International Journal of Current Research and Review
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IJCRR - 6(13), July, 2014

Pages: 31-37

Date of Publication: 12-Jul-2014


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CURRENT TRENDS IN ECLAMPSIA AT TERTIARY CARE HOSPITAL

Author: Deliwala K. J., Patel R. V., Shah P. T., Thaker R. V., Patel S. L.

Category: Healthcare

Abstract:Aims and Objectives: (1) To evaluate the incidence of eclampsia (2) To study material and perinatal outcome in eclamptic patients and its management. Methodology: Prospective study was done between July 2007 to June 2012. A total of 308 patients with eclampsia were included in the study. Results: The incidence of eclampsia is about 1.31 %. Majority of patients were primipara and between 21-25 years of age group. 97.1% of patients showed good response to MgSO4 therapy. 53.9 % patients had vaginal delivery while 46.1 % patients had LSCS. Conclusion: Eclampsia is not a totally preventable disease but its incidence can be decreased by proper antenatal care, early diagnosis of Pregnancy Induced Hypertension (PIH) and its proper management.

Full Text:

INTRODUCTION
Eclampsia is defined as new onset of grandmal seizure activity and/or coma during pregnancy, labour or postpartum in a woman with signs or symptoms of preeclampsia, more than 50% occur in third trimester.1 It is one of the leading cause of maternal and perinatal mortality as well as morbidity throughout the world.2,3 Every year more than 50,000 deaths occurred due to eclampsia, most of which occurs in developing countries.4 Recent series reports antepartum eclampsia in 38-53% and postpartum eclampsia in 11-44%.1 Primigravidas are at higher risk of developing eclampsia and that antepartum convulsions are more dangerous than those beginning after delivery.5,6 Incidence of eclampsia is said to be declined, still is a major problem for maternal mortality associated with increased risk of abruptio placenta, disseminated intravascular coagulation (DIC), acute renal failure (ARF), cerebral hemorrhage. It also reduces uteroplacental perfusion, places the foetus at high risk for intra uterine growth retardation (IUGR), preterm birth, and perinatal mortality.6 The main pathology might be generalized vasoconstriction and the endothelial dysfunction and signs and symptoms appear in late mid trimester or in the advanced stage of disease. Mainstay of management in case of eclampsia is early delivery, to improve the prognosis in terms of reducing maternal and perinatal morbidity and mortality. The current study was done to determine the clinical presentation and management of eclampsia, maternal complications and foetal outcome who presented in our institution during the year July 2007 to June 2012.

AIMS AND OBJECTIVES

  • To evaluate the incidence of eclampsia in terms of age, parity, socio economic status and gestational age.
  • To study mode of delivery, complications, management of eclampsia and perinatal outcome.
  • To recognise various factors influencing the prognosis of maternal and foetal outcome.

MATERIAL AND METHODS
Prospective study was conducted at the department of obstetrics and gynaecology in one of the tertiary care teaching hospital. 308 cases of eclampsia patients were taken randomly to study the clinical manifestations, mode of delivery, management and its complications. On admission, assessment of each women was done on an individual basis depending on the severity of condition and the gestational age. Once the patients were stabilized with anti-hypertensive and MgSO4 therapy and detailed history was elicited. Induction of delivery was generally done after 3-4 hours from the last fit. If cervix favourable, induction done with Inj. Oxytocin i.v. infusion drip. If unfavourable, cervix ripened with prostaglandin gel. In case of failed induction cesarean section was done under general anaesthesia.

RESULTS
In our study, 308 patients of eclampsia were analysed between the period of July 2007 to June 2012. The incidence of eclampsia is 1.31% in our study.During the present study it is noted that about 80% of patients were emergency while 20% were registered patients. Highest incidence of eclampsia (55.2 %) was seen in the age group of21-25 years (Table Iand Chart I). In our study, almost 74 % of patients were primigravida. About 64.9 % patients had antepartum eclampsia, 15.9 % patients had intrapartum eclampsia while 19.2 % patients had postpartum eclampsia (Table IIand Chart II). Highest incidence of eclampsia was seen between 28-36 weeks of gestation(Table IIIand Chart III) which requires some screening test for prediction of PIH.In our study 88% of patients were having diastolic BP ≥100, 10% of patients had no oedema, 57.8% had +1 oedema and 50% had massive proteinuria. Out of 308 patients, 299 patients (97.1%) showed a good response to MgSO4 therapy (PRITCHARD regime). Only 9 patients (2.9%) required other anti convulsant therapy. Among those 9 patients, 3 had status epilepticus, 3 had two convulsions after MgSO4 therapy and 3 were known case of epilepsy. In patients with atypical eclampsia or prolonged coma, other diagnosis should be considered in women with onset of convulsion more than 48 hours postpartum or in women with focal neurological deficits. In present series, 53.9% of patients had vaginal delivery and 46.1% had cesarean delivery (Table IV). Out of total 308 babies, 9 were stillborn. In 50 live preterm births, 18 babies were expired due to low birth weight and birth asphyxia. Out of 179 live full term babies 9 were expired – 3 due to meconium aspiration and 6 due to birth asphyxia (Table V and VI, and Chart IV). In our study, maternal complication rate was 24.4% while maternal mortality rate was 5% (Table VIIand VIII and Chart V and VI).

DISCUSSION
The hypertensive disorders of pregnancy (HDP) and particularly the pre eclampsia- eclampsia syndrome remain the leading cause of pregnancy related morbidity and mortality worldwide.7 Hypertensive disorders of pregnancy affect almost 7 % of all pregnancies and remain one of the leading causes of adverse maternal and neonatal outcomes, both in developed and developing world. Eclampsia is a major cause of maternal mortality along with hemorrhage and infection.8 This is second most common cause of maternal death during pregnancy.9The incidence of eclampsia is 1.31% in our study while Olakunleet al shows incidence of 1.61%.10The data from public hospitals show a high incidence of eclampsia because all complicated cases from smaller centers, even private clinics are shifted when a patient’s condition deteriorates.11 There is a better understanding of pathophysiology of eclampsia in recent years. It is now generally accepted that eclampsia is a multi-organ disorder unique to human pregnancy. There is generalized vasospasm affecting tissue perfusion in vital organs like brain, liver, kidney, etc. The cause of seizures is attributed to platelet thrombi, hypoxia due to local vasoconstriction or foci of haemorrhage in the cerebral cortex. It must be remembered that though eclampsia often follows severe pre-eclampsia, it can come like a bolt from the blue in a woman without preexisting preeclampsia.11 Eclampsia is more common in women who have not taken antenatal care. In India only 60 % of pregnant women receive antenatal care.11 Good antenatal care will help in prevention of PIH, early detection of PIH and to modify the severity of PIH by giving proper treatment in time. It was suggested that prophylactic use of aspirin, calcium, vitamin C and E may help in preventing PIH and thus may help in preventing eclamptic fit. Aspirin generated a lot of interest as a prophylaxis for PIH. However, recent studies show that its usefulness is to be confirmed by large multicentric trials prophylactic use of aspirin is controversial. Some studies have shown low serum levels of anti-oxidants in women with PIH. Anti-oxidants are known to reduce endothelial cell activation. Eclampsia is a disease specifically of teenage primigravida but highest incidence (55.2%) is seen in age group of 21-25 years in our study. This shift from, teenage to 21-25 years can be explained by late marriages in last few years.12 In our study, almost 74% patients were primigravida which supports the genetic theory of development of preeclampsia where alloimmunity between maternal and foetal tissues is the predisposing factor.13Reynolds suggested the possibility of a single gene likely to be responsible for pregnancy induced hypertension (PIH) which is usually responsible for eclampsia in many cases.14 Eclampsia can recur in future pregnancies in approximately 2% of eclamptics.In our study, about 65% of patients were antepartum. This is because developing countries still are struggling to cope with inadequate ANC, home deliveries and unsupervised deliveries.15In present series, 53.9% patients had vaginal delivery and 46.1 % had cesarean delivery. Umar et al (2007) showed 48.3 % had vaginal delivery and 51.7 % had cesarean delivery.16Vaginal delivery is a safe option resulting in low maternal mortality rates as long as foetal presentation and status are appropriate and labour progresses in an ordinary fashion.17Labour should be closely watched to detect emerging complications like eclampsia, cardiac failure, pulmonary oedema, respiratory failure, cerebrovascular accidents, eye complications, fetal complications like foetal distress/ and death. Neonatologist should be present at birth to look after the newborn. Maternal complication rate was 24.4 % in present series. Rate of complications depends upon number of convulsions, duration of convulsion, duration of admission between hospitalization and last fit, proper nursing care and least time for delivery. Maternal mortality rate was 5 % in our study while Chekari A et al (2008) showed maternal mortality rate of 6.7 %.18Analyzing the causes of death it was found that delayed hospitalization, early onset of eclampsia, low socio-economic status of woman and lack of essential obstetric care are fundamental determinants of maternal death.

CONCLUSION
Eclampsia is not a totally preventable disease but its incidences can be decreased by proper antenatal care, early diagnosis of PIH and pre-eclampsia and its proper management with selective termination to improve maternal and perinatal outcome. This study suggests that MgSO4 therapy is considered as the best therapy and is very effective in preventing and controlling convulsions. Termination of pregnancy is the primary treatment for eclampsia. Induction of labour with oxytocics and prostaglandins decreases the duration of labour. Cesarean section has definite place to improve feto-maternal prognosis. Incidence of complications in LSCS has become very low due to better operative techniques, proper anaesthesia and easy availability of blood components. If vaginal delivery fails following induction of labour cesarean section is preferred.

ACKNOWLEDGEMENT
We acknowledge the immense help received from the scholars whose articles are cited and included in references of our manuscript. We 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. We are also thankful to our seniors, colleagues and patients to help us in our study. Not only that we are also thankful to our family for their kind cooperation and support.

References:

1. Sibai BM. Diagnosis, prevention and management of eclampsia. ObstGynecol; 2005; Feb; 105 (2).

2. Dare FO, Eniola OA, Bariweni AC. Eclampsia revisited. Nig. J Med; 1998; 7; 168-171 cs.

3. Adetoro OO. The pattern of eclampsia at the university of Ilorin teaching hospital, Ilorin Nieria, International J of gynecology and Obstetrics; 31: 221-226.

4. Duley L Maternal Mortality associated with hypertensive disorders of pregnancy in Africa, Asia,Latin America and Caribbean. Br. J. ObstetGynecol 1992; 99: 547-553.

5. Percy CN In: Handbook of Obstetric Medicine Isis Medical Media oxford 1997.

6. Chelsey LC. A short history of eclampsia, ObstetGynecol 1974; 43: 599-602.

7. Acharya p, Damania K.R., Konar H., Misra S., Singh A., Thanawala U., et al.; Pregnancy induced hypertension; In Duftary S.; ECAB clinical update: Obstretricsand Gynecology; High-Risk Labour and Delivery; Haryana; Elsevier; 2011; 42-44.

8. PatilMithil M. et al – Role of Neuro imaging in patients with Atypical Eclampsia – The Journal of Obstetrics and Gynecology of India ( September – October 2012 ) 62 (5) : 526- 530.

9. D’Souza R., Bhide A.; Hypertensive disorders of pregnanacy; In: Thanawala U, Divakear H.; ECAB clinical update: Obstretricsand Gynecology; Medical disorders in pregnancy; New Delhi; Elsevier; 2009; 1-37.

10. Olakunle Kusemiju MBBS : The internet journal of third world medicine, 2008, Volume 6 number.

11. Bhatt R., Patel V., Patel C.; EclampsiaDiagnosis and management; In Mittal C., Mittal P., Emergencies in Obstetrics and Gynecology; Volume I, Second edition; Delhi; Peepee; 2012; 95-101.

12. Wang Y, Gu Y, Zhag Y et al. Evidence of endothelial dysfunction in pre-eclampsia. Decreased endothelial nitric oxide synthatase expression is associated with increased cell permeability in endothelial cells from preeclampsia. Am. J. Obstet. Gynecol, 2004; 190: 817.

13. Kanki T, Mihara F, Nakanoh. Diffusion weighted images and vasogenicoedema in pregnancy. ObsteGynecol. 1999; 93: 821-3.

14. Reynolds C., Mabie W. Hypertension studies in pregnancy; In Current Obst. Gynec. Decheney A.; Ninth Edition; Lange Medical Books, New York; 2000; 338.

15. Naidu K, Modly J. SPECT, CT scan, and TCD findings in eclampsia. Br. J. ObstetGynecol. 1997; 104 (10) : 1162-72.

16. J. Tukur B. A. Umar, R. Rabi U. Annals of African Medicine volume 6, No. 4; 2007: 164- 167.

17. Pritchard J. A. Cunningham FG, Pritchard SA the Parkland Memorial Hospital, protocol for treatment of eclampsia. Evaluation of 245 cases Am. J. Obstet. Gynecol 148: 951, 1984.

18. MigullM;Chekairi, A. Hypertension in pregnancy, 27(2), May 2008.





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

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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.

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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
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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
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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
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
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A Study by Purushottam S. G. et al. entitled "Development of Fenofibrate Solid Dispersions for the Plausible Aqueous Solubility Augmentation of this BCS Class-II Drug" is awarded Best article for Vol 13 issue 10
A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09
A Study by Mardhiah Kamaruddin et al. entitled "The Pattern of Creatinine Clearance in Gestational and Chronic Hypertension Women from the Third Trimester to 12 Weeks Postpartum" is awarded Best Article for Vol 13 issue 08
A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07
A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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International Journal of Current Research and Review (IJCRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal

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