International Journal of Current Research and Review
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IJCRR - 2nd Wave of COVID-19: Role of Social Awareness, Health and Technology Sector, June, 2021

Pages: 146-151

Date of Publication: 11-Jun-2021


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Availability of Healthcare Resources on Equitable Bases in the United States During Covid-19: A Review on Health Economic Aspects

Author: Narasimhan S, Zubair SM, Narasimhan MS

Category: Healthcare

Abstract:Background: COVID-19 is a respiratory ailment spreading from human to human unprecedently bringing about a condition of a pandemic. Rehearsing individual cleanliness is carefully suggested by the U.S. as a prudent step. In any case, to control the ailment spread at the network level there is the need to guarantee an even-handed conveyance of the medicinal services offices among the favoured and oppressed populace of the U.S. Objective: To understand the resource allocation of the healthcare sector in the U.S. and the challenges faced while mitigating the economic impact on the U.S. during COVID-19. Methods: The literature review was performed using databases such as PubMed, Scopus, EBSCO and Google Scholar for the government reports released. Results: Although the U.S. has taken several measures to control the impact of COVID-19 on the population as well as the economy. The underprivileged and some minority groups in the country have been affected by this pandemic. Health insurance plan has been modified in favour of the people so, they could have access to healthcare services. However, in the entire effort of mitigation, the country has faced certain challenges. Compare to the whites, Native Americans, African American and LatinX are facing consequences of the lockdown of the country at a greater intensity. Due to unemployment access to basic necessity was not possible for poor people. The downfall of the economy created a divide in the rural and urban hospitals on the grounds of revenue, availability of health resources and specialists. Conclusion: It is essential to contain and get ready to alleviate further episodes, especially in nations with battling or under-resourced health system framework. As a consequence, marginal propensity to consume and marginal propensity to save comes down to per capita expenditure of individuals on health and medical care hikes.

Keywords: COVID-19, Economics, Healthcare sector, Health resources, Health insurance, United States

Full Text:

INTRODUCTION

Coronavirus is an emerging zoonotic disease that is causing public health threats all over the world. The history of human coronavirus. started in 1965.1 It is a disease of animal origin as the natural reservoir of coronavirus is found in cats, bats, cattle and camels.2 This new group of viruses was named coronavirus (corona denoting the crown-like appearance of the surface projections).1 The only method to address this highly fatal and contagious disease is to provide prompt symptomatic treatment.3 Center for Disease Control (CDC) updated on 4th June the total number of cases in the U.S. is 1,842,101 and total deaths are 107,029.4 The mortality rate ranges between 0.25% and 3.0%.11.5 The vulnerable population have elevated fatality rates such as person aged 80 years and the person with comorbidities like cardiovascular disease and diabetes.6

COVID-19 is a respiratory disease transmitted by aerosols and fomite is spreading from human to human unprecedently resulting in coronavirus infection worldwide leading to a pandemic state. Practising personal hygiene is strictly recommended by the nation as a precautionary measure. However, to control the disease spread at the community level there is the need to ensure there is equitable distribution of the healthcare facilities among the privileged and underprivileged population of the U.S. The population of the U.S. is 329748944 and the demand for healthcare services is high as the COVID-19 cases continue to grow at a speedy rate.7 As the vaccination for COVID-19 is yet to innovative, early diagnosis and symptomatic treatment is the only way to stop the disease from worsening. Hence it becomes important that all people receive early and prompt treatment at the initial stage of the disease.

The paper focused on the country’s preparedness in terms of budgeting and allocation of healthcare resources and funds on an equitable basis. The steps lay down by the U.S. to combat the disease through health insurance schemes.  Also, the challenges faced by the country to mitigate the economic impact on health sectors in this pandemic. The review paper will be contemplating the two principal of health economics explicitly efficiency impacts and the equity impacts during the COVID-19 outbreak in the U.S. Both the outcome of the concept is to measure the quality-adjusted life years (QALYs). Efficiency in health economics is used to get the finest cost for money for the health care resource.8 It is the relation between resource inputs such as costs, in the terms of labour or equipment and intermediate outputs or final health outcomes i.e. QUALYs.

MATERIALS AND METHODS

Databases and government official websites providing information regarding health economics and insurance of the U.S. in the state of COVID-19 pandemic were considered. Databases such as PubMed, Medline, EBSCO host, dimensions and web of science were searched for the impact on the healthcare sector due to this pandemic from 2019. The language of included articles was restricted to English only. Data extracted to meet the objectives of the paper are costs to the health system, allocation of health care resources, health insurance companies, and health system funding and fiscal implications. Accessibility to healthcare facilities, out-of-pocket expenditure, impoverishing, health status., vulnerable groups (Existing challenges) and mitigation strategies to reduce the impact of the pandemic.

RESULTS

Status of healthcare resources as per the American Hospital Association (AHA)

As per the report of AHA of 2018, the U.S. maintains 5198 community hospitals and 209 federal hospitals. The availability of hospital beds in community hospital are 792,417 and ICU beds counting is 96,500 which includes beds for neonatal and paediatric. The ventilators specifically required in the treatment of the COVID-19 are approximately 62,000 in the entire country. The buffer stock according to Strategic National Stockpile is estimated to be around 10,000 to 20,000. The ventilators with basic functions which can be of great help during the shortage of resources are 98,000 because there exist certain norms for the amount of supply and manufacturing the ventilators.9

The present scenario in the country states there is an urgent need for trained health care professionals specializing in the respiratory disease speciality such as respiratory therapists and trained critical care staff who are capable of managing the ventilators. Availability of the doctors as well as other healthcare providers in the hospital at all shift is one of the necessities to be met. The nation possesses 76,000 full-time respiratory therapists and 512,000 critical care nurses only from Community hospitals.9 As per the law in California, for every four ventilated patients one respiratory therapist should be allotted. If followed then with the available respiratory therapist only 100,000 patients can care per day.10

Healthcare professionals and providers are facing a shortage of essential PPE like N95 masks, regular masks, protection gowns and diagnostic kits. The letter requesting the grant of funds worth 100 billion U.S.$ has been issued to the speaker of the house Congress. The appeal is done by AHA President and CEO, Executive Vice President and CEO of the American Medical Association, nevertheless CEO of American Nurses Association Enterprise too.11

Health insurance and out of pocket expenditure

COVID-19 is a public health emergency to sensitize the disease concern and to encourage people to take a righteous decision in terms of testing and treatment. Americans have been allowed to avoid governmental or monetary interruption to seek medical help regarding COVID-19 and all the medical care services are provided by a health plan will be without deductibles. An individual paying a high deductible health plan (HDHP) under the Internal Revenue Service (IRS) as a part of their health insurance can avail the health grant to test and treat COVID-19 without deductibles. If the deductibles paid towards HDHP will be with minimum deductibles for self or family.

The HDHP fulfils to deliver health benefits for testing and treatment of COVID-19. without claim to deductible or cost-sharing. This health plan satiates constraint with certain requirements to minimum deductibles and maximum out of the pocket expenditure. A certain amount is paid by the policyholder before the insurance provider starts bearing the expenses. Under this plan as preventive care, vaccination is pondered with HDHP.9

Efficiency impacts

The treatment of COVID-19 is pricy and variable, this requires a good trace of finances. Which will help to support the financial crisis to make up for the COVID-19 outbreak to contain several hospitals in the U.S. who are trying to protect the capital instead of using them in elective procedures and store buffer stock to treat the COVID-19 patients in a state of emergency.11

The current situation of rising coronavirus cases in the country has led to the paucity of basic healthcare resources like beds and ventilators besides, the scarcity of specialised doctors and nurses. Those on duty are either infected or being quarantined due to exposure. The impact of this pandemic has left with a scarcity of healthcare providers in the big cities as well.  It has been observed, in the rural hospital's space is less, health care supply is inadequate to meet the increasing cases of COVID-19. Now, the U.S. priority is to make it cost-effective by reducing the gap between therapeutic needs and the supply chains productions of the resources and allocation of scarce resources efficiently among the population in serious.10

To keep the hospital financially stable, manage the limited resources and reduce the spread of the disease, many hospitals closed outpatient departments. Some of them started postponing or cancelling elective visits and procedures. This step affected the financial viability of a few hospitals as the revenue from the outpatient department (OPD) and elective visits were hampered. According to the 2014 reports of Healthcare Research and Quality, out of total inpatient revenue, 30% is contributed from elective admissions. Which accounts for more than $700 from elective admissions if compared to the emergency department.12

Hospitals in certain districts will encounter both more prominent income due to COVID-19 hospitalizations and more noteworthy costs identified with extra staff and assets, while different medical clinics will encounter generally less income because of state or government direction to limit unnecessary admissions.12

This pandemic situation has brought a divide between rural and urban hospitals (bigger or smaller hospitals) in terms of revenue content. As per the 2019-year analysis 1 in 5 rural hospitals has a probability of shutting because of financial difficulties. The concern is, according to the March 28, 2020 report almost 10 million people have claimed unemployment insurance. Bearing all the consequences of the pandemic COVID-19, the U.S. economy will be hit by 10 to 25% in the second quarter and will face a recession.13

Equity impacts

Equity in treatment

COVID-19 pandemic has uncovered numerous deficiencies in U.S. medical care, especially the ability to deal with a general wellbeing crisis. Insufficiencies in the foundation, underreporting, distribution and admittance to COVID-19 screening tests, logical inconsistencies in the transmission of factual real-time information, and deficient arrangement of resources such as PPE to overburdened hospitals and health care workers are a couple of the issues intensifying the antagonistic impacts of this pandemic on the wellbeing and government assistance of the country. In any case, perhaps the most serious issue the COVID-19. has lit up is the wide scope of disparities in our country's way to deal with medical services. These have just gotten more straightforward all through the COVID-19 emergency.14

The public health measure of social distancing has given rise to discrimination in the society, racism and differences between the vulnerable populations of the U.S. The extent of discrimination has gone based on gender where women are found to be affected more and increased discrimination among Asian Americans in society, especially in the workplace.15 For people from poor or underestimated foundations, instructive frameworks, labour groups, and work environment conditions regularly propagate frameworks of persecution, force, and benefit, bringing about them encountering minimization and segregation inside these frameworks and getting less fortunate and professional results. This period has generated fear among the population of losing their jobs due to a major economic crisis. COVID-19 is having an unemployment impact on the workers of colour, low-income groups, uneducated and people with less liquid assets if compared to the white-collared professionals and people of higher middle-class society. Compare to the whites, African American/Black, Native Americans and LatinX are facing consequences of the lockdown of the country at a greater intensity.29

Considering the vulnerable population of the U.S.

The U.S. government supports the vulnerable population by giving them financial aid/ relief for sustainability during the COVID-19 outbreak. Under Coronavirus Aid, Relief, and Economic Security (CARES) act Americans have been benefitted from Economic Impact Payments (Payments). The Internal Revenue Service (IRS) endures to self-direct the payments to the authorized individual; however, some may have to supply additional information to the IRS to receive the rewards.16

Paid sick leave for 10 days will be given for an employee who is not capable to work due to quarantine or self-quarantine or has coronavirus symptoms and is seeking medical help. The wage on the worker’s ordinary rate of pay, or, if higher, the Federal minimal salary or any applicable State or local minimum salary, up to $511 in line with day, overall, no more than $5,110.17

If someone is not capable to work since to care for someone who is affected by COVID-19 or to take care of the child as a result of the closure of the child’s school or paid caretaker is not available due to COVID-19. The employee is eligible for two weeks of paid sick leave at two-thirds the employee’s regular rate of pay or, if better, the Federal minimum salary or any relevant State or local minimum wage, up to $200 in step with day, however, no extra than $2,000 in general.17

If an employee is not able to work so has to look after the child since the closure of the school, place of care, if the caretaker is not available because of COVID-19. He is eligible for paid family and medical leave of 10 weeks. The employee will be remunerated equal to two-thirds of the employee’s normal pay, up to $200 per day and $10,000 in total.17

Challenges faced in mitigating strategies

Congress in the U.S.A permitted the CARES Act and the Paycheck Protection Program and Health Care Enhancement Act, in which $175 billion is provided as emergency funding for hospitals and other health care organizations. However, the disbursement of this fund is challenging as it has to be provided to the neediest in this pandemic situation. The big hospitals are producing revenue from outpatients and elective services. Whereas, the problem is faced by the smaller rural hospitals who are unable to get the revenue. If these budgetary lacunas continue to persist then it might lead to the shutting down of the rural hospitals.12

Deferred shipments and manufacturing plans make monetary issues for organizations with substantial obligations in the U.S. The effect on the worldwide equity value markets and departure from financial specialists selling resources, for example, high return securities and unpredictable stocks. Concerns about budget risks may evaporate liquidity in the financial economy. National banks of the U.S. are working hard to deal with a V-shaped recession to cope up with the downturn after the pandemic is over.18

Some of the challenges faced in the process of implementing preventive measures by the U.S. government were depicted on the vulnerable population. Women found it difficult to continue working as the daycares, schools, and external resources are closed down.19 Social distancing protocols have led to the shutting of restaurants/bars, travel and transportation, entertainment, personal services, and certain types of retail and production factories.20 Thus, causing a major impact on the employment status of the U.S. population.

Workers who work in basic administrations, for example, markets, may not be furnished with the essential PPE gear to shield them safe from getting the infection. A few of them need to pick between their wellbeing and the need to procure wages to pay for fundamental necessities. The instability of the circumstance is additionally exacerbated by the way that numerous. market labourers are utilized in the lowest pay permitted by law occupations with little access to benefits, for example, medical expenses and paid sick leave.19

Due to the current outbreak, the dentist worldwide is sufferers since dentistry is a profession where dentist work in close contact of the patient mouth was more likely to spread COVID-19 is at greater risk. Due to which many regulatory bodies of dental practitioners are performing only emergency procedures. In the U.S. due to monetary dread to pay salaries to employees and economical losses some practices are shut down and some continue to work.21

DISCUSSION

Novel coronavirus first case was identified and later found a cluster of pneumonia cases in Wuhan Municipal Health Commission, China, which reported a cluster of cases of pneumonia in Wuhan, Hubei Province China. On 30th January WHO Director-General declared novel coronavirus 2019 a public health emergency of international concern (PHEIC). WHO released a strategic preparedness and response plan to help and protect the health system of the weaker State.2 Every country has taken up an appropriate measure to control and contain the disease spread. In the U.S., the Centres for Disease Control (CDC) has taken initiative to respond to support COVID-19 along with the National Healthcare Safety Network to track the disease. The CDC along with multiple surveillance system, epidemiology network and in alliance with the state, local, and academic partners scrutinise the evolution of the disease and its impact in the U.S. 22

Financial aid and management

The CDC emphasis on laboratory test to both symptomatic and asymptomatic in detect and report the case timely for public health action. To encourage people to test, the U.S. government supports the vulnerable population by giving them financial aid/ relief for sustainability during the COVID-19 outbreak.22 Under CARES act Americans have been benefitted from Economic Impact Payments (Payments). The IRS endures to self-direct the payments to the authorized individual; however, some may have to supply additional information to the IRS to receive the rewards.16 In Vietnam detection of cases, isolation, tracing cases and the surveillance of the suspected cases with the support of the Emergency Public Health Operations Centre was set in the General Department of Preventive Medicine to guide the provincial CDCs.23 In the UK National Health Service (NHS) monitors the testing and treatment of COVID-19 cases for British citizens and visitors as well.24

Financial aid is provided by the UK government for COVID-19 cases through NHS, which comprises sick pay leave, COVID-19 testing, remote management of patients, support for stay home models.25 In the U.S.A due to monetary dread to pay salaries to employees and economical losses some of the dental practices are shut down and some continue to work.21  In the UK, The British dental association has also stopped routine dental practice hence dental doctors are in financial losses.26

Efficiency impacts

The current rise in the number of cases as the U.S. stands with a greater number of COVID-19 cases across the world, to keep the hospital financially stable, manage the limited resources and reduce the spread of the disease wherein poses the shortage of health care workers, respiratory therapist and PPE. Community health workers in Brazil are trained for 4- 6 weeks on health promotion and public health surveillance along with that online course are conducted to train them.27 Vietnam is confronting with a shortage of medical equipment, PPE for the medical staffs.23 In U.K. new NHS guidelines to release bed capacity, free up the maximum possible IPD and critical care, increasing respiratory support. The U.K is also providing aftercare support for the patient recovered from the COVID-19 with rehabilitation.25 Availability of intensive care and intermediate care beds is also deficient in Europe, Germany ranging from 29.2 to 4.2 beds per 100,000 populations in Portugal, the study conducted in 2010-11.28 Most the countries are less prepared for the outbreak as there is a greater number of cases and disease spread is faster in rate.

Equity impacts

A remarkable disparity among the ethics groups across the U.S. is seen from the past even with the medical system for their timely care about the health. The equitable impact which is seen in treating the COVID-19 is also with the socio-economic backgrounds. Due to structural racism among the black and brown families, they have denied access to quality health care, affordable housing and financial security.29 A person from a low socio-economic group has factors connected to his lifestyle of not taking nutritive food, spending enough money to take care of his health. The risk factor of COVID-19 is identified as comorbidity. People from the low-income group cannot offer to maintain the social norms to prevent disease since their livelihood is dependent on their work; hence a greater number of cases are seen among the ethnic groups which are giving rise to inequity. Unemployment is also seen as a major setback to the pandemic crisis. Many Americans during this crisis lack decent work to protect them from the risk of being infected.19

Long term and short-term effect of COVID-19

The short-term effect of the pandemic is a risk among the population being infected by the disease. Economic instability for a freelancer working on the field, daily wage worker, employment insecurity in the short course until the epidemic slows down. Temporary suspension of school and colleges to control the outbreak put parents in a situation to stay back to take care of their kids leading to job instability. E-Commerce and internet-based jobs will be more secured and safer. An uninsured person due to coronavirus infection has to bear the catastrophic health expenditure. Shortage of PPE leads to a rise in demand and production of the goods and downfall in the other products will be stagnant. In the healthcare industry due to the cancellation of elective surgery and procedure, the income of the hospital will be condensed. Impediment in travel and tourism decrease the income of the individual, the corporate sector as well as the public sector. It leads to too much pressure on the government to ensure the health care and social security of the mass.

If the pandemic persists for a long time the rate of growth of Gross Domestic Product (GDP) declines. Disequilibrium between the aggregate supply and aggregate demand occurs; effective demand will be inelastic due to unemployment. As a consequence, marginal propensity to consume and marginal propensity to save comes down to per capita expenditure of individuals on health and medical care hikes. Instantly it leads to continuous raise in public expenditure in general, health, medical care, research and development investment in the pharmaceutical industry, social security measures, relief measures in particular. Interruptive circular flow of factors, product and wealth strains international trade. Trade cycles, market failure and disequilibrium balance of payments curtail the entire global economy.

CONCLUSION

It is essential to contain and get ready to alleviate further episodes, especially in nations with battling or under-resourced health system framework. The COVID-19 pandemic speaks to an exceptional clinical and financial test for the U.S. medicinal services framework. Without strong and continued administrative help, practically all emergency rural hospitals will encounter finance-related challenges. Be that as it May, small hospitals, autonomous, provincial, and have basic access status. are especially in danger. Policymakers ought to offer committed help to these emergency clinics to get to CARES Act reserves and consider distributing extra subsidizing to them during the COVID-19 pandemic. There is a need to support the countries which are struggling to find the vaccine to stop the spread of the disease. Enlightenment of self-interest in preventing the infection is an essential nevertheless equitable approach to global health is of foremost importance.

Authors contribution:

Concept and design: Dr Sabah. Mohd. Zubair and Dr Sphoorti. Narasimhan

Acquisition, analysis, or interpretation of data: Dr Sphoorti. Narasimhan

Drafting of the manuscript: Dr Sphoorti. Narasimhan and Dr Sabah. Mohd. Zubair

Critical revision of the manuscript for important intellectual content: DR. Narasimhan M. S and Dr Sabah. Mohd. Zubair

Source(s) of support: None

Acknowledgement: Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors/editors/publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.

Conflicts of Interest: All the authors declare that there is no conflict of interests. This study did not receive any financial support.

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  4. Elizabeth Warren. Lawmakers Urge HHS to Address Racial Disparities in Access to Testing and Treatment during the Coronavirus Pandemic. 2020 March 30. [cited on 2020 June 15]. https://www.warren.senate.gov/oversight/letters/lawmakers-urge-hhs-to-address-racial-disparities-in-access-to-testing-and-treatment-during-the-coronavirus-pandemic

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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.

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

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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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