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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
Conservative Management of Osteoarthritis with Hypertension and Ischaemic Heart Disease through Ayurvedic Treatment: A Case Report
Correspondence Address :
Satyajit Pandurang Kulkarni,
Flat No. D 303, Brij Orcidkh Road, Near Pramukh Plots, Vavol, Gandhinagar-382610, Gujarat, India.
E-mail: satyajitkulkarni2001@gmail.com
The ayurvedic management of osteoarthritis is well known, but the management of arthritis with co-morbidities such as hypertension, ischaemic heart disease, obesity, and lumbar spondylosis through Ayurvedic treatment is yet to be discovered. In the present case, a 50-year-old female presented with complaints of mild to moderate pain in the lower back region, legs, knee joints, and swelling over both knees for five years. She also had a history of hypertension and IHD for 10 years and had been taking Non Steroidal Anti-inflammatory Drugs (NSAIDs) without any relief. Seeking Ayurvedic treatment, the patient discontinued NSAIDs and underwent Panchakarma for four weeks. The treatment resulted in significant pain relief, improved VAS score, and increased walking distance. The present case report provides a detailed ayurvedic treatment protocol for managing arthritis with co-morbidities such as hypertension, ischaemic heart disease, obesity, and lumbar spondylosis.
Arthritis, Ayurvedic medicine, Co-morbidities, Panchakarma
A 50-year-old female presented at Goenka Hospital in Gandhinagar, Gujarat, for Ayurvedic treatment of various complaints, including pain in the lower back region, legs, and knee joints, as well as swelling in both knees with restricted movements for the past five years. The pain was continuous, mild to moderate in nature, and usually aggravated by physical activities. The pain in her left leg was more intense than in her right leg. Additionally, the patient experienced worsened low back pain in the early morning.
The patient had a history of hypertension and IHD for 10 years and was receiving regular treatment. She began experiencing pain in her knees and lower back five years ago and had been taking NSAIDs, which did not provide any relief. As a result, she sought ayurvedic treatment refer to (Table/Fig 1).
During the examination, she was found to be obese, with a body weight of 74 kg and a height of 5 feet 2 inches (BMI 30). There was moderate fat accumulation in both the abdomen and hip joints. Slight swelling was observed in both knee joints, with the left knee being more affected than the right. Additionally, crepitus was detected in both knee joints. The patient was unable to walk more than 10 steps. However, her vital signs, including temperature, pulse rate, and blood pressure, were within normal ranges. The Visual Analogue Scale (VAS) score was 6/10 for the right leg, 7/10 for the left leg, and 6/10 for the low back.
She was diagnosed with Sthaulya and Aamvata according to Ayurvedic principles. She was placed on ayurvedic treatment for Four weeks avoiding the use of NSAIDs. However, modern medicines for HTN and IHD were continued.
During her four-week stay at the hospital, drugs were prescribed for Aama Dosha for the initial four days. Panchakarma called ‘Udvartana’ (heated 500 gm of Triphala powder and used as a massage aid) was administered once in the morning along with Trayodashang Guggul (250 mg twice a day), Medohara Vati (250 mg twice a day), Rasnadi Kashayam (10 mL twice a day), and Ajmodadi Churna (1 gm twice a day) orally with hot water. Additionally, Panchakarma treatments such as oil massage, sudation, Katibasti, and Janubasti were administered as required (Table/Fig 2),(Table/Fig 3).
Follow-up was done based on two assessment parameters:
1. The self-reported Visual Analogue Scale (VAS): A self-reported VAS scale was used to measure knee joint pain, leg pain, and low back pain. The scale ranged from 0 (indicating no pain) to 10 (indicating unbearable pain). Every day, during the morning round (10-10:30 AM). It can be observed that there was a progressive decrease in the self-reported VAS scale, except on 15th June 2022, when the patient experienced aggravated symptoms (Table/Fig 4). After being discharged, the patient reported decreased pain levels. The VAS score for the left leg decreased from 7/10 to 2/10, while the right leg decreased from 6/10 to 3/10. The low back pain also significantly reduced from 6/10 to 1/10.
2. Walking distance: The patient was asked to walk independently every morning until she could. The distance was measured daily, and the mean length was 19.27 metres (range: 7-50 metres). The walking distance gradually increased from 7 metres on the first day to 50 metres on the 28th day.
Ayurvedic treatments involving dry powder massage, followed by massage with sesame oil, hot fomentation, Kati Basti, Janu Basti, and oral Ayurvedic drugs have significantly relieved pain, edema, and restricted movements in patients with osteoarthritis who also have a history of HTN, lumbar spondylosis, obesity, and IHD.
Ayurveda consultants widely treat arthritis with ayurvedic medicines and Panchakarma. However, when arthritis co-exists with HTN or IHD, they usually refer such cases to modern medical specialists. In this particular case. The ayurvedic treatment effectively provided relief for arthritis symptoms co-existing with HTN, IHD, obesity and lumbar spondylosis.
Research conducted by Grampurohit PL et al., focused on treating 25 cases of osteoarthritis with a Panchakarma method called Anuvasan Basti using Ksheerbala oil for 10 consecutive days, without any internal medication. A follow-up was conducted after 20 days to evaluate the results. The study observed a significant reduction in pain, swelling, tenderness, and crepitus without any radiological changes (1). However, the present study excluded osteoarthritis cases with hypertension or IHD.
In the present case study, personalised medication was utilised through various Panchakarma procedures such as Udvartana, massage, and hot fomentation to treat a patient with osteoarthritis, hypertension, and IHD. Ayurveda’s philosophy emphasises the importance of tailored treatments for each individual.
A case of Motor Neuron Disease (MND) was treated for almost a year using Panchakarma procedures such as Udvartana, Swedana, and oral Ayurvedic medication, as reported by Policepatil BV (2).
The study showed a significant increase in the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) from 29 before the treatment to 38 after the treatment, indicating positive improvement in speech, swallowing, food cutting, climbing, orthopnoea, and salivation. However, the patient in this case did not have a history of arthritis, hypertension, IHD, or lumbar spondylosis. The similarity between the present case and the current case is that both used Udavartana and Swedana for Panchakarma treatment, as both diseases are Vata dominant, according to Ayurveda.
In a study conducted by Rajoria K et al., limb girdle dystrophy was treated using different Panchakarma procedures (3). Similarly, Rohit S and Rahul M used Panchakarma procedures like Snehana (external oleation), Swedana (passive heat therapy), Hrudaydhara (concoction dripping treatment), and Basti (enema) twice a day for seven days, followed by Kadha ARJ et al., for the next 30 days in patients with Congestive Heart Failure (CHF) (4). The effect was assessed using Maximum Aerobic Capacity (MAC) uptake. A significant improvement was seen in MAC levels on the seventh day (7.11% p=0.029) compared to the baseline. This improvement remained stable during the two follow-ups on the 30th and 90th days. In the present case report, the patient had a history of IHD and hypertension with arthritis and lumbar spondylosis. Therefore, in the present case, Panchakarma procedures were used, but they were slightly modified based on the disease condition.
A clinical trial conducted by Sane R et al., demonstrated the effectiveness of heart failure reversal treatment as an additional therapy for patients with chronic heart failure (5). The trial involved 70 patients, with one group receiving Heart Failure Reversal Therapy (HFRT) in addition to the Standard CHF Treatment (SCT), while the other group only received SCT. The results showed that HFRT improved the functional capacity of CHF patients without any safety concerns. In the current case study, some of the Panchakarma procedures were administered similarly to the aforementioned trial.
Rastogi S and Chiappelli F found improvement in blood pressure and pulse rate in hypertensive patients who were given Sarvang Swedana (6). In the present case study, as the patient was a known hypertensive, the observational study by Rastogi S and Chiappelli F provided a basis for performing Panchakarma (Swedana) in the present case study (6). An in-vitro study revealed that Trayodashang Guggul had anti-inflammatory and antioxidant properties. It also inhibited membrane stabilising, protein denaturation inhibitory, antilipoxygenase, and antiproteinase activities (7). Trayodashang Guggul has been used in this case report as well. Similarly, Ajmodadi Churna was found to exhibit anti-inflammatory activity by mediating prostaglandins (8).
Both panchakarma and ayurvedic medicines have been effective in treating uncomplicated cases of arthritis. However, this particular case provided a detailed insight into the treatment protocol for arthritis accompanied by several other health conditions such as HTN, IHD, obesity, and lumbar spondylosis. Therefore, Ayurvedic treatment can also be considered as an alternative treatment modality when arthritis patients present with such co-morbidities.
Arthritis patients who also suffer from co-morbidities like HTN, IHD, obesity, and lumbar spondylosis are usually referred to modern medical specialists. However, the present case report shows that these patients can find relief through Ayurvedic treatments such as Panchakarma and Ayurvedic medicines. Ayurvedic consultants can now treat arthritis through Ayurvedic medicines and Panchakarma when arthritis co-exists with the above-mentioned conditions.
The authors acknowledge the hospital staff of Goenka Hospital and the Panchakarma staff for their service.
DOI: 10.7860/JCDR/2023/64381.18588
Date of Submission: Mar 30, 2023
Date of Peer Review: May 20, 2023
Date of Acceptance: Aug 01, 2023
Date of Publishing: Oct 01, 2023
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: Apr 04, 2023
• Manual Googling: Jun 13, 2023
• iThenticate Software: Jul 26, 2023 (1%)
ETYMOLOGY: Author Origin
EMENDATIONS: 7
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