International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 4(17), September, 2012

Pages: 153-159

Date of Publication: 14-Sep-2012


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Non-Healing Skin Ulcer in HIV/Tuberculosis Co-Infection: A Case Report.

Author: Monali N. Rajurkar, Silpi Basak

Category: Healthcare

Abstract:Introduction: Tuberculosis (TB) is very common in India, China and other developing countries. World Health
Organisation (WHO) had estimated 9.2 million new cases of TB, worldwide in 2006 of which 7.7% were positive
for Human Immunodeficiency Virus (HIV). In India, at the end of 2007, there were 2.5 million people living with
HIV and AIDS (PLWHA) whereas incidence of TB was 1.8 million cases per year. Tuberculosis is the most
common HIV related opportunistic infection in India and caring for patients with HIV/TB co-infection is a major
public health challenge. The incidence of tuberculosis is more in people living with HIV infection. So, WHO has
developed the strategy of treating HIV/TB co-infection irrespective of patient?s CD4 count. If any HIV positive
patient is diagnosed to be infected with tuberculosis, the Antitubercular treatment (ATT) is started along with
Antiretroviral therapy (ART).
Here, we report a case of skin ulcer due to Mycobacterium tuberculosis on chest, secondary to pulmonary
tuberculosis in HIV infected person with varied presentation.
Material and Methods: At first pyogenic infection due to Methicillin Resistant Staphylococcus auereus (MRSA)
was diagnosed. As the patient did not improve even after the full course of Linezolid therapy for Methicillin
Resistant Staphylococcus aureus (MRSA) which was superadded infection, the discharge and also tissue material
were collected from the base of ulcer and cultured on Lowenstein \? Jenesen media and Ziehl-Neelsen staining were
done. The acid fast bacilli were present on staining and growth on Lowenstein - Jenesen media was identified as
Mycobacterium tuberculosis.
Outcome of study: As the patient was also HIV positive both ATT and ART was started. A significant
improvement of the cutaneous lesion was noted after one month of treatment and patient was discharged after
another fifteen days.
Conclusion: Tuberculosis is very common in India and sophisticated automated system for detecting M.tuberculosis
is not available in all centers. Any non-healing ulcer not responding to routine antibiotics must be screened for
tuberculosis in developing countries. If tuberculosis is detected, promptly HIV testing must be done so that
treatment strategy can be finalised.
Word count - 341

Keywords: HIV/TB co-infection, People living with HIV and AIDS (PLWHA), Skin tuberculosis

Full Text:

INTRODUCTION Tuberculosis is one of the oldest disease, known to mankind and its evidence is detected even in Egyptian mummies. It remains as a leading cause of death worldwide, especially in developing countries like India, China etc. In the initial period of twentieth century, V.A.Moore has rightly said that as a destroyer of mankind, tuberculosis has no equal [1]. Almost one third of world population is infected with tuberculosis and in 1993 World Health Organisation (WHO) has declared tuberculosis an global emergency [2]. The risk of developing tuberculosis is estimated to be between 20-37 times greater in people living with HIV than among those without HIV infection[3]. Similarly, tuberculosis accelerates the progression of HIV infection to Acquired Immuno Deficiency Syndrome (AIDS) and shorten the survival of such patients. Of 1.8 million HIV related deaths in 2009, 22% were due to tuberculosis[4]. Even risk of drug resistant tuberculosis is higher amongst persons with HIV infection compared to others (HIV negative). Tuberculosis skin ulcers are extremely unusual. Cutaneous tuberculosis is caused by Mycobacterium tuberculosis and rarely by Mycobacterium bovis. Even in India and China where tuberculosis is quite common, cutaneous tuberculosis cases are rare i.e. 0.1 to 2.5%[5]. Moreover, Seeman et al in 2008 have reported that cutaneous tuberculosis is still a difficult disease to diagnose[6]. Here, we present a case with ulcerative lesion on right side of chest. The patient was diagnosed as a case of cutaneous tuberculosis with HIV and was treated with proper antiretroviral therapy and antitubercular drugs. Word count - 246 CASE STYDY OBSERVATIONS AND RESULTS: A 38 years old man presented with multiple ulcers over right axilla extending to the right chest wall with purulent discharge, was admitted to our hospital. The patient gave the history of small swelling over right axilla, 6-8 months back which was gradually increasing in size and was painful. As the patient was an agricultural worker, the history of trauma or thorn prick was specifically asked to rule out any actinomycotic or fungal infection. The patient had history of persistent cough 3-4 months back. But there was no history of weight loss. Patient was treated by many doctors from time to time but patient did not respond. The swelling was around 4cm × 3cm and as it was on the lower part of right axilla, it was diagnosed as axillary abscess and incision and drainage was done two and half month back, in a private nursing home. The pus was not sent for any investigation and patient was treated with antibiotic. As patient was very anaemic, 2 bottles of blood transfusion was given in the nursing home. Then other axillary swelling developed and ulcerated within one and half month. Hence, multiple ulcers with purulent discharge developed extending from right axilla to right chest wall( Photo 1). The investigations done in our hospital was: Fasting plasma glucose levels: 90 mg/dl, Haemoglobin: 6.1 gm/dl, ESR: 138 mm in first hour, Peripheral smear showed microcytic hypochromic anaemia, platelets were adequate and other parameters were in normal limits and X – ray chest: Lungs clear. Fine needle aspiration cytology (FNAC) from ulcerative lesion showed acute inflammatory cells. Gram?s staining of the pus showed plenty of Gram positive cocci arranged in clusters. On routine culture, Methicillin Resistant Staphylococcus aureus(MRSA) was isolated which was sensitive to Vancomycin and Linezolid and resistant to Penicillin, Erythromycin, Ciprofloxacin and Quinapristine, Dalfopristine. Methicillin resistance was detected using Cefoxitin (Cx 30μg) disk as per CLSI guideline[7].The patient was treated with Linezolid but the ulcers were not healing. Considering high ESR and as the ulcers were not healing, the discharge was collected from edge and base of the ulcer and Ziehl Neelsen staining with 20% H2SO4 was done. In the smear plenty of Acid fast bacilli (AFB) were present and some were beaded in appearance (Photo 2). On the same day, patient?s sputum sample were examined and it was negative for Acid fast bacilli. On next day morning, the induced sputum was collected and smear showed plenty of Acid fast bacilli (3+) and some were beaded in appearance (Photo 3). As the patient was AFB positive, patient?s serum was tested for HIV antibody and the patient was found to be HIV positive as per NACO guidelines [8], though the patient did not give any relevant history. The tissue collected from base of ulcer was homogenized and concentrated by Petroff?s method and the deposit was inoculated into two bottles of Lowenstein-Jensen media (L-J). Patient?s sputum was also inoculated into two bottles of L-J media after Petroff?s method. The rough, tough and buff coloured colonies of M.tuberculosis appear on L-J slant on fourth week from sputum and from the tissue growth appeared on sixth week on L-J media (Photo 4). The AFB staining from the growth revealed plenty of Acid fast bacilli and the growth was niacin positive. As the patient was HIV positive and sputum and exudate from ulcer was positive for Mycobacterium tuberculosis, Antiretroviral therapy (ART) and antitubercular drug regimen was also started on the same day. The patient responded to the treatment very well and after three and half months came for follow up when skin ulcers healed completely. DISCUSSION : Cutaneous tuberculosis is also an ancient disease and were described long before Robert Koch identified Mycobacterium tuberculosis in 1882. Laennec in 1826 first gave the description of cutaneous tuberculosis on his own prosector?s wart which developed after an injury while performing autopsy on a patient with spinal tuberculosis[9]. In 1886, Reil and Paltauf established that the wart was a tubercular lesion[10]. The clinical varieties of cutaneous tuberculosis can be divided into three broad groups – a) patients who were not previously exposed to M.tuberculosis, b) patients who were previously sensitized and c) tuberculids that develops a hypersensitive response of a tuberculosis focus elsewhere in the body. As previously sensitized hosts are very common in developing countries like India, lupus vulgaris is the most common variety of cutaneous tuberculosis reported from India, followed by TB verrucosa cutis and scrofuloderma[5]. No systematic survey for prevalence of cutaneous tuberculosis has been carried out in India. In one of the study it was found that cutaneous tuberculosis was associated with tuberculosis in other organs in 22.1% patients and the other organ most commonly involved were lungs. Even in the present case, the patient was having tubercular ulcer along with involvement of lungs. Most studies also reported that male are most commonly affected. Cutaneous tuberculosis sometimes has very diverse clinical presentation. The initial presentation may resemble a common bacterial infection or the ulcerative lesion may have superadded bacterial infection [11, 12]. In our case, initially patient had superadded infection with Methicillin Resistant Staphylococcus aureus(MRSA). After taking full course of Linezolid, the ulcer remained as it is and that made us to think for doing acid fast staining from the discharge. In culture, the growth was identified as M.tuberculosis. Currently the cause of skin ulcers may be vascular ulcers, squamous cell carcinoma, rodent ulcers, tubercular ulcers etc [13]. The differential diagnosis of cutaneous tuberculosis also includes infections with Mycobacterium ulcerans and Mycobacterium marium, Cutaneous anthrax, Cutaneous leishmaniasis, Sporotrichosis, Cat scratch disease due to Bartonella henselae etc [14]. In our case, as the patient was suffering from tuberculosis and HIV seropositive, the patient was treated with ART and ATT. In 2009, out of 1.7 million people died from tuberculosis. 4,00,000(24%) were among people living with HIV. Tuberculosis is also one of the leading cause of morbidity and mortality among PLWHA. Hence, WHO implemented collaborative HIV / Tuberculosis activities to decrease the burden of HIV / Tuberculosis coinfection. In patients with latent Tuberculosis infection, the risk of developing active diseases is several hundred folds higher among persons who acquire HIV. In 2007 it was reported from Brazil, 80% reduction in tuberculosis cases in HAART treated compared to ART naïve HIV infected person [15]. CONCLUSION: It has been observed that HIV epidemic continues to fuel TB epidemics and each increasing the morbidity and mortality of the other. WHO recommends the implementation of the Three I?s for HIV / Tuberculosis co-infection to reduce the burden of Tuberculosis among people living with HIV[16]. The three I?s are – i) Intensive tuberculosis case finding, ii) Isoniazid preventive therapy and iii) Infection control for tuberculosis. There is strong evidence that Antiretro-viral Therapy (ART) can lower a person?s viral load and restore the immune system and hence, significantly reduces HIV and Tuberculosis. WHO in 2011 recommends earlier ART at ≤350 CD4 count and immediate initiation of ART for all patients with HIV/TB co-infection irrespective of CD4 count[17]. Proper training and continuing medical education of health care workers is needed for early detection of cases with HIV/TB co-infection, so that WHO treatment strategies can be followed for a better outcome of the patient. Hence to conclude, in India, China and other developing countries, any non-healing skin ulcer, not responding to routine antibiotics, must be screened for tuberculosis and if positive, the patient must be screened for HIV. 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.

References:

1. Meyer JA Captain of All these Men of Death : Tuberculosis Historical Highlights. St. Louis. Warren H Green. 1977 2. Khatri GR, Frieden TR, Controlling tuberculosis in India. The New England Journal of Medicine 2002;347:1420-1425. 3. Guidelines for intensified tuberculosis case finding and isoniazid preventive therapy for people living with HIV in resourceconstrained setting. World Health Organization, 2011. 4. UNAIDS 2010 Global Report fact Sheet in World Health Organization HIV/TB Facts 2011;1-8. 5. Raman M. Cutaneous tuberculosis. Chapter 25. In Tuberculosis. Sharma SK, Mohan A editors. Jaypee Brothers Medical Publishers New Delhi, 2nd ed. 2009;384-396. 6. Seeman R., Trabonlsi R and Kanj S. Primary Mycobacterium tuberculosis complex cutaneous infection, Report of two cases and literature review. International Journal of Infectious Diseases 2008;12: 472-477. 7. Clinical and laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility testing 2006; 9th ed. CLSI document M2-M9 Wayne, PA: CLSI, 2006. 8. Detection of HIV infection Ch. 6, In: National AIDS Control Organisation, Guidelines on HIV testing, March 2007;38-53. 9. Laennec RTH, Traite de l?auscultation mediate et des maladies des pneumons et du Coeur Vol 1, Paris : Asselin and Cie ;1826 p 649-650. Quoted in Marmelzat WL Laennec and the prosector?s wart??. Arch Dermatol. 1962;86:122-124. 10. Riehl G, Paltauf R Tuberculosis verrucosa cutis. Eine bisher notch nitch beschriebne Form von Hauttuberenlose. Vjschn Derm Syph 1886; 13:19 Quoted in Most com Lupus vulgaris Raman M 11. Tappeiner G, Wolff K. Tuberculosis and other Mycobacterial infections. In Freedberg IM, Eisen AZ, Wolff K et al. eds. Dermatology in general Medicine, Vol 2, 5th edn. New Yark: McGraw – Hill, 1999:2274- 2292. 12. Beyt BE Jr.,Orbals DW, Santa Cruz DJ, et al. Cutaneous mycobacteriosis: analysis of 34 cases with a new classification of the disease. Medicine 1981;60: 95-109. 13. A Morrone, F Dassoni, MC Pajno et al Ulcers of the face and neck in women with pulmonary tuberculosis: presentation of a clinical case, Clinical case report, Rural and Remote Health, The International Electronic and Journal of Rural and Remote Health Research, Education Practice and Policy, 2010:10:1485-1489(Online).

14. GL Dandagi. Primary tuberculosis of skin – a nodular variant rare case report, Journal of Clinical and Diagnostic Research, 2010;4:3561-65. 15. Miranda A, Morgan M, Jamal L, Laserson K, Barreire D Silva G, Santos J et al Impact of antiretroviral therapy on the incidence of tuberculosis: the Brazilian experience, 1995- 2001, 2007;PLos ONE 2 e826. 16. Guidelines on intensified tuberculosis case finding and isoniazid preventive therapy for people living with HIV in resource constrained setting, WHO 2011 http://whqlibdoc.who.int/publications/2011/97 89241500708_eng.pdf 17. Guidelines on antiretroviral therapy for HIV infection in adults and adolescents. WHO 2010 http://whqlibdoc.who.int/publications/2010/97 89241599764_eng.pdf

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
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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
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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 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
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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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