International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 2nd Wave of COVID-19: Role of Social Awareness, Health and Technology Sector, June, 2021

Pages: 67-70

Date of Publication: 11-Jun-2021


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Early Pulmonary Hypertension in COVID 19 Patient: A Case Report

Author: Nimkar SV, Dubey A, Talwar D, Kumar S

Category: Healthcare

Abstract:Introduction: This COVID 19 pandemic has altered the routine practices and the acute management of PAH patients. Patients with pre-existing PAH are very sensitive to the changes in their cardiopulmonary status. Objective: To study a case of early pulmonary hypertension in COVID 19. Case Report: A 45-year-old male presented with complaints of breathlessness at rest for 15 days which was gradually progressive. PCR was done and tested positive. The patient was treated for the same with negative PCR repeated report after 14 days and then again patient presented with the above complaints after 14 days of discharge. COVID-19 infection poses a bizarre threat to the vulnerable population with PAH. The inpatient needs have been increased during the pandemic. Observations: PAH patients had great difficulty in surviving the interventions which pose a significant cost during a pandemic that is stretching the health care system. So far, we have not seen many PAH patients with COVID-19 infections, and most of them have had favorable outcomes. This reflects the ability of these patients to isolate and quarantine themselves properly. Also, we are approaching having a successful treatment option or a vaccination for COVID-19 shortly. Conclusion: In the current report, PH was associated with clinical, imaging and laboratory findings of more severe post-COVID-19 and with no morbid outcomes. A final decision is yet to be made. We believe it is important to screen for COVID-19 infection in all patients.

Keywords: COVID 19, Pulmonary hypertension, 2d echo, Mortality, Pandemic

Full Text:

Introduction

Pulmonary hypertension (PH) is primary (idiopathic) or secondary to a variety of underlying conditions like pulmonary, cardiovascular or systemic conditions.1,2 A prolonged elevation of pulmonary arterial pressure to more than 25 mm Hg at rest or more than 30 mm Hg with exercise, with mean pulmonary-capillary wedge pressure and left ventricular end-diastolic pressure of less than 15 mm Hg, is known as pulmonary arterial hypertension.3 Histologically, the appearance of lung tissue is similar in each condition: intimal fibrosis, increased medial thickness, pulmonary arterial occlusion, and plexiform lesions predominate.4

The COVID-19 pandemic has exhibited many peculiar challenges when caring for patients with pulmonary hypertension (PH), particularly the patients with pre-existing pulmonary arterial hypertension (PAH), and chronic thromboembolic pulmonary hypertension (CTEPH). The presence of whether pre-existing PH or PH as a direct result of the lung injury that occurs post COVID-19 infection, or cardiomyopathy resulted from COVID-19 infection, or other comorbidity is likely to be a major contributor to the morbidity and mortality associated with COVID-19 infection.5,6

We report a case of a 45-year-old male with Bilateral Pleural Effusion with Mild ascites and Grade III Renal parenchymal disease (RPD) who had an asymptomatic course of COVID-19 infection who tested positive for infection by screening.

Case Presentation

A 45-year-old male presented with complaints of pedal oedema and distension of the abdomen for 6 days. He also had complaints of breathlessness at rest for 15 days which was gradually progressive.   14 days back   On the previous admission, due to the current COVID-19 pandemic and as per our local strategy to eliminate COVID-19 infection among the population nasopharyngeal swab to screen for COVID-19, PCR was done and tested positive. Patient treated for same and PCR report repeated after 14 days it was negative (JNMC/COV/10175/2020) patient was discharged and then again patient presented with above complaints after 14 days discharge. On general examination: Pulse: 90/min, BP: 100/70mmHg, Oxygen saturation on room air was 95%, respiratory rate: 24/min. On abdominal examination: Distended abdomen with free fluid present in the abdomen, shifting dullness present. On respiratory examination: Dull percussion note, reduced breath sounds in both lung bases with bronchial breathing over the left infra-scapular area.

Blood investigations revealed-CBC investigations on cell count with PS showed 9.4 g/dL Hb, 31.2 g/dl MCHC, 72.5 p MCV, and 22.6 pg MCH. Total RBC count was 4.16 million/mm3, 7800/ microlitre, and 2.49/microlitre of blood. Prothrombin Time of 12.5 seconds, APTT 30.20 seconds, INR: 1.28.CK-MB value 29 IU/L.  random blood sugar 151 mg/dL, Calcium: 6.g/dl,  KFT showed Urea: 45 mg/dl, Creatinine: 1.2 mg/dl, Serum sodium: 146 mmol/L, Serum potassium: 4.7 mmol/L, LFT showed Serum albumin: 3.9 g/dl,  alkaline phosphatase level was 55 IU/L. Albumin(3.9g/dL), Bilirubin conjugated(0.2 mg/dL), bilirubin unconjugated (0.7 mg/dL), globulin (3.8 g/dL), SGPT (50 U/L), SGOT (34 U/L), total protein (7.7 g/dL), and total bilirubin (0.9 mg/dL) Lipid profile showed total cholesterol of 170 mg/dL, triglycerides value was 102 mg/dL dHDL, LDL, and VLDL values of 57mg/dL, 93mg/dL, and 20 mg/dL.Arterial blood gas (ABG) test showed 7.4 pH, 36.3 mmHg PCO2, and 110 mmHg PO2. Hepatitis B/Hepatitis C/ HIV status of this patient was negative (Figure 1).

2D Echo showed dilated right atrium, tricuspid regurgitant velocity 3.2 m/sec, systolic pulmonary artery pressure 44mmhg, left ventricle (LV), hypokinetic Inferior wall(IW) and Anterior wall (AW). Motion mode (M.mode) of 2D echo showed LVIDD value of 5.5cm, LVIDS value of 4.5cm, IVs value is 10, posterior wall is 10, EF value is  30%, LA is 4.0cm. Dilated LV, severe pulmonary hypertension, mild AR, severe TR, Grade 3 diastolic dysfunction. IVC congested and non-collpsing (Figure 2).

A coronary angiography report showed mild coronary artery disease (CAD). HRCT scan of the thorax showed moderate pleural effusion on both sides with basal lung atelectasis with subsegmental collapse consolidation on the left basal lung. The severity score was 0/25 indicating no obvious abnormality in bilateral lung fields.

The treatment regime followed for the patient during his hospital stay was as given:

  • Injection Heparin 2500 IU

  • Injection NTG 100mcg

  • Injection Dilzem 5mg

The patient was discharged after treatment and waiting for follow up.

Discussion

Patients with pre-existing PAH are very sensitive to the changes in their cardiopulmonary status. Any interruption of care or the emergence of new cardiac or pulmonary pathology may result in death. In PAH, hospitalization is a risk factor for disease development. A newly available case series suggested that 86% of critically ill COVID-19-infected patients had heart failure and chronic kidney disease as the most common underlying medical conditions.7 PAH patients have shown to have worse outcomes with all-cause hospitalizations.5 One should always keep in mind that COVID-19 infection may lead to hypoxemia leading to hypoxic pulmonary vasoconstriction, which increases pulmonary vascular resistance (PVR) resulting in decompensation of a high-risk PAH patient.7 Keep oxygen saturation above 92%, continuing oral and parenteral therapies like phosphodiesterase-5 inhibitors (PDE5i), soluble guanylate cyclase stimulator (sGC), endothelin receptor antagonist (ERA), oral prostacyclin, oral prostaglandin I2 receptor agonist (PGI2) and intravenous or subcutaneous prostacyclins while treating with concurrent therapies for COVID-19 infection are recommended. As per institutional guidelines, continuing treatment with investigational therapies for COVID-19 infection along with the PAH treatment is also recommended.

COVID-19 infection poses a bizarre threat to the vulnerable population with PAH. PAH patients had great difficulty in surviving the interventions which posses a significant cost during a pandemic that is stretching the health care system. There is a shortage of ventilators during the COVID-19 pandemic, which poses even further concern for their utility in this population. A study done by Pagnesi et al. in 2020 stated that the prevalence of PH was 12.0%. Patients with PH were older and had a higher burden of pre-existing cardiac comorbidities and signs of more severe acute respiratory syndrome in COVID-19 infection.8

Lee and colleagues in their study found that the cumulative incidence of recognized COVID-19 was similar to the general population. However, outcomes were worse, with a 50% rate of hospitalization and a 12% mortality rate in patients with PAH and CTEPH affected by COVID-19. The fact that incidence was higher in higher prevalence states seems to validate the conclusion that the rate is probably similar to the general population.9 A small survey and other COVID-19 PAH/CTEPH series reported to date have suggested that COVID-19 has a relatively benign course in the setting of PAH and surprisingly favourable clinical outcomes.10-12

So far, we have not seen many PAH patients with COVID-19 infections, and most of them have had favourable outcomes. This reflects the ability of these patients to isolate and quarantine themselves properly. Also, we are approaching having a successful treatment option or a vaccination for COVID-19 shortly.

Conclusion

To our best knowledge, it is the first report of pulmonary hypertension in post-COVID 19 infections. We reported a smooth clinical course for COVID-19 infection in a male with Bilateral Pleural Effusion with Mild ascites and Grade III Renal parenchymal disease (RPD).  In the current report, PH was associated with clinical, imaging and laboratory findings of more severe post-COVID-19 and with no morbid outcomes. One of the worthiest questions to ask nowadays is whether those patients should be considered high risk for COVID 19 infection and its complications during this pandemic or not. A final decision is yet to be made. We believe it is important to screen for COVID-19 infection in all patients.

Acknowledgement: None

Conflict of Interest and Source of Funding: None

Author Contribution:

Nimkar SV: Manuscript Preparation, Data Collection

Dubey A: Manuscript editing

Talwar D: Pliagrism Removal

Kumar S: Final editing and preparation according to journal guidelines

References:

  1. Farber HW, Loscalzo J. Pulmonary arterial hypertension. N Engl J Med. 2004;351(16):1655-65.

  2. Wiltshire E, Peña AS, MacKenzie K, Shaw G, Couper J. High dose folic acid is a potential treatment for pulmonary hypertension, including when associated with COVID-19 pneumonia. Med Hypoth. 2020;143:110142.

  3. Simonneau G, Montani D, Celermajer DS, Denton CP, Gatzoulis MA, Krowka M, et al. Haemodynamic definitions and updated clinical classification of pulmonary hypertension. Eur Respiratory J. 2019;53(1):1801913.

  4. Rubin LJ. Primary pulmonary hypertension. N Engl J Med 1997;336:111-7.

  5. Ryan JJ, Melendres-Groves L, Zamanian RT, Oudiz RJ, Chakinala M, Rosenzweig EB, et al. Care of patients with pulmonary arterial hypertension during the coronavirus (COVID-19) pandemic. Pulm Circ. 2020;10(2):2045894020920153.

  6. Jain A, DhruvTalwar SK. Spectrum of Respiratory Involvement in COVID 19 Era: An Overview. Indian J Forensic Med Toxicol. 2020;14(4):6593.

  7. Sahay S, Farber HW. Management of hospitalized patients with pulmonary arterial hypertension and COVID-19 infection. Pulm Circ. 2020;10(3)1-5.

  8. Pagnesi M, Baldetti L, Beneduce A, Calvo F, Gramegna M, Pazzanese V, et al. Pulmonary hypertension and right ventricular involvement in hospitalised patients with COVID-19. Heart. 2020;106(17):1324-31.

  9. Lee JD, Burger CD, Delossantos GB, Grinnan D, Ralph DD, Rayner SG, et al. A survey-based estimate of COVID-19 incidence and outcomes among patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension and impact on the process of care. Ann Am Thorac Soc 2020;17:1576–82.

  10. Horn EM, Chakinala M, Oudiz R, Joseloff E, Rosenzweig EB. Could pulmonary arterial hypertension patients be at a lower risk from severe COVID-19? Pulm. Circ. 2020;10(2):1-2.

  11. Scuri P, Iacovoni A, Abete R, Cereda A, Grosu A, Senni M. An unexpected recovery of patients with pulmonary arterial hypertension and SARS-CoV-2 pneumonia: A case series. Pulm. Circ. 2020;10:204589402095658.

  12. Nuche J, Pérez-Olivares C, De La Cal TS, López-Guarch CJ, Ynsaurriaga FA, Escribano-Subías P. Clinical course of COVID-19 in pulmonary arterial hypertension patients. Rev Esp Cardiol. 2020;73:775–778.

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Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

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

Women Researcher Award:

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

Emerging Researcher Award:

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


Best Article Award

A Study by Humaira Tahir et al. entitled "Comparison of First Analgesic Demand after Major Surgeries of Obstetrics and Gynecology between Pre-Emptive Versus Intra-Operative Groups by Using Intravenous Paracetamol: A Cross-Sectional Study" is awarded Best Article for Vol 14 issue 14
A Study by Monica K. entitled "Risk Predictors for Lymphoma Development in Sjogren Syndrome - A Systematic Review" is awarded Best Article for Vol 14 issue 13
A Study by Mokhtar M Sh et al. entitled "Prevalence of Hospital Mortality of Critically Ill Elderly Patients" is awarded Best Article for Vol 14 issue 12
A Study by Vidya S. Bhat et al. entitled "Effect of an Indigenous Cleanser on the Microbial Biofilm on Acrylic Denture Base - A Pilot Study" is awarded Best Article for Vol 14 issue 11
A Study by Pandya S. et al. entitled "Acute and 28-Day Repeated Dose Subacute Toxicological Evaluation of Coroprotect Tablet in Rodents" is awarded Best Article for Vol 14 issue 10
A Study by Muhammad Zaki et al. entitled "Effect of Hemoglobin Level on the Severity of Acute Bronchiolitis in Children: A Case-Control Study" is awarded Best Article for Vol 14 issue 09
A Study by Vinita S & Ayushi S entitled "Role of Colour Doppler and Transvaginal Sonography for diagnosis of endometrial pathology in women presenting with Abnormal Uterine Bleeding" is awarded Best Article for Vol 14 issue 08
A Study by Prabhu A et al. entitled "Awareness of Common Eye Conditions among the ASHA (Accredited Social Health Activist) Workers in the Rural Communities of Udupi District- A Pilot Study" is awarded Best Article for Vol 14 issue 07
A Study by Divya MP et al. entitled "Non-Echoplanar Diffusion-Weighted Imaging and 3D Fiesta Magnetic Resonance Imaging Sequences with High Resolution Computed Tomography Temporal Bone in Assessment and Predicting the Outcome of Chronic Suppurative Otitis Media with Cholesteatoma" is awarded Best Article for Vol 14 issue 06
A Study by Zahoor Illahi Soomro et al. entitled "Functional Outcomes of Fracture Distal Radius after Fixation with Two Different Plates: A Retrospective Comparative Study" is awarded Best Article for Vol 14 issue 05
A Study by Ajai KG & Athira KN entitled "Patients’ Gratification Towards Service Delivery Among Government Hospitals with Particular Orientation Towards Primary Health Centres" is awarded Best Article for Vol 14 issue 04
A Study by Mbungu Mulaila AP et al. entitled "Ovarian Pregnancy in Kindu City, D.R. Congo - A Case Report" is awarded Best Article for Vol 14 issue 03
A Study by Maryam MJ et al. entitled "Evaluation Serum Chemerin and Visfatin Levels with Rheumatoid Arthritis: Possible Diagnostic Biomarkers" is awarded Best Article for Vol 14 issue 02
A Study by Shanthan KR et al. entitled "Comparison of Ultrasound Guided Versus Nerve Stimulator Guided Technique of Supraclavicular Brachial Plexus Block in Patients Undergoing Upper Limb Surgeries" is awarded Best Article for Vol 14 issue 01
A Study by Amol Sanap et al. entitled "The Outcome of Coxofemoral Bypass Using Cemented Bipolar Hemiarthroplasty in the Treatment of Unstable Intertrochanteric Fracture of Femur in a Rural Setup" is awarded Best Article Award of Vol 13 issue 24
A Study by Manoj KP et al. entitled "A Randomized Comparative Clinical Trial to Know the Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block Against Multimodal Analgesia for Postoperative Analgesia Following Caesarean Section" is awarded Best Article Award of Vol 13 issue 23
A Study by Karimova II et al. entitled "Changes in the Activity of Intestinal Carbohydrases in Alloxan-Induced Diabetic Rats and Their Correction with Prenalon" is awarded Best Article of Vol 13 issue 22
A Study by Ashish B Roge et al. entitled "Development, Validation of RP-HPLC Method and GC MS Analysis of Desloratadine HCL and It’s Degradation Products" is awarded Best Article of Vol 13 issue 21
A Study by Isha Gaurav et al. entitled "Association of ABO Blood Group with Oral Cancer and Precancer – A Case-control Study" is awarded Best Article for Vol 13 issue 20
A Study by Amr Y. Zakaria et al. entitled "Single Nucleotide Polymorphisms of ATP-Binding Cassette Gene(ABCC3 rs4793665) affect High Dose Methotrexate-Induced Nephrotoxicity in Children with Osteosarcoma" is awarded Best Article for Vol 13 issue 19
A Study by Kholis Ernawati et al. entitled "The Utilization of Mobile-Based Information Technology in the Management of Dengue Fever in the Community Year 2019-2020: Systematic Review" is awarded Best Article for Vol 13 issue 18
A Study by Bhat Asifa et al. entitled "Efficacy of Modified Carbapenem Inactivation Method for Carbapenemase Detection and Comparative Evaluation with Polymerase Chain Reaction for the Identification of Carbapenemase Producing Klebsiella pneumonia Isolates" is awarded Best Article for Vol 13 issue 17
A Study by Gupta R. et al. entitled "A Clinical Study of Paediatric Tracheostomy: Our Experience in a Tertiary Care Hospital in North India" is awarded Best Article for Vol 13 issue 16
A Study by Chandran Anand et al. entitled "A Prospective Study on Assessment of Quality of Life of Patients Receiving Sorafenib for Hepatocellular Carcinoma" is awarded Best article for Vol 13 issue 15
A Study by Rosa PS et al. entitled "Emotional State Due to the Covid – 19 Pandemic in People Residing in a Vulnerable Area in North Lima" is awarded Best Article for Vol 13 issue 14
A Study by Suvarna Sunder J et al. entitled "Endodontic Revascularization of Necrotic Permanent Anterior Tooth with Platelet Rich Fibrin, Platelet Rich Plasma, and Blood Clot - A Comparative Study" is awarded Best Article for Vol 13 issue 13
A Study by Mona Isam Eldin Osman et al. entitled "Psychological Impact and Risk Factors of Sexual Abuse on Sudanese Children in Khartoum State" is awarded Best Article for Vol 13 issue 12
A Study by Khaw Ming Sheng & Sathiapriya Ramiah entitled "Web Based Suicide Prevention Application for Patients Suffering from Depression" is awarded Best Article for Vol 13 issue 11
A Study by Purushottam S. G. et al. entitled "Development of Fenofibrate Solid Dispersions for the Plausible Aqueous Solubility Augmentation of this BCS Class-II Drug" is awarded Best article for Vol 13 issue 10
A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09
A Study by Mardhiah Kamaruddin et al. entitled "The Pattern of Creatinine Clearance in Gestational and Chronic Hypertension Women from the Third Trimester to 12 Weeks Postpartum" is awarded Best Article for Vol 13 issue 08
A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07
A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

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


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


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