International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
logo
slider
slider
slider
slider
Bootstrap Slider

Indexed and Abstracted in: Crossref, CAS Abstracts, Publons, Google Scholar, Open J-Gate, ROAD, Indian Citation Index (ICI), ResearchGATE, Ulrich's Periodicals Directory, WorldCat (World's largest network of library content and services)

Search Articles

Track manuscript

Full Html

IJCRR - Vol 13 Issue 13, July, 2021

Pages: 28-32

Date of Publication: 05-Jul-2021


Print Article   Download XML  Download PDF

A Comparative Analysis of Scoring Systems in Upper Gastrointestinal Bleed to Predict Mortality and Rebleed among Patients from South India

Author: Aradya H V, Deepak Suvarna, Anurag Lavekar, Nandeesh HP, Vijay Kumar T R, Anupama C

Category: Healthcare

Abstract:Introduction: One of the major gastroenterological emergencies encountered is Upper Gastrointestinal bleeding. The major factors which influence the bleeding are the age of the patients, Comorbid conditions, Haemoglobin, ulcer size, shock, and need for repeated blood transfusion. The increased mortality rate among patients with upper gastrointestinal bleeding is due to rebleeding. Objective: To compare the Sensitivity, Specificity of the various scoring system in predicting the outcome of upper gastrointestinal bleeding. Methodology: A Prospective study was conducted at JSS Hospital, Mysore, India inMarch 2018. to September 2018. Comparison of different scoring systems (Rockall, Blatchford, AIMS 65, T score, and PNED score) was done using the ROC curve in predicting the risk of rebleed and mortality. Results: The area under the curve was more for the PNED Score, followed by Rockall Score. It was least for the T Scoring Technique when compared with Mortality Scoring Pattern with the risk scoring. All the scoring systems were found to be statistically Significant for the Mortality risk factor except for Blatchford Score. The different risk scoring for rebleeding was found to be statistically significant for all Scores except for the PNED Score which was significant. Conclusion: Rockall score, PNED, Blatchford Glasgow score and AIMS 65 has very good sensitivity, specificity, and negative predictive value for rebleed and mortality. However, their positive predictive value for rebleed and mortality is a limiting factor.

Keywords: GI Bleed Scoring, Rebleed, Duodenal Ulcer, Mortality

Full Text:

Introduction:

One of the major gastroenterological emergencies encountered is Upper Gastrointestinal bleeding. It is considered to be one of the most challenging and life-threatening problems which require immediate hospitalization and surgical intervention for the better outcome of the patient.

The overall mortality of upper gastrointestinal bleeding ranges from 10 % to 40% among the patients who are more prone to bleeding disorders and with other comorbid illnesses.1

 The causes of upper gastrointestinal bleeding range from Mallory Weiss tear to large variceal bleeding. The major factors which influence the bleeding are the age of the patients, Comorbid conditions, Haemoglobin, ulcer size, shock, and need for repeated blood transfusion. The increased mortality rate among patients with upper gastrointestinal bleeding is due to rebleeding.2

All the patients suffering from Upper gastrointestinal bleed are hospitalized and subjected to endoscopic examination irrespective of type (variceal or nonvariceal), quantity and severity of the bleeding. The endoscopic examination and the treatment of upper gastrointestinal bleeding within 24 hours can reduce mortality significantly.

To assess the risk of mortality and other complications related to upper gastrointestinal bleeding various scoring methods have been developed. Few of the scoring system requires the usage of endoscopy findings to conclude the risk and few of the scoring systems doesn’t require an endoscopy to arrive at the risk assessment of upper gastrointestinal bleeding.

One of the most common risk assessment scores used is Rockall Score3 and Progetto Nazionale Emorragia Digestiva (PNED) 4 which require the findings of endoscopy before calculating the risk score.  There are still many scoring systems that are used to assess the risk score using endoscopy, but they are inferior to the Rockall Score and PNED score. The scoring system using endoscopy can cause a delay in arriving or calculating the risk score due to delay in the performing endoscopy in our health care setting .5

Hence other scoring systems were developed which don’t require the findings of the endoscopy and determine the risk by the pre-endoscopic scores for upper GI Bleeding were ‘admission’ Rockall Score, Glasgow Blatchford score, and the AIMS65 score. These scoring systems use clinical, hemodynamic, and quickly available laboratory values for Glasgow Blatchford and AIMS65 Scoring. Few studies suggested that these scores could be used to identify patients at very low risk which can be managed in the outpatients. 6,7

In our study, we have tried to compare the different scoring methods used in risk assessment of Upper gastrointestinal bleeding.

Objective:

 To compare the Sensitivity, Specificity of the various scoring system in predicting the outcome of upper gastrointestinal bleeding.

Materials and Methods:

A Prospective study was conducted at JSS Hospital, Mysore, India inMarch 2018. to September 2018. All the patients who were admitted to the department of medical gastroenterology with a history of hematemesis and melena during the study period were included in the study. Patients in whom Upper Gastroendoscopy was not possible were excluded from the study. A detailed history and clinical examination were done. Complete hemogram, Liver Function Test, Renal Function Test, Upper Gastroendoscopy was done for included patients. Statistical analysis was done using SPS 17. Comparison of different scoring systems (Rockall, Blatchford, AIMS 65, T score, and PNED score) was done using a ROC curve in predicting the risk of rebleed and mortality. A correlation test was used to check the association between Mortality and rebleed with Hemoglobin, creatinine, and Total Leucocyte Count. The Ethical Clearance from the University was obtained.

Results:

A total of 198 Patients who were included in the study were analyzed. The overall mortality rate was 12.6 % (25/198). The rebleed rate was 16.1 % (32 / 198). The mortality rate in patients with rebleed was 40.6 % (13/32).

The most common causes of upper Gastro-Intestinal bleeding were ulcers in the duodenum and oesophagus, 39 each (19.6 %). Oesophagal varices were seen in 16.6% of the cases. Gastric Varices (10.6%), Gastric Ulcer (9.5%), Portal Gastropathy (9%), Mallory Weis Tear (4.5%), GRED (4%) were the other common etiologies responsible for the bleeding in the upper gastrointestinal Bleeding ( Table 1).

Rebleed and mortality were correlated with the levels of Hemoglobin, Levels of Creatinine, and Total Leucocyte Count.

The Hemoglobin and total Leucocyte count was found to be Positively Correlated with both Rebleeding and Mortality among the cases. The Creatinine level was found to be negatively Correlated with mortality among the cases and positively correlated with Rebleed ( Table 2 and 3).

The sensitivity was found to be 100 % for Rockall Score, Blatchford Score, AIMS65 Score and PNED Score. T Scoring technique was found to have a lease sensitivity of 33% when compared to other scoring techniques. The specificity was found to be high for the PNED Scoring technique at 51 %, Followed by AIMS65 Scoring at 48 %. The Blatchford Score had a specificity of only 0.7%. The negative Predictive value was 91% for T Score and 100 % for all the remaining scoring Systems. Positive Predictive value was highest for T Score and least for Blatchford Scores (Graph 1).

The area under the curve was more for the PNED Score, followed by Rockall Score. It was least for the T Scoring Technique when compared with Mortality Scoring Pattern with the risk scoring. All the scoring systems were found to be statistically Significant for the Mortality risk factor except for Blatchford Score ( Table 4).

The sensitivity was found to be 100 % for Rockall Score, Blatchford Score, AIMS65 Score. It was 92% for PNED Score and 28% for the T Scoring technique. The specificity was found to be high for the PNED Scoring technique at 52 %, Followed by AIMS65 Scoring at 47 %. The Blatchford Score had a specificity of only 0.7%. The negative Predictive value was 98% for T Score and 79 % for the T score. The remaining score had a 100% Negative Predictive Value. Positive Predictive value was highest for PNED Score (13%) and AIMS65 Score (6%) (Graph 2).

The different risk scoring for rebleeding was found to better with the PNED Score covering more area followed by AIMS65 Score. T score showed the least covered area under the curve. All the Scoring was found to be statistically insignificant except for the PNED Score which was significant.

Discussion:

Out of the total 198 cases which were analyzed, the common causes of Upper Gastrointestinal Bleeding seen in our study was similar to various studies .8,9

In our study, we tried to evaluate a total of 5 different scoring systems that can predict the outcome of upper gastrointestinal bleeding in terms of mortality and rebleeding among the patients. The scoring techniques like AIMS65, Glasgow Blatchford score, and T Score were the scores that didn’t require emergency endoscopy to determine the outcome. Rockall and PNED Risk scoring required the findings of the endoscopy to arrive at any conclusion.

Of all these scoring systems it is the AIMS65 Score that can determine the outcomes of the Patients without considering the comorbid conditions which are suffered by the patients. Few of the researcher evaluated the GBS scoring without considering the endoscopic findings or the comorbid conditions and its termed as Clinical Rockall Score .3,4,7,8

In our study, we could conclude that the usage of Blatchford Score and AIMS 65 both were equally useful (Sensitivity 100%) in determining the mortality than T Scoring System among those patients in whom it was not able to perform endoscopy within 24 hours. in the studies done by various authors .10,11,12. The limitation of the AIMS65 Scoring was the low Positive Predictive value (10%) which means a significant number of low-risk patients with upper GI Bleeding will be missed.

Many of the research studies reported that Rockall Score, Blatchford, AIMS 65 Score, and PNED Score were found similar to the predicting mortality which was comparable to other studies .13,14,15

In the study done by Tammaro L et al.16, the T-score was found to use in the triage patients who are likely to have high-risk endoscopic stigmata and therefore need intervention. The conditions like rebleeding, to predict the high-risk endoscopic stigmata and mortality was found to be similar to GBS. The findings of our study were contradictory to our study findings where T score was found to have the least sensitivity among all the scores in predicting mortality.

According to Tammaro and collaborators,17 a T-score of ≤ 6 was able to predict the presence of high-risk endoscopic stigmata. The Specificity was 96% and the Positive Predictive value was 74.5% in predicting the need for an early endoscopy. He also recommended the use of non-endoscopic scoring Rockall and GBS score in acute GI Bleeding.

 The major aspect of the risk scoring assessment for the upper gastrointestinal is the timing of the endoscopy. The timing of the endoscopy determines which risk scoring assessment is better in predicting the outcome of mortality or rebleeding among the patients.

Bhakurun suggested that endoscopy is always beneficial in reducing mortality and improving the outcome is performed within 24 hours from the admission.  Though Endoscopy is not associated with the reduction of mortality or rebleeding it will help increase the efficiency of the care of high-risk patients and reducing the duration of hospital stay. These benefits of performing endoscopy give an added advantage of the risk scores which uses endoscopy when compared to risk score without endoscopy.18

Conclusion:

Duodenal and oesophageal ulcers are the most common causes of Upper GI bleed in this study. Rockall score, PNED, Blatchford Glasgow score, and AIMS 65 have very good sensitivity, specificity, and negative predictive value for rebleed and mortality. However, their positive predictive value for rebleed and mortality is a limiting factor.

Acknowledgment: 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.

Conflict of Intrest: Nil

Source of Funding: Nil

Authors contribution:

Aradia H V: Planning and Data Collection of the study, Analysis of the results, Manuscript Writing and Literature Review

 Deepak Suvarna: Manuscript Writing and Literature Review

 Anurag Lavekar: Data Collection of the study

 Nandeesh HP : Review of the Article and Manuscript Writing

 Vijay ‎Kumar T R: Analysis of the study, Data Collection of the study

 Anupama C: Analysis of the study, Literature Review

References:

  1. Walls R, Hockberger R, Gausche M. Rosen’s Emergency. Medicine-Concepts and Clinical Practice: Elsevier Health Sciences;9 th edition: May 2017.

  2. Bogoch A, Gastrointestinal bleeding, Chap-6, Vol 1, Bockus. Gastroenterology, 4th Std. 1985; 1: 65-110.

  3. Rockall TA, Logan RFA, Devlin HB, Northfield TC. Risk assessment after acute upper gastrointestinal haemorrhage. Gut .1996;38(3): 316-21.

  4. Marmo R, Koch M, Cipolletta L, Italian registry on upper gastrointestinal bleeding (Progetto Nazionale Emorragie Digestive-- PNED 2). Predicting mortality in non-variceal upper gastrointestinal bleeders: validation of the Italian PNED Score and Prospective Comparison with the Rockall Score. Am J Gastroenterol. 2010; 105(6):1284-91.

  5. Hearnshaw SA, Logan RFA, Lowe D, Travis SPL, Murphy MF, Palmer KR. Use of endoscopy for management of acute upper gastrointestinal bleeding in the UK: results of a nationwide audit. Gut . 2010; 59(8):1022- 9.

  6. Blatchford O, Murray WR, Blatchford M. A risk score to predict the need for treatment for upper gastrointestinal haemorrhage. Lancet. 2000; 356(9238):1318-21.

  7. Saltzman JR, Tabak YP, Hyett BH, Sun X, Travis AC, Johannes RS. A simple risk score accurately predicts in-hospital mortality, length of stay, and cost in acute upper GI bleeding. Gastroin Endosc. 2011; 74(6):1215-24.

  8. Chan J C H, Ayaru L.Analysis of risk scoring for the outpatient management of acute upper gastrointestinal bleeding. Frontl Gastroent .2011; 2(1):19–25.

  9. Subramanian V, Hawkey CJ. Assessing bleeds clinically: what’s the score? Lancet. 2009; 373(9657):5–7.

  10. Stanley AJ, Ashley D, Dalton HR, Mowat C, Gaya DR, Thompson E, et al. Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation. Lancet. 2009;373(9657):42-7.

  11. Stephens JR, Hare NC, Warshow U, Hamad N, Fellows HJ, Pritchard C, et al. Management of minor upper gastrointestinal haemorrhage in the community using the Glasgow Blatchford Score. Eur J Gastroenterol Hepatol. 2009;21(12):1340-6

  12. Palmer K, Nairn M; Guideline Development Group. Management of acute gastrointestinal blood loss: summary of SIGN guidelines. Bri Med J .2008;337: 1832.

  13. Yaka E, Y?lmaz S, Do?an NÖ, Pekdemir M. Comparison of the Glasgow-Blatchford and AIMS65 scoring systems for risk stratification in upper gastrointestinal bleeding in the emergency department. Acad Emerg Med. 2015; 22(1):22-30.

  14. Hyett BH, Abougergi MS, Charpentier JP. The AIMS65 score compared with the Glasgow-Blatchford score in predicting outcomes in upper GI bleeding. Gastrointest Endosc. 2013; 77(4):551-7.

  15. Abougergi MS, Charpentier JP, Bethea E, A prospective multicenter study of the AIMS65 score compared with the Glasgow Blatchford score in predicting upper gastrointestinal haemorrhage outcomes. J Clin Gastroenterol. 2016; 50(6):464-9.

  16. Tammaro L, Di Paolo MC, Zullo A, Hassan C, Morini S, Caliendo S, Pallotta L. Endoscopic findings in patients with upper gastrointestinal bleeding clinically classified into three risk groups before endoscopy. World J Gastroenterol. 2008; 14(32): 5046-5050.

  17. Tammaro L, Buda A, Di Paolo MC, Zullo A, Hassan C, Riccio E, Vassallo R, Caserta L, Anderloni A, Natali A. A simplified clinical risk score predicts the need for early endoscopy in non-variceal upper gastrointestinal bleeding. Dig Liver Dis. 2014; 46(9): 783-787.

  18. Barkun AN, Bardou M, Kuipers EJ, Sung J, Hunt RH, Martel M, Sinclair P. International consensus recommendations on the management of patients with non-variceal upper gastrointestinal bleeding. Ann Intern Med .2010; 152(2): 101-113 .

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

List of Awardees

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


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


RSS feed

Indexed and Abstracted in


Antiplagiarism Policy: IJCRR strongly condemn and discourage practice of plagiarism. All received manuscripts have to pass through "Plagiarism Detection Software" test before Toto Macau forwarding for peer review. We consider "Plagiarism is a crime"

IJCRR Code of Conduct: To achieve a high standard of publication, we adopt Good Publishing Practices (updated in 2022) which are inspired by guidelines provided by Committee on Publication Ethics (COPE), Open Access Scholarly Publishers Association (OASPA) and International Committee of Medical Journal Editors (ICMJE)

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.



ABOUT US

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

Contact

148, IMSR Building, Ayurvedic Layout,
        Near NIT Complex, Sakkardara,
        Nagpur-24, Maharashtra State, India

editor@ijcrr.com

editor.ijcrr@gmail.com


Copyright © 2022 IJCRR. Specialized online journals by ubijournal .Website by Ubitech solutions