International Journal of Current Research and Review
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IJCRR - Vol 13 Issue 17, September, 2021

Pages: 10-15

Date of Publication: 12-Sep-2021


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Clinician's Choice of Health Related Quality of Life Index in Maxillectomy Patients with Obturator Prostheses: A Systematic Review

Author: Raut A, Hota S, Bhusan P, Mohanty A K, Padmanaban A

Category: Healthcare

Abstract:Introduction: Patients suffering from maxillary defects generally encounter difficulty in mastication, speech and postoperative depression. Such clinical cases can be rehabilitated with reconstructive surgery or obturator prostheses with or without implants to improve the quality of life(QOL). Study Selection: A systematic search of PubMed and web of science databases for articles published before 2020 December was performed by reviewers (reviewed). A manual search of articles published from January 2000 to December 2020 was also conducted. The present study identifies the most preferred QOL assessment index in patients with head and neck cancers who had undergone rehabilitation with obturator prostheses. Result: Most of the studies were cross-sectional and the most preferred HRQOL index used was OFS and UWQOL scale version 4. The result of the study also showed that meaningful quality of life can be achieved in patients who have undergone reconstruction with obturator prosthesis following maxillectomy. The study provides relevant information in selecting HRQOL measures as well as planning future studies and developing treatment protocols. Conclusion: The limited data indicate that fabrication of the obturator prostheses significantly contributes to improved psycho-logical well-being and the quality of life for maxillectomy patients. Well-designed clinical studies are necessary to draw definitive conclusions about how the fabrication of obturator prostheses affects the quality of life of maxillectomy patients.

Keywords: Health-related quality of life, Maxillectomy, Obturator functioning, Mastication, Swallowing, Cancer

Full Text:

INTRODUCTION

Maxillofacial Prosthetics is the art and science of anatomic, functional or cosmetic reconstruction using non-living substitutes of those regions in the maxilla, mandible, face and even other body parts that are missing or defective because of surgical intervention, trauma, pathology or developmental or congenital malformation.

The WHO defines the quality of life as the individual’s perception of their position in life in the context of the culture and value systems in which they live and concerning their goals, expectations, standards and concerns.2

Maxillary cancer represents a rare form of head and neck malignancy that can have a profound impact on the quality of life. The direct effect of cancer required therapeutic interventions and it can result in significant facial disfigurement as well as functional disability involving both swallowing and speech.4,16

Studies on the quality of life of patients with head and neck cancer have shown high levels of emotional anguish, physical constraints and disturbances in body image and damage in social relations.12 However, studies on changes perceived in quality of life after prosthetic rehabilitation are limited.

Traditionally, obturator prostheses have been used to occlude areas of the palate that have been resected. Reconstruction with obturator prostheses (with or without implants) diminishes difficulties associated with mastication and swallowing and has been shown to result in significant improvement in speech intelligibility and communication performance.16,17

Studies in the literature on quality of life in patients with maxillectomy and rehabilitation with obturators have shown that the correlation between obturator function and quality of life can be influenced by clinical factors, such as type of tumours and stage of disease, the extent of the ablative defect, postoperative radiation therapy, number and condition of remaining maxillary teeth and demographic and other social variables.1,14

Also, there are various types of scales/ indices available to assess the quality of life after prosthetic rehabilitation that increases randomness to draw a significant conclusion.

AIM

The study aims to identify

  1. most frequently used  index for assessment of the quality of life with obturator prosthesis in maxillectomy patients and

  2.  Factors/determinants that can influence overall QoL.

MATERIALS AND METHOD

A systematic literature review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review.11

Focused question patient intervention comparison and outcome (PICO format)

 The review is focused on:” What is the efficacy of obturator prosthesis on quality of life of maxillectomy patients?”

Search strategy

A  MEDLINE  electronic search on   PubMed from  January  2000  to  December  2020 was conducted for articles published in the dental literature, and limited to human trials, using the search terms 'maxillofacial prosthesis', 'patient satisfaction, 'palatal obturators', 'positive life evaluation', 'head & neck cancer', 'health-related quality of life, 'maxillary obturator', 'facial prostheses'. (Table 1)

Moreover, a manual search of the following journals was also conducted: Journal of Prosthetic Dentistry, Journal of Oral Maxillofacial  Surgery, and the  International  Journal of Oral and Maxillofacial  Surgery, Journal of Plastic, Reconstructive & Aesthetic Surgery, Journal of  Archives of  Otolaryngology-Head and  Neck  Surgery, Journal of Head & Neck, Journal of Advanced prosthodontics.

Study exclusion criteria: Duplicate studies, in vitro and in vivo, obtained from the search results, case reports or case series, and studies based on interviews or commentaries were excluded to eliminate bias in the results. Studies of patients other than non-neoplastic origin were also excluded.

Two independent reviewers selected the studies for the systematic reviewing through each phasing of review screening, eligibility criteria and inclusion criteria. The Cohen kappa method was used to calculate inter-reviewer agreement. The selected studies were classified according to the Jadad scale. Studies classified as “low quality” had a score between 0 and 2, and those between 3and 5 were classified as “high quality.”

RESULTS

A total of 15 articles from the electronic and manual search of the PUBMED database were included in the study (Table 1). Out of 15 articles, twelve studies have used the OFS assessment index as it is the most common tool for such a study. The mean age was 55 years. Of the 15 articles, eleven were cross-sectional and four were longitudinal.

Results of the study can be summarized as

  1. No significant correlation between the extent of the defect or maxillary defect classification and QOL or obturator functioning.

  2. No significant correlation between various age groups and QOL.

  3. Maxillectomy patients who receive additional radiation and chemotherapy rate score low on the QOL scale. Otherwise no significant difference between QOL of patients with prosthetic obturator prostheses or free flap reconstruction.

  4. No complications related to obturator prostheses were reported.

  5. The use of dental implants in combination with CAD/CAM results in the best functional outcome and least morbidity.

  6. Further research such as the application of stem cells may help to overcome associated problems of obturator prostheses or free flap reconstruction and improve overall QOL.

DISCUSSION

The systematic review shortlisted a limited number of studies that evaluated the QOL of patients with maxillary defects who underwent prosthetic rehabilitation with obturator prostheses. A direct comparison of the QOL scores was a challenge as most of the studies included were not randomized or double-blind studies. Most of the articles are based on cross-sectional study design tending to adapt to most treatments over time and thus differences among groups may be identified only in a longitudinal study.

UWQOL score

The questionnaire consists of 15 questions. The first 12 domains concern areas of daily living that are often affected by treatment of head and neck cancer, such as pain, disfigurement, activity, recreation and entertainment, chewing, swallowing, speech, shoulder disability, taste, saliva, and 2 new emotional domains of mood and anxiety. To describe current functional status, each domain has a maximum score of 100 points, indicating the highest level of function, and a minimum score of 0, indicating the poorest level of function.

OFS score

The OFS was developed at Memorial Sloan-Kettering Cancer Center as a means of assessing the self-reported functioning of an obturator. TheOFS score gives information about the degree of patient satisfaction and qualitative assessment of obturator prosthesis. The questionnaire is very intelligently framed to give relevant information regarding eating and speech. Dryness of mouth, an effect of radiotherapy on major and possibly minor salivary glands, was included as an item in the scale because poor lubrication of the mouth is a possible contributor to poorer fit or functioning of the prosthesis. Another item, “difficulty talking on the phone,” was added to the scale to assess communication difficulties in the absence of visual cues. The answer to each question is rated in a numerical value from 0 to 100.

Most of the studies used more than one index to measure HRQOL. The most frequently used scale is OFS, however, more studies are needed for establishing the clinical utility of OFS as a screening measure.  Different retention mechanisms like the addition of attachments, zygomatic implants and rapid prototyping or CAD/CAM techniques score high on the scale.

Other Variables

Brown et al. attempted a practical classification of maxillectomy defects that describes the defect and indicates the likely functional and aesthetic outcome.8In this study most commonly reported defects were 2A or 2B. Leakage when swallowing food was the most commonly reported problem however adaptation develops to maintain QOL.

Age was considered an influential factor to decide the type of reconstruction by the patient. One study based on the rehabilitation of hemipalato maxillectomy defects using a prosthetic obturator or a vascularized bone containing free flap highlighted the advantage of a permanent tissue closure of the palatal defect to reduce morbidity.5The study revealed young patients prefer surgical closure despite the additional cost and procedure involved. Prosthetic rehabilitation is better when it follows reconstruction. However, no statistically significant differences were seen between obturators and free flap groups. Reconstruction complications are more evident in patients with malignant tumours resulting in relapse, dehiscence of the grafted tissue, fistula development and necrosis.

The quality and quantity of supporting tissue and remaining natural teeth influence the relationship and position of the prosthesis to the implant. A retained implant obturator prosthesis is indicated as long as the supporting bone is adequate for the fixation of implants.

Postoperative radiotherapy negatively influences mean maximal mouth opening. The limited mouth opening profoundly diminishes the quality of life due to the inability of speech, mastication and deglutition. Post radiation trismus compromises the prognosis. Open defects were more compromised because of both radiotherapy and chemotherapy leading to elevated response on the total OFS score which would suggest overall dissatisfaction with the obturator scale.6,10,20,23

Reduced salivation and susceptibility to frequent soft tissue injury and frail nature of oral mucosa following radiation therapy is a significant limiting aspect. The absence of clinically significant xerostomia does not preclude the possibility of dry mouth. Silicone-lined obturators were well anchored and comfortable exhibiting greater efficiency towards QoL. Dryness of mouth is also associated with lower speech intelligibility scores. Another study revealed participants found moist and softer foodstuff easier to masticate; hard and dry foods presented the greatest difficulty. This was attributed to the greater likelihood of reduced salivation post maxillectomies.22

One of the studies added a question specifically related to difficulty talking on the phone in the OFS scale as an adaptation measure.4Poor aeromechanical speech results were associated with patient-reported avoidance of social events, whereas lower speech intelligibility outcomes were related to the overall poorer perception of speech function on the OFS.9

Two studies emphasized specialists emphasizing regular care and follow up visits for obturators as an appropriate treatment option to identify tumour recurrence, discomfort and adaptation failure before treatment failure.12,21

One study claimed that patients who underwent a facial approach reported on lower quality of life than those who underwent a transoral approach. Female patients showed a higher level of depression than male patients, although this did not reach significance.4Also better ratings were found for patients who received a higher level of education.

Implants offer more promising and predictable treatment options by supporting an obturator prosthesis in place and improving mastication and tissue adaptation.24However, limited residual bone after a maxillectomy is a large problem for the implant approach. The use of zygomatic implants with magnets and bar attachments has changed the treatment modality and offered retention force to enhance support and improve the stability of the obturator prosthesis. A treatment approach consisting of multiple zygomatic implants was considered to create a source of vertical resistance and retention. The advent of zygomatic implants has drastically enhanced treatment and potentially revolutionized maxillary reconstruction following extensive ablative tumour resection.3

As the selected articles are suggestive of low quality on the Jadad scale no robust inference can be drawn. The free tissue transfer reconstruction eliminates physiologic distress to the patients and provide excellent management of maxillectomy defects but on the contrary obturator prostheses provide immediate reestablishment of facial morphology and oral functioning. There is a significant improvement in speech, swallowing and overall quality of life with operators under regular follow up period.

Health-related quality of life (HRQOL) is an important outcome parameter following treatment of head and neck cancer. Two national bodies, the British Association of Head and Neck Oncologists and the British Association of Otorhinolaryngologists Head and Neck Surgeons http:/www.bahno.org.uk/bulletin.htm#quality, both recommend that HRQOL should be longitudinally recorded. Questionnaires give a structured insight into the patients’ opinions. They facilitate multidisciplinary teams working with the recognition of poor outcome groups and the opportunity to identify problem areas and target support/intervention.

Limitations of the study:

  1. The most important limitation in the included studies was that there was significant clinical heterogeneity between the studies which makes it difficult to conclude. Statistically, significant improvement cannot be calculated due to the inability to perform the meta-analysis. Prospective, blinded, randomized, multicenter studies with standardized methodology need to be performed. According to the Jadad scale, all selected studies showed low quality. Direct comparison of the results are not possible as in different studies, different tests and scales were used to evaluate the QoL.

  2. Small sample size: As maxillary cancer is a rare tumour with increased mortality small sample sizes are typically found in studies of maxillectomy patients.

  3. Despite intensive research related to the quality of life post-cancer therapy, only a few studies evaluate the quality of life of maxillectomy patients rehabilitated with an obturator.

  4. Because of the low incidence of maxillofacial tumors, it is not possible to organize prospective studies.

CONCLUSION

This systematic review reveals good obturator function is strongly correlated with the improved quality of life. Patients who undergo maxillectomy often enquire about the quality of life post-surgery. The present study data can be used to reassure patients following maxillectomy and prosthetic reconstruction to have an acceptable quality of life. However, the presence of family members, socioeconomic status and valued activities and interests all help people with cancer to overcome functional disability. Stem cell regeneration and advanced future research can modify the approach to obturator prosthesis or free flap reconstruction and will help to improve patients' QoL after maxillectomy in the future. Future research objective also includes the need for meta-analysis.

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

Source of Funding: self

Conflict of Interest: Nil

References:

1. Kumar P, Alvi HA, Rao J, Singh BP, Jurel SK, Kumar L, et al. Assessment of the quality of life in maxillectomy patients: A longitudinal study. J Adv Prosthodont. 2013;5:29-35.

2. What quality of life? The WHOQOL Group. World Health Organization Quality of Life Assessment. World Health Forum. 1996;17:354-6.

3. Wang F, Huang W, Zhang C, Sun J, Qu X, Wu Y.Functional outcome and quality of life after a maxillectomy: a comparison between an implant-supported obturator and implant-supported ?xed prostheses in a free vascularized flap.Clin. Oral Impl. Res. 2017 Feb;28(2):137-143.

4. Irish J, Sandhu N, Simpson C, Wood R, Gilbert R, Gullane P, et al. Quality of life in patients with maxillectomy prostheses. Head Neck. 2009;31:813-21.

5. Genden EM, Okay D, Stepp MT, Rezaee RP, Mojica JS, Buchbinder D, et al. Comparison of functional and quality-of-life outcomes in patients with and without palatomaxillary reconstruction: a preliminary report. Arch OtolaryngolHead Neck Surg 2003;129:775-80.

6..Kreeft AM, Krap M, Wismeijer D, Speksnijder CM, Smeele LE, Bosch SD, et al. Oral function after maxillectomy and reconstruction with an obturator. Int J Oral Maxillofac Surg 2012;41:1387-92.

7..Borlase G. Use of obturators in rehabilitation of maxillectomy defects. Ann R AustralasColl Dent Surg. 2000 Oct;15:75-9.

8. Brown JS, Rogers SN, McNally DN, Boyle M. A modified classification for the maxillectomy defect. Head Neck. 2000;22:17-26.

9. Rieger JM, Wolfaardt JF, Jha N, Seikaly H. Maxillary obturators: the relationship between patient satisfaction and speech outcome. Head Neck. 2003;25:895-903.

10.  Rogers SN, Lowe D, McNally D, Brown JS, Vaughan ED. Health-related quality of life after maxillectomy: a comparison between prosthetic obturation and free flap. J Oral Maxillofac Surg. 2003;61:174-81.

11 Brandao TB, Filho A, Batista V, Oliveira M, Silva A. Obturator prostheses versus free tissue transfers: A systematic review of the optimal approach to improving the quality of life for patients with maxillary defects. J Prosthet Dent. 2016;115:247-253

12. Goiato MC, Pesqueira AA, Silva  CR, Filho HG, Santos DMD. Patient satisfaction with maxillofacial prosthesis. Literature review. JPlas Recons Aes Surg. 2009;62:175-180.

13. Ali MM, Khalifa N, Alhajj MN. Quality of life and problems associated with obturators of patients with maxillectomies. Head Med. 2018 14:2:1-9

14. Seignemartin CP, Miranda ME,Luz JGC,Teixeira RG. Understandability of speech predicts quality of life among maxillectomy patients restored with obturator prosthesis. J Oral Maxillofac Surg 2015;73:2040-2048.

15. Chen C, Ren WH, Huang RZ, Gao L, Hu ZP, Zhang LM, et al.Quality of Life in Patients After Maxillectomy and Placement of Prosthetic Obturator.Int J Prosthodont. Jul-Aug 2016;29(4):363-8.

16. Arigbede AO, Dosumu OO, Shaba OP, Esan TA. Evaluation of speech in patients with partial surgically acquired defects: pre and post prosthetic obturation. J Contemp Dent Pract. 2006;7:89–96.

17. Sullivan M, Gaebler C, Beukelman D, Mahanna G, Marshall J, Lydiatt D et al. Impact of palatal prosthodontic intervention on communication performance of patient’s maxillectomy defects: a multilevel outcome study. Head Neck. 2002;24:530–538.

18. Riaz N, Warriach RA.Quality of life in patients with obturator prostheses. J Ayub Med Coll Abbottabad. Apr-Jun 2010;22(2):121-5.

19. Artopoulo LL, Karademas EC, Papadogeorgakis N, PapathanasiouI, Plyzois G. Effects of sociodemographic, treatment variables and medical characteristics on quality of life of patients with maxillectomy restored with obturator prostheses. J Prosthet Dent. 2017

20. Chigurupati R, Aloor N, Salas R, Schmidt BL. Quality of life after maxillectomy and prosthetic obturator rehabilitation. J Oral Maxillofac Surg. 2013;71:1471-8.

21. Santos DMD, Caxias FP, Bitencourt SB, Turcio KH, Pesqueira AA, Goiato MC. Oral rehabilitation of patients after maxillectomy. A systematic review.Br J Oral Maxillofac Surg. 2017.

22. Ikusika OF, Dosumu OO, Ajayi DM, Ogurinde TJ. Effect of the resilient lining of obturator bulbs on patients with maxillectomies. J Prosthet Dent. 2016 Dec;116(6):932-936.

23. Said M, Otomaru T, Yeerken Y, Taniguchi H. Masticatory function and oral health-related quality of life in patients after partial maxillectomies with closed or open defects. J Prosthet Dent. 2017 Jul;118(1):108-112

24. Buurman DJM, Speksnijder CM, Engelen BHBT, Kessler P Peter Kessler, Masticatory performance and oral health-related quality of life in edentulous maxillectomy patients: A cross-sectional study to compare implant-supported obturators and conventional obturators. Clin Oral Impl Res. 2020;31:405–416.

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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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‘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.


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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
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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
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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
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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
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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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