International Journal of Current Research and Review
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IJCRR - 14(7), April, 2022

Pages: 24-31

Date of Publication: 05-Apr-2022


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Preoperative Anxiety in Cardiac Surgery Patients

Author: Adhyapak Sadhana

Category: Healthcare

Abstract:Introduction: People with high level of anxiety experience significant distress & impairment in interpersonal as well as social functioning. There are many medical conditions where patients develop high levels of anxiety. Anxiety with surgery is associated with autonomic changes, supplementary doses of anesthetic drugs, increased level of postoperative pain & more chances of postoperative nausea & vomiting. To prevent & treat anxiety effectively, one must assess level of anxiety accurately. A nurse can assess anxiety & reduce it to a manageable & comfortable level. Aims: A study was conducted to anticipate preoperative anxiety among patients undergoing cardiac surgeries & to identify dimensions of anxiety. Methodology: A quantitative approach was used for this cross-sectional study. Content validity of the tool was done&reliability was calculated using Karl Pearson's coefficient of correlation. The sample was calculated by 80 % confidence level with 5% error. Total sample was 80 patients admitted in cardiothoracic ward. Samples were selected by convenient sample technique. Anxiety level was identified with the help of Amsterdam Preoperative Anxiety & Information Scale. Along with anxiety level, researcher also tried to find the possible causes of anxiety. Result: Descriptive data was analyzed & association between variables was identified. 82.5% of patients were males & 17.5 % were females. Most of them i.e., 86.3 % underwent coronary artery bypass graft (CABG) & 13.8% underwent valvular surgeries. It was seen that 16.3% of patients had high level of anxiety related to anesthesia, 27.5% of patients had high level of anxiety related to surgery & overall high anxiety level was seen in 21.3% of patients. The association was seen with gender, previous experience of surgery & duration of hospitalization. Most common causes of anxiety identified were worried about postoperative pain & family concern. Conclusion: Nurses can identify triggers of anxiety, recognize the symptoms of onset of anxiety & intervene before patient reaches to panic stage.

Keywords: Preoperative, Anxiety, Cardiac surgery, Coronary artery, Valvular surgery, Bypass graft

Full Text:

Introduction

Anxiety is a strong concern for something happening. Many times, anxiety disturbs activities of daily living. People with a high level of anxiety experience significant distress & impairment in interpersonal as well as social functioning. There are many medical conditions where patients develop high levels of anxiety. Anxiety with surgery is associated with autonomic changes, supplementary doses of anesthetic drugs, increased level of postoperative pain & more chances of postoperative nausea & vomiting. A cohort study was conducted & Amsterdam Preoperative Anxiety & Information Scale was used to assess anxiety. The various sources of anxiety were related to anesthesia, surgery & other related factors. Anxiety scores were seen on the higher side with higher education & patients undergoing general anesthesia. The association was also seen with female gender. 1

Leopold Eberhart et al analyzed anxiety in preoperative period & also found predictors of anxiety. It was a cross-sectional study where anxiety was assessed with the help of Amsterdam Preoperative Anxiety & Information Scale. 40.5% patients showed high level of anxiety & total preoperative anxiety score was 9.9. Main concern for fear was mistaken by the anesthetist, as fatigue & drowsiness. It was seen that gender, positive & negative anesthesia experience predicted anxiety subscales.2 Ghogiang Gu3 determined the relationship between coronary surgeries & symptoms of anxiety & depression in coronary heart disease patients. Patients were asked to complete the Hospital Anxiety & Depression Scale & separate questionnaire before & after surgery. Coronary surgeries were found to be significantly associated with symptoms of anxiety & depression. It was also seen that symptoms related to anxiety increased one day before & after surgery.

According to Sigdel S4 One of the main risk factors for the development of anxiety is the presence of cardiac disease & surgery. Total 140 patients were investigated with the help of the State-Trait Anxiety Inventory (STAI)& preoperative anxiety was seen in 58.5% of patients. Female gender & previous anesthesia exposure were identified as risk factors.

Cardiovascular disease is associated with increased risk of morbidity in the short & long term. One of the major treatments for cardiovascular disease is surgery. Today there are various surgical options available for patients to relieve cardiac symptoms & improve quality of life. But during any form of treatment, patient-reported outcome is the most important aspect.5 Under patient-reported outcomes, patient himself/herself assesses the various physical & psychological symptoms. Anxiety is one of the important reactions noted in patients waiting for surgeries. Increased level of anxiety is associated with negative consequences of postoperative outcome & rehabilitative process.6 To prevent & treat anxiety effectively, one must assess level of anxiety accurately. Nurse can assess anxiety & reduce it to a manageable & comfortable level. The nurses’ goal is to assist patients with anxiety to develop adaptive coping strategies.

Jose Prado7 Olivares et al. assessed level of anxiety using State-Trait Anxiety Inventory in patients undergoing cardiac surgeries. Coronary artery bypass graft (CABG) was performed on 47% of patients & valvular surgeries were performed on 26.7% of patients. Total 60 samples were included in the study. Moderate to high level of anxiety was seen in 80% of patients. First surgical intervention was found to be related with level of anxiety. It was concluded that patients undergoing cardiac surgeries should be given well-framed program through individualized education. Similarly, Jitendra Jeenger et al.8 found the prevalence of depression & anxiety after first myocardial attack. 60 cases of diagnosed acute myocardial infarction were compared with 60 healthy individuals. Patients with myocardial infarction were seen to be enduring from depression and anxiety symptoms. 40% of myocardial infarction patients showed depressive episodes & 35% showed anxiety symptoms.

Objectives

The main objectives of the study were to assess preoperative anxiety among patients undergoing cardiac surgery, to identify the association between preoperative anxiety & demographic variables & to find possible causes of preoperative anxiety.

Methodology

Research design

A quantitative approach was used for this cross-sectional study. The study population was patients admitted for cardiac surgeries i.e., coronary artery bypass graft & valvular surgeries. Sample was calculated by 80 % confidence level with 5% error. Total sample was 80 patients admitted in cardiothoracic ward. Samples were selected by convenient sample technique.

Development of tool

Tool included three sections. Section I included demographic details like age, gender, education, occupation, marital status, type of family, BMI, previous experience of surgery & type of surgery.

Section II was Amsterdam Preoperative Anxiety & Information Scale (APAIS) to assess level of anxiety. Boker A9 et al. evaluated different scales of anxiety i.e., state-trait anxiety inventory, Amsterdam Preoperative Anxiety & Information Scale & Visual analogue scale. It was seen that it was an advantage to use APAIS as patients could easily answer the questions. Consistent correlation of APAIS was seen with other anxiety scales. So, the investigator decided to use this scale.

Amsterdam Preoperative Anxiety & Information Scale consists of 6 questions with a Likert scale ranging from 1 (not at all) to 5 (extremely). Out of these four questions show level of anxiety & two questions identify patient’s need for information. Researcher identified anxiety related to anesthesia, anxiety related to surgery, total anxiety & patient’s need for information. Researcher decided the scoring system to divide anxiety in mild, moderate & severe levels.

Section III was a self-administered questionnaire. This included 10 yes/ no type questions related to possible causes of preoperative anxiety. All the questions were easily understood & readily answered by the sample.

Ethical consideration

The researcher got approval from the institutional research & recognition committee & institutional ethical committee. Written informed consent was taken from each sample before data collection.

Validity & reliability

Content validity was done from 12 experts of related field. Reliability was done using the test-retest method. The formula used was Karl Pearson’s coefficient of correlation. It was found to be 0.99. So, the tool was considered reliable & was retained. A pilot study was done on 10 samples to assess the feasibility of the study. It was done in the month of December 2020.

Data collection

Data was collected from January 2021 to June 2021. It was a private charitable hospital from Pune. Data was collected on the day of surgery prior to surgery. Patients took approximately 10 minutes to answer the questions. They completed it in the wards before they were shifted to the operation theatre.

Inclusion & exclusion criteria

Patients admitted only for coronary artery bypass graft & valvular surgeries were included & patients undergone emergency surgeries were excluded from the study. It was assumed that patients waiting for cardiac surgeries present high levels of anxiety & assessment of preoperative anxiety have better postoperative outcomes.

Results

Section I

Above table indicates that 5% of the patients undergoing cardiac surgery were in the age group of 31-45 years, 80% of them were in 46-60 years and 15% of them were above 60 years. 82.5% of them were males and 17.5% of them were females.

21.3% of them had primary education, 40% of them had secondary education and 38.8% of them were educated up to graduation and above.26.3% of them were working in private sector, 10% of them were from government sector, 18.8% of them had business, 16.3% of them were farmers/laborers, 20% of them were retired and 8.8% of them were houseworkers.91.3% of them were married, 1.3% of them were unmarried, 2.5% of them were divorced and 5% of them were widow.37.5% of them were from nuclear family and 62.5% of them were from joint family.

Fig 1 shows that 6.3% of them were admitted in the hospital for 1 day before surgery, 28.8% of them were admitted for 2 days before surgery, 36.3% of them 3 days before surgery and 28.8% of them for more than 3 days before surgery.

Table No 2 shows that 20% of them had history of chronic illness, 31.3% of them had history of previous surgery & 17.5% of them used substance. It is also seen that 86.3% of them underwent CABG and 3.8% of them had valvular surgery.

Section II - It deals with analysis of data related to preoperative anxiety among patients undergoing cardiac surgery.

Table No 3 suggests that 40% of the patients had mild preoperative anxiety related to anaesthesia, 43.8% of them had moderate preoperative anxiety and 16.3% of them had high preoperative anxiety related to anaesthesia.

18.8% of the patients had mild preoperative anxiety related to surgery, 53.8% of them had moderate preoperative anxiety and 27.5% of them had high preoperative anxiety related to surgery.

20% of the patients had mild overall preoperative anxiety, 57.5% of them had moderate overall preoperative anxiety and 21.3% of them had severe overall preoperative anxiety.

25% of them did not require information, 45% of them needed litter information and 31.3% of them needed more information.

Section III

Analysis of data related to association between preoperative anxiety & demographic variables.

Table No 4 indicates that Since p-values corresponding to gender, education, occupation, family type, BMI, previous surgery, and duration of hospital stay before surgery were small (less than 0.05), the demographic variables gender, education, occupation, family type, BMI, previous surgery and duration of hospital stay before surgery were found to have significant association with the preoperative anxiety among patients undergoing cardiac surgery.

Fig 2 shows that 66.3% of the patients undergoing cardiac surgery were worried about post-operative pain. 36.3% of them were anxious about pain during surgical pain. 2.5% of them were afraid of unknown. 30% of them anxious about the improvement after surgery. None of them were anxious about post-operative nausea and vomiting. 21.3% of them were anxious about the complications. 2.5% of them were anxious about the loss of job. 62.5% of them were anxious about the family concern. 23.8% of them were worried about economic conditions.

Discussion

Mehdi F et al.10 evaluated preoperative anxiety & susceptible components in cardiac surgery patients. Patients between the age group of 18-65 were assessed for anxiety & association was found with various demographic variables. Females & patients with opioid addiction exhibited high level of anxiety (p<0.001). No association was seen with factors like family support & underlying disease. In present study association was seen with factors like gender, education, occupation, family type & hospital stay before surgery.

C. Ramesh et al.11 studied preoperative anxiety among patients with coronary artery bypass graft surgery. State – trait anxiety inventory was used to assess anxiety level. It was found that 84% of patients presented with preoperative anxiety. Chi-square test (11.57, p<0.001) was used to find association & gender was found to be associated with preoperative anxiety. In present study Amsterdam Preoperative Anxiety & Information Scale was used to assess anxiety &Fisher exact test was applied to find association between preoperative anxiety & demographic variables.

JoaquinH P et al.12 identified preoperative anxiety level in patients posted for heart surgery. Visual analogue scale was used to measure anxiety level. Anxiety was seen in 28% of patients & similar findings are seen in present study. But coronary artery bypass graft (OR 3.026, p<0.001) was associated with preoperative anxiety which is contradictory to present study where no association was seen with type of surgery.

Priya Gangadharan et al.13 conducted a descriptive study on 20 admitted patients posted for elective surgery. The anxiety was measured using State Trait Anxiety Inventory. Findings indicated that 60% of patients had high level of anxiety, 30% had moderate anxiety & low anxiety was seen by 10% of patients. Various levels of anxiety were associated with marital status. In these cases, nurses can plan interventions accordingly.

Anna R14et al. evaluated intensity of stress & level of anxiety in heart surgery patients. Intensity of stress was measured by standardized questionnaire in 58 patients admitted for heart surgery.

Mistakes by anesthetist was the main reason for anxiety.2 In present study postoperative pain & family concern were the main causes of anxiety. In another study common causes found were death worry, chances of complications & unpredicted postoperative consequences. In Present study 30% patients were worried about improvement after surgery & 21.3% were worried about complications after surgery.

High levels of anxiety 11,2,15 is seen in patients waiting for surgeries. Different studies have identified level of anxiety as well as possible causes of preoperative anxiety. It is seen that there are variables like gender, previous surgical experience, social support has association with preoperative anxiety. Different causes like inability to recover, harm from health professionals, fear of unknown, blood transfusion fear is found.

Shiho Takenaka16 measured mean value of intraoperative nociception in patients undergoing thoracic surgeries. It was found that nociception during intraoperative period was likely to be associated with preoperative anxiety. Even Rodrigues17 identified association of preoperative anxiety symptoms with hemodynamic instability in the postoperative period.

Association of anxiety was found with low level of education, potential cardiac function & sequence of surgery. In present study also association was seen with previous surgery.3

If preoperative anxiety is evaluated, the factors that would cause anxiety also can be explored. According to identified factors causing anxiety, intervention programme can be planned for patients undergoing cardiac surgeries.7

Janesson18discussed about factors that affected patient’s recovery in postoperative period. It was seen that those patients who were involved in decision making & to whom adequate preoperative knowledge was provided, had better satisfaction level in postoperative period. It was also suggested that patient’s literacy skills should be identified before surgery because that affects recovery in postop period.

Antonia K19 conducted randomized control trial on 395 patients where 205 patients were in intervention group. Preoperative education was given by nurses to intervention group & anxiety was assessed on admission day, before surgery & before discharge. State trait Anxiety Inventory was used to assess anxiety level. It was observed that level of anxiety was decreased before surgery in intervention group. Even there was decrease in mean anxiety score during follow up period. It was concluded that education delivered by nurses in preoperative period reduced anxiety & complications in postoperative period. Niknejad R20 inspected   effect of orientation tour on anxiety in preoperative period & it was seen that preorientation tour has reduced anxiety level in CABG patients. Such interventions can be planned by nurses working in cardiothoracic ward. Ping G21 revealed effectiveness of preoperative education among cardiac surgery patients. Extensive review of literature was done & it was found that some studies proved that preoperative education improved physical as well as psychological recovery of patients. So, training to staff nurses regarding preoperative education becomes greatest important. Similarly Pazar B22 investigated effect of preoperative education regarding patient comfort & anxiety to patients undergoing cardiac surgeries. A randomised control trial was performed on 200 patients & it was seen that those patients who received preoperative education exhibited low levels of anxiety.

Asilioglu K23educated cardiac surgery patients about preoperative anxiety & patients in the experimental group had lower anxiety scores than patients in the control group.

Mousari M24Nurses should be aware of complementary therapies & they should be able to use these supportive & nonpharmacological interventions to help patients reduce preoperative anxiety levels.  Similarly Joke Bradt25 patients who are waiting for surgery often have higher levels of anxiety. This may end up with prolonged wound healing & dismissive physical effects. It may even increase the risk of infection. Drugs help to reduce anxiety levels, but nurses can plan & make use of some nonpharmacological measures & control anxiety levels. Nurses can plan individualized care plan as each individual is unique & presents individual character & coping style.26

Conclusion

After analysing objectives of this study, it can be concluded that it is crucial for each patient to recognize about his or her own anxiety. Nurses are the ones who can assess anxiety of patients by different ways & help patients use variety of coping techniques to relieve it. Coping strategies like reading, verbalizing, physical activity reduces level of anxiety. Individualized education is also important. This enhances level of confidence. Even though similar studies are done previously, present study suggests that factors like female gender, occupation, type of family & hospital duration should be given more concern to reduce post operative problems. Different findings may be seen with different type of sample & dissimilar hospital environment. Education to nurses regarding preoperative assessment will give more fruitful services & better patient outcome. Patients with high anxiety have more desire to gain the knowledge. So, high risk patients must undergo proper evaluation & management to minimize anxiety levels.

Nursing implications

Preoperative assessment is required to distin

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

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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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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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