International Journal of Current Research and Review
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IJCRR - 6(20), October, 2014

Pages: 41-47

Date of Publication: 20-Oct-2014


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CONCEPT AND MANAGEMENT OF WAJAUL- MAFASIL (ARTHRITIS) IN GRECO ARABIC MEDICINE -AN OVERVIEW

Author: Mirza Ghufran Baig, Mohd. Aleemuddin Quamri, Javed Ali S, Shaikh Imtiyaz, Mohammad Sheeraz, Zaheer Ahmed

Category: Healthcare

Abstract:Arthritis is one of the commonest joint disorder affecting millions of people worldwide with an estimated 15% (40 million) of Americans had some form of arthritis in 1995 and by the year 2020, an estimated 59.4 million will be affected. In India it affects 15% (180 million) people. Ancient Unani scholars have elaborately described inflammation and pain of joints under the caption of Waja ul Mafasil and managed with multidimensional approach, in contrast with the present day management of disease mainly with non-steroidal anti-inflammatory drugs (NSAIDs) which will be having large number of adverse effects. This review article highlight the salient features describing arthritis with reference to Waja ul Mafasil for empathizing disease condition as enunciated by Unani scholars to provide a better alternative in terms of cost effective managements and side effects.

Keywords: Waja ul Mafasil, Arthritis, Joints pain, Unani medicine

Full Text:

INTRODUCTION
Waja ul Mafasil is an Arabic term, where Waja literally means ‘pain’ and Mafasil means ‘joints’. It is a painful or inflammatory condition affecting joints, its surrounding muscle and ligaments1 and may involve any joint viz; knee, hips, wrists, hands etc2,3,4 with accumulation of mawade fuzooni (vitiated matter) in the joints as the causative factor liable for pain and inflammation.5, 6 As per Unani literature in human body all bones are inter-related and inter-connected to form joints; articular surfaces of some joints are cartilaginous and possess some intervening spaces, 7,8 which helps them to perform different kinds of movements. These spaces are filled with rutubat (fluid) i.e., rutubate tajawif (synovial / interstitial fluid), which act as a lubricant and keep the joint surface consistently moist, so as to prevent from friction.5, 8While the articular surfaces of some joints are non-cartilaginous where consideration of this function is not necessary, a joint is created between two bones without any appendages or intervening space.5, 7, 8 Abu Sahal Masihi categorized all joints of the human body broadly into two types: Mafsal: Movable joints Lahaam: Immovable joints Ibn Sina, categorized the joints based on the articulation into three types: Chaneeda mafsal salas (Diarthrosis): Freely movable joints Mafsal usregair mossiq (Amphiarthosis): Slightly movable Usre gair mumdissiq (Synarthrosis): Immovable7, 8

Asbaab (Etiology)
Ibn Sina categorized the etiology of Waja ul Mafasil in to two types3, 4, 6, 10 Asbabe fa’ilah (primary causes) 2) Asbabe munfa’ilah (secondary causes) while another eminent Unani scholar Ismail Jurjani in his treatise “Zakhirae khuwarezam Shahi” classified as “Asbabe asli” and “Asbabe a’rzi.” 5 (figure 1)

1. Asbabe fa’ilah
These are the primary causes responsible for the initiation of Waja ul Mafasil such as Sue mizaj (Maltemperament) and Mawade fasidah (vitiated humours/morbid).11 Sue mizaj (altered temperament)3 Alteration in the mizaj may be general (entire body) local (particular organ). Different types of kaefiyat act in different ways such as Hararat as a multahib (inflammatory), Burudat as a mubarrid (refrigerant) and munjamid (consolidant), yabusat as a muyabbis (dessicant) and munqabiz (astringent). These alteration aggravate when Ratoobate gharibiya (abnormal fluids) are also involved.3,11

Mawade fasidah (vitiated humours)
The vitiated matter will be Dame khalis (pure sanguine), Dame balghami (phlegmatic sanguine), Dame safravi (bilious sanguine), Dame saudavi (melecholic sanguine), Balghame khalis (pure phlegmatic), Suddae Balghame kham (obstruent of raw phlegma), Mirrahe khalis (pure bilious), Balgham and Mirrah ka murahkkab (phlegmatic bilious), Midda (pus), Riyah (flatulent). It is often due to Balgham (phlegma) then Balghame kham (raw phlegm), than Dam (sanguine), then safra (bile) and rarely due to Sauda (black bile) 3,11

2. Asbabe munfa’ilah
They include weakness of joint,2,6 improper digestion13, sedentary life style,2 lack of exercise 13, excessive coitus2,13, use of alcohol and intoxicating agents2,13, sudden withdrawal or discontinuing the habit of Istifragh like fasd, is’haal, excessive coitus,2 exercise or coitus just after foods 2, horse riding 2 In zakhirae khuwarezam Shahi, Asbab are classified as Asbabe asli and Asbabe a’rzi. 5 Three factors are included in Asbabe Asli; movements, heat production, weak digestive power or excretion of joints while Asbabe A`rzi are mentioned under the context of asbabe munfaila5 . Figure 1: Flowchart depicting etiology of Waja ul Mafasil

Mahiyate marz (Pathogenesis)
Joints get easily affected with various morbid matters, for the following reasons

• Wide joint space as compared to other organs of body. 1,5

• Hypersensitivity due to nerve innervations.1,2

• Barid yabis Mizaj (cold and dry temperament) of joints.5

• Zaeef hararat (Feeble heat) of joint.1

• Improper resolution of morbid matter (tahlil of mawad) in joint cavity.1

• Due to upright and dependent position of the organ as it lies in relation to the other organs.1,3,10

• Joints are covered with ligaments, tendons and muscles, hence the accumulated morbid matter are not easily removed through skin pores.1

• Weak quwate hazema wa dafea` (digestive and excretory powers).1,5

Accumulation of mawade fuzooni (vitiated matter) in joints will produce pain and inflammation. Following factors are responsible for the collection of mawade fasidah within the joint spaces; 5Weakness of joints increases susceptibility to accumulation of mawad. 6 When vigorous physical movements occur, it stimulate the mawad (matter)I and produce heat in the joint cavity, which has the property of absorbing and attracting fluids or mawad (matter). During the movements the morbid matters which are stagnated in the interstitial spaces starts migrating and gets collected in the joint cavity, since it has adequate space to receive. Besides this the temperament of the contents of joint like bone, cartilage, tendons and ligaments is sard wa khushk (cold and dry),1 due to this prime reason the joint fails to perform its digestion. Thus the morbid matter collected in the joint spaces is not eliminated properly, which gradually affects the joints8 (figure 2).

Classification of Waja ul Mafasil according to Mizaj
Akbar Arzani has classified Waja ul Mafasil into:6

• Non inflammatory due sue mizaj sada

 • Inflammatory due to sue mizaj maddi

Waja ul Mafasil Sada (Due to simple altered temperament)
In this condition there is no morbid material involved, there is alteration in kaefiyat only. it may be divided into three types. 3,4,6,11

• Haar multahib (inflammatory)

• Barid munjamid (consolidant)

• Yabis munqabiz (astringent)

Waja-ul-Mafasil Maddi (Due to altered temperament with humoural involvement) 3,4,6,11,12
In Waja ul Mafasil Maddi there is accumulation of morbid maWaja-ul-Mafasil Maddi (Due to altered temperament with humoural involvement) 3,4,6,11,12tters or humour inside the joint cavity. It may be further divided into following types.

• Waja ul Mafasil Balghami (phlegmatic)

• Waja ul Mafasil Damavi (sanguineous)

• Waja ul Mafasil Safravi (bilious)

• Waja ul Mafasil Saudavi (melancholic)

• Waja ul Mafasil Reehi (Due to excessive flatulent matter)

• Waja ul Mafasil Murakkab (Involvement of compound/mixed humors)

Classification based on involvement of joint Wajaul Mafasil is a general term used either for painful joints of body or specially hands and feet but it can affect wrist, elbow, hip, ankle and knee.11 Specific name of its various types based on the involvement of joints are • Irqunnasa (sciatica) 1,2,3,4,5,6,10,11,13,14,15,16,17 • Niqris (gout)1,2,3,4,5,6,10,11,13,14,15,16 • Waja ur rakba (knee joint pain) :,3,4,11,17, • Waja uz zahr (low Back pain) 3,4,10,11,17 • Waja ul warik (hip joint pain) 3,4,6,10,11,16,17 • Wala ul khasera (buttock pain) 1 • Wajs us saqain (calf pain) 11 • Waja ul aqib ( heel pain) 11 Zakariya Razi considered Waja ul Mafasil, Niqras and IrqunNisa, as a disease of the same genus.17 Ali ibn Abbas Majoosi and other Unani scholars believe that Waja ul mafasil can also occur in intervertebral, temporomandibular and joints of auditory ossicles. 11,12, Alamaat (Clinical Features) Waja ul Mafasil Balghami (Phlegmatic) • Commonest form of Waja ul Mafasil. 1,6,17, • The onset of symptoms and sign are gradual3 . • Area of affected joint is swollen, soft, whitish and cold on touch1,3,12, • Pain and throbbing is nominal1,3,12 • Swelling is soft and cold with deep pain and tenderness marked1 • Aggravated by exposure of cold2,3,12 • Relieved by exposure of heat over affected part1,3,12 • Generalized and localized symptoms of dominance of phlegm (Ghalbae Balgham) will be present3, 12 • History of using diet or drugs causing abnormal genesis of phlegm is positive1

Waja ul Mafasil Damavi (Sanguineous)
• It is second commonest form of Waja ul Mafasil. 1,6

• Onset is comparatively sudden, symptoms and signs are sever.3

• The swelling is more marked with severity of pain1,2,3,6,12

• Pain is throbbing in nature. 1,3,6,12

• Marked redness of skin over the joint. 1,2,3,6,12

• Warmth over affected joint. 2,3,6,12

• Aggravated by exposure of heat 2, 3

• Relieved by exposure of cold application over affected part or venesection.2,3,6,12

• Generalized and localized symptoms of dominance of sanguine (Ghalbae Khoon) will be present. ,2,3,6,12 Waja ul Mafasil Safravi (Bilious) • Rare variety of Waja ul Mafasil. 1,6, • In this type, onset is sudden.3 • There is slight yellow discoloration or there may also be red tinge to yellow discoloration of skin over the joints. 1,2,3,6, • The swelling is less marked, with warmthness 1,2,3,6, and throbbing pain is relatively more in comparison to Waja ul Mafasil damvi over the joints.3,12,17 • Aggravated by exposure of heat.2,3,19 • Relieved by exposure of cold application over affected part.1,2,3,6,12,17 • Generalized and localized symptoms of dominance of Bile (Ghalbae safra) will be present.3,12

Waja ul Mafasil Saudavi (Melancholic)
• Rarest variety of Waja ul Mafasil. 1,6

• Area of affected joint is cold and dry on touch 1,2,3,6,12

• There is dryness of the skin around the joints. 1,2,3,12

• The pain is mild, swelling is moderate but hard on touch. 1,3,6,12

• Aggravated by exposure of cold.

• Relieved by exposure of heat application over affected part. ,3,6,12

• Generalized and localized symptoms of dominance of black bile (Ghalbae Sauda) will be present.3,6 

Waja ul Mafasil Murakkab (Involvement of compound/mixed humours)
Though every single humour is responsible for causing Waja ul Mafasil but mixed humours can also cause the disease. Among them mixture of Balgham and Safra, sauda and safra is quite common but Balgham and Sauda is rarest.1,6,11,17Mixture of ghaleez balgham and tez Safra is worst variety of Waja ul Mafasil. Hence safra causes throbbing pain and balgham is responsible for chronicity /prolong duration12

Waja ul Mafasil Rehi (Pneumatic)
It is a rare type of Waja ul Mafasil,where pain is mild, absence of heaviness, shifting in nature, with sever distension due to Riyah6,11

Tahajjure Mafasil (Degenerative Arthritis)
When patient suffer with Waja ul Mafasil for longer duration, due to the freezing of ghaleez barid madda.11,17 inside the joint will leads to stiffening of the joint. In the initial stage of (waram) inflammation, use of either barid and mukhaddir zimad or mudir (diuretic) and qawi mushil (strong purgative) without munjiz can causes tahajjur in the joint.11 Sometimes it restrict the movement of affected joint.11

Tashkhees (Diagnosis)
The diagnosis of Waja ul Mafasil due to Sue mizaj sada or maddi. 10,11can be made through following points

• Presence or absence of swelling, inflammation, heaviness with pain in or over the joint,

• Color change over affected joint,

• Onset of pain either sudden or gradual, if onset is gradual, without heaviness, inflammation or swelling and no change in skin colour of affected joint, then it is considered to be due to sue mizaj sada, but Waja ul Mafasil is rarely found in sue mizaj sada.

• Change in tactile sensation, pulse, urine and other Unani diagnostic parameter are helpful in knowing the nature of sue mizaj.

• If pain is mild, absence of heaviness, shifting in nature, with severe distension, indicates due to Riyah

 • Presence of marked swelling or inflammation, color changes, sudden onset of disease, or pain with heaviness is to be consider due to khilti madda10,11

General principles of Treatment 7,18
The treatment of Waja ul Mafasil in Unani system of medicine is carried out by using one of three modes or with combination viz. 1. Ilaj bit Tadbeer wa Ilaj bit taghzia (Regimenal therapy and Dietotherapy) 2. Ilaj bid Dawa (pharmacotherapy) 3. Ilaj bil Yad (surgical therapy)

Usoole Ilaj (Line of Management)
Waja ul Mafasil in initial stage can be treated easily but if it persists for a longer period it becomes difficult to treat. 11 If it is due to Sue mizaj sada, it can be treated with taadile mizaj (alteration of temperament) such as if pain is due to Sue mizaj haar (Excess of heat) then for Taadile mizaj (alteration of temperament) cold applications is useful for restoration of health, in the same way in case of Sue mizaj barid (Excessive cold) hot applications is useful.10,11 • Removal of causes • In Zamanae Ibteda (early stage) Qabezat (Astringent) and Radeat (Repellent) in Zamanae Tazayyud (Progressive Stage) less Qabezat and Radeat than Mohallilat (anti-inflammatory) and in Inteha (Peak Stage) Mohallilat and Munzijat (concoctives) and in Zamanae Inhetat (late/Declinig stage) Mohallilat and Murakhkhiyat (local relaxant) should be used. • Tanqiyae mawad (evacuation of vitiated or morbid matter) 11 • In case of balghami and saudavi variety, first use munzijaat (concoctives) for making humours suitable for excretion then use Mus’hilaat (Purgatives) for its evacuation followed by mubarridat (refrigerant) for normalizing the excess heat produced by Mus’hilat.

Ilaj (Management)
Nuskha Munjiz Balgham: Maviz munaqqa (Vitis Vinefera) 9 number, Badiyan (Foeniculum vulgure) 5gm, Aslussus (glycyrrhiza glabera) 7gm, Parshiyawshan (Adiantum cappilus) 7gm, Injeer zarda (Ficus carica) 2 number Or; Bekhe Badiyan (Foeniculum vulgare)7gm, Bekhe kibr (Capparis Spinosa) 7gm, Bekhe kirafs (Apium Graviolanse) 7gm, Bekhe Izkhar (Andropogon Schoenthus) 7gm, Socked in the water over night and next morning Prepare Decoction And use with Gulqand 20gm. Nuskha Munjiz Saud: Badranjboya (Mellisa officinalis)7gm, Aftimoon (Cuscuta reflexa) 7gm, Bisfaij (Polypodium vulgure) 5gm, Aslussus (glycyrrhiza glabera) 7gm,Gaozaban (Borage officinalis) 7gm, Bekhe kibr (Capparis spinosa) 7gm, Badiyan (Foeniculum vulgure) 7gm, Inabussalub (Solanum nigrum) 7gm, Suranjan (Cholchicum luteum) 5 gm 11 Socked in the water over night and next morning prepare decoction and use with Gulqand 20gm or turanjabeen (Alhaji Pseudoalhaji) 20gm. Mus’hilaat Balgham: Sana Makki (Cassia Aungustifolia), Turbud (Ipomea turpthum), Zanjabil (Zingiber Offici-nalis),, Khayarishamber (Cassia Fistula) 11 Shame hanzal (Citullus Cholocynthis), Suranjan (Cholchicum Luteum), Bozidan (Pyrethrum indicum), Hajre Armani (armanian stone) , Habul Neel(Ipomoea nil)1 Mus’hilaat Sauda: Matbookhe Aftimoon 6 or Aftimoon (Cuscuta reflexa) ,Turbud (Ipomea turpthum), Kharbaq siyah (Helloborus niger), Halelah Kabli (Terminalia chebula). Mubarridat: Shire Tukhme kahu (Lactuka sativa), Shirae Tukhme kaddu (Cucurbita maxima), Shirae Tukhme Kasni (Chicorium intybus), Shirae Tukhme Khyarain (Cucumis sativus), 11 The reason for administering the Nuskhae Tabrid is to reduce heat and agitation of Khilte Dam, Safra or Mushilat. Fasad and Moaddelate Dam: In case of predominance of khilte dam, Fasd (venesection) and moadelate dam (alterative) should be use1,6 Mus’hilaat safra: In case of Predominance of Safra use of munzijat is not mandatory only mus’hilat can be use directly if disease is not of longer duration. such as Matbookhe Halelah 1,6,11 Matbookhe Halelah: Poste Halelae Kabli (Terminelia chebula), Shahetra (Fumeria officinalis), Tukhme Kasoos (Cuscuta reflexa), Tukhme Kasni (Chicorium intybus), Poste Bekhe Badiyan (Foeniculum vulgare), Aalu Bukhara (Prunus domestica), Unnab( Zizyphus sativus ) along With Maghze Amaltas (Cassia fistula)19 While managing the Waja ul Mafasil Murakkab Which is caused due to admixture of different humours (akhlaat) due importance should be given in the selection of drugs having multiple effects on different humours; however it should always be kept in the mind to rectify the predominant humour with specific Munzij followed by Mushil. Musakkine Alm (analgesics) to reduce pain. e.g. Afyun (papaver somniferum), Zafran (Crocus sativus), Bekhe Luffa (Atropa belladona), Suranjan (Cholchicum luteum)1 Abe kahu (Lactuca sativa)6 can be used as a zimad (paste)11 Use of Raadeaat (repellent) in initial stages of warm. e.g Sandale Safaid (Santulum Album), Sandale Surkh (Ptero carpus santilimus), foofal (Areca catechu), Aqaqiya (Acacia) prepare zimad with Sirka (Vinegar) and Aabe kishneez (Coriandrum sativum) 11Gule surkh (Rosa damascus)6 Use of Muhallile Awraam (anti inflammatory drugs) in the last stage of warm. e.g. Khitmi (Althoea officinalis), Baboona (Anthimis nobilis), Nakhoona (Trigonella uncata) in the form of zimad 1 Mullayinat wa Murakhiyate Auram:. Arade Hulba (Trigonella foenum), Tukhme Katan (Linum usitatissimum), Muqil (Commiphora mukul), Jao’sheer (Ferula galbaniflua), each 7gm and Tukhme Arand (Ricinnis communis) 7 number, prepare paste with Roghane zaitoon (oil of Oleum europium), Roghane Gao (oil of Bos taurus) and Charbie Buz (fat Of Capra aegagrus hircus) 1,6 Muhallil Wa Mullayinate Auram: use in combination in case of Tahajjur Mafasil: Arade krisna (Pisum sativum), Turmus (Lupinus albus ), Ushq (Dorema ammoniacum), Anjadaan (Ferula foetida), Arade baqla (Vicia feba), as a zimad along with Sikanjabeen 10 Use of Kasire Riyah (carminative) drugs in case of Waja ul Mafasil Rehi. e.g. Sa’tar (Zataria multiflora), Anisoon (Pimpinella anisam), Tukhme kasoos (Cuscuta reflexa), Zira siyah (Carum cavri), Badiyan (Foeniculum vulgure)11 Local application of drugs in the form of Zimad (paste), Tikor (fomentation) and Roghan (oil) etc, are recommended during the course of treatment to relieve pain and reduce the inflammation.

Murakkab Advia (Compound Drugs)
Majune Azraqi11,20,21 Majune Ushba1,11,19, Majune Suranjan 1,11,19,20,21, Majune Chobchini19, Majune flasifa19,21 Majune Jograj Goggul20, Habbe Azaraqi 1,19,20,21 Habbe Suranjan 1,19,20,21, Habbe Asgand ,19,20,21, Habbe Gule Aak 1,20,21,22,23,Habbe Hindi19 Habbe Mafasil19 Ilaj bit tadbeer (Regimenal Therapy) Dalk (Massage) It is a type of Riyazat (Manipulation method) resolve and liquefies vitiated matter, produces slight heat and strengthen ligaments and muscle 24 It is also helpful in evacuation of viscous and adhered matter accumulated inside the joints24, and relieves pain, 25,26 produces heat which removes barudat and rehi mawad 24,25,diverts morbid matter,24 reduces swelling, 25,26 excretes fuzlaat specially of last grade of digestion (hazme Akheer)27 Dalk layyin Kaseer (Gentle and prolog massage) Specially dalk layyin kaseer (gentle and prolong massage) is more beneficial for such painful conditions, because dalke layyin make organ soft and relaxes the muscle 25,27 According to Ibn rushd it opens the pores which is helpful in excretion of mawad . 27 While Dalke kaseer is helpful for tehlil mawad which is part and parcel in the causation of Waja ul Mafasil24,25 Roghaniyat (Oils) used for Waja ul Mafasil Roghane Baboona20,21Roghane Dhatura11,21 Roghane Surkh19,21 Roghane Suranjan19,21 Roghane Gule Aak1,20,21 Roghane Malkangni21 Roghane Hifte Barg20, Roghane Kuchla1,20 Roghane Hina19Roghane Zanjabil19 Roghane Shibit19Roghane Qust1

Hijama
Hijama (Cupping) is one of the oldest and popular therapeutic regimen in Unani system of medicine indicated in different forms/ types of Waja ul Mafasil such as gout, sciatica, knee pain28 It is beneficial for Waja ul Mafasil because it is used for Tanqiya and Imalae mawad (diversion and evacuation of morbid matter) from affected part3,4,26,28,29,30,31,32,33 it relives pain,26, 28 ,29 ,31, 32, 33 resolves inflammation, 28 ,29 ,31, 32, 33 flatulence, 26 produces localized heat by increasing local blood circulation 26,28 Jalinoos believed that hijama is beneficial in resolving Ghaleez Khilt 14

Fasd (Venesection/ Phlebotomy)
Fasd is one of the classical methods of treatment in Unani system of medicine for cleansing, evacuation and diversion of surplus and morbid humours from the body, which helps in relieving inflammatory congestion and pain in Waja ul Mafasil, such as sciatica and lumbago. This objective will be achieved through fasd of specified veins of the body part7 . Irsale Alaq (Leech Therapy) Leech or hirudotherapy is one of the most important and widely practiced method of regimenal therapy used for local evacuation of morbid humours very effectively with use of medicinal leeches to treat various ailment including Waja ul Mafasil. 18, 34

DISCUSSION
Waja ul Mafasil has been discussed by ancient Unani scholars in detail as to its etiology, types, clinical features and management.1,2,5,6,11,12,29 The concept of Unani medicine when applied in this scientific era has promising hope. Several studies had suggested the beneficial use of single and compound Unani formulations in arthritis.3,4,28,31,32,33 The efficacy of classical Unani regimenal procedures such as Irsale Alaq (leeching),34 Hijama (Cupping) 3,4,28,31,32,33 Dalk (Massage),25 in the management of different types of Waja ul Mafasil also show a ray of hope for the mitigation of patients suffering from this chronic disease.

CONCLUSION
The profound literary survey pertaining to Waja ul Mafasil as to its concept, detailed classification, iology and multidimensional approach in the management testifies to the fact that this age old disease was meticulously managed by Unani scholars successfully in spite of the limitations prevailed over at that time. This has been documented in the classical literature of Unani medicine. Of late scientific studies with different Unani formulations are being carried out by different research institutions to validate these claims. The scintillating point of this approach is through drug less regimental therapies viz; Irsale alaq ,Fasd , Hijama, Dalk which seems to be a boon for intervention of disease condition in terms of easy to perform, cost effective and at the same time devoid of adverse effects. Hence the objective of this review would be fully accomplished if it reaches a larger section of medical domain and ultimately benefit the humanity.

ACKNOWLEDGEMENT
Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed particularly assistance rendered by staff of Central library of National institute of Unani medicine, Bangalore in providing the necessary classical literature

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17. Zakariya Razi. Al Hawi fit Tib. (Urdu Translation by CCRUM) Vol.X1. New Delhi: Ministry of Health and Family Welfare, Govt. of India; 2004. p. 75-79, 89.

18. O.C. Grunner. The Canon of Medicine of Avicenna. London: First Book, Luzac & Co., 1930. p.353, 513–514.

19. Mohammad Kabiruddin. Al-Quarabadeen. 3rd Ed.New Dehli: CCRUM; 2006.p. 183-186,466-468,1210-1215

20. Mohammad Kabiruddin. Bayaze Kabeer. New Dehli: Idarae Kitabus shifa; 2010.p. 30, 37, 50, 57, 88, 94, 176, 177, 179, 80, 89-93.

21. Qarabadeene Majidi. New Delhi: All India Tibbi Conference Ajanta offset & publication; 1996.p. 68, 69,85, 92, 149,155-158, 164-165, 346, 276, 378.

22. National Formulary of Unani Medicine. Part- III, 1sted. New Delhi: Ministry of Health and Family Welfare Govt of India; 2001.p. 15

23. Mohammed Said. Hamdard Pharmacopoeia of Eastern Medicine. 2nded (Reprint) Delhi: Sri Satguru Publications; 1997. p.150

24. Burhan Uuddin Nafees. kulliyate Nafeesi, Part-II. Translated by Hkm. Kabeer Uddin, New Dehli: Idarae Kitabusshifa; YNM. p. 622-626

25. Shaikh Ejaz. Study 0f Efficacy of Dalak (Massage) in the Treatment of Osteoarthritis (with and without Roghan-eSurkh) Indian journal of Unani Medicine. 2011. 6 (2): 33- 40

26. Ibn Sina. Kulliyate Qanoon. Urdu Translated by Mohammad Kabeer Uddin. New Dehli: Ejaz Publishing house; 2006.p.347-349

27. Ibn Rushd. Kitabal Kulliyat (Urdu Translation by CCRUM). 2nded. New Delhi: Ministry of Health and Family Welfare, Govt. of India; 1987.p.346 .

28. Nighat A, Shakir J, Abdul H, Jamal A, Bilal A. Clinical efficacy of Hijamat (Cupping) in Waja ul Mafasil Muzmin (arthriris). Indian journal of Traditional Knowledge. 2005. 4 (4): 412-415

29. Akbar Arzani. Meezanut Tib. Dehli: Daftarululoom; 1940. p.147-148

30. Ibn ul Qaf Masihi. Kitab Umda fil Jarahat. Hyderabad: Doeratul moarif usmaniya university;1935.p.15-35

31. Nayab M, Ansari M A, Anwar M, Yaseen A, Effect of Hijamat Bila Shart in the Management of Waja uz Zohar - A Clinical Study. Hippocratic journal of Unani Medicine. 2011.vol.6 : 79-86

32. Zarnigar, Riyaz A. Clinical efficacy of Al Hijama (Cupping) in Waja ul Mafasil Muzmin (Osteo arthriris). Indian journal of Traditional Knowledge.2011. 10 (2):327-329

33. Akhtar J, Siddiqui MK. Utility of Cupping Therapy Hijamat in Unani medicine Indian journal of Traditional Knowledge.2008 .7 (4): 572-74.

34. Zaidi SMA, Jamil SS, Sultana A, ZamanF, Fuzail M. “Safety and efficacy of leech therapy for Symptomatic knee osteoarthritis using Indian medicinal leech.” Indian journal of Traditional Knowledge. 2009. 8 (3):437-442.

Announcements

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

COPE guidelines for Reviewers

SCOPUS indexing: 2014, 2019 to 2021


Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

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

Women Researcher Award:

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

Emerging Researcher Award:

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


Best Article Award

A study by 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
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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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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