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

Pages: 215-219

Date of Publication: 11-Jun-2021


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Spectrum of Atypical HRCT Chest Imaging Features in Covid 19 Patients from Eastern India -A Revelation

Author: Rohit Arora, Kamal K. Sen, Sangram Panda, Sudhansu Sekhar Mohanty, Mayank Goyal, Roopak Dubey

Category: Healthcare

Abstract:Background: Coronavirus Disease 2019 (COVID-19), a severe respiratory syndrome is a pandemic, known to affect patients of all age groups with varied imaging features. Aim and Objective: To identify and categorize the additional Atypical imaging features detected in COVID 19 patients from eastern India. Method: HRCT images of 1300 COVID-19 patients without any known co-morbid conditions and showing positive HRCT findings were analyzed and evaluated for prevalence of atypical imaging features. HRCT images were categorized into typical, atypical and indeterminate. Further the additional atypical features were evaluated. Results: Out of 1300 patients, 320 (24.6%) patients showed atypical imaging features, 860 patients (64.6%) were in the Typical and 140 (10.7%) were in the indeterminate category. Amongst patients with atypical imaging features, we found that isolated lobar or segmental consolidation without associated GGO's prevalent in 5.6% of patients, discrete pulmonary nodules which include both centrilobular and tree-in-bud nodular patterns in 42%, mediastinal/hilar lymphadenopathy in 9.3%. About 11% of patients had pleural effusion and 1.2% demonstrated pneumothorax and pneumomediastinum. Linear or subsegmental atelectasis was noted in 66% of patients. Conclusion: Significantly higher additional atypical features like atelectatic bands & subpleural curvilinear atelectasis (66%), followed by discrete nodules (42%) were associated with COVID 19 diagnosis in the absence of any known co-morbid conditions. We propose that imaging findings that have not been categorized under any of the existing four groups, be incorporated in either a mixed category or added to any of the existing groups, in the current imaging-based classification for COVID 19.

Keywords: Atypical, COVID 19, HRCT, GGO, RT-PCR

Full Text:

INTRODUCTION

Coronavirus infection has become a global concern since the outbreak of Severe Acute Respiratory Syndrome Coronavirus (SARS-COV-1) in 2002-2003.1,2 and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in 2012.3,4 In late December 2019, an outbreak of pneumonia was reported in Wuhan, China caused by novel coronavirus 2019-nCoV, currently designated as a severe acute respiratory syndrome (SARS-COV-2) by the International Committee on Taxonomy of Viruses (ICTV).5 The disease has now been officially named COVID 19 by World Health Organization. On January 7, 2020 a novel coronavirus has been identified as a causative agent by viral typing.6

Initially, it caused an outbreak of pneumonia in china and thereafter had spread globally with nearly 9 million confirmed cases and 470,000 deaths till June 23,2020.7 With the growing global concerns about the COVID-19 outbreak, it necessitates a comprehensive understanding of the hallmark and/ or atypical imaging features for an early diagnosis. In a study by Simpson et al. in the year 2020 imaging findings were categorized into four groups: Typical, Atypical, Indeterminate and Negative for COVID 19.8 It provides a set protocol that can reduce variation in reporting. The primary findings on chest radiographs and CT is that of atypical pneumonia or organizing pneumonia.   

Reverse transcriptase-polymerase chain reactions (RT-PCR), which serves as a gold standard, has a sensitivity of about 71 per cent,9 while High-Resolution Computed Tomography (HRCT) Thorax appears to have a much higher sensitivity as analysed by Fang et al. who reported a 98 % sensitivity for the diagnosis of COVID-19.10 RT PCR for COVID-19 takes about 2-3 days for the results to come and hence clinicians are dependent on accurate diagnostic imaging for isolation & specific management.11

In this study, we have attempted to analyse HRCT images of 1300 COVID-19 and HRCT positive patients and evaluated the prevalence of the atypical imaging features amongst our study group. In addition, imaging findings amongst the patients from this part of the country, which do not fit under any of the existing groups necessitated inclusion in a separate category. Hence, we propose a modification of the available criteria for categorizing COVID 19 based on imaging and incorporation of these imaging features.

MATERIALS AND METHODS

Patient population and study design

This is a prospective study conducted in Odisha COVID Hospital, KIMS, India.

1300 consecutive COVID positive (RT-PCR ) patients without known co-morbid conditions with positive imaging features on HRCT Thorax were included in our study group.  

Computerised Tomography ( CT)  Acquisition Technique

Chest CT acquisitions were obtained with the patients in the supine position during end inspiration. Evaluation is done with 64-slice CT Siemens Somatom go. Up having 2.2 cm stellar detector with Sinogram Affirmed Iterative Reconstruction (SAFIRE) software dedicated only to patients of COVID 19. The scan was performed with the following technical parameters tube voltage 100-120 V; tube current modulation 180-400 mAs; automated exposure control; collimation width 64 X 0.625 mm; interslice gap 0mm; reconstruction algorithm: iterative-based reconstruction. Reconstructions were obtained at a slice thickness of 1.25 mm.

The scanning range covered the area from the level of the thoracic inlet to the diaphragm.

Computerised Tomography (CT) Image Analysis

All the CT images were viewed by two Residents involved in the study, followed by two Senior Radiologists. Radiological findings were classified into three groups viz. Typical, Atypical and Indeterminate for COVID 19 (Table 1), similar to an earlier study by Simpson S et.al. Negative for COVID 19 pneumonia were excluded in our study population. All data were anonymized and collected in a shared database. In our study the following atypical features were considered for analysis:

Presence of

a) Soft tissue nodules

b) Pleural effusion or pleural thickening

c) Mediastinal or hilar lymphadenopathy (> 10mm in short axis diameter)

d) Isolated consolidation

e) Presence of atelectasis

f) Presence subpleural linear or curvilinear opacification

g) Underlying lung diseases like fibrosis, bronchiectasis changes or emphysema

h) Pleural effusion or pleural thickening, lymphadenopathy and pneumothorax or pneumo-mediastinum in addition to ground glass opacifications (GGO’s).

The nodule is around or irregular opacity of less than 3 cm in diameter with sharp or ill-defined margins. They are classified as centrilobular or tree-in-bud and discrete nodules.12 GGO represent filling of alveolar space with pus, oedema, haemorrhage or cells causing haziness with preserved broncho-vascular marking.13,14 Consolidation refers to opacification of the alveolar space with the abutment of broncho-vascular markings.15,16 Sub pleural lines (also known as pleural lines) refers to thin linear or curvilinear opacities, 1-3 mm in thickness, lying less than 1 cm from and parallel to the pleural surface.

RESULTS

1300 positive COVID-19 patients, with positive imaging findings were analysed. We found that 320 patients (24.6%) showed atypical imaging features, 860 patients (64.6%) were in the Typical and 140 (10.7%) were in the indeterminate category (Fig.1).

We found that of the 24.6% patients having atypical imaging findings on HRCT, Isolated lobar or segmental consolidation without associated GGO’s was noted in 5.6% of patients, 42.8% had discrete pulmonary nodules which includes both centrilobular and tree-in-bud nodular patterns, 9.3% presented with mediastinal lymphadenopathy/ hilar lymphadenopathy. About 11.2% had pleural effusion and 1.2% demonstrated pneumothorax and pneumomediastinum. Linear or subsegmental atelectasis was noted in 66.2% of patients (Table 1).

About 86% of the patients showing atypical imaging features on HRCT belonged to the adult age group while 9% and 5% belonged to the elderly and paediatric age group respectively.

We also found the presence of GGOs in addition to discrete nodules in 73, hilar or mediastinal lymphadenopathy in 42, pneumothorax or pneumomediastinum in 1 and pleural effusion in 7 patients and about 212 patients showed linear or subsegmental atelectasis (Table 2), probably due to partly resolving pneumonia or early fibrosis.

DISCUSSION

Established guidelines are the need of the hour for a comprehensive understanding of Typical & atypical imaging features on CT, for an early diagnosis and effective patient management.

The commonest imaging findings noted on HRCT in our study population were multifocal GGO’s of rounded morphology, GGO’s with associated interlobular septal thickening termed as “crazy paving appearance” and GGO’s associated with air space consolidation. There was the involvement of multiple lobes especially lower lobes with a peripheral distribution and basal zone predilection in the majority of the cases. Other features included halo-sign, reverse halo-sign, non-rounded or non-peripheral GGO’s with or without consolidation lacking specific distribution, coarse linear or curvilinear opacities or fine subpleural reticulations, isolated consolidation without GGO, discrete small nodules (centrilobular or tree in bud), pleural effusion, pneumothorax/ pneumomediastinum, bronchiectasis changes and lymphadenopathy.

320 patients showed atypical imaging features which accounts for about 24.6 % of the total study sample. Atypical imaging features (Fig. 2) in this study group were, isolated lobar or segmental consolidation without GGO’s in 18 patients, discrete pulmonary nodules, both centrilobular and tree-in-bud patterns in 137, hilar or mediastinal lymphadenopathy in 30, pleural effusion or pleural thickening in 36 and pneumothorax or pneumo-mediastinum in 4 patients. 212 patients showed linear or subsegmental atelectasis.

In a study by Federica Ciccarese et al., it was stated that 7 out of 211 (3.3%) COVID positive patients had atypical imaging features. However, 60 out of 249 (24 %) patients showed atypical imaging features who were negative on RT-PCR17 indicating that these features have a more common association with a non-COVID aetiology. In another study by Sudhir Bhandari et al. on 80 COVID patients revealed that about 2.5% of patients had atypical imaging features on HRCT.18 In another retrospective study on 96 suspected COVID patients by de Jaegere et al. (RSNA) found that amongst 45 RT-PCR positive patients, 2.5-5.3% showed atypical imaging features on HRCT.19 This depicts a significantly higher prevalence of atypical imaging features in COVID 19 patients in our study sample, as compared to the previous studies. Hence it is felt that atypical imaging features may not be such an uncommon association in  COVID 19, as previously conceptualized.

As per the presently available literature, the Chest CT severity score does not include certain atypical imaging features like pleural effusion, pneumothorax or pneumomediastinum and lymphadenopathy.20 At present, atypical features on imaging is thought to be associated with non- COVID 19 aetiology, like Tuberculosis or other viral infections, aspiration pneumonia and metastasis.21 But in our study we found an association of additional atypical imaging features in a significant number of RT-PCR positive patients, without any comorbidities like tuberculosis, chronic kidney diseases, hepatitis and immunocompromised conditions like HIV, Hepatitis B and patients on immunosuppressants. Hence images must be analysed meticulously in order not to overlook these features that will help in accurate CT staging, standardisation and enhance the diagnostic efficacy.

Atypical imaging features were most commonly seen in the adult age group and less commonly in the paediatric and elderly age groups in our study population. The probable cause of this adult involvement could be due to higher exposure to the infected population.

We also found that certain additional imaging findings were overlapping and were not categorized under any of the types i.e. Typical, Atypical, Indeterminate for COVID as per present imaging-based classification. These findings are as follows:

  1. Unaccompanied ground glass opacifications and nodules

  2. Ground glass opacifications and pleural effusion/ pleural thickening

  3. Ground glass opacifications and pneumothorax/ pneumomediastinum

  4. Ground glass opacifications and hilar/ mediastinal lymphadenopathy

  5. Linear or Sub-segmental atelectasis

CONCLUSION

In our study group in this part of the country, the Typical features were 64.6%, indeterminate 10.7% and Atypical 24.6%. Significantly higher atypical features like atelectatic bands & subpleural curvilinear atelectasis (66%), followed by discrete nodules (42%) were more in favour of COVID 19 in absence of any other known co-morbid conditions like tuberculosis, chronic kidney diseases, hepatitis and immunocompromised conditions like HIV, Hep B and patients on immunosuppressants. It was noted that the prevalence of atypical features was more prevalent in the adult population.

We propose that the imaging findings found in our study, which have not been categorized under any of the four groups, need to be incorporated in either a mixed category or any of the existing groups in the current imaging, based classification for COVID 19.

In this pandemic situation, all patients with respiratory tract infection, fever, dyspnoea & HRCT features of COVID, including these atypical features, may be subjected to RT PCR to rule out COVID 19. Faster diagnosis, early isolation to restrict the spread of the disease will help society at large, besides helping in specific management.

Conflict of Interest: Nil

Source of funding: Nil

Authors' contributions

Arora R, Sen KK, Panda S, Mohanty SS, Goyal M, Dubey R.

Arora R - Primary and corresponding author is responsible for ensuring that the descriptions are accurate and agreed by all authors,

Sen KK – Guide for manuscript preparation,

Panda S and Mohanty SS had made substantial contributions to all of the following: (1) the conception and design of the radiological work; (2) the acquisition, analysis, and interpretation of radiological data; and (3) drafting the work and revising it

Goyal M and Dubey R had made substantial contributions to (1) acquisition, analysis, and interpretation of clinico-laboratory data and (2) drafting the work and revising it.

All authors approved the submitted version. All authors have agreed both to be personally accountable for the author’s own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

Figure 2: Axial section through HRCT chest demonstrating atypical imaging features. (A) Mediastinal lymphadenopathy; (B) Ground glass opacifications, pneumothorax, pneumomediastinum and subcutaneous emphysema; (C) Peripheral confluent ground glass opacifications; (D) Subpleural curvilinear opacifications; (E) Isolated segmental consolidation; (F) Tree-in bud nodules.

References:

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

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

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Best Article Award

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A study by Saurabh Suvidha entitled \"A Case of Mucoid Degeneration of Uterine Fibroid with Hydrosalphinx and Ovarian Cyst\" is awarded Best article of Vol 14 issue 21
A study by Alice Alice entitled \"Strengthening of Human Milk Banking across South Asian Countries: A Next Step Forward\" is awarded Best article of Vol 14 issue 20
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A study by Singh R. et al. entitled \"A Prospective Study to Find the Association of Astigmatism in Patients of Vernal Keratoconjunctivitis (VKC) in a Tertiary Health Care Centre in India (Vindhya Region MP)\" is awarded Best Article for Vol 14 issue 15
A Study by Humaira Tahir et al. entitled "Comparison of First Analgesic Demand after Major Surgeries of Obstetrics and Gynecology between Pre-Emptive Versus Intra-Operative Groups by Using Intravenous Paracetamol: A Cross-Sectional Study" is awarded Best Article for Vol 14 issue 14
A Study by Monica K. entitled "Risk Predictors for Lymphoma Development in Sjogren Syndrome - A Systematic Review" is awarded Best Article for Vol 14 issue 13
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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
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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
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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
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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
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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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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

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