International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 5(13), July, 2013

Pages: 29-36

Date of Publication: 17-Jul-2013


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A STUDY OF VARIATIONS IN THE SHORT SAPHENOUS VENOUS SYSTEM WITH CLINICAL CORRELATION

Author: Anupama D., Nagaraj D.N., B.S. Suresh, R. Lakshmi Prabha Subhash

Category: Healthcare

Abstract:The common liability of the superficial venous system of the lower extremity to varicoses has naturally attracted the attention of Anatomists and Surgeons. Variations in the superficial veins of the lower limb are very common. The extent of such variations, their connections to either the Long or Short saphenous venous systems are usually described. Generally the clinical assessment, including tourniquet tests and Doppler ultrasound, of primary varicose veins presents no problem. However, in some patients the information so obtained is inadequate for appropriate management and difficulties arise because of abnormal communication between the Long and short saphenous veins. Sometimes the main trunks alone are affected and in others only the tributaries are anomalous. In few cases both are involved. In extensive varicose veins, because of overlap of the long and short saphenous territories, it can be difficult to assess which system is involved or whether both are affected. Detailed knowledge regarding the anatomical variations such as reduplication of the long saphenous vein and unusual termination of the short saphenous vein is a prerequisite in the diagnosis and management of varicose veins. Usually the short saphenous vein terminates in the popliteal fossa a few cms above the knee joint, but in almost one half of patients it terminates at a higher or lower level. In this study short saphenous vein terminated at unusual sites is described. Although attention has been mainly directed to the great saphenous vein for the elucidation of the causation of the varicose condition, the study of the small saphenous vein, which phylogenetically is the more important vein, throws light upon the problem.Interestingly variations seen in this study should be kept in mind due to its clinical and surgical significance.

Keywords: Short Saphenous vein, Long saphenous vein, Popliteal vein, Anomalous, Varicoses.

Full Text:

INTRODUCTION
The short(small or lesser ) saphenous vein begins posterior to the lateral malleolus as a continuation of lateral marginal vein. In the lower third of the calf, it ascends lateral to the tendo calcaneus, lying on the deep fascia and covered only by superficial fascia and skin. Inclining medially to the midline of the calf, it penetrates into the deep fascia within which it ascends on gastrocnemius, only emerging between it and the deep fascia gradually at about the junction of intermediate and proximal thirds of the calf. Then it ascends between the two heads of gastrocnemius and proceeds to terminate into popliteal vein. Its mode of termination is variable. Mercier's classification describes six types of terminations: 1: The saphenopopliteal junction is situated 2 to 15 cm above the popliteal crease; this situation is observed in half of all cases; 2: The saphenopopliteal junction is also situated 2 to 15 cm above the popliteal crease, but is prolonged by a trunk which anastomoses with the long saphenous vein; 3: The so-called high saphenopopliteal junction terminates on the posterior aspect of the thigh, in the femoral vein, which communicates with the long saphenous vein; 4: The saphenopopliteal junction does not exist and the short saphenous vein terminates exclusively in the long saphenous vein; 5: The high saphenopopliteal junction terminates on the posterior aspect of the thigh,in the femoral vein; 6: The saphenopopliteal junction is complex, with a number of intramuscular anastomoses. It is important for the surgeons operating the varicose veins to be aware of these unusual modes of termination of short saphenous vein, to allow the surgeon for complete flush ligation of the same failing which recurrence is common.

MATERIALS AND METHODS
50 embalmed lower limb specimens were thoroughly cleaned, carefully dissected and studied in detail. Photographs of the same were taken.

OBSERVATIONS AND RESULTS
Sapheno politeal junction (Type1) was the most common type of termination as shown in fig 1. The next common mode of termination was high Sapheno popliteal junction (Type 5) which opened in to femoral vein on the posterior aspect of thigh as shown in fig.2. Sapheno popliteal junction with trunk extending to anastomose with long saphenous vein (Type 2) was the third commonest mode of termination as shown in fig. 3. High long saphenous termination only (Type 4) was seen in one of the limbs as in fig.4. Type 3 termination was seen in one case, where in one branch of the small saphenous vein formed an arch which entered the popliteal vein on an average of 4-5 cm. above the knee-joint, just below the middle of the popliteal space. The terminal part of the arch received the small superficial posterior vein of the thigh (v. cut. fem. post. of Meyer, v. femoro-poplitea of Hyrtl). This vein began in the junction of upper and middle third of the thigh, and ran under the deep fascia on the medial side of the sciatic nerve fig.5. In addition, this vein communicated with the deep posterior muscular veins of the thigh. The other branch of short saphenous vein ran round the medial side of the middle of the thigh towards the great saphenous vein. In one of the limbs, it opened directly into the great saphenous vein, just before its termination. In one limb it terminated in posterior tibial vein below the kneejoint fig6. (Type6) In one case, a small cutaneous veins found running down from the popliteal space to join the long saphenous vein which may be regarded as the usual upward continuation of the main trunk. In another case, it trifurcated in the popliteal fossa, one branch opening in to popliteal vein, second joining the posterior deep femoral vein and the third joining the great saphenous vein just above the knee. In two cases, it terminated by forming a common trunk with gastrocnemius veins which further opened in to popliteal vein fig.7and in another it opened in to posterior tibial vein.(Type6)

DISCUSSION
ONTOGENY:

EmbryologIcally the small saphenous vein represents the post-axial vein of the hind limb bud; it is the first vein to appear and originally opens into the internal iliac through the sciatic and gluteal veins. The subsequent transformation into a short vein opening into the popliteal vein, may be an adaptation to the elongation and relative rigidity of the hind limb. This abbreviation of the post-axial vein of the lower extremity is the main difference in the venous system of the fore and hind limbs. Comparative anatomy seems to indicate that the termination of the small saphenous vein into the popliteal vein is an adaptation peculiar to higher mammals including man. In this the small saphenous vein ends exclusively in the popliteal vein.

CLINICAL IMPLICATIONS
Several anatomical studies have described various types of Short saphenous vein termination among which the study of Giacomini stands out. Varicose veins are one of the commonest disease of veins of the lower limb. It affects more than 5% of the adult population in the western countries. More than ½ of adult men and 2/3 of adult women have physically identifiable varicosities. Varicose veins range in severity from the undesirable appearance of venectasia to protuberant tortuous varicosities with or without associated dermatitis, cutaneous ulceration or severe pigmentation. The cause for varicose veins is said to be multifactorial. It is also linked to FOXC2 gene. As a result of anatomical study of the distribution of varicose veins with the aid of investigations, the treatment is usually decided. The present understanding of the anatomy of the area is to allow the selection of treatment on the basis of the probable cause. The particular anatomical and hemodynamic characteristics of veins of the popliteal fossa responsible for a number of therapeutic difficulties which is related to the confluence of popliteal and saphenous collecting vessels and muscle draining veins. The hemodynamic difficulties are to the fact that the popliteal fossa which is the site of very intense pressure variations. As one of the causes for the varicoses is possible variations in the anatomical course of small saphenous vein and its anastomotic channels, it is very important to alienate the varicosity to either short saphenous or long saphenous venous systems. Usually varicoses in the back of the leg with a palpable dialated small saphenous trunk is suggestive of the incompetence of small saphenous vein. Some varicose veins join both the systems where it becomes confusing to define the mode and extent of surgical management. There is some evidence to say that a more accurate surgical approach reduces the incidence of recurrence of varicose vein which is the most common complication. Unless flush ligation is performed, recurrence is likely. Abnormally distributed varices or a suspiscion of lesser saphenous incompetence requires further assement as the termination of the lesser saphenous vein is very variable.8,9 The principles on which the surgical treatment is based, are to ligate the point of communication, the saphenofemoral and /or saphenopopliteal junctions and to remove the major part of the incompetent trunk to prevent connections to the tributaries. The tributaries are then individually removed by making minor cut downs and avulsions. Preoperative ultrasound localization of the junction should ideally be carried. A transverse skin incision is made in the popliteal fossa just below the termination of the vein. The deep fascia is then split to identify vein till sapheno popliteal junction before it is divided. Tributaries may enter the vein just before its termination. After the vein has been divided, careful stripping of the vein is done from above downwards with dissecting off the sural nerve to ensure that the whole of the small saphenous vein is removed. This obliterates the junction with the midcalf perforator vein which is responsible for many recurrences. Recurrent venous reflux in the popliteal fossa with recurrent varicose veins following short saphenous surgery has been reported frequently. 5,6.7. Incompetence of the short saphenous vein was found to be the main source. Recurrent Short saphenous vein varicosity or persistence may be of 4 types Type 1- Intact Sapheno Popliteal Junction as well as Short saphenous vein. Type 2- Varicosities in the popliteal fossa communicating with Short saphenous vein stump. Type 3- Residual Short saphenous vein communicating with the popliteal vein via a tortuous vein. Type 4-Non communicating residual Short saphenous vein. 10 The relation of the arch of the small saphenous vein to the tibial nerve may be important since it explains the obstinate pain in the leg when the veins become varicose, as it is always intimately connected with it. Motor nerve injury (tibial nerve) should not occur if the affected area is carefully displayed during surgical procedures.3 Damage to the other veins and arteries in the vicinity is also avoidable with detailed anatomical knowledge of the region and also helps to prevent recurrence.11 Compartment syndrome is an infrequent but serious complication which can occur post operatively following short saphenous vein surgery where in raised pressure within a tight compartment results in a combination of sensory andmotor symptoms with vascular compromise.12

References:

1. Veins of the lower limbs in Cardio vascular system.In: Susan Standring, Gray’s anatomy. 37th ed, Edinburgh:Churchill Livingstone; p15 

2. Hollinsheds surgical anatomy, 4th ed, ch 5, Lower limb as a whole, p 345 .

3. Observations on the superficial venous system of the lower extremity by Charles Kosinski.p131-142.

4. F.P. Keeling andM. Lea Thomas.1987, The British Journal of Radiology,60.235-240.

5. Bailey and Love’s Short practice of surgery.25th ed. Venous disorders. Kevin Burnand. ch54, p9 27-932.

6. Farquharson’s text book of operative surgery.R.F.Rintoul.8th ed, 2002. Churchill Livingstone, p57-63.

7. Carol.E.H, Scott Conner in Operative Anatomy.3rd ed Lippincott Williams.p745

8. Wesley .S. Moore, Vascular surgery- a comprehensive review.6th ed. Ch. 42,Chronic venous insufficiency. Niren angle andJohn.T.Bergan, p826-833.

9. Philippe Blanchemaison, Jerome Camponovo, Short Saphenous TerritoryAnatomy of recurrences following SPJunction ligation- Ectatic gastrocnemius veins.p1-3.

10. Tong Y, Royle J. Recurrent varicose veins after short saphenous vein surgery: a duplex ultra sound study.Cardio vascular surg 1996 Jun;4(3):364-7.

11. S-Y Kim, E-A Park, Y-C Shin Preoperative determination of anatomic variations of the small saphenous vein for varicose vein surgery by 3 dimensional tomography venography.Phlebology28.October 2011 at rsmjournals.com

12. Yousef Shahin,Niteen Tapuria andPeter Lee Chong.Compartment syndrome following short saphenous varicose vein surgery:a case report.Cases Journal 2009;2:7118.






 

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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.

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
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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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