International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
Bootstrap Slider

Indexed and Abstracted in: SCOPUS, Crossref, CAS Abstracts, Publons, CiteFactor, Open J-Gate, ROAD, Indian Citation Index (ICI), Indian Journals Index (IJINDEX), Internet Archive, IP Indexing, Google Scholar, Scientific Indexing Services, Index Copernicus, Science Central, Revistas Medicas Portuguesas, EBSCO, BOAI, SOROS, NEWJOUR, ResearchGATE, Ulrich's Periodicals Directory, DocStoc, PdfCast, getCITED, SkyDrive, Citebase, e-Print, WorldCat (World's largest network of library content and services), Electronic Journals Library by University Library of Regensburg, SciPeople.

Search Articles

Track manuscript

Readers around the world

Full Html

IJCRR - Vol 10 Issue 11, June, 2018

Pages: 20-25

Date of Publication: 11-Jun-2018


Print Article   Download XML  Download PDF

Anencephaly: Incidence, Risk Factors and Biochemical Analysis of Mother

Author: Shilpa K., Priya Ranganath, Sumathi S.

Category: Healthcare

Abstract:Introduction: Anencephaly is a common & lethal neural tube defect (NTD) which occurs due to the defective closure of rostral pore of neural tube. The study aims to identify the risk factors associated with anencephaly in our population. Attempt was made to correlate the incidence of anencephaly with associated systemic and congenital anomalies, maternal factors, biochemical analysis of mother for ACE, alpha fetoprotein, folic acid & random blood sugar.
Material & Method: The present study included 60 anencephalic fetuses of 20-30 weeks & mothers of the fetuses from Victoria & Vani Vilas hospital attached to Bangalore Medical College & Research Institute. Study was conducted over a time period of 3 years from August 2014 to June 2017.
Results: The incidence of anencephaly in Victoria and Vanivilas hospital was 1.04 in 1000 births. 23 (38.4%) were males & 37(61.6%) were females. The alpha fetoprotein is high in 100% of cases & ACE level was normal in 85 % cases, in 1.6% it was high & in 13.4% cases it was low. In 15%, folic acid was low & 15% cases were hyperglycemic.
Conclusion: Better knowledge of unexpected fetal loss is the promise for better parental counseling & for prevention of recurrences. Understanding & identifying the risk factors associated with anencephaly in our population, allows approaches to avoid them & there by lower the incidence of anencephaly in our population.

Full Text:

Introduction:

Anencephaly is a common & lethal neural tube defect (NTD) which occurs due to the defective closure of rostral pore of neural tube. It is also known by other name like acrania (absence of skull), acephaly (absence of head), merocrania & meroanencephaly. Anencephaly can diagnosed by ultrasound examination (USG) & by elevated maternal alpha feto protein1 & Amniocentesis2. Studies show that a woman who had one child of NTD such as anencephaly will also have 3% risk of having another child with a NTD3. Women taking certain medications for epilepsy & women with insulin-dependent- diabetes mellitus have a higher risk4.  The study aims to identify the risk factors associated with anencephaly in our population. Attempt was made to correlate the incidence with associated systemic anomalies, maternal factors, biochemical analysis of mother for ACE, Alpha fetoprotien, Folic acid & RBS, correlation of biochemical analysis with associated anomalies.

Material & Methods:

The present study included 60 anencephalic fetuses (23 males & 37 females) of 20-30 weeks & mothers of the fetuses from Victoria & Vani vilas hospital attached to Bangalore Medical College & Research Institute, Bangalore. Study was conducted over a time period of 3 years from August 2014 to June 2017. The total number of deliveries during this period was 57429. All the procedures were approved by research board & ethical committee of BMCRI, Bangalore. Consent for autopsy was requested compassionately, respectfully & fully informed. Complete history regarding the age of mother, febrile illness during pregnancy, medications taken during pregnancy, maternal diabetes, family history for NTDs & Folic acid supplementation were taken. The fetuses were dissected & the dissecting instruments required for fetal autopsy are small scissors & forceps & scalpels. Measurements of crown heel, crown rump, head circumference, foot length, & weight are taken for comparison with standard chart. Dissection was performed by positioning of the body. The body was kept in supine position with a wooden block under the shoulder to keep the neck in extended position.

A curved incision was made bilaterally from the acromion process through the medial border of shoulder joint to mid-axillary line laterally; this continued to the iliac crest over the inguinal ligament to meet pubic symphysis.  The skin with the superficial tissue flap was reflected up the root of the neck, then to the inferior margin of mandible bilaterally, taking care not to injure the neck structures and rectus sheath.  This way, whole of the front of the neck, chest and abdomen was exposed5.

Opening the abdominal cavity: A paramedian incision was made on rectus near pubic symphysis up to xiphoid process.

Opening thoracic cavity:  Sternum was removed by cutting at costochondral junction and then separating sternoclavicular joint. All the major organs (lungs, heart, spleen, kidney, adrenal gland) were weighed & data recorded with expected values. Photographs were taken. The samples were fixed with 10% buffered formaldehyde approximately to 24 hours. The associated abnormalities were grouped according to main organ system to which they belonged.

Maternal analysis: 2 ml of blood with EDTA & 2 ml of whole blood was withdrawn from the mother before delivery; sent for analysis of alpha fetoprotein, folic acid, acetyl cholinesterase and blood glucose (random blood sugar).

Anencephaly & associated anomalies were compared with the biochemical analysis of mother. The observed data were subjected to Fisher's exact tests and the significance was determined with P< 0.05 for statistical significance. The statistical tests were performed using software SPSS 15 (Statistical Package for Social Sciences).

 

Results: The number of deliveries conducted between August 2014 to June 2017 at Victoria Hospital, Bangalore is shown in Table 1. The total number of deliveries during this period was 57429. Of these deliveries 60 fetuses (males 23 &37 females) with anencephaly, of age 20 to 30 weeks were collected from Department of OBG, Victoria & Vani Vilas hospital attached to Bangalore Medical College & Research Institute, Bangalore.

Classification of mothers according to age showed that maternal age in 1.6% were < 20year, 83.4% were 21-35 years, 13.4% were 36-40 years and 1.6% was >40 years.  The mean of maternal age is 24.4 years.  When mothers were classified according to their level of education, it was noticed that 91.6% were found to be high school were 3.4%.  The study showed that 76.7% of mothers were unemployed (housewives) & 46% of the respondents were found to have regular visits to antenatal care centers. When respondents were inquired about experiencing any form of febrile illness during pregnancy (specifically the first trimester), 86.6% of mothers had no febrile illness during pregnancy; only 14.4% of them reported so. Season of birth were 40% were born in winter, 16.6% were in spring, summer & 26.7% in autumn. The study showed that 8.3% of mothers had multiple abortions, 1.6% had abortion with asthma, diabetes with obesity & hypertension, 5% were diabetic & 81.6 % were normal. 10% of mothers reported taking medications during pregnancy, 1.6% mentioned antiemetic, 5% NSAID (paracetamol & aspirin), 1.6% mentioned herbal medication.  None of the respondents was found to have been exposed to any form of radiation during pregnancy. 15% mothers got consanguineous marriage, all were 1st cousins & remaining 51 (85%) cases were unrelated.

The study showed that 76.7% of mothers were taking folic acid during pregnancy. Regarding the timing of folic acid consumption during pregnancy, only 5% took folic acid preconception (Chart 1).

The comparison of control group (normal fetuses) & case group (anencephalic fetuses) indicates that there is no difference seen.  The weight of fetus with anencephaly is more than the control group, and weight of liver was less than control group, and these were statistically significant.

Associated anomalies were present in 42 (70%) fetuses (Table 2). Out of 42 fetuses, those who had associated anomalies were 17 (40.4%) males and 25 (59.6%) were females. All the fetuses had acrania (100%) & 19 (45.3%) fetuses had spina bifida; there were no anomalies found in reproductive system.

The 6 cases (14.3%) had facial defects (4.7% were males & 9.5% were females). The most common defect was cleft palate & cleft lip (9.5% cases), it was found to be statistically significant. In 19 cases (45.3%), spina bifida was very common, in 1 (2.3%) along with spina bifida, cleft lip & palate was also found. The spina bifida upto sacral region was seen in 4.7% of cases & it was found to be statistically significant.

Anomalies in limbs: 1 case (2.3%) had Amelia of right lower limb, congenital dislocation of right elbow joint, malrotation of gut towards left, which was found to be statistically significant (Figure 1).

CVS: in 1 male fetus (2.3%), there was a single ventricle (mono ventricle) on the left side, with two outlets (aorta & pulmonary trunk), which was found to be statistically significant (Figure 2 a&b).

Lungs: in 1 case (2.3%), left lung had 2 fissures & 3 lobes, in 1 (2.3%) right lung had 3 fissures with 4 lobes. In 2 cases (4.7%) both lungs had single oblique fissure with 2 lobes (Fig 3).  In 1 case (2.3%), there was malrotation of gut towards left side & also absence of pancreas (Fig 4).

Urinary system: 1 case (2.3%) had unilateral biureter on left side (Fig 5) & 1 case (2.3%) had horse shoe shaped kidney; both are statistically significant (Figure 6a& b).

There were no anomalies found in reproductive system. In 2 male cases (4.7%), there was umbilical hernia (Fig 7).  Diaphragmatic hernia was not seen. Amniotic band syndrome (fig 8), encephalocele (fig 9) & omphalocele (fig 10) were seen in 2.3% of cases.

Male fetuses had 40.4% of overall associated anomalies & female fetuses 59.6% of associated anomalies. The female anencephalic fetuses were found to have more number of associated anomalies.

Biochemical Analysis of mother: In 100% of mothers AFP were high, this was a confirmatory test for anencephaly (NTDs).

Normal Values

AFP                              - upto 10 IU/ml

Folic acid                     -3.1-17.5ng/ml

Acetylcholine esterase-1700-5778U/L

Blood glucose (RBS) –upto 140 mg/dl

ACE- The 85% of cases ACE level were normal, 13.3% low & 1.7% of cases it was high. Folic acid level in 68.3% cases were normal, 28.3% of cases were low & 3.4% cases were high. RBS were high in 15% of cases all mothers were diabetic, 3.4% cases low & 81.6% were normal.

The Mean, SD & P values are given in (Table 3).

ACE level were high in 1.6% of cases of spina bifida & it was low in anomalies of  limb , GIT, Urinary system & umbilical hernia (1.6%cases).

 

Folic acid was low in 1.6% of cases with anomalies of skull & face, limb, CVS & urinary system & high in 5% of cases with spina bifida.

RBS was high in 1.6% of cases with anomalies of GIT, Urinary system and other anomalies & 3.2% with spina bifida.  It was low in 1.6% of cases with spina bifida & umbilical hernia.

Discussion: Incidence of anencephaly is reported to be 1:1000 to 1:20000. In the present study the incidence of anencephaly in Victoria and Vanivilas hospital was 1.04 in 1000 births.

Literature showed that anencephaly is more common in females6,7.  In the present study, 23(38.4%) were males & 37(61.6%) were females. The birth was of  1st order in 40% of  cases , 35% cases were 2nd  order, 21.6% were 3rd  order & 3.4% cases were 4th order.

Age of mother in 1.6% cases were <20, 83.4% were 21-35, 13.4% cases 36-40 & in 1.6%, >40.

Season of birth: 16.7% cases were born in spring, 26.7% in autumn, 40% in winter & 16.6%were summer which was similar in some studies8.

Maternal occupation: 76.7% cases mothers were house wives, 10% cases farmers, 1.6% were tailor & teacher & 3.4 % were group D.

Family history of both the mother & father was taken in which 1.6% cases had Down’s syndrome for 1st cousin & in 1.6% father of the fetus had hyperthyroidism.

15% mothers got consanguinity, all were first cousins & 85% were unrelated which was similar in few studies9,10,11

The rate of anencephaly could be higher in underdeveloped countries due to possible misdiagnosis, most probably due to poor diet; improper maternal health care, inappropriate treatment & environmental factors also contribute to it9. The ratio of anencephaly is higher in Iranian population than compared to European population. It has been calculated that in Iranian population 13.1/10,000 newborns had anencephaly whose mothers aged >35 years & consanguineous marriage contributes 36 % to anencephaly which was found to be similar in present study12.

Congenital anomalies vary in different studies.  The study of malformation is greatly helpful in genetic counseling & prenatal diagnosis in successive pregnancies13. Anomalies were found in 42 cases (70%) in the present study & it is compared with the other studies.

In present study, out of 42 cases, 25 females (41.7%) & 17 males (28.3%) showed associated anomalies; majority of anomalies were in female anencephalic fetuses which was similar to some studies. Cleft lip & palate were the most common defect (14.3%) & 19 (45.3%) had spina bifida.  There were no reproductive system anomalies in the present study.

Most of the organs in the present study were anatomically normal when it was compared with the control group & some studies19.

Literature showed that anencephalic fetuses were successful donors of hearts & kidneys for transplantation7.

The intake of 4mg per day of folic acid intake is recommended in mothers with history of neural tube defect7,20.

The alpha fetoprotein is high in 100% of cases which was similar in a study21 & ACE level was normal in 85 % cases, in 1.6% it was high & in 13.4% cases it was low (22,23,24,25,26

 In 15%, folic acid was low & 15% cases were hyperglycemic20

The intake of 4mg per day of folic acid intake is recommended in mothers with history of neural tube defect7,20.

In present study ACE level were high in 1.6% of cases of spina bifida & it was low in anomalies of (1.6%cases) Limb, GIT, Urinary system & umbilical hernia.

Folic acid was low in 1.6% of cases with anomalies of skull & face, limb, CVS & Urinary system &high in 5% of cases with spina bifida.

RBS was high in 1.6% of cases with anomalies of GIT, Urinary system and other anomalies & 3.2% with spina bifida.  It was low in 1.6% of cases with Spina bifida & umbilical hernia.

Conclusion:

Better knowledge of unexpected fetal loss is the promise for better parental counseling & for prevention of recurrences. Understanding & identifying the risk factors associated with anencephaly in our population, allows approaches to avoid them & thereby lower the incidence of anencephaly in our population. To prevent the NTD, dietary supplements should be provided to low socioeconomic pregnant females. Peri-conceptional & 1st trimester folic acid supplementation is of prime importance. All pregnant mothers have to go in for triple marker tests; that is, beta HCG, alpha fetoprotein and estradiol.

Amniocentesis could be made compulsory for mothers with a history of an anencephalic child.  The mother has to be counseled regarding the risks of another such fetus. The family has to be told about pedigree charts, incidence and occurrence of anencephaly in the population.

References:

  1. Moore LK, Persaud TV. Editors. The Developing Human Philadelpia: Saunders; 1998, p.478-9

  2. Clara G, Jenny N, Mona S. Testing & pregnancy. In: Genetics in Family medicine. The Australian Handbook for General Practitioners. Australia: Dr Kristine BS; 2007:18

  3. Cowcock S, Ainbender E, Prescott G. The recurrence risk for neural tube defects in united states : A collaborative study. American Journal of Medical Genetics 1980: 5(3): 309-14.

  4.  “Anencephaly ” Genetics Home Reference. National Institute of Health. 22 August 2011.

  5. Patowary AJ: the fourth incision –few modifications in autopsy incisions , J Indian acad forensic  med 32(3) pg 234-238 ISSN 0971-0973

  6. Kheir AEM, Eisa WMH, Neural tube defects; clinical patterns, Associated risk factors & maternal awareness in Khortoum state Sudan, Journal of medicine & medical research 2015,3(1)1-6.

  7. Gupta P, Nain P & Singh J. Anencephaly:A Neural tube defects –A review, American journal of pharmtech research, 2016; 2(3).

  8. Ranganath P, Rajangam S, Perinatology - Journal of perinatal and neonatal care vol 9, 2007 (1):43-47

  9. Hassan M, Muhammed N, Gul F, Ahmad S, Frequency of Anencephaly in Hazara Division Of Pakistan, American Journal of Drug Delivery & therapeutics 2015,2(1)039-043

  10. Kaur N, Kaur A, Gupta S. Ultra sound evaluation of fetal CNS anomalies & its correlation with postnatal outcome IJCRR,2017; 5(3).

  11. Reddy J, Ramanappa  MV  Anencephaly and its associated anomalies in antenatal scans,J.Evid Based Med .Healthc,pISSN-2349-2562,eISSN-2349-2016;Vol.3(23),1033-1035.

  12. Golalipour MJ, Najafi L, Keshtkar AA, Prevalence of Anencephaly in Gorgan , northern Iran , Arc Iran Med 2010;13:34-7

  13. Naik S, Venkataramanababu P, Study of various congenital anomalies in fetal & neonatal autopsies, International Journal of Research in medical sciences May 2015,3(5)1114-1117

  14. Tan KB, Tan SH, Yeo GS, Anencephaly in Singapore: a ten year series 1993-2002. Singapore Med J , 2007;48:12-5

  15. Vare AM, Bansal PC. Anencephaly: An Anatomical study of 41 anencephalies Indian journal Pediatric 1971; 38: 301-305

  16. Neilson LAG, Maroun LL, Graem N. Neural tube defects & associated anomalies in a fetal  &perinatal autopsy series, Acta patho Microbial Immunol scand 2006;114:239-246

  17. Panduranga C, Kangle R, Suranagi V, Pilli GS, Anencephaly: A pathological study of 41 cases J sci soc 2012 :39:81-84

  18. Singh J, Kapoor K, Kochhar S. Incidence of Anencephaly in a tertiary care hospital in North west India International journal of scientific & research publications 2015,5(9)2230-315

  19. Potters pediatric pathology  volume 1 & volume 2, second edition Elsevier.

  20. Lisa Moore, Anencephaly, Journal of Diagnostic Medical Sonography 2010, 26 (6)286-289

  21. Brock DHK, Alpha fetoprotien & neural tube defects, J. Clin.Path, 29, 10; 157-164

  22. Engl N, J Med. 322:669-674 March 8, 1990 DOI: 10:10056/NEJM 199003083221006.

  23. Incore V, Ninios AP, Pavlik J, Hsu CD, Prenatal diagnosis of acrania associated with Amniotic band syndrome: Obstet Gynecol 2003

  24. Macri JN, Weiss RR. Prenatal serum alpha feto protein screening for neural tube defects. obstet gynecol 1982;59:633-9

  25. Amniotic-fluid alpha feto protein measurement in antenatal diagnosis of anencephaly and open spina bifida in early pregnancy: second report of U.K. collaborative study on alpha feto protein in relation to neural tube defects. Lancet1979;2:651-62.

  26. Report of collaborative Acetylcholine esterase study .amniotic fluid acetylcholineesterase electrophoresis as a secondary test in the diagnosis of anencephaly and open spina bifida in early pregnancy.lancet1981; 2:321-4

Research Incentive Schemes

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 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 COLAKOGLU 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 Arpita M. et al 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
Late to bed everyday? You may die early, get depression
Egg a day tied to lower risk of heart disease
88 Percent Of Delhi Population Has Vitamin D Deficiency: ASSOCHAM Report

List of Awardees

Awardees of COVID-19 Research

Woman Researcher Award

A Study by Neha Garg et al. entitled "Optimization of the Response to nCOVID-19 Pandemic in Pregnant Women – An Urgent Appeal in Indian Scenario" published in Vol 12 issue 09

A Study by Sana Parveen and Shraddha Jain entitled "Pathophysiologic Enigma of COVID-19 Pandemic with Clinical Correlates" published in Vol 12 issue 13

A Study by Rashmi Jain et al. entitled "Current Consensus Review Article on Drugs and Biologics against nCOVID-19 – A Systematic Review" published in Vol 12 issue 09

Emerging Researcher Award

A Study by Madhan Jeyaraman et al. entitled "Vitamin-D: An Immune Shield Against nCOVID-19" published in Vol 12 issue 09

Study by Dheeraj Kumar Chopra et al. entitled "Lipid-Based Solid Dispersions of Azilsartan Medoxomil with Improved Oral Bioavailability: In Vitro and In Vivo Evaluation" published in Vol 12 issue 19


RSS feed

Indexed and Abstracted in


Antiplagiarism Policy: IJCRR strongly condemn and discourage practice of plagiarism. All received manuscripts have to pass through "Plagiarism Detection Software" test before forwarding for peer review. We consider "Plagiarism is a crime"

IJCRR Code of Conduct: We at IJCRR voluntarily adopt policies on Code of Conduct, and Code of Ethics given by OASPA and COPE. To know about IJCRRs Code of Conduct, Code of Ethics, Artical Retraction policy, Digital Preservation Policy, and Journals Licence policy click here

Disclaimer: International Journal of Current Research and Review (JICRR) 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.



Company name

International Journal of Current Research and Review (JICRR) 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

Contact

148, IMSR Building, Ayurvedic Layout,
        Near NIT Complex, Sakkardara,
        Nagpur-24, Maharashtra State, India

editor@ijcrr.com

editor.ijcrr@gmail.com


Copyright © 2020 IJCRR. Specialized online journals by ubijournal .Website by Ubitech solutions