International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 14(4), February, 2022

Pages: 87-90

Date of Publication: 15-Feb-2022


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Diagnostic Value of Post Decontamination Smear Microscopy for Enhanced Detection of Tuberculosis

Author: Swati Salila, U. N. Gaikwad

Category: Healthcare

Abstract:Introduction: A direct smear microscopy is a universal tool used for the diagnosis of tuberculosis under programmatic settings. Early diagnosis of TB is crucial both clinically and epidemiologically. It is essential to ensure proper and early identification of cases, and good treatment outcomes to be able to limit its transmission and obtain successful TB control especially in low-income countries. The study aims to evaluate the efficacy of smear microscopy performed on post-NaLC\?NaOH decontaminated samples in the diagnosis of Tuberculosis. Materials and Methods: The samples were subjected to direct smear microscopy using Ziehl-Neelson (ZN) stain followed by decontamination and concentration by NALC-NaOH method and culture on Lowenstein Jensen media as well as in MGIT 960 system. Results of direct smear microscopy and post decontamination smear microscopy were compared against culture as the gold standard. Results: A total 705 samples were processed of which 658 were negative for acid-fast bacilli by direct microscopy. We observed that direct microscopy showed 41.22% (47) positivity whereas microscopy by post decontamination showed 60.52% (69) positive. A true diagnostic yield of 24% was obtained by post decontamination smear microscopy over direct microscopy.The overall sensitivity, specificity, PPV and NPV for direct and post decontamination smear was calculated as 36.84%, 99.15%, 89.36%, 89.06% and 60.52%, 97.96%, 85.19%, 92.79% respectively.Thus, the sensitivity of detection was increased by 23.68% on post decontamination smear microscopy with a diagnostic accuracy of 91.91%. Conclusion: Post decontamination smears showed a significant increase in diagnostic yield as compared to direct smear microscopy. Performing and reporting PDSM on samples requested for culture, as an additional step, inappropriate laboratory settings can have a greater impact in providing rapid and accurate diagnosis especially in smear-negative and extra-pulmonary TB cases.

Keywords: Concentration methods, Smear-negative pulmonary TB, Post decontamination smear microscopy, EPTB, Diagnostic accuracy, Sensitivity

Full Text:

Introduction:

A direct smear microscopy is a universal tool used for the diagnosis of tuberculosis(TB)  under programmatic settings. Sputum smear microscopy is a century-old test but remains the primary tool for diagnosing TB in low-income countries. The Ziehl–Neelsen method has endured as a reliable and effective way to demonstrate acid-fast bacteria.1 It is an important tool in the initial screening of the disease as it can differentiate MTB which appears as long, curved, and beaded bacilli from Non-Tuberculous Mycobacteria (NTM) which appear as short, straight bacilli with no specific morphology.2,3 However, the threshold for detection of acid-fast bacilli (AFB) in samples under optimal conditions is very high (104 to 105 bacilli/ml) making smear microscopy a less sensitive tool for diagnosing pulmonary TB.4

Although simple and cost-effective, it significantly lacks sensitivity and specificity in detecting tubercle bacilli, especially in extrapulmonary tuberculosis (EPTB) due to its paucibacillary nature of the disease, the variable clinical presentations, needs for invasive procedures to secure appropriate samples, and lack of laboratory facilities in the resource-limited settings5. The conventional methods of diagnosis of TB has various limitations hence the rapid diagnosis of EPTB is a challenging task. Moreover, in a developing country like India where healthcare professionals are facing difficulties in diagnosing the disease due to limited infrastructure, better methods are gravely needed for control programs.

Under the TB program conditions and due to technical constraints, the yield is further decreased (IUATLD, 2005).6 Definitive and rapid diagnosis of extrapulmonary tuberculosis is challenging since conventional techniques have limitations. Smear-negative pulmonary TB (SNPT) represents 30–60% of all pulmonary TB cases, according to region.7 Early diagnosis of TB is crucial both clinically and epidemiologically. It is essential to ensure proper and early identification of cases, and good treatment outcomes to be able to limit its transmission and obtain successful TB control. In laboratory settings with culture facilities, the diagnostic capacity of smear-negative pulmonary and extrapulmonary samples can be increased by examining the post-decontamination smears adding to the rapidity of diagnosis. This is especially helpful in direct smear-negative and EPTB samples. With this hypothesis for increased diagnostic yield, the study aims to evaluate the efficacy of smear microscopy performed on post-NaLC–NaOH decontaminated samples in the diagnosis of Tuberculosis.

Materials and Methods

A cross-sectional analysis of samples requested for mycobacterial culture from clinically suspected tuberculosis cases, over a period of 18 months(Jan 2018 - Jun 2019) was done in the department of Microbiology, AIIMS, Raipur. The samples were subjected to direct smear microscopy using Ziehl-Neelson (ZN) stain followed by decontamination and concentration by NALC-NaOH method and culture on Lowenstein Jensen media as well as in MGIT 960 system. ZN smears were prepared from the decontaminated samples. The growth on culture was confirmed for MTB by MPT-64 antigen immuno-chromatography test. Results of direct smear microscopy and post-decontamination smear microscopy were compared against culture as gold standard.

Data Analysis

Results of direct smear microscopy and post-decontamination smear microscopy were compared against culture as the gold standard to find out: Sensitivity, Specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), and Diagnostic Accuracy. The p-value <0.05 is considered statistically significant.

Results

A total 705 samples were processed of which 237 were pulmonary and 468 were extrapulmonary. Out of these 705 samples, 658 were negative for acid-fast bacilli by direct microscopy. A positivity rate of 16% by culture (114/705) was observed in this study. We observed that direct microscopy could detect 36.84% of culture positives whereas post-decontamination smear microscopy could detect 60.52% of culture positives.

Amongst these, 36 (5.47%) comprising of 18 pulmonary and 18 extrapulmonary samples were additionally picked up as smear-positive on post-decontamination smear microscopy as compared to 39(pulmonary) and 8(extra-pulmonary) on direct smear microscopy. Twenty-eight (77.7%) of them were further confirmed as culture positive for mycobacteria. Results of direct smear and post-decontamination smear microscopy were compared (Table 1)and an additional yield by post-decontamination smear microscopy = 36 (5.47%) out of all smear negatives was observed.

Results of ZN microscopy was compared against culture as gold standard test. We observed that direct microscopy could detect 36.84% of culture positives whereas post-decontamination smear microscopy could detect 60.52% of culture positives. True diagnostic yield of 24% (28/114) was obtained by post-decontamination smear microscopy over direct microscopy. Amongst these 28 isolates:23 (20.17%) were Mycobacterium tuberculosis complex, 5 (4.3%) were non-tubercular Mycobacteria, 13 (11.4%) pulmonary samples, 15 (13.15%) extrapulmonary samples (pleural fluid>cervical LN>gastric aspirate, pus, peritoneal fluid, urine).

The overall sensitivity, specificity, PPV and NPV for direct and post-decontamination smear (Table – 2) was calculated as 36.84%, 99.15%, 89.36%, 89.06% and 60.52%, 97.96%, 85.19%, 92.79% respectively. Thus, the sensitivity of detection was increased by 23.68% on post-decontamination smear microscopy with a diagnostic accuracy of 91.91%.

Discussion

Microscopy detection rates before and after the concentration of specimens were compared. The sensitivity of detection by microscopy increased by 23.68% over those without concentration. It is comparable to the study conducted by Morcillo et al. which shows increased sensitivity of concentrated microscopy by 15.2% (Hypertonic Saline-SodiumHydroxide: 73.5%) to 16.7% (NALC-NaOH: 75.0%) over those without concentration (58.3%)8.

Ganozaet al. had conducted similar study which showed sensitivity for AFB smears was increased from 28.6 % using the direct method to 71.4 % (Hypertonic Saline-Sodium Hydroxide) and 66.7 % (NALC-NaOH) using decontamination and concentration methods9.

Hence the use of the concentrated method for preparing smears for AFB microscopy increases sensitivity in identifying positive TB cases, compared to the direct method.

There were 2 samples positive with the direct method but negative with the concentrated method one of which was found to be positive by culture. It might have occurred due to inappropriate sample concentration and smear preparation, smear preparation from a negative sample accidentally, faulty staining process, or inappropriate microscopic observation. Four specimens which were positive in both direct and concentrated smear microscopy but negative in culture. Probably these patients were taking anti-TB drugs while collecting the specimens and the dead bacilli failed to grow on L-J media. No change in Sensitivity was observed by both the methods as described 81.6% for direct smear and 82.7% for the concentrated smear in a  study conducted by Barez, et al.10 In another study, Cattamanchi et al.11 failed to find a difference in sensitivity between direct and concentrated sputum smear microscopy, the calculated sensitivity of direct and concentrated smear microscopy was not significantly different (51% vs. 52%).A recent study conducted by Uddin et al. showed a sensitivity of direct and concentrated smear microscopy was different when using positive culture as the gold standard (71% vs. 83%)12.

Limitations of this study - The effect of increased diagnostic yield by post-decontamination smear microscopy on therapeutic decisions could not be assessed.

Conclusion & Recommendation:

Post-decontamination smears showed a significant increase in diagnostic yield as compared to direct smear microscopy. Performing and reporting post-decontamination smear microscopy on samples requested for culture, as an additional step, inappropriate laboratory settings can have a greater impact in providing rapid and accurate diagnosis especially in smear-negative and extra-pulmonary TB cases.

Acknowledgement: I thank Dr. U. N. Gaikwad, Addl. Prof., Deptt. of Microbiology, AIIMS Raipur for her full support in conducting this study.

Source of Funding: None

Conflict of Interest: None

Authors’ Contribution: Dr. U. N. Gaikwad conceived the idea and encouraged Dr. Swati Salila to investigate on the hypothesis and supervised throughout the study. Data compilation and drafting was done by Dr. Swati Salila. Both authors discussed the results and contributed to the final manuscript.

References:

  1.  Bishop P.J., Neuman G. The history of the Ziehl–Neelsen stain Tubercle, 51 (1970), pp. 196-206

  2. Ritu Singhal, Vithal Prasad Myneedu. Microscopy as a diagnostic tool in pulmonary tuberculosis, Int J of Mycobacteriology, Volume 4, Issue 1, 2015, Pages 1-6, ISSN 2212-5531.

  3. C. Dye, C.J. Watt, D.M. Bleed, S.M. Hosseini, M.C. Raviglione. Evolution of tuberculosis control and prospects for reducing tuberculosis incidence, prevalence, and deaths globally JAMA, 293 (22) (2005), pp. 2767-2775

  4. Magalhães JLO, Lima JFC, Araújo AA, Coutinho IO, Leal NC and Almeida AMP.Microscopic detection of Mycobacterium tuberculosis in direct or processed sputum smears, Rev Soc Bras Med Trop 51(2):237-239, March-April, 2018 doi: 10.1590/0037-8682-0238-2017

  5. Purohit M, Mustafa T. Laboratory Diagnosis of Extra-pulmonary Tuberculosis (EPTB) in Resource-constrained Setting: State of the Art, Challenges and the Need. J Clin Diagn Res. 2015;9(4):EE01-EE6. doi:10.7860/JCDR/2015/12422.5792

  6. Activity Report of the International Union Against Tuberculosis and Lung Disease, Jan-Dec 2005.

  7. World Health Organization. Improving the diagnosis and treatment of smear-negative pulmonary and extrapulmonary tuberculosis among adults and adolescents. Recommendations for HIV prevalent and resource-constrained settings. 2007. Available: www.who.int

  8. Morcillo N, Imperiale B, Palomino JC. New simple decontamination method improves microscopic detection and culture of mycobacteria in clinical practice. Infection and Drug Resistance 2008:1 21–26

  9. Ganoza CA, Ricaldi JN, Chauca J, Rojas G, Munayco C, Agapito J, et. al. Novel hypertonic saline–sodium hydroxide (HS–SH) method for decontamination and concentration of sputum samples for Mycobacterium tuberculosis microscopy and culture. Journal of Medical Microbiology (2008), 57, 1094–1098

  10. Marie YC, Barez MD, Myrna T, Mendoza MD, Regina S, Celada RMTet. al. Accuracy of AFB in relation to TB culture in detection of pulmonary tuberculosis. Phil J Microbiol Infect Dis. 1995, 24 (2): 33-36.

  11. Cattamanchi A, Dowdy DW, Davis JL, Worodria W, Yoo S, Joloba M, et.al.Sensitivity of direct versus concentrated sputum smear microscopy in HIV-infected patients suspected of having pulmonary tuberculosis. BMC Infect Dis. 2009, 9: 53-10.1186/1471-2334-9-53.

  12. Uddin M.K.M., Chowdhury M.R., Ahmed S, Rehman MT, Khatun R, Leth FV, et al. Comparison of direct versus concentrated smear microscopy in detection of pulmonary tuberculosis. BMC Res Notes 6, 291 (2013).

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Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

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

Women Researcher Award:

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

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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.


Best Article Award

A study by Dorothy Ebere Adimora et al. entitled \"Remediation for Effects of Domestic Violence on Psychological well-being, Depression and Suicide among Women During COVID-19 Pandemic: A Cross-cultural Study of Nigeria and Spain\" is awarded Best Article of Vol 14 issue 23
A study by Muhas C. et al. entitled \"Study on Knowledge & Awareness About Pharmacovigilance Among Pharmacists in South India\" is awarded Best article for Vol 14 issue 22
A study by Saurabh Suvidha entitled \"A Case of Mucoid Degeneration of Uterine Fibroid with Hydrosalphinx and Ovarian Cyst\" is awarded Best article of Vol 14 issue 21
A study by Alice Alice entitled \"Strengthening of Human Milk Banking across South Asian Countries: A Next Step Forward\" is awarded Best article of Vol 14 issue 20
A study by Sathyanarayanan AR et al. entitled \"The on-task Attention of Individuals with Autism Spectrum Disorder-An Eye Tracker Study Using Auticare\" is awarded Best article of Vol 14 issue 19
A study by Gupta P. et al. entitled \"A Short Review on \"A Novel Approach in Fast Dissolving Film & their Evaluation Studies\" is awarded Best Article of Vol 14 issue 18.
A study by Shafaque M. et al. entitled \"A Case-Control Study Performed in Karachi on Inflammatory Markers by Ciprofloxacin and CoAmoxicillin in Patients with Chronic Suppurative Otitis Media\" is awarded Best Article of Vol 14 issue 17
A study by Ali Nawaz et al. entitled \"A Comparative Study of Tubeless versus Standard Percutaneous Nephrolithotomy (PCNL) \? A Randomized Controlled Study\" is awarded Best Article for Vol 14 issue 16.
A study by Singh R. et al. entitled \"A Prospective Study to Find the Association of Astigmatism in Patients of Vernal Keratoconjunctivitis (VKC) in a Tertiary Health Care Centre in India (Vindhya Region MP)\" is awarded Best Article for Vol 14 issue 15
A Study by Humaira Tahir et al. entitled "Comparison of First Analgesic Demand after Major Surgeries of Obstetrics and Gynecology between Pre-Emptive Versus Intra-Operative Groups by Using Intravenous Paracetamol: A Cross-Sectional Study" is awarded Best Article for Vol 14 issue 14
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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
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
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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
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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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