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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Case report
Full Version
Cardiopulmonary Rehabilitation along with Inspiratory Muscle Training to Improve Aerobic Capacity in Athletic Patient Following Atrial Septal Defect Closure: A Case Report
Correspondence Address :
Dr. Chitakshi Chobisa,
Postgraduate Scholar, Department of Cardiorespiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha-442001, Maharashtra, India.
E-mail: chitrakshichoubisa30@gmail.com
An Atrial Septal Defect (ASD) is a type of congenital heart defect in which there is an abnormal opening between the two atria. Hereby, the authors present a case report that describes a 16 mm diameter ostium secundum ASD that was diagnosed in an 18-year-old female district badminton player who came to casualty with chief complaints of difficulty in breathing while playing and an episode of syncope. After undergoing ASD closure surgery, cardiovascular rehabilitation and PowerBreathe device-assisted inspiratory muscle training were initiated. The present study emphasises the value of interdisciplinary treatment, including physiotherapy, to enhance overall functional status and respiratory function in the management of congenital cardiac disorders. Significant improvements were observed in pain, exercise ability, anxiety, and weariness, according to the end measures. In addition to highlighting the importance of these treatments in the postoperative care of patients with congenital heart disorders, the debate sheds light on the advantages of inspiratory muscle training and its possible effects on cardiopulmonary function. The present comprehensive approach, which combines pharmacological, surgical, and physical therapy treatments, has shown to improve patient outcomes and create opportunities for future advancements in the field of congenital cardiac disease management.
Midsternotomy, Physiotherapy, Powerbreathe
An 18-year-old female district badminton player arrived at hospital with complaints of exhaustion, breathing difficulty while playing, and an episode of syncope that had been progressively worsening over the past week. No co-morbidities were noted. The patient was admitted to the ward, where a 2-dimensional (2D) echo was performed, revealing the presence of an ASD with a diameter of approximately 16 mm (Table/Fig 1). An Echocardiogram (ECG) showed signs of right ventricular hypertrophy and complete right bundle branch block (Table/Fig 2). Surgical closure of the ASD was recommended, along with first-line medication therapy. She underwent a midsternotomy for ASD closure six days after the diagnosis, which was performed by a senior Cardiac Surgeon, an Anaesthesiologist, the in-charge sister, and a ward boy. An autologous pericardial patch containing 5-0 prolene was used to seal the ASD. Following the procedure, on Postoperative Day one (POD-1), she was transferred to the Cardiovascular and Thoracic Surgery Intensive Care Unit (CVTS ICU), and a referral for physical therapy was made.
On POD 1, a Physiotherapist visited the patient in the CVTS ICU. The patient was receiving six liters of oxygen via a face mask and complained of pain at the suture site and breathing difficulties. She was agitated, apprehensive, and concerned. Before the examination, informed consent was obtained from the patient’s parents. The patient was assessed in a supine position, followed instructions, and displayed cognition and orientation. During the examination, the drains, Foley’s catheter, central line, and femoral line were all in place. In the cardiovascular examination, the patient’s blood pressure was 118/77 mmHg, pulse rate was 110 beats per minute, respiratory rate was 21 breaths per minute, oxygen saturation was 99%, and auscultation revealed normal S1 and S2 heart sounds. There was reduced movement of the chest wall. On auscultation of breath sounds, there was modest crepitation throughout the lungs and diminished breath sounds in the bilateral inframammary and axillary areas.
Clinical investigations: The ECG showed right ventricular hypertrophy and complete right bundle branch block due to a QRS duration exceeding 120 ms and a PR interval longer than 60 ms. The 2D echocardiography revealed a large ostium secundum ASD with a diameter of 16 mm. The preoperative chest X-ray displayed cardiomegaly and prominent cardiovascular markings, while the postoperative chest X-ray exhibited cardiomegaly and a central line (Table/Fig 3),(Table/Fig 4).
• Therapeutic intervention: A Physiotherapist visited the patient twice a day, and routine monitoring and examinations were carried out. Rehabilitation sessions were conducted and their outcomes were recorded weekly. The events and their descriptions have been illustrated in (Table/Fig 5). The goals were to alleviate dyspnoea, improve respiration, promote relaxation, enhance general functional status, and encourage early participation in athletic activities. A well-planned interventional protocol was implemented (Table/Fig 6) (1),(2),(3).
Follow-up and outcome measures: The patient was evaluated preoperatively, on postoperative day 1, and after 2 weeks. Follow-up was conducted two weeks after discharge and is documented in (Table/Fig 10). Outcome measures included the numerical pain rating scale, maximal inspiratory pressure using the PI Max device, the 6-minute walk test, the American Thoracic Society (ATS) scale for dyspnoea (4), incentive spirometry, the Fatigue Severity Scale (5), and the Beck Anxiety Inventory. Upon discharge, the patient received a comprehensive exercise program, self-monitoring techniques for vital signs, and guidance on recognising warning signs. She was provided with exercise guidelines and a daily activity tracker to follow at home to rebuild her strength and work toward her recovery goals. Breathing retraining exercises and hygiene practices were part of her daily routine. She was educated on relaxation techniques and methods to relieve dyspnoea for effective symptom management. Dietary advice included maintaining a high-protein diet to support muscle recovery and overall health. The patient expressed high satisfaction with the prescribed protocol, demonstrating a positive attitude, receptiveness, and enthusiasm for her progress. She indicated a willingness to adhere to the treatment plan for as long as necessary, signaling a favorable outlook for her ongoing recovery and overall well-being.
A congenital heart disease is characterised by a significant structural abnormality in the heart or the major blood vessels within the chest, and this abnormality may or may not result in functional consequences (6). One of the most common types of congenital heart defects, ASD, affects around 25% of infants. An ASD arises from an unclosed connection between the right and left atria. It includes anomalies that affect the actual septal membrane in addition to anomalies that permit communication between the two atria. From most common to least common, there are five different kinds of ASD: sinus venosus defect, ostium secundum defect, ostium primum defect, and patent foramen ovale (7).
Hereby, the authors present a case of an 18-year-old female patient who is a badminton player diagnosed with ASD and underwent corrective surgery for the same, after which she was referred to cardiopulmonary rehabilitation. After the repair of an ASD, athletes may benefit from cardiopulmonary rehabilitation in addition to inspiratory muscle exercise. Prior to and following defect closure, research assessed the ventilatory function and cardiopulmonary exercise capability in persons with ASD. According to the study, following ASD closure, cardiopulmonary exercise capacity increased (8). Cardiopulmonary exercise metrics were slightly different between children with ASD and typical youngsters. The two most significant abnormalities were an increase in airway resistance during maximal exertion and a decrease in maximum oxygen absorption (9).
Using the PowerBreathe device, a clinical experiment conducted at the University of Colorado Boulder evaluated the impact of Inspiratory Muscle Strength Training (IMST) on blood pressure, heart attack risk, and physical and cognitive performance. According to the experiment, people who used the PowerBreathe even for a short while each day showed notable reductions in blood pressure and enhancements in large-artery performance (10). The PowerBreathe gadget offers cardiopulmonary rehabilitation in addition to helping with sports performance and fitness. The National Health Service (NHS) in the UK has even authorised the PowerBreathe Medic for prescription usage, and PowerBreathe IMT is utilised by several prestigious organisations. In the contemporary uniformed services, where protective equipment may limit mobility and impede breathing, their breathing apparatuses might be utilised to prevent injuries (10). Research suggests that using a breathing muscle-strengthening gadget for five minutes a day may help decrease blood pressure. With IMST, resistance is applied to your breaths as you inhale and exhale using a tiny, portable device (11). The PowerBreathe gadget helps strengthen and enhance the breathing muscles by applying resistance to them. Strength and function of the respiratory muscles may increase as a result of this resistance exercise, which may enhance cardiopulmonary function (9). IMT is helpful as a respiratory treatment to help athletes prepare for certain sports. Nonetheless, few research studies with excellent methodology are available (12). One of the linear load resistor types now available on the market is Powerbreathe®, which produces resistance using either an electronic valve or a spring-loaded mechanism. The primary distinction between this tool and others is its capacity to provide the highest load during therapy and to modify inspiratory resistance in response to the pressure×lung volume curve. By giving the patient a sense of comfort, this feature may produce load stabilisation along the breath (13).
The present case report sheds light on the comprehensive management of an 18-year-old female with a significant ASD through a multidisciplinary approach. The integration of open-heart surgery, postoperative care, and meticulous physiotherapy, including inspiratory muscle training with the PowerBreathe device, played a pivotal role in enhancing the patient’s cardiopulmonary function and overall well-being. The successful outcomes observed in present case underscore the importance of tailored physiotherapeutic interventions, emphasising preoperative education, postoperative rehabilitation, and continuous support during the recovery period. Inspiratory muscle training, facilitated by innovative devices like PowerBreathe, emerges as a valuable adjunct in enhancing respiratory muscle strength and promoting optimal cardiopulmonary function. The findings not only highlight the efficacy of such interventions in the context of congenital heart diseases but also emphasise the potential applications in sports medicine and general respiratory health. The case underscores the significance of continued research and exploration of innovative approaches to improve the quality of life for individuals with congenital heart disorders. This comprehensive approach, encompassing medical, surgical, and physiotherapeutic interventions, showcases the potential for enhanced patient outcomes, paving the way for future advancements in the field of congenital heart disease management.
DOI: 10.7860/JCDR/2024/68775.19344
Date of Submission: Dec 01, 2023
Date of Peer Review: Feb 02, 2024
Date of Acceptance: Feb 26, 2024
Date of Publishing: May 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Dec 04, 2023
• Manual Googling: Feb 14, 2024
• iThenticate Software: Feb 24, 2024 (7%)
ETYMOLOGY: Author Origin
EMENDATIONS: 6
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com