who gave the name as Kaposi sarcoma in 1912.2 But, it took nearly more than 100 years we discovered the causal organism of Kaposi’s sarcoma as HHV-8 in 1994.3 This is a kind of indolent angioproliferative spindle cell tumor cancer developed from endothelial and immune cells under the skin and soft tissues caused by the human herpes virus-8 or Kaposi’s sarcoma herpesvirus (KSHV).3-5 KS is a multicentric vascular tumor of mesenchymal origin derived due to the hyperplasia affecting the blood vessels developing on soft tissues in multiple areas of the entire body at once.6-10

Further, as the Kaposi's sarcoma herpesvirus (KSHV) is easily transmitted either sexually via blood and saliva or vertically through parturition, the act of childbirth from mother to her baby;11-17 it may lie dormant or replicated to cause cancer in human. This has usually been observed that the persons who are immunocompetent can carry the load of KSHV without any problem, but it triggers the Kaposi's sarcoma in immunocompromised individuals. This is most commonly developed in either immunodeficient or the patients kept under immunosuppressant medications.18,19 The present review on Kaposi’s sarcoma is prepared in the light of recent researches done so far in the field of viral origin of cancer. In the present review, clinical presentation, histopathology, stages and the types of Kaposi’s sarcoma with the treatment of the same disease have been discussed as under :

Clinical Presentation

Clinically, there are four types of Kaposi's sarcoma developed in human as chronic or European, endemic or African, transplant-associated or iatrogenic and AIDS-related or epidemic Kaposi's sarcoma.20,21 The diagnosis of Kaposi’s sarcoma is based on the visual inspections of characteristically colored, cutaneous, non-itchy, painless and even non dangerous spots appeared on skin. These spots are red or purple on white skin and blue brown or black on dark skin. These lesions are found on face including nose, around the eyes, ears and lips; oral cavity including gingiva, palate, tongue and buccal mucosa and the lower extremities or lower limbs. Early on, these lesions are usually painless but when bleed or ulcerated over time become painful. Most specifically the lesions present in the areas of legs or groin may cause the feet to swell moving very painfully.19-23

Further, these lesions are also found on some internal organs, especially on the lungs and the gastrointestinal tract. If the virus infects the lungs, it often quickly gets worse, causing respiratory failure and death.22 Similarly, the infection taking place in digestive system shows no symptoms at all except the pain in the stomach until it becomes very advanced. In an advanced stage, intestinal obstruction, bleeding and bloody stool may come out during defecation. But, despite all these complications, a patient suffering from gastrointestinal Kaposi sarcoma looks like as normal as was being before 5 years of infections. It means that even after 5 years of diagnosis a person with KSHV looks like a normal average person. And, it all happens due to the differential medications provided to the patient that often responding well in time.23-25

In addition, the patients suffering from Kaposi’s sarcoma may also show some associated symptoms such as swollen lymph nodes, cough, fever, fatigue, loss of appetite, weight loss, edema in foot, nausea, painful stomach, and vomiting. Similarly, the KS life-threatening conditions may also occur as difficult swallowing, intolerable belly pain with bloody defecation, intestinal blockage, severe swelling in upper and lower limbs, face or scrotum, severe coughing and the shortness of breath.24

Sometimes, the lesion of KS also arises as a systemic inflammatory condition due to the physical stimuli precisely at the site of trauma such as injury, surgical or other wounds is characteristically known as koebner’s phenomenon. The etiopathology of this phenomenon is not yet known. Although, this is a rare phenomenon in connection with KS; the koebnerization has also been documented in several other skin diseases, including vitiligo, psoriasis, lichen planus, and viral warts.25 

Histopathology of the Disease 

The histopathology of Kaposi’s sarcoma shows red cells in slit like spaces formed by atypical spindle cell proliferation of endothelial and associated inflammatory cells. These cells grow faster and survive for a longer period of time. The KSHV has been isolated in almost all the cases of Kaposi’s sarcoma cancer.5,26,27 The KSHV proteins in cancer cells and Periodic-acid-Shiff (PAS) reagent positive hyaline bodies are also seen in the cytoplasm.9,28

Stages of Kaposi’s sarcoma

Depending upon whether the Kaposi’s sarcoma is localized, external, internal, or immunosuppressed, there have been various attempts to classify the stages of Kaposi's sarcoma.26,29,30-32 On the basis of lesions in lymph nodes, the stages of disease distribution and the clinical pace of progression, the Kaposi’s sarcoma is further diagnosed histologically as under:

Stage I  Maculonodular stage

Small macules and nodules are confined to appear only on the lower extremities.

Stage II  Infiltrative stage

The plaques are formed on the same lower extremities. Sometimes, they are still associated with small nodules.

Stage III  Florid Stage

Often ulcerated angiomatous multiple plaques and nodules are found.

Stage IV  Disseminated Stage 

Multiple angiomatous nodules and plaques extending beyond the lower extremities.

Types of Kaposi’s sarcoma

Epidemiologically, the Kaposi’s sarcoma can primarily be categorized into four types ranging from minimal mucocutaneous lesions to extensive organ involvement. The different types of KS are based on different populations it captured in, but changes within the KS Cells are more or less similar20. They are of four types given as under:

  1. Sporadic, classic (Mediterranean), European, chronic type of Kaposi’s sarcoma.

  2. Endemic, African Lymphadenopathic type of Kaposi’s sarcoma.

  3. Transplant associated (Iatrogenic) Immunocompromised Kaposi's sarcoma.

  4. Epidemic, AIDS related Acquired Immuno deficient Kaposi’s sarcoma.33-38

Sporadic, classic (Mediterranean), European, chronic type of Kaposi’s sarcoma   

This type of KS is primarily occurred in the eastern European population, Ascanajee Jews and Mediterranean descent.39-42 Elderly men with weak immunity between 50 to 70 years of age are more affected than female.37 Chronic Kaposi’s sarcoma usually has silent, protracted or indolent course and is usually limited to the skin. It slowly progresses over many years and often is not the cause of death. As this is non-aggressive and slow growing KS, the lesions do not grow as quickly, and new lesions do not develop as often. They have solitary, one or more lesions on legs ankles or soles48. Italians using topical steroids are more prone to have this type of cancer.34 Skin lesions are mostly found on the distal lower extremities or lower limbs. This form of disease rarely has lymph node, mucous membrane or visceral involvement. Oral mucosa is sometimes affected. In addition, the visceral lesions are usually asymptomatic and discovered only by autopsy. Clinically, gastrointestinal bleeding may occur. Approximately, one third of same KS patients may also develop another malignancy in future as non-Hodgkin lymphoma.43-47

Endemic, African, Lymphadenopathic type of Kaposi’s sarcoma

This is an endemic African type of Kaposi's sarcoma mainly found in males under the age of 40, mostly in countries of Malawi, Uganda, Swaziland, Zambia and Zimbabwe.49 Quite a good number of children of both sexes (approximately 70%) before attaining the age of puberty have also been reported to develop the KS with absolute mortality within three years. It has also been observed that in all these cases, only visceral nodes were affected. The cutaneous lesions were all absent in children but may appear in adults. The malaria and malnutrition prevalent in the region have also been reported to play some role in developing the KS as it weakens the children’s immunity severely.50-55

 

Transplant associated (Iatrogenic), Immunocompromised Kaposi’s sarcoma

Kaposi’s sarcoma is also developed in those who have undergone solid organ transplantation receiving immunosuppressive therapy like the excessive use of cyclosporin A medication.55,56 It usually develops within two years of organ transplantation. This is an aggressive type of cancer affecting the lower distal extremities, visceral organs, and lymph nodes. However, the individuals born with congenital immunodeficiency are not at the elevated risk of developing Kaposi’s sarcoma.57-60 Recently, a new drug named sirolimus has given rather better results acting as antitumor and immunosuppressant both at a time.45 As this kind of KS affects the people who have had undergone organ transplantation taking immunosuppressive drugs to slow down their immune system, this is now being observed that lowering the dose of immunodrugs makes the KS lesions either go away or get smaller. The greater the immunosuppression, the more extensive and aggressive KS will be.46-48

Epidemic, AIDS-related Acquired Immunodeficient Kaposi’s sarcoma

Another type of Kaposi's sarcoma is a type of cancer that people with AIDS often get. Here KS is an AIDS defining condition. It means that an HIV positive person suffering from KS is definitely has progressed to AIDS. But, on the other hand, a person having been suffering from KS may not be suffering from AIDS. KS can also develop in an otherwise healthy person as well.49 This is clinically most aggressive and common opportunistic malignancy in HIV patients worldwide, occurring mostly in Africa and the USA. In the 1980s, AIDS related KS was very common in the USA. Similarly, this has also been one of the most common cancers in Uganda and Zambia, especially in children. The risk groups are gay and heterosexual men and women. But, it remains prevalent amongst men who have sex with men.19,50-52 All of them were HIV positive. But, now a very different type of Kaposi’s sarcoma has also been developing in male homosexuals who are HIV negative.

Since the KSHV is an oncogenic virus, the AIDS related KS has gained much attention due to its abnormal pathogenicity in human. It has been observed that at least three genes are responsible for the cause of KS in AIDS patient. They are named as ORF71, ORF72, and ORF73. With both localized and disseminated cutaneous involvement, the AIDS related KS often initially involves the lymph nodes, which is later on disseminated to various parts of the viscera. Generally, the pulmonary and gastrointestinal mucocutaneous lymph nodes are involved.22,23 Oral Kaposi’s sarcoma in acquired immunodeficiency syndrome have also been reported.57 In the early 1980s, KS was one of the most frequent malignancies reported in AIDS patient before the introduction of antiretroviral therapies.25 Further, in United States, treating the HIV patients with highly active antiretroviral therapy (HAART) has resulted in the fewer cases of AIDS associated KS but in rest parts of the world where HAART services are not easy to provide, KS in AIDS patients have advanced quickly.58 Kaposi’s sarcoma has rarely been reported from India. The first case of AIDS related KS from India was reported in 1993, and since then only 16 cases have been reported.59-61

Treatment of the Disease

Unfortunately, there is nothing available at present as treatment to kill the KSHV absolutely, instead of only alleviating the symptoms to slow down the disease progression. Similarly, there is no any routine method for identifying the KS in an individual except the antibody test.62-65 Nowadays, KS diagnosis in lesion specimens usually requires not only histological and immunohistochemical characterization but also HHV-8 detection using new molecular biology.25 Similarly, an oncologist and cancer expert can only identify the lesions present on the body. This is also quite unfortunate for us that sometimes a patient himself do not require any treatment as initially the lesions are otherwise painless. One of the oldest drugs to treat the lesions of Kaposi sarcoma is thalidomide. The drug has helped in shrinking the lesions of KS.66 But, as the drug has got some serious side effects, the other drugs like lenalidomide and pomalidomide are being studied for the same purposes.67-69 Angiogenesis inhibitors blocking the growth of blood vessels within tumors may also treat the lesions of KS. The drug named bevacizumab is one of them20. The other drugs like sirolimus and everolimus are being studied further.67-70

Further, the treatment options are more or less found similar to those recommended for other types of cancer such as surgical excision70, radiation71, chemotherapy72, electrochemotherapy to use electric impulse in injecting the chemo drugs into tumors effectively73,74 such as vincristin75,76 vinblastin77, Vincaleucoblastin78, bleomycin76 and doxorubicin.76 Other treatment modalities are cutaneous cryosurgery79, cryotherapy in which the lesions are freezed using liquid nitrogen80, use of cytokine inhibitors68, immunotherapy including interferon, antiviral medications including Zidovudine, ganciclovir, Valganciclovir, cidofovir, and the topical application of alitretinoin gel (Panretin).80-85

In addition, it has also been observed that some specific drugs commonly used for cancers are also being studied for use against Kaposi’s sarcoma such as paclitaxel86, docetaxel87 and imatinib.88 Similarly, antiretroviral therapy has also been found to be the best way to treat the Kaposi’s sarcoma. It has not only even clear up the skin lesions but to have lowered the cases simultaneously.89-91  While infection of KSHV in human is estimated to account for nearly >44000 new cancer cases and 20,000 deaths globally every year, their efforts to develop vaccines are limited.92-95  

Since Kaposi sarcoma is not a curable disease, it could be treated to a limited extent to control the symptoms. The choice of treatment modalities depends upon the extent of the disease. Though it often progresses slowly, KS can ultimately be fatal. One should always seek treatment for KS. Further, as the indolent KS appears usually in older people taking many years to develop and grow, many people die of some other parainfections before their KS becomes serious enough to be fatal. Similarly, as the AIDS related KS is now treatable and not a cause of death by itself, we should nothing more to worry about it except to be alert in the future.92-95

PERSPECTIVES

Kaposi sarcoma is a rare, slow growing tumor cancer that develops underneath the skin with reddish-purple or blue-brown in colour lesions. These lesions are mainly found on the face, nose, legs, and around the anus. Some internal organs, especially the lungs and gastrointestinal tract are also affected. The gastrointestinal tract lesions are typically symptomless. Rarely, they may lead to bloody stools, pain, diarrhea or physical obstruction. But, the lung infection usually causes breathlessness due to blockage. A lung bleeding lesion may leak blood with mucus, which the individual then coughs up.96,97,98

Kaposi's sarcoma herpesvirus (KSHV) has been isolated in nearly all patients tumor suffering from the same cancer. This is spindle cell tumor thought to be derived from endothelial cell lineage. It arises as a cancer of lymphatic endothelium in vascular channels which are filled with blood cells giving the tumor its characteristic bruise - like appearance. The highly vascular network of KS tumor leaked R.B.C. in the surrounding tissues causing the tumor black in colour developing the inflammation and pain in the lesions.99-102

Further, there are four types of Kaposi sarcoma that have so far been described in literature they are European or classic, endemic or African, transplant-associated and AIDS-related. Generally, it has been observed that Kaposi's sarcoma is more linked to either immunocompromised patients infected with AIDS or had undergone organ transplantation taking immunosuppressive medications. The HHV-8 virus has also been found to be involved in producing some rare cancer like a blood cancer known as primary effusion lymphoma and multicentric Castleman disease.99-100 This is a sexually transmitted virus but can also be spread by some other ways also as direct contact through blood and saliva. Since, all forms of KS are manifested in the oral cavity; the KSHV is more easily being transmitted via saliva as well.16,17

Conclusion

Cancer is an outcome of viral infection. It starts as a chronic inflammation (Kapositis) which ultimately produce Kaposi sarcoma. KS is a relatively large, linear double-stranded DNA tumor virus101 that transforms the cells in such a way that it multiplied indefinitely to live longer which eventually develops to form cancer, but it does not mean that all infected individuals will develop the cancer, appearing that some other factors are also required for it to develop.8,98 We opined, as the KS has a variable course and is not curable, it can possibly be treated and controlled symptomatically for a longer period of time. Finally, we should promote the public awareness using media for early detection and diagnosis of Kaposi's sarcoma, especially in Africa.102

Abbreviations

KSHV             -           Kaposi’s sarcoma herpes virus

AIDS               -           Acquired immune deficiency syndrome

KS                   -           Kaposi’s sarcoma

PEL                 -           Primary effusion lymphoma

MCD               -           Multicentric Castleman’s disease

HHV                -           Human herpesvirus

PAS                 -           Periodic-acid-Shiff reagent

HIV                 -           Human immunodeficiency virus

HAART          -           Highly active antiretroviral therapy

RBC                -           Red blood corpuscles

DNA               -           Deoxyribonucleic acid 

ACKNOWLEDGEMENTS: This piece of research work is dedicated to the memory of my maternal grandfather marhoom Hazi Mohammad Shakoor. The author acknowledges the help received from scholars whose articles are cited in references to this manuscript. The authors are also grateful to the institution concerned for providing us with necessary facilities during this research work.

Financial support: No Financial support was granted during the course of this research work.

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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


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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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