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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
A Case Report of Ring Tourniquet Syndrome: A Paradigm of Danger
Correspondence Address :
Dr. Ratnakar Ambade,
9, Meghe Heights 4, JNMC Campus, Wardha-442005, Maharashtra, India.
E-mail: drambade@hotmail.com
Ring Tourniquet Syndrome (RTS) is a rare but potentially serious condition that occurs when a small, tight object such as a hair, thread, or string becomes wrapped around a finger, toe, or other body part, creating a tourniquet-like effect. This can lead to tissue damage, swelling, a bluish colour of the finger, and in severe cases, loss of the affected digit or limb. Here, we present a case of an 11-year-old female patient who was diagnosed with RTS due to a metallic latch on the left index finger. The patient was managed with the removal of the latch under local anaesthesia in the operating theatre and regained full range of motion without any signs of ischaemia on a 2-week follow-up. This case report highlights the successful salvage of a finger affected by RTS through prompt recognition and appropriate intervention.
Cyanosis, Ischaemia, Necrosis
An 11-year-old female presented to the orthopaedic casualty with complaints of pain and bluish discolouration of the left index finger due to a metallic latch of a door striking her left index finger for the past two hours. The pain was excruciating and moderate in intensity. The patient and relatives gave a history of girl playing with the door latch. Subsequently, her index finger got stuck in the door latch. Multiple attempts were made to remove it at home, resulting in the latch getting embedded deep in the dorsal aspect of the finger. The pain increased in intensity, and bluish discolouration of the finger started after the attempts. After multiple failed attempts, relatives brought the patient to the casualty after two hours of the injury.
On examination, the metallic door latch was seen stuck deeply on the dorsal aspect of the metacarpophalangeal joint. There was diffuse swelling, cyanosis, and decreased sensation on the affected finger without any purulent discharge (Table/Fig 1). The range of motion was painful and not possible at the metacarpophalangeal joint of the affected finger. The vitals were within normal limits, and the finger’s temperature was raised. Oxygen saturation was not recordable in the affected finger. Capillary refilling was checked by pressing the nail bed of the affected finger and was found to be delayed.
Complete blood count and postoperative plain X-ray showed no remarkable changes. Blood investigations were within normal limits. Colour Doppler of the index finger showed biphasic forward flow in the affected finger.
A diagnosis of RTS with impending gangrene was made. The patient was given tetanus prophylaxis and immediately taken into the operating room. A jumbo cutter was used to make a window in the latch. The window was widened using the plier and later elevated using the osteotome and periosteum elevator. The latch was removed, and the wound was examined, which showed no tendon injury (Table/Fig 2),(Table/Fig 3).
A single dose of injectable broad-spectrum antibiotic was given. Oxygen saturation was 98% recordable immediately after the removal of the metallic latch. A plain X-ray of the hand was done, and a fracture was ruled out due to the tightly embedded latch (Table/Fig 4).
The patient was discharged the next day with oral antibiotics and analgesics prescribed for three days. Daily dressing was done on an outpatient basis. On follow-up of two weeks, the wound was healed, and the patient regained painless full range of motion of the affected finger with no signs of ischaemia or necrosis.
The RTS is a constriction injury caused by any jewellery or metals. Rings getting caught on fingers are a regular complaint made to the emergency room, but fingers stuck in other circumferential metal objects are rare. Patients may have sores from prior ring removal efforts, as well as finger pain, oedema, ischaemia, and wounds. Ring imprisonment may be caused by applying a ring that is too small or by swelling around a ring that was once properly fitted. There have been previous reports of injuries to the hand or wrist, oedema, deforming arthritis, and other disorders (1),(2). Constriction of digital vessels worsens the oedema by reducing the venous and lymphatic drainage, and ultimately, arterial supply is hampered. This may lead to cyanosis and ischaemia of the affected finger if left untreated. Necrosis is the next consequence of the untreated constriction, which may lead to the amputation of the finger (Table/Fig 5).
If left untreated for a long time, it can lead to finger ischaemia and necrosis, leading to the only option of amputation (3). Based on the intensity and acuteness of the afflicted tissue, as well as 2the characteristics of the band, emergency management should be considered. More aggressive techniques must be used if conservative ones fail. A tight band can be appendage-threatening, though rarely life-threatening. First-line therapy may involve more invasive procedures rather than more conservative ones when there is deformation of the damaged tissues or loss of function (4). In order to prevent irreversible injury to the limb and prevent amputation, it is crucial to have a high clinical suspicion, especially in vulnerable patients with psychiatric disorders. One such case of tourniquet syndrome of the lower limb has been reported in a psychiatric patient, which led to the neurovascular complications of the affected limb (5). Another case of acquired constriction ring syndrome reported in a child led to severe oedema and the imminent danger of gangrene, which required complete decompression in the operation theatre (6).
Ring constriction syndrome is a rare but potentially limb-threatening condition that requires prompt recognition and intervention. Delayed treatment can lead to irreversible damage, requiring more extensive surgical procedures such as digit amputation. Similarly, a report by Mohan A et al., showed ring entrapment leading to ischaemia, an oedematous finger which was treated by amputation (7). Also, Mengesha MG and Lambiso B showed similar management due to delay and timely management (8). Pahwa HS et al. noted a case of penile constriction syndrome leading to partial amputation of the penis in a child (9).
Losing a finger for an 11-year-old is a physically as well as mentally disabling condition. Especially for females, it is very disturbing for the patient as well as relatives from a cosmetic point of view, and keeping in mind the future endeavours. Here, immediate operative intervention led to finger salvage, there were no signs of ischaemia or necrosis postoperatively, and a full range of motion was regained. It resulted in an excellent outcome. Hence, the present case report highlights the extravagant outcome with prompt decision and quick interventions.
Non invasive measures should be attempted initially to remove the constricting object, such as the two rubber band technique (10). However, in cases where the condition rapidly progresses or causes significant pain and oedema and where signs of cyanosis and ischaemia have already started to set in, early surgical intervention becomes necessary to prevent tissue necrosis and preserve the affected digit.
Successful salvage of a finger affected by RTS could be achieved through prompt recognition and appropriate intervention. Timely diagnosis, immediate removal of the constricting object, and meticulous wound care are essential for preventing irreversible damage and preserving the affected digit. The present case serves as a reminder to healthcare providers of the importance of vigilance in identifying RTS and initiating timely treatment to optimise patient outcomes.
DOI: 10.7860/JCDR/2023/65553.18210
Date of Submission: May 23, 2023
Date of Peer Review: Jun 15, 2023
Date of Acceptance: Jun 23, 2023
Date of Publishing: Jul 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: May 24, 2023
• Manual Googling: Jun 02, 2023
• iThenticate Software: Jun 21, 2023 (2%)
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