International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - Vol 13 Issue 13, July, 2021

Pages: 114-117

Date of Publication: 05-Jul-2021


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Systolic Blood Pressure and Heart Rate Responses of Individuals with Neck Versus Abdominal Obesity in Response to - Incentive Spirometry Based 10 Sustained Maximal Inspirations (A Possible Clinical Tool)

Author: Mayank Shukla, Ankita Samuel

Category: Healthcare

Abstract:Introduction: Deposition of fat over the upper trunk and neck is called neck obesity. It is a topographical central fat distribution. In this cross-sectional study, it is demonstrated that individuals with neck obesity are having a hyperresponsive cardiovascular system, to the incentive spirometry breathing exercise as compared to abdominal obese individuals. Objective: To check sustained maximal inspirations using incentive spirometry (IS) as a tool for cardiovascular (CVS) responses of the neck and abdominal obese individuals. Methods: Sample size and population: N=30 individuals (15 with neck obesity and 15 with abdominal obesity volunteered and gave written informed consent to participate. The setting was the Research Lab of AIPT, Amity University, Noida, UP. India. Inclusion Criteria: Age group: 18-30 years; BMI ≥25kg/cm2 ; Circumference of abdomen ≥ 88 cm in females and ≥ 102 cm in males; [abdominal obesity group]; Circumference of neck ≥ 35 cm in females and ≥ 41 cm in males. [neck obesity group]. Exclusion Criteria: Any previous history of cardiovascular disease; Uncontrolled diabetes mellitus; Hb, < 10mg/dl; Known asthma; known COPD; Smoking history.Intervention: Sustained maximal inspirations 10 per minute were carefully administered. Outcome measures: heart rate, blood pressure responses. Results: Significant changes in systolic blood pressure (SBP) & heart rate (HR) are seen between the neck and abdominal obese population (p< 0.05) at 95% CI. Pre incentive spirometry Sustained Maximal Inspiration breaths, SBP of abdominal obese individuals (mean\?SD-115.47\?7.38) was higher than neck obese (mean\?SD-108.73\?8.54) at (p = 0.028*); whereas post-incentive spirometry SBP was more in neck obese ((mean\?SD-126.80\?7.84 ) than in abdominal obese ((mean\?SD-114.0\?11.0) at (p = 0.001*). HR also increased significantly post incentive spirometer in neck obese (mean\?SD-100.53\?11.37) than in abdominal obese (mean\?SD-92.80\?1.16) at (p = 0.046*). Conclusion: IS based CVS responses are significantly different in the neck obese. It may be checked further using IS based SMI as a tool for other populations.

Keywords: Hypertension, Tachycardia, Cardiovascular screening, Obesity, Sustained maximal inspirations

Full Text:

INTRODUCTION

Excessive deposition of fat topographically on specific body segments is known as regional obesity. It may cause cardiovascular presentations.1  Neck obesity is considered an index of upper body obesity. It may cause different responses of blood pressure from those seen for abdominal obesity.2  Incentive spirometry (IS) induces sustained maximal inspirations (SMI). They produce changes in the cardiovascular features. Cardiopulmonary is a single functional unit that gives rise to two different body systems of cardiovascular and pulmonary.3,4

OBJECTIVE

The objective was to compare responses of systolic and diastolic blood pressure, heart rate and peripheral arterial saturation of neck obese and abdominal obese individuals to 10 breaths in 1minute using IS.

PROPOSED RATIONALE AND IMPLICATIONS

The rationale is seen in Fig. 1. Changes in the neck can lead to changes in CVS responses to IS based SMI. Interconnecting structures are carotid and aortic bodies via the autonomic nervous system. How fat deposition changes these features is to be found. Framingham heart study in their landmark findings have reported upon the localization of fat deposition and related health risk.17

RESULT AND DISCUSSION

Institutional Ethical clearance and informed consent: The study protocol was reviewed and cleared by the Institutional NTCC committee of Amity Institute of Physiotherapy, Amity University Uttar Pradesh. NTCC/AIPT/MPT AY 2014-15-A1102713009.Weekly review and internal and external presentations were done for the progress. Written informed consent was obtained from all participants.

N=30 Individual with obesity (15 necks obese and 15 abdominal obese) was taken as per the inclusion and exclusion criteria. Both males and females participated in the study as seen in Table -1.

Their resting blood pressure, heart rate, and peripheral oxygen saturation (SpO2) were recorded twice, and an average was taken, following which they were asked to breathe in and out of a flow-based incentive spirometer (IS) 10 breaths in a minute. During these patients were instructed to take inspirations and to raise the ball maximally, hold it for 5 seconds and repeat it after a brief pause.  Incentive spirometry induces biofeedback & self-controlled sustained maximal inspirations (SMI). After IS the parameters were measured again immediately. 5, 6, 7

Written informed consent was taken from all participants. Ethical approval for this research was granted by the institutional NTCC committee of AIPT, AUUP.

Systolic blood pressure is a marker of cardiac contractility, which usually is required to overcome the afterload. Significant changes in this are interpreted as increased contractility of the myocardium. Increased systolic blood pressure is responsible for various adverse effects. In Fig 2 it is seen that there are a significant increase in SBP for neck obese (Grp-1) individuals in response to IS based 10 SMIs in 1 minute. Neck circumference is reported to have higher odds of hypertension.18There are recent reports of cut-off points of NC for children for cardiometabolic risk.19A systematic review has also confirmed NC as a new measure for hypertension. We have shown hyperresponsive SBP to IS based SMIs, it may be taken up in future studies how this measure affects clinical outcomes in different population like individuals with metabolic syndrome or survivors of an acute cardiac event. 8,9 Also, routine use of hypertensive response to IS based 10 SMI instead of resting BP, or in addition to it is a new paradigm of this research report.

Diastolic blood pressure (DBP) usually does not change in response to respiratory interaction in asymptomatic individuals, therefore changes are not witnessed by us in DBP with SMI as seen in Fig-3. It is dependent upon the cardiac preload; it may vary in the clinical populations and may be checked by future studies carried out for the IS based SMI responses. 10,11

Heart rate is seen as changing significantly in the study as seen in Fig 4. This is important because increased heart rate is a response that may form the very basis of all adverse effects as well. It has obvious clinical implication for symptomatology during activities of daily living, occupational or leisure time for different populations with regional obesity.12

The neck is the connecting body segment between the cranium and trunk. It houses the cervical spine, brain stem, cervical plexus, carotid arteries, baroreceptors, carotid bodies, trachea, oesophagus and thyroid gland. The distribution of fat varies among individuals with obesity irrespective of gender where there may be more deposition on the trunk or the neck in certain individuals leading to specific physiological changes.2 Deposition of fat on the neck is an independent prognostic marker for cardiovascular diseases and may reflect in the general assessment of obese individuals.3,4 In clinical practices, the BMI is usually considered as an obesity marker and abdominal obesity is also considered. Neck obesity is not considered generally.5 It can be easily checked by checking neck circumference. 13,14,15

Incentive spirometry involves the use of sustained maximal inspirations. These bellowing movements of the lungs and sustained maximal inspiration/ Valsalva manoeuvre are known to stimulate the nervous system.6 Cardiopulmonary system is one unit and changes in each usually reflect in the other.7 Thus incentive spirometry was used. It is commonly used in hospitals and clinics.

 The cardiovascular responses were exaggerated among the individuals with neck obesity and it may have a sympathetic wing activation response in the autonomic nervous system.1,8,9There are many reports which have demonstrated the different clinical implications of obesity and neck obesity has become a cause to fight for.,14,15.

It has been seen in the present study that cardiovascular responses are exaggerated to incentive spirometry induced sustained maximal inspirations significantly among neck obese. This forms an important simple clinical test that may be used for the global neck obese population’ CVS.17

During the screening of COVID-19 cases after they have recovered and for checking the cardiac status this test (IS based CVS screening) is making a case as well.18, 19,20

CONCLUSION

Neck Obesity is an independent cardiovascular clinical marker that needs to be checked for preventive and treatment effects. Testing CVS responses to 10 sustained maximal breaths in a minute using incentive spirometry, can be used in initial and follow-up screening of susceptible populations.

Conflict of interest: Authors declare no conflict of interest.

Financial support: Nil.

Acknowledgement: Authors would like to acknowledge all participants for their time and participation. The 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. The authors also acknowledge the valuable comments of the reviewers and editors.

Authors’ Contribution: Ankita Samuel contributed to conceptualization, data collection, analysis, report writing for the research. Mayank Shukla contributed to conceptualization, data analysis, report writing and journal communication for the paper.

References:

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2.Zen V, Fuchs FD, Wainstein MV, Gonçalves SC, Biavatti K, Riedner CE, Fuchs FC, Wainstein RV, Rhoden EL, Ribeiro JP, Fuchs SC. Neck circumference and central obesity are independent predictors of coronary artery disease in patients undergoing coronary angiography. Am J Cardiovasc Dis. 2012;2(4):323-30.          

3.Joshipura K, Muñoz-Torres F, Vergara J, Palacios C, Pérez CM. Neck Circumference May Be a Better Alternative to Standard Anthropometric Measures. J Diabetes Res. 2016; 2016:6058916.

4.Wang Y, Chen HJ, Shaikh S, Mathur P. Is obesity becoming a public health problem in India? Examine the shift from under- to overnutrition problems over time. Obes Rev. 2009 Jul;10(4):456-74.

5.Borel AL, Coumes S, Reche F, Ruckly S, Pépin JL, Tamisier R, Wion N, Arvieux C. Waist, neck circumferences, waist-to-hip ratio: Which is the best cardiometabolic risk marker in women with severe obesity? The SOON cohort. PLoS One. 2018 Nov 8;13(11): e0206617.

6.Yakinci C, Mungen B, Karabiber H, Tayfun M, Evereklioglu C. Autonomic nervous system functions in obese children. Brain Dev. 2000 May;22(3):151-3.

7.Tonhajzerova I, Javorka M, Trunkvalterova Z, Chroma O, Javorkova J, Lazarova Z, Ciljakova M, Javorka K. Cardio-respiratory interaction and autonomic dysfunction in obesity. J Physiol Pharmacol. 2008 Dec 1;59(Suppl 6):709-18.

8.Malden D, Lacey B, Emberson J, Karpe F, Allen N, Bennett D, Lewington S. Body Fat Distribution and Systolic Blood Pressure in 10,000 Adults with Whole-Body Imaging: UK Biobank and Oxford BioBank. Obesity (Silver Spring). 2019 Jul;27(7):1200-1206.

9.Balasubramanian P, Hall D, Subramanian M. Sympathetic nervous system as a target for aging and obesity-related cardiovascular diseases. Gerosci. 2019 Feb 15;41(1):13-24.

10.Sparrow D, Borkan GA, Gerzof SG, Wisniewski C, Silbert CK. Relationship of fat distribution to glucose tolerance: results of computed tomography in male participants of the Normative Aging Study. Diab. 1986 Apr 1;35(4):411-5.

11.Cornier MA, Despres JP, Davis N, Grossniklaus DA, Klein S, Lamarche B et al. Assessing adiposity: a scientific statement from the American Heart Association. Circul. 2011 Nov 1;124(18):1996-2019.

12.Bastien M, Poirier P, Lemieux I, Després JP. Overview of epidemiology and contribution of obesity to cardiovascular disease. Progress in cardiovascular diseases. 2014 Jan 1;56(4):369-81.

13.Ortega FB, Sui X, Lavie CJ, Blair SN. Body mass index, the most widely used but also widely criticized index: would a criterion standard measure of total body fat be a better predictor of cardiovascular disease mortality? In Mayo Clinic Proceed. 2016 Apr 91; (4):443-455.

14.Piché ME, Poirier P, Lemieux I, Després JP. Overview of epidemiology and contribution of obesity and body fat distribution to cardiovascular disease: an update. Progr Cardiov Dise. 2018 Jul 1;61(2):103-13.

15.Henriksson H, Henriksson P, Tynelius P, Ekstedt M, Berglind D, Labayen I, et al. Cardiorespiratory fitness, muscular strength, and obesity in adolescence and later chronic disability due to cardiovascular disease: a cohort study of 1 million men. Eur Heart J. 2020 Apr 14;41(15):1503-1510.

16. Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A, Jain SS, Burkhoff D, Kumaraiah D, Rabbani L, Schwartz A. COVID-19 and cardiovascular disease. Circul. 2020 May 19;141(20):1648-55.

17-Kannel WB, Cupples LA, Ramaswami R, Stokes III J, Kreger BE, Higgins M. Regional obesity and risk of cardiovascular disease; the Framingham Study. J Cli Epidem. 1991 Jan 1;44(2):183-90.

18- Nafiu OO, Zepeda A, Curcio C, Prasad Y. Association of neck circumference and obesity status with elevated blood pressure in children. J Hum Hypert. 2014 Apr;28(4):263-8.

19- de Santis Filgueiras M, de Albuquerque FM, Castro AP, Rocha NP, Milagres LC, de Novaes JF. Neck circumference cutoff points to identify excess android fat. J de pediatria. 2020 May 1;96(3):356-63.

20- Moradi S, Mohammadi H, Javaheri A, Ghavami A, Rouhani MH. Association between neck circumference and blood pressure: a systematic review and meta-analysis of observational studies. Horm Metab Res. 2019 Aug 1;51(8):495-502.

Announcements

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

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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


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