International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - Vol 13 Issue 17, September, 2021

Pages: 84-87

Date of Publication: 12-Sep-2021


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Effectiveness of Right Median Nerve Electrical Stimulation in Improving Functional Status in Persons with Traumatic Brain Injury

Author: Divya L, Kumaresan A, Prathap Suganthirababu, Vignesh S

Category: Healthcare

Abstract:Background: Traumatic brain injury is one of the devastating clinical conditions, leading to loss of consciousness and arousal at some point of time after injury. The median nerve serves as the peripheral gateway for accessing the central nervous system among persons with coma. Aim: The study aims to evaluate the effectiveness of the right median nerve electrical stimulation on functional status in participants with traumatic brain injury. Methods: A quasi-experimental study was done on 30 traumatic brain injury participants. Participants were recruited after obtaining an informed consent form from the participant's caregiver. Ranchos Los Amigos Scale was used as a screening tool for the inclusion of participants. The pre-test measurement of functional status was obtained through the Disability rating scale. Right median nerve electrical stimulation was given over the right hand for four weeks. At the end of study duration, Post-test measurements were taken and data were tabulated and analyzed statistically by using Wilcoxon signed-rank test. Results: It was observed that there was a significant improvement in functional status (P< 0.001) in participants with traumatic brain injury. Conclusion: Right median nerve electrical stimulation is a safe, inexpensive, and noninvasive technique that has a beneficial effect on improving functional status among brain injury participants.

Keywords: Traumatic Brain Injury, Coma, Median Nerve, Right Median Nerve Stimulation, Functional Status, Disability Rating Scale

Full Text:

Introduction

Traumatic brain injury (TBI) is a form of acquired brain injury leading to insult to the brain due to sudden trauma and the Centers for Disease Control and Prevention (CDC) defines TBI as craniocerebral trauma related to neurological/neuropsychological abnormalities, skull fracture, intracranial lesions or death.1,2At the global, it has been estimated that the annual incidence and mortality from TBI are 200 and 20/100000/year, respectively.3,4The incidence, mortality, and case-fatality rates in India were 150/100000, 20/100000, and 10% based on an epidemiological study.4,5In India, it is estimated that nearly about 1 million dies every year.6Road Traffic accident (RTA) is regarded as one of the leading causes of TBI. RTA contributes to  (60%) of TBI followed by falls (20-25%) and violence (10%).4 Males are suspectable to TBI with 75% incidence in contrast to females and the ratio of injury in male to female in India is about  3:1.7, 8

TBI has been categorized into primary or secondary brain injury. The former is due to the consequences of the physical insult whose pattern and extent of damage depend upon the nature, intensity, and duration of impact.9 Primary and secondary TBI cause temporary and/or permanent dysfunction in the brain, which limits a patient’s activities, affects participation in society, and lowers the quality of life.10,11About 17% of TBI persons undergo a period of complete unconsciousness or coma.12TBI patients have a clinical presentation with the signs and symptoms of loss of consciousness, ear and nose bleed, seizures, paresis, nausea, balance deficits, cognitive-communication and swallowing.13 Physical therapists play a vital role in the neurorehabilitation of traumatic brain injury patients.

The disorders of consciousness(DOC) include coma, vegetative state, and minimally conscious state. Clinical diagnosis of coma is defined by absent or limited vocal or muscle activity and presence of decreased or any abnormal response to noxious stimuli, an absence of sleep-wake cycle.14

Severe DOC range from coma via vegetative state (VS) also referred to as unresponsiveness wakefulness syndrome, a condition during which the patient shows no behavioural evidence of conscious–to minimally conscious state (MCS), characterized by one or more minimal but definite behavioural signs of consciousness.15,18

In the past decades, physiotherapy techniques including neuromuscular electrical stimulation have played a vital role in neurorehabilitation for facilitating or inhibiting muscle tone. It also plays an essential role in unconscious patients. For providing stimulation, the median nerve of the right arm was selected. The right side of the brain has a major representation for cortical reorganization and is responsible for cognitive and sensory reorganization. The sensory distribution of the right hand has a larger cortical representation in the brain. Median nerve stimulation might function by acting on a few neurotransmitters.19,20The disability rating scales (DRS) has been utilized in moderate and severe TBI. DRS can be easily administered and has good reliability and validity. This study aims to evaluate the effect of the right median nerve stimulation on functional status among traumatic brain injury participants.

Methods

The study was a Quasi-experimental study conducted in Saveetha Medical Hospital, Thandalam, Chennai. The sample was drawn from the Physiotherapy neurorehabilitation centre and Inpatient Units at Saveetha Medical Hospital. The study was conducted after getting approval from the Institutional Human Ethical Committee of Saveetha Institute of Medical and Technical Sciences 038/07/2020/IRB-HS/SIMATIC. A convenient sampling technique was used for 30 participants in the study. The safety and simplicity of the procedure were explained to participants caregivers and an informed consent form was obtained from them. Ranchos Los Amigos (RLA) scale was used as a confirmatory test for the inclusion of participants. Selection criteria included RLA Level 1-2 participants, both male, and female, aged between 20 to 55 years, hand dominance–right hand. Participants were excluded if there was, vital signs of unstable, injury of median nerve/brachial plexus and fracture of right wrist, metallic implant in the right upper limb, cervical spinal cord injury, absent sensation in the thenar eminence of the right hand, history of seizures, Cardiac arrhythmia /Pacemaker implanted and pregnancy.

Pre-treatment reading of functional status was noted by using a disability rating scale. After the pre-test measures, participants received treatment through the right side median nerve stimulation. The participant position was supine lying with upper extremity elbow extended, forearm supinated, wrist and fingers extended. The right side forearm was selected for treatment and Neuromuscular electrical stimulation equipment was used.

In order, to reduce the skin resistance hand was wiped with a cotton swab. The electrode placement was active electrode over the volar aspect of the right forearm and the inactive electrode over the volar 2/3rd of the right forearm. Parameters of neuromuscular electrical stimulation- the type of current: surged faradic current, waveform: asymmetric biphasic, frequency: 40hz, duration: 300 ms, amplitude: 20 sec/min, no of contractions: based on the response of muscle to avoid fatigue. The skin was examined for erythema under the electrode site during each treatment session. Similarly, Post-treatment readings were noted by using a disability rating scale.

Results

The collected data were tabulated and analyzed using a nonparametric test. Wilcoxon signed-rank test was utilized for within-group analysis. The significance level of (P<0.001) was considered statistically significant. The results are presented in Table 1. There was a significant difference in pre-test and post-test values of DRS (P<0.001).

As per literature, right median nerve stimulation has been reported to improve the outcomes for traumatic comatose cases.21 The study was done to investigate the effect of the right median nerve stimulation on the functional status by utilizing DRS. DRS scale ranges from 0 to 29.22 The lowest score represents no disability and the highest score is 29 which represents an extreme vegetative state. In the present study from Table 1, the pre-test median score was 28 and after the treatment, the post-test median score was observed to be 24 within the group. The Z value=4.316 and P<0.001 denotes statistical improvement within the group.

Discussion

Hence, the right side median nerve stimulation has effective recovery on functional recovery among traumatic brain injury participants and the probable reason for improvement might be activation of ascending reticular activating system(ARAS) through afferent stimuli provided via right median nerve stimulation and the spinoreticular component of the median nerve synapsing with the neurons of the ARAS.23 A study conducted by Kwan et al. have stated that when the right median nerve is stimulated with certain painful intensity, it results in activation of ARAS and serve as the pathway for the therapeutic function of electrical stimulation.24

Over, a period of four weeks of study duration, the results of the present study revealed that there was significant functional recovery among traumatic brain injuries by the administration of the right median nerve stimulation. The limitation of the study includes the recruitment of participants from a single study centre and qualitative outcomes were used.  In the future, it is recommended that the same study can be done with a large sample population based on age, the severity of the injury and quantitative outcomes such as EEG, fMRI, SPECT scans can be used to assess the cortical reorganization.

Conclusion

The study concludes that the right median nerve has a beneficial effect on the functional status of traumatic brain injury participants. Right median nerve stimulation is easy to administer, inexpensive and can be used in neurorehabilitation in participants with decreased consciousness.

Acknowledgement

The author acknowledges the support received from the Department of Saveetha College of Physiotherapy, Chennai. Authors acknowledge the authors/editors/publishers of all those articles, journals and books that have been utilized in the study.

Funding Source: Self

Conflict of Interest: Nil

References:

1. Solmaz et al. Traumatic brain injury due to gunshot wounds. A single Institution's experience with 442 consecutive patients. Turk Neurosurg.2009;19:216-23.

2. Centers for Disease Control and Prevention (CDC). National centre for traumatic brain injury prevention and control. Report to Congress on mild traumatic brain injury in the United States: Steps to prevents serious public health problem. Atlanta (GA): Centers for Disease Control and Prevention. 2003.

3. Romer CJ, Zitnay G, Gururaj G et al. Prevention, critical care and rehabilitation of Neurotrauma WHO Collaborating center for Neurotrauma.1995.

4. Gururaj G. An Epidemiological approach to prevention, prehospital care and Rehabilitation In neurotrauma, Neurology India.1995;43(3):106.

5. Gururaj G. Epidemiology of Traumatic brain injuries.Indian Scenario. Neur Res.2002;24:1-5.

6. Masel B, Dewitt D. Traumatic Brain injury disease. Long-term consequences of traumatic brain injury. In H.Levin, D&R.Chan(Eds), Understanding traumatic brain injury. Curr Res Fut Direct.2014.

7.  Iranmanesh.F. Outcome of Head trauma. Indian J Pediatr.2009;76(9):929-31.

8. Oyedele EA, Andy E, Solomon GM, Rifkatu L, Nanbur S. The prevalence of traumatic the head is seen in a tertiary health facility in North-Central Nigeria.IJPHR.2015;3(4):127-9.

9. Mass AI MAGS.Prognosis and clinical trial design in traumatic brain injury: The IMPACT study.2007.

10. B.T Mausbach, et al. Activity Restriction and depression in medical patients and their caregivers. A meta-analysis, ClinicalPsychology Review.2011; Vol 3: No 6,pp.900-908.

11. K.A Cappa, J.C Conger, A.J. Conger.Injury severity and outcome.A meta-analysis of prospective studies on TBI.Health Pschol.2011;30(5): 542-560.

12. Mohammad Ali HeidariGorijiet.al.Effect of auditory Stimulation on traumatic coma duration in intensive care unit of the Medical Sciences University of Mazandaran. 2014;8(1);69-72.

13. Gill P, Gill T, Kamath A, Whisnant B. Readability assess­ment of concussion and traumatic brain injury publications by the Centers for Disease Control and Prevention. Int J General Med.2012; 5:923-933.

14. Laureys S, Owen A, Schiff N. Brain Function in a coma,  vegetative state, and related disorders.  Lancet Neur.2004;3(9):537-46.

15. Jennett B, Plum F. Persistent Vegetative state after brain damage- A syndrome in search of a name. The Lancet.1972;229(7753):734-37.

16. LaureysS, Celesia G G, Cohadon F, Lavrijsen J, Leon-Carrion J, Sannita WG et al. European Task Force on Disorders of consciousness Unresponsive wakefulness syndrome: A new name for the vegetative state or apallic syndrome. BMC Med.2010;8-68.

17.  Giacinto JT, Ashwal S, Childs N, Cranford R, Jennett B, Katz DI et al. The minimally conscious state: definition and diagnostic criteria. Neurology.2002; 58(3):349-53.

18. Giacino JT, Kalmar K, Whyte J. The JFK Coma recovery scale- Revised measurement characteristics and diagnostic utility. Arch Phys Med Rehabil.2004;85:2020-2029.

19. Cooper EB, Scherder EJ, Cooper JB. Electrical treatment of reduced consciousness: experience with coma and Alzheimer's disease. Neuropsychol Rehabil. 2005;15:389-405.

20. Lei J, Wang L Gao G, Cooper E, Jiang J. Right Median Nerve Electrical Stimulation for acute traumatic coma patients. J Neurotrauma.2015;32(20):1584-1589.

21. Michal VaimanEphraimnEviatar, Samuel Segal, Tel Aviv, Israel, Surface electromyographic studies of swallowing in normal subjects. A review of 440 adults. Report  Quantitative Data. Timing Measures Otolaryngology-Head and Neck Surgery 2004;131:548-555.

22. Rappaport M, Hall KM, Hopkins K, Belleza T, Cope DN. A disability rating scale for severe head trauma: coma to community. Arch Phys Med Rehabil.1982;63(3):118-23.

23. Kaur H, Gupta D, Sharma V. Right Median nerve stimulation for improving consciousness: A case series.Int J Neo Ther.2015;12(2):144-8.

24. Kwan CL,Crawley AP, Mikulis DJ, Davis KD. An fMRI study of the anterior cingulated cortex and surrounding medial wall activations by noxious cutaneous heat and cold stimuli.Pain.2000;85(3):359-74.

Announcements

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

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SCOPUS indexing: 2014, 2019 to 2021


Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

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

Women Researcher Award:

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

Emerging Researcher Award:

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


Best Article Award

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

List of Awardees

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


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


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