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IJCRR - 14(1), January, 2022

Pages: 98-103

Date of Publication: 03-Jan-2022


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Utility of Fluorescence Immunoassay in Early Diagnosis of Dengue

Author: Das Rashmita, Joshi Suvarna, Palewar Meghna, Karyakarte Rajesh

Category: Healthcare

Abstract:Introduction: Early and prompt diagnosis of dengue infection can help in improving the clinical outcome of patients by ensuring early initiation of supportive treatment. Non-structural glycoprotein-1 (NS-1) is a useful biomarker for the early diagnosis of dengue as it is abundantly present in the serum during the early stages of infection. Several rapid diagnostic tests targeting NS-1 antigen are commercially available and many more are being developed. The present study evaluated a newly developed fluorescence immunoassay (FIA), NS-1 QUANTI CARD test, to determine its effectiveness in the early diagnosis of dengue. Methods and Material: A total of 85 serum samples from clinically suspected dengue patients were tested for NS1 antigen by ELISA, FIA and rapid immunochromatography test (ICT). The performance characteristics of FIA and ICT were calculated considering ELISA as the gold standard test. Sensitivity, specificity, predictive values, likelihood ratios and Cohen's Kappa value for the level of agreement were calculated using MedCalc\? Statistical Software version 19.6.4. Results: The overall sensitivity, specificity, positive and negative predictive values of FIA and ICT were found to be 96.5%, 96.4%, 93.3%, 98.1% and 65.5%, 83.9%, 67.8%, 82.4%, respectively. There was almost a perfect level of agreement between the ELISA and QUANTI CARD test whereas ELISA and ICT results had a moderate level of agreement. Conclusion: Owing to its shorter turnaround time (TAT), the NS1 Ag QUANTI CARD test can be a better alternative to ELISA for dengue diagnosis in resource-limited settings and critically ill patients for prompt diagnosis.

Keywords: Dengue, Enzyme Linked Immunosorbent Assay (ELISA), Fluorescence immunoassay (FIA), i-Quant Analyser, Nonstructural (NS1) antigen, QUANTI CARD

Full Text:

Introduction

Dengue, the most common arboviral infection worldwide, has spread rapidly to more than 129 countries. World over, about 3.9 billion people are at risk of acquiring dengue infection, 70% of these people at risk are from Asia. Over the last two decades, the number of reported cases has increased by eight-fold from half a million cases in 2000 to 2.4 million cases in 2010 and 4.2 million cases in 2019. Similarly, the reported deaths have increased from 960 to 4032 over 15 years, from 2000 to 2015.1

           The virus causes a wide spectrum of disease manifestations ranging from subclinical infection to severe disease that leads to bleeding, organ impairment and death. Therefore, early diagnosis of infection can help improve the clinical outcome of the disease by ensuring early initiation of supportive therapy and close follow-up, thus lowering the fatalities to less than 1%.2 The major obstacle in early diagnosis is the non-specific clinical presentation that may lead to delay and misdiagnosis of the disease. Therefore, all clinically suspected cases must be confirmed by laboratory tests for efficient and accurate diagnosis.3

           A range of laboratory diagnostic tests have been developed for dengue diagnosis. Definitive diagnosis of dengue includes isolation of virus by culture, viral genomic RNA detection by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR), detection of viral products like Non-Structural (NS1) protein or detection of host immune response to the virus by measuring the specific IgM/IgG antibodies against dengue virus using rapid immunochromatography test or Enzyme-Linked Immunosorbent Assay.2

           Virus isolation by culture is the gold standard test for dengue diagnosis. It is time-consuming as it takes days and weeks to complete. The RT-PCR test requires specialized reagents and technical expertise. Both the tests are useful in the first five days of illness and thereafter the sensitivity of the tests decreases as the viremia decreases over time.4 Serological diagnosis is not helpful during acute illness as the antibodies remain undetectable until 3-4 days post-symptom onset and require a second sample within 14-21 days for definitive diagnosis. NS-1 protein is released during the infection and is accumulated in human serum in very high concentrations. It is detectable early during the infection. Therefore, NS1 antigen has become an attractive target for diagnostic assay development as it is more specific and shows high specificity. However, the choice of diagnostic method depends on the time of sample collection, laboratory facilities the technical expertise available, and the purpose of testing, i.e., clinical diagnosis, epidemiological studies, or vaccine development.5

The most widely used test for diagnosis of dengue is Enzyme-Linked Immunosorbent Assay (ELISA) which is used for the detection of viral antigen and anti-DENV IgM/IgG antibodies in patient serum. It has high specificity and sensitivity, but at the same time, it is time-consuming, labor-intensive and requires skilled manpower and equipment.4 Therefore, in the past two decades, with the growing demand for point-of-care diagnostics, many Rapid Diagnostic Tests (RDTs) have flooded the market. However, the available diagnostic tests vary in their sensitivity and specificity.6

            With the above background, the current study aims to evaluate the diagnostic accuracy and utility of a newly developed rapid fluorescence immunoassay test, i.e., Dengue NS1 Ag QUANTI CARD test with a commercially available NS1 antigen rapid immunochromatography test and NS1 ELISA for early diagnosis of dengue infection.

Material and Methods

The present study was carried out in the Department of Microbiology at Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra.

Study Design: A diagnostic evaluation study

Specimen collection

            A total of 85 serum samples from patients suspected of dengue infection with fever for less than or equal to five days were collected and tested. Following all standard precautions, 5 mL of blood sample was collected in a clean plain vacutainer. The blood was allowed to clot at room temperature for 45 minutes and then serum was separated.  10 serum samples were also collected from healthy individuals to evaluate the specificity of the newly developed test.

Methodology

The collected serum samples were tested for NS1 antigen (NS1 Ag) using fluorescence immunoassay (FIA), Rapid Immunochromatography test (ICT) and ELISA test.

Dengue NS1 QUANTI CARD (J. Mitra & Co. Pvt. Ltd., New Delhi, India) is a fluorescence immunoassay test based on the principles of sandwich immunoassay. It is a cartridge-based test for the qualitative detection of Dengue NS1 Ag in human serum/plasma. On a nitrocellulose membrane, the test region is coated with specific anti-dengue NS1 antibodies. When a sample containing NS1 Ag is added, the antigen forms a complex with a conjugated antibody directed against the NS1 Ag. The antigen-antibody complex migrates along the nitrocellulose membrane to the test region and binds to immobilized antibodies forming an antibody-antigen-antibody immunocomplex. The results are read after 30 minutes using iQuant analyser. The results obtained were interpreted in terms of NS1 Ag units as reactive (> 1.1 U), equivocal (> 0.9 to < 1.1 U) or non-reactive (< 0.9 U).

Dengue NS1 rapid antigen test (RAT) was performed using Dengucheck, a rapid qualitative immunochromatographic test for detection of NS1 Ag in serum/ plasma (Zephyr Biomedicals, a division of Tulip diagnostics (P) Ltd, Goa, India) according to the manufacturer’s instructions.

            Similarly, Dengue NS1 Ag ELISA was performed using Dengue NS1 antigen Microlisa (J. Mitra & Co. Pvt. Ltd., New Delhi, India) according to the manufacturer’s instructions. It is a solid phase Enzyme-Linked Immunosorbent assay based on the principles of direct sandwich ELISA.

               Reproducibility of the test results of the newly available fluorescence immunoassay test, NS1 QUANTI CARD, was evaluated by testing four samples (two weak positive samples and two negative samples for NS1 Ag) at four different times by the same technician.

Statistical analysis

The data obtained was compiled using Microsoft® Excel. Sensitivity, specificity, predictive values, likelihood ratios and Cohen’s Kappa value for the level of agreement were calculated using MedCalc® Statistical Software version 19.6.4.

Results

Characteristics of the study population

A total of 85 samples were collected from suspected patients of dengue. The mean age of the study population was 20.98 years and the sex ratio (male: female) was 1.7:1.

Characteristics of the diagnostic tests

A comparison of several functional attributes of NS1 QUANTI CARD test, NS1 rapid immunochromatography and NS1 ELISA test is shown in Table 1.

Correlation between results of fluorescence immunoassay and rapid immunochromatography with NS1 ELISA test.

        Out of 85 samples tested, NS1 ELISA was positive in 29 (34.1%) and negative in 56 (65.9%) samples; dengue NS1 QUANTI CARD test was positive in 30 (35.3%) and negative in 55 (64.7%) samples, and NS1 rapid immunochromatography test was positive in 28 (32.9%) and negative in 55 (67.1%) samples. The correlation between the results of NS1 ELISA, NS1 QUANTI CARD test and rapid immunochromatography test is shown in Table 2 and 3, respectively.

Performance characteristics of fluorescence immunoassay and rapid immunochromatography test considering ELISA as the gold standard test.

The performance characteristics of the Dengue NS1 QUANTI CARD test, Dengue NS1 Ag rapid immunochromatography test was calculated considering Dengue NS1 ELISA as the gold standard test as shown in Table 4.

To test the specificity of the newly developed test, 10 serum samples collected from healthy individuals were tested. The specificity and NPV of the Dengue NS1 QUANTI CARD test were found to be 100% and 80%, respectively.

Reproducibility testing of Dengue NS1 QUANTI CARD test.      

The dengue NS1 QUANTI CARD test results were reproducible with all dengue samples (two dengue NS1 Ag positive and two dengue NS1 Ag negative) in four different runs as shown in Table 5.

Discussion:

Dengue infection usually presents with non-specific symptoms, mimicking any other viral infection. However, due to a wide spectrum of disease presentation, early diagnosis and prompt treatment are of paramount importance.1 Detection of NS1 antigen has emerged as a popular diagnostic method for early diagnosis of dengue as it becomes detectable from day 1 to day 9 after the onset of disease in both primary and secondary dengue cases.5 Therefore, many diagnostic tests have been developed using NS1 as a target and are being assessed for early diagnosis of dengue.

           One such newly developed test, the Dengue NS1 Ag QUANTI CARD test, a fluorescence immunoassay test based on the principles of sandwich immunoassay was evaluated in this study. In the present study, the QUANTI CARD test produced results comparable to that of ELISA. The sensitivity, specificity, PPV and NPV of the FIA test were found to be 96.5%, 96.4%, 93.3% and 98.1%, respectively. The Cohen’s Kappa value was found to be 0.92, indicating almost total agreement between ELISA and QUANTI CARD test results. The test showed reproducible results when tested at four different times. Our findings are similar to those of Pohekar et al. where the sensitivity, specificity, PPV and NPV were 100%, 98.3%, 97.4% and 100%, respectively.7

           The need for a simple point-of-care diagnostic test has led to the large-scale production of Rapid Diagnostic Tests (RDTs) using the immunochromatographic format. In this study, the sensitivity, specificity, PPV and NPV of RDT were 65.5%, 83.9%, 67.8% and 82.4%, respectively. The Cohen’s Kappa value was 0.499, indicating a moderate level of agreement between ELISA and rapid ICT test results. The performance of the RDT kit was lower as compared to other studies in India as various studies have reported a sensitivity of 88% to 100% and a specificity of 90% to 98%.8-11 In a study by Yow et al. (2021), the sensitivity and specificity of six RDT kits were found to be 68.5% to 87% and 100%, respectively.12 Similarly, Pal et al. (2014) in their study have highlighted that the sensitivity of NS1 antigen rapid tests that have been reported in the literature varies from 58% to 99%.4

              After comparing the characteristics of the three tests, it is observed that the ELISA test requires technical expertise, is time-consuming and requires a constant power supply for its operations. It requires approximately 2-3 hours of assay time. RDTs based on the principle of FIA and ICT, on the other hand, are easy to perform with very little expertise and require 15 to 30 minutes of run time. However, the interpretation of results in the case of an ICT is subjective. This is of particular importance while interpreting tests with weak positive bands. Whereas the results of the FIA test are read using iQuant Analyser. This provides a numerical value to every test, thereby ruling out any subjectivity during the interpretation of results. The inbuilt memory of the iQuant analyser can store results that can be used for future reference. It also has a 1-hour battery backup which keeps the machine operational in case of power failure.

Conclusion

To conclude, the performance of the newly developed Dengue NS1 Ag QUANTI CARD test was superior to the rapid immunochromatographic test and was comparable to the performance of the ELISA test. Due to its superior sensitivity, the ELISA test will remain the recommended choice of test in laboratories with trained manpower and equipment. On the other hand, in resource-limited settings such as in semi-urban and rural areas, with restricted availability of skilled manpower and equipment, the fluorescence immunoassay with high sensitivity and lesser TAT can be a better alternative to ELISA. It would be a valuable tool for prompt diagnosis of dengue infection in critically ill patients as it may impact patient management by early initiation of appropriate therapy.

Acknowledgement:

We acknowledge Mrs Shobha Sabale and Mrs Sonal Kalbhor for their technical support during the study.

Source of funding: Nil

Conflict of Interest: Authors have declared that no conflict of interest exists.

Authors’ Contribution:

This work was carried out in collaboration among all authors. Authors Rashmita Das, Suvarna Joshi, Meghna Palewarand Rajesh Karyakarte have conceptualised and designed the study. Authors Rashmita Das, Suvarna Joshiand Meghna Palewar performed data acquisition and managed the literature searches. Authors Rashmita Das, Suvarna Joshi performed the data analysis and author Rashmita Das wrote the first draft of the manuscript. Authors Rashmita Das, Suvarna Joshi, Meghna Palewar and Rajesh Karyakarte performed manuscript editing. All authors reviewed and approved the final manuscript.

References:

1. Dengue and severe dengue [Internet]. WHO 2021. [cited 29 July 2021]. Available from: https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue

2. Dutta A, Dighade R, Malpekar K, Bisure K. Comparison of Diagnostic Modalities in Early Dengue in a Tertiary Hospital in Mumbai. Ann. Int. Med. Den. Res. 2021;7(1):MB01-MB05.

3. Chong Z, Sekaran S, Soe H, Peramalah D, Rampal S, Ng C. Diagnostic accuracy and utility of three dengue diagnostic tests for the diagnosis of acute dengue infection in Malaysia. BMC Inf Dis. 2020;20(1):1-11.

4. Pal S, Dauner AL, Mitra I, Forshey BM, Garcia P, Morrison AC, Halsey ES, Kochel TJ, Wu SJ. Evaluation of dengue NS1 antigen rapid tests and ELISA kits using clinical samples. PLoS One.2014;9(11):1-8.

5. National Vector Borne Disease Control Program. National Guidelines for Clinical Management of Dengue Fever. New Delhi: Government of India; 2015:15.

6. Raafat N, Blacksell S, Maude R. A Review of Dengue Diagnostics and Implications for Surveillance and Control. Trans. R. Soc. Trop. Med. Hyg. 2019;113(11):653-660.

7. Pohekar J, Bhalchandra M, Ghogre H, Pathrikar T. Evaluation and Comparison of Currently Available Fluorescence Immunoassay (FIA) Test with Rapid Immuno-Chromatographic Test (ICT) Considering NS 1 ELISA as a Reference Test. Int J Curr Microbiol Appl Sci. 2017;6(11):506-513.

8. Reddy R, Sahai K, Malik A, Shoba S, Khera A. Comparative Analysis of Rapid Dengue Testing and ELISA for NS1 Antigen and IgM in Acute Dengue Infection. Int J Curr Microbiol Appl Sci. 2016;5(10):931-937.

9. Naidu A, Venkateswarlu P, Umadevi S, Sailaja M, Praveena B, Devi A. Detection of Dengue NS1 by a Comparative Analysis of Panbio Elisa and Rapid Diagnostic Test. Sch. J. Appl. Med. Sci. 2017;5(3B):816-820.

10. Hassan S, Khare V, Singh M, Asghar S. Comparison of Rapid Immuno- Chromatographic Card Test with ELISA in Diagnosis of Dengue Fever at Tertiary Care Centre. Indian J Microbiol Res. 2018;5(2):284-287.

11. Gill M, Kaur A, Kukreja S, Chhabra N. Comparative Evaluation of a Rapid Test with ELISA for the Detection of Dengue Infection. Indian J Microbiol Res. 2016;3(4):405-407.

12. Yow K, Aik J, Tan E, Ng L, Lai Y. Rapid Diagnostic Tests for the Detection of Recent Dengue Infections: An Evaluation of Six Kits on Clinical Specimens. PLoS ONE. 2021;16(4):1-11.

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.

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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.

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

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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 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 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
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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
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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"
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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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Disclaimer: 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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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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