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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
Management of Adverse Effects of Chemotherapy in Ovarian Cancer through Ayurveda: A Case Report
Correspondence Address :
Dr. Pankaj Yadav,
Postgraduate Scholar, Department of Kayachikitsa, Datta Meghe Institute of Higher Education and Research, Wardha-442107, Maharashtra, India.
E-mail: py84442@gmail.com
Cancer is a condition where abnormal cells multiply uncontrollably and can invade nearby tissues. Only 30% of women with ovarian cancer can expect to live for more than 5 years, as 70% of cases are diagnosed at an advanced stage. Ovarian malignancies account for about 15 to 20% of genital malignancies. Surgical intervention and chemotherapy are conventional measures used to treat these conditions. However, due to the specific side effects of chemotherapy, there is a high demand for safer ayurvedic interventions. Hereby, the authors present, a 54-year-old female patient who was diagnosed with ovarian cancer and advised to undergo chemotherapy. After completing six cycles of chemotherapy, administered once every four weeks for six months, the patient experienced complaints of anorexia, nausea, vomiting, epigastric pain, and a burning sensation in the stomach and lower limbs. Despite taking antacids and other suggested medications by the oncologist, the symptoms did not subside. Therefore, the patient sought ayurvedic treatment. Shaman Ayurvedic Chikitsa (Jawahar Mohra Pisti, Keharva Pisti, Swarna Makshik, Mukta Pisti), Shatavari Ghrita, Turmeric Kwath, and Pathya Vihar were prescribed for three consecutive months. After 5-7 days, the patient noticed significant relief in the aforementioned symptoms and felt better. The frequency of vomiting, complaints of anorexia, and burning sensation were also significantly reduced. After three months of ayurvedic treatment, the functions of Apana Vayu, Samana Vayu, and Pachaka Pitta were normalised through appropriate treatment. The selected combination of ayurvedic medicines provided relief due to their Vata-Pitta Shamak, Sheeta guna, and Pittahara properties, which alleviated the burning sensation. In present case report, the aforementioned ayurvedic prescription significantly reduced the adverse effects of chemotherapy and radiotherapy due to its Vata-Pitta Shamak and Pittahara properties.
Anorexia, Ayurvedic treatment, Carcinoma, Nausea, Ovarian, Vomiting
In present case, a 54-year-old female patient with a postoperative case of ovarian carcinoma approached the Kayachikitsa Outpatient Department (OPD) in 2022 with chief complaints of loss of appetite, nausea, vomiting, pain in the epigastric region, and a burning sensation in the stomach. She also experienced increased frequency of micturition and a burning sensation in her lower limbs for the past six months. She attained menarche at the age of 14 years and had regular cycles with a 28-day interval and a four-day bleeding cycle. At the time of cancer diagnosis in her right ovary, she underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy on July 13, 2019, followed by six cycles of chemotherapy. After chemotherapy, the grading of her symptoms is as shown in (Table/Fig 1) (1).
Radiological investigations, specifically a Contrast Enhanched Computed Tomography (CECT) abdomen, revealed bilateral heterogeneously enhancing adrenal masses with the left-sided mass showing a solid appearance and the right-sided mass having a mixed solid cystic appearance. The findings also suggested mild peritoneal thickening and metastatic seeding. Further cytopathology revealed cohesive tumour cell clusters identified as adenocarcinoma. The hereditary cancer panel genes indicated carcinoma of the ovary with pathogenic variations in genes. The drug used for chemotherapy in present case was albumin-bound paclitaxel (nab-paclitaxel, Abraxane), administered intravenously in six cycles once a month, for a total duration of six months. To alleviate the symptoms and maintain a healthy lifestyle, an ayurvedic treatment protocol was administered as described in (Table/Fig 2).
The therapeutic outcome of the patient after completing three months of treatment is outlined in (Table/Fig 3) (1). A follow-up was conducted after one month of treatment to assess disease recurrence or any other conditions. The improvement in the patient’s quality of life before and after treatment is described in (Table/Fig 4) (2).
The World Health Organisation (WHO) recently declared cancer to be the most dangerous killer in the world, one of the most deadly challenges that has been rapidly spreading in the 21st Century (3). Ovarian cancer is a type of cell growth that develops in the ovaries. These cells have the ability to invade healthy body tissue and multiply quickly. Its incidence is increased in females, especially in those aged over 50 years (4). Ovarian cancer is the leading cause of death in India (5), despite conventional treatments like surgery, chemotherapy, and radiotherapy.
The typical course of chemotherapy for epithelial ovarian cancer involves three to six cycles of treatment, depending on the stage and type of ovarian cancer. A cycle is a schedule of regular doses of a drug, followed by a rest period (6). Chemotherapy is commonly used in practice for conservative purposes. However, it is highly associated with various side effects, such as anorexia, nausea, vomiting, gastric trouble, severe fatigue, hair loss, and burning sensation, among others.
The treatment of cancer using modern regimens is notorious for being accompanied by drug-induced toxic side effects, which highlights the need for a perfect cure for the illness from the complementary and alternative medicine system. The primary purpose of ayurvedic therapy is to determine the underlying cause of a condition. The therapeutic methods mentioned in the classical texts of Ayurveda can be categorised into the following four groups: Rasayana Chikitsa (restoration of normal function), Roganashani Chikitsa (disease cure), Prakritisthapani Chikitsa (health maintenance), and Naishthiki Chikitsa (spiritual approach) (7).
The present study demonstrates the promising and significant role of Ayurveda in managing these side effects. A similar case study entitled “Management of chemotherapy adversity through Ayurveda: An experience” (8) concludes that the side effects of chemotherapy may be controlled by Ayurveda adjunct therapy.
Cancer is characterised in Ayurveda as either inflammatory or non inflammatory swellings. They could either be Arbuda (tumour) or Granthi (nodular/glandular swellings), which are comparable to minor or major neoplasms, respectively. According to ayurvedic literature, Apana Vayu is located in the Shroni (pelvis), Vasti (bladder), Medhra (penis), and Uru. Apana Vayu is responsible for excreting mala (feces) outside of the body. To restore normalcy to their functions, Apana Vayu, Samana Vayu, and Pachaka Pitta must be treated according to the symptoms. When Apana Vayu becomes vitiated, their regular operations are impeded (8).
The treatment principles mentioned in the texts of Ayurveda can be effectively formulated by considering all these scenarios of pathogenesis and symptoms that correct Apana Vayu, Agnimandhya, Pitta Shamak, Sheeta guna, Pittahara, and Rasayana properties. In this instance, the patient experiences Udara Gaurava (abdominal heaviness) and Vibandha (constipation), which are signs of vitiated Apana Vayu. However, because Samana Vayu is directly above Apana Vayu, over time these symptoms worsen and result in Samana Vayu Dushti and vitiation of Pachaka Pitta, causing Udarshula (abdominal pain), Chardi (vomiting), and Udara Gaurava (abdominal heaviness) along with burning sensation (9).
The patient was given a combination of Mukta pisti, kherawa pisti, Swarna Makshik, and Jawahar Mohra Pisti, considering their Sheeta guna and pittahara properties that revive Udaradaha. Haridra (9) (Turmeric) has Kapha Vata Shamak qualities, which are responsible for its anti-inflammatory effects (Shothghna). It possesses Ushna Virya and Katu Vipaka, which strengthen Pachak pitta and aid in digestion.
In Haridra, curcumin, turmerone, and polysaccharides are the active ingredients that primarily exhibit anticancer properties. Therefore, these active compounds prevent Tumour Necrosis Factor (TNF)-induced Akt activation, which is where metastasis growth occurs, and thereby suppress tumour angiogenesis, helping prevent the recurrence of cancerous cells.
Suvarna Sootshekhar Rasa: It is a mixture of herbs and minerals, mainly containing drugs with Deepana, Pachana, Garvishnashak, and Shulaghna properties (10). They have Katu, Tikta, and Madhur Rasa, Tikshna, Vyavayi, Laghu, Ruksha, Vikasi Guna, Ushna Virya with Madhur and Katu Vipaka. Hence, this formulation mainly works as Pachana of Aama (undigested food). Thereby, it reduces the increased sourness and penetrating power of Pitta and relieves epigastric pain and burning sensation.
Shatavari ghrita has Rashayan, Vatapitta Shamak, and Balya properties (11). Due to these properties of Shatavari, it nourishes all the depleted Dhatus.
Lavanbhaskar churna (12) has the property of Vatanulomana, decreasing Udara daha by neutralising the increased Pachaka Pitta and thereby decreasing the burning sensation. Avipattikar Churna (13) has Sukhvirechak property because of Trivrutta. So, considering the patient’s reduced physical strength, it is used for Mrudu Virechana to regulate Pitta. It helps smoothly clear the large and small intestines without inducing any excessive weakness.
The present case study demonstrates the significant role of Ayurveda in successfully managing the adverse effects of chemotherapy. Therefore, based on the therapeutic outcomes of this study, it can be concluded that ayurvedic remedies play a crucial and important role in managing the adverse effects of chemotherapy in cases of ovarian cancer. It helps improve the quality of life of patients suffering from such conditions after undergoing chemotherapy. No side effects were observed in the patient, indicating that it can be considered a safe and effective therapy. Based on the successful outcome of ayurvedic intervention in the management of ovarian cancer, it is necessary to plan further clinical trials with a larger sample size and longer duration, if required in the future.
Authors would like to acknowledge Dr. Vaishali Kuchewar for providing appropriate guidance regarding the diagnosis and treatment of the patient.
DOI: 10.7860/JCDR/2023/66789.18834
Date of Submission: Jul 29, 2023
Date of Peer Review: Sep 25, 2023
Date of Acceptance: Oct 22, 2023
Date of Publishing: Dec 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. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jul 29, 2023
• Manual Googling: Oct 02, 2023
• iThenticate Software: Oct 19, 2023 (7%)
ETYMOLOGY: Author Origin
EMENDATIONS: 7
- 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