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: 159-161

Date of Publication: 05-Jul-2021


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A Successful Outcome in a Case of Ruptured Rudimentary Horn Pregnancy

Author: Anupama Bahadur, Rajlaxmi Mundhra, Latika Chawla, Juhi Mishra, Megha Ajmani, Jaya Chaturvedi

Category: Healthcare

Abstract:Introduction: Mullerian anomalies occur owing to developmental defect at various stages. They range from Mullerian agenesis to mild arcuate uterus. Lateral fusion defect results in the formation of the rudimentary horn of the uterus. Incidence of rudimentary horn pregnancy is known to occur in 1/100,000 and 1/140,000 pregnancy. Aims: To evaluate a case of the second trimester ruptured rudimentary horn pregnancy Methodology: A 23-year-old primigravida at 18 weeks 4 days gestation presented in shock with gross hemoperitoneum. Results: Prompt intervention with exploratory laparotomy with excision of the rudimentary horn with massive blood transfusion and ventilatory support was lifesaving. The patient conceived spontaneously 4 months of laparotomy and gave birth to a term male baby by caesarean section. Conclusion: Uterine anomalies though rare must be kept in differential diagnosis for any pregnant women presenting with shock and hemoperitoneum as early diagnosis and management can result in a better outcome.

Keywords: Mullerian anomaly, Ruptured rudimentary horn pregnancy, Hemoperitoneum, Maternal collapse, Massive blood transfusion

Full Text:

INTRODUCTION

Maldevelopment of Mullerian ducts occur at different stages like interruption during differentiation, migration, fusion, canalization of Mullerian ducts, and based on this, there can be a spectrum of anomalies.1 On one end remains Mullerian agenesis characterized by failure of development of ducts and at the other end lies arcuate uterus, which is a mild abnormality of canalization. Bicornuate uterus remains midway between these two extremes and is mainly a unification defect. Most patients remain asymptomatic but at times the rudimentary horn may contain a cavity with functional endometrium with the capacity to sustain a pregnancy. Rudimentary horn pregnancy is seen between 1/100,000 and 1/140,000 pregnancy.2

The fate of this atypical pregnancy is mainly rupturing of the pregnant horn during the first or second trimester, resulting in intractable heavy bleeding, with the diagnosis being made intraoperative for maternal rescue.3,4 Literature search has shown that such women have a poor pregnancy outcome in form of abortion, preterm delivery, low birth weight or operative and caesarean delivery.5 The ultrasound diagnosis of a pregnancy in a malformed uterus remains a difficult task. Hysteroscopy and laparoscopy are the gold standard for the diagnosis of uterine anomalies and help differentiate bicornuate from the septate uterus.

We herein present a case of a maternal near-miss survivor with a ruptured rudimentary horn pregnancy necessitating surgical management. She subsequently delivered a full-term healthy baby in her subsequent pregnancy.

CASE REPORT:

A 23-year-old primigravida at 18 weeks 4 days gestation with no previous antenatal check-ups presented with abdominal pain and distension. On general examination, she was severely anaemic (clinically 5-6 gm%), pulse rate of 110/minutes and blood pressure of 100/60 mm Hg. Bedside ultrasound revealed a live pregnancy corresponding to 13 weeks 1 day’s gestation with the gross intraabdominal collection. Because of suspicion of hemoperitoneum with declining general condition (blood pressure of 70/40 mmHg and tachycardia of 130/minutes), immediate laparotomy was done with blood at hand. Intraoperatively, a unicornuate uterus with a ruptured right rudimentary horn was seen with the fetus lying in the abdominal cavity (Figure1). Approximately 3.5 litres of hemoperitoneum was drained (ESHRE/ESGE class U4a). Right uterine horn excision was done. Three units packed red cell transfusion and 4 units of fresh frozen plasma were transfused intraoperatively. She was kept in the Intensive care unit postoperatively wherein she required ventilatory support and inotropes on her first postoperative day. She received massive blood transfusion (7 units PRBC’s, 4 RDPs and 9 cryoprecipitates) during the recovery period. Postoperatively, she developed lung consolidation with pleural effusion necessitating pleural tapping. She also underwent six serial hemodialyses for acute renal injury. With a multidisciplinary team approach, the patient recovered and was discharged in a stable condition on a post-operative day 30. She received psychological counselling and was advised to delay the next conception. Histopathology report of the specimen confirmed uterine horn within normal histological limits. The patient was lost to follow up. She conceived spontaneously 4 months after laparotomy. She underwent irregular antenatal care at a nearby health care centre. The antenatal period was uneventful. She delivered a healthy male child at 38 weeks gestation by caesarean section. On day 3 of caesarean delivery, she developed shortness of breath and anasarca. She was referred to our hospital in a state of shock and altered sensorium. Arterial blood gas analysis showed severe metabolic acidosis. Immediate intubation was done and started on ionotropic support. She was identified to have acute kidney injury and underwent hemodialysis. SARS CoV 19 test was negative. With serial hemodialysis and broad-spectrum antibiotics, she was finally discharged in stable condition.

DISCUSSION:

Mullerian anomalies are diagnosed in 6.3% and 3.8% of infertile & fertile women as compared to sterile (2.4%) ones.6

Unicornuate uterus accounts for 5–13% of Mullerian duct anomalies with the presence of a rudimentary horn in 74–90% of cases.7,8

 Approximately 25% of these horns have a functional endometrium in their cavity and does not communicate with the main cavity of the contralateral Hemi-uterus (ESHRE/ESGE class U4 or ASRM class II b). The rudimentary horn is preferentially situated on right (62%).3

The risk of spontaneous rupture of anomalous uteri is seen in the first trimester but the cause remains unexplained. Literature search shows that there is an abnormal vascular network between these 2 Hemi-cavities of bicornuate uteri, at the level of the midline.9 Weakening of the uterine wall, particularly at the level of the fundus may be a possible hypothesis predisposing to spontaneous rupture.

Sonographic diagnosis of this malformation is a real challenge owing to the limited field of view as compared to other diagnostic imaging modalities and lateral deviation of the rudimentary horn.10 Many times, the diagnosis is made intraoperatively because of suspected hemoperitoneum in early pregnancy.4

Surgery remains the treatment of choice for ruptured rudimentary horn pregnancy. Prompt diagnosis and early surgical intervention is the mainstay of therapy.  If fertility has to be preserved, excision of rudimentary horn with ipsilateral salpingectomy remains the recommended surgery. With advancements in minimally invasive surgery, laparoscopy is safe and effective, particularly in early unruptured cases. In the above case, because of a large gravid uterus and significant bleeding, the decision of exploratory laparotomy was made.

The subsequent obstetric prognosis seems reassuring. Diagnostic imaging of the reproductive system after this treatment has shown no negative effect of surgery on future fertility with no reported cases of the ruptured uterus during subsequent pregnancy in the remaining unicornuate uterus after rudimentary horn excision.11

To date, several studies have evaluated reproductive outcomes in women with congenital Mullerian duct anomalies. However, evidence from well-controlled studies is lacking on the risk of rupture uterus before or during labour after excision of the rudimentary horn. Though this risk is rare, obstetricians should always prognosticate their patients about maternal and fetal complications. It has been reviewed that unicornuate uterus has 2.7% ectopic pregnancy, 24.3% first-trimester abortion, 9.7% second-trimester abortion, 20.1% preterm birth, 3.8 % intrauterine fetal demise and 51.5% live birth.12

An association of birth defects in fetuses born to mother with congenital uterine malformations have been reported. These defects may due to reduced uterine volumes, which leads to insufficient space for a developing fetus to undergo proper growth, while mechanical pressure impacts the growing fetal structures. Martinez et al. demonstrated that birth defect(s) were 4 times higher among babies born to mothers with uterine defects than in women without such defect. The risk was found to be statistically significant for nasal hypoplasia, omphalocele, limb deficiencies, teratomas, and acardia-anencephaly.13 Zyla et al. in their study found that the most frequent defects were clubfoot and other defects of the limbs.5 No such defect was seen in our case.

CONCLUSION:

Uterine anomalies though rare must always be considered in early pregnant lady presenting with hemoperitoneum. Timely diagnosis and proper management not only save the patient in the current pregnancy but also increases the chance of a successful future pregnancy.

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.

Conflict of interest: No conflict of interest exists for this article.

Source of Funding: No funding was required for this article.

Author contributions:

Anupama Bahadur & Rajlaxmi Mundhra: Main surgeons, Concept, design, analysis, interpretation, literature search and writing

Latika Chawla: Check draft, analysis

Juhi Mishra. Megha Ajmani: literature search, writing the first draft

Jaya Chaturvedi: Draft check and analysis

References:

    1. Rechberger T, Kulik-Rechberger B. Congenital anomalies of the female reproductive tract –Diagnosis and management. Ginekol Pol. 2011;82:137–45.

    2. Jain R, Gami N, Puri M, Trivedi SS. A rare case of intact rudimentary horn pregnancy presenting as hemoperitoneum. J Hum Reprod Sci. 2010;3:113–5.

    3. Nahum GG. Rudimentary uterine horn pregnancy: the 20th-century worldwide experience of 588 cases. J Reprod Med. 2002; 47:151–163.

    1. Ahmed Y, Shahzadi M & Abdelbaset M.Tale of rudimentary horn pregnancy: case reports and literature review. J Maternal-Fet Neona Med.2019; 32:4, 671-676, 

    1. ?y?a MM, Wilczy?ski J, Nowakowska-G??b A, Maniecka-Bry?a I, Nowakowska D. Pregnancy and Delivery in Women with Uterine Malformations. Adv Clin Exp Med. 2015;24(5):873?879. doi:10.17219/acem/23171

    2. Raga F, Bauset C, Remohi J, Bonilla-Musoles F, Simon C, Pellicer A. Reproductive impact of congenital Mullerian anomalies. Hum. Reprod. 1997;12:2277–2281

    3. Grimbizis GF, Gordts S, Di Spiezio SA, Brucker S, De Angelis C. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod. 2013 Aug;28(8):2032-44.

    4. Bruand M, Thubert T, Winer N, Gueudry P, Dochez V. Rupture of Non-communicating Rudimentary Horn of Uterus at 12 Weeks' Gestation. Cureus. 2020;12(3):e7191. Published 2020 Mar 6. doi:10.7759/cureus.7191

    5. Nazzaro G, Locci M, Marilena M, Salzano E, Palmieri T, De Placido G. Differentiating between septate and bicornuate uterus: bi-dimensional and 3-dimensional power Doppler findings. J Minim Invasive Gynecol. 2014;21(5):870?876. doi:10.1016/j.jmig.2014.03.023

    6. Sonographic findings of early pregnancy in the rudimentary horn of a unicornuate uterus: a two-case report. Dove CK, Harvey SM, Spalluto LB. Clin Imaging. 2018;47:25–29.

    7. Pados G, Tsolakidis D, Athanatos D, Almaloglou K, Nikolaidis N, Tarlatzis B. Reproductive and obstetric outcome after laparoscopic excision of functional, non-communicating broadly attached rudimentary horn: a case series. Eur J Obstet Gynecol Reprod Biol. 2014;182:33?37. doi:10.1016/j.ejogrb.2014.08.023

    8. Reichman D, Laufer MR, Robinson B. Pregnancy outcomes in unicornuate uteri: a review. Fertil Steril. 2009;91:1886–94.

    9. Martinez-Frías ML, Bermejo E, Rodríguez-Pinilla E, Frías JL. Congenital anomalies in the offspring of mothers with a bicornuate uterus. Pediatrics. 1998;101(4):E10. doi:10.1542/peds.101.4.e10

Announcements

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

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Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

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

Women Researcher Award:

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

Emerging Researcher Award:

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


Best Article Award

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

List of Awardees

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


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


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