Article in PDF
How to Cite
Citation Manager
Readers' Comments (0)
Audio Visual Article Statistics
Link
to PUBMED
Print this Article
Send to a Friend
Advertisers
Access Statistics Resources
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
Utility of Phlebotomy Tourniquet as a Cost-effective Adjuvant in Diabetic Wound Closure: A Case Report
Correspondence Address :
Mr. Aarsh Gajjar,
Student, Department of General Surgery, Seth GSMC and KEM Hospital, Parel, Mumbai-400012, Maharashtra, India.
E-mail: aarshpgajjar@gmail.com
Diabetes Mellitus (DM) is associated with numerous complications, including cardiovascular diseases, blindness, renal failure, and foot ulcers, which can result in morbidity, amputation, and increased mortality rates. Present case is of a 50-year-old patient with a Diabetic Foot Ulcer (DFU) who underwent amputation of the 2nd, 3rd, and 4th toes of the right foot and was managed on an outpatient basis. A phlebotomy tourniquet was tied across the wound and gradually tightened to approximate the wound edges, facilitating wound contraction. After 45 days of treatment, the wound had fully healed. This case suggests that using a phlebotomy tourniquet can effectively close wounds when other techniques, such as skin grafting, are not feasible.
Diabetic foot, Diabetes complication, Wound closure techniques
A 50-year-old patient with a 10-year history of poorly controlled DM on insulin underwent Ray’s amputation and debridement of the 3rd toe, 14 days after presenting with an acute DFU. However, after the surgery, the wound displayed dusky edges and necrotic tissue at its base (Table/Fig 1). A digital angiography examination revealed the presence of a plaque in the middle section of the Superficial Femoral Artery (SFA), causing 50% stenosis. Additionally, multiple tandem plaques and occlusions were observed in the Anterior Tibial Artery (ATA), with very poor distal runoff in the Dorsalis Pedis Artery (DPA). There was a near-complete occlusion of the proximal and middle sections of the Posterior Tibial Artery (PTA), with very poor flow observed in the distal PTA. Significant stenosis was also noted in the peroneal artery. The SFA lesion was treated using a 5×40 mm balloon (Bard, Ultraverse). Attempts were made to treat the lesions in the ATA and PTA but were unsuccessful. Angioplasty of the peroneal artery was performed using a 2×100 mm balloon (Bard, Ultraverse). Following the angioplasty procedure, improved blood flow was observed in the DPA through the peroneal artery, as well as in the plantar arch through the peroneal artery and the DPA.
The treating surgeon recommended further debridement following angiography and angioplasty, leading to the patient being transferred to our centre. After the angioplasty, the 2nd and 4th toes displayed gangrenous changes, and the patient was advised to undergo Ray’s or Trans Meta Tarsal (TMT) amputation to prevent an unstable foot. However, the patient declined and requested the removal of only the gangrenous 2nd and 4th toes. The patient was then managed on an outpatient basis with regular dressings. After the second surgery, the wound was large but displayed healthy granulation at its base (Table/Fig 2). The challenge then arose: how to approximate the edges of this wide wound. Initially, skin grafting was considered a possibility, but it was determined that it would not be able to withstand the pressure on the sole. As such, an innovative approach was taken and decided to approximate the wound edges using a phlebotomy tourniquet (Table/Fig 3).
The use of the tourniquet allowed for a gradual tightening of the wound edges with each dressing, bringing them closer together over time. After 45 days of this treatment, the wound edges had completely approximated, and the wound had fully healed (Table/Fig 4). X-ray of the patient showed amputated bones without any underlying osteomyelitis (Table/Fig 5). This case demonstrates the potential utility of using a phlebotomy tourniquet in wound closure, particularly in situations where traditional methods such as skin grafting may not be feasible.
Wound development, particularly DFUs, is a prevalent complication of DM that can result in physical disability and emotional distress in patients. DM contributes to the formation of DFUs through various mechanisms. It affects approximately 40-60 million people with diabetes worldwide (1) and is characterised by chronic wound formation that combines metabolic disturbances, nerve damage, hypoperfusion, and altered biomechanics of the lower extremities (2). The primary cause of ulcers is typically the absence of pain due to neuropathy (3). Conversely, neuropathy itself renders the skin of the foot dry and fragile, enhancing its proneness to cracking. DFUs significantly impact the quality of life and are associated with a wide range of mortality and morbidity. Moreover, serious complications 4such as infection, sepsis, and amputation may arise from DFUs (4). Routine care has been demonstrated to produce only gradual improvements in the wound healing process.
Currently, treatments for managing DFUs include debridement, pressure relief (“off-loading”), antibiotics, revascularisation, Vacuum-Assisted Closure (VAC) therapy, secondary suturing, stapling, and skin adhesive glues (5). The development of a successful clinical treatment for DFUs remains a challenge for the scientific community. Although a multitude of treatments is currently being used in the management of DFUs, their affordability remains a barrier to their use, particularly in low- and middle-income economies (6). Present study used the method of phlebotomy tourniquet, which has a ubiquitous presence in the medical care setting, makes the treatment almost cost-free. Furthermore, most treatment modalities such as secondary suturing, stapling, and skin adhesive glues are effective for minor wounds, making them unsuitable for a large wound as in present case. VAC was not considered due to its unavailability and the longer recovery time period.
Despite numerous modalities of treatment being available, authors chose to use their novel method of wound approximation, considering the health and economic burden to the patient, as well as the limited availability of treatments. The centre had limited resources and the patient was from an economically disadvantaged background, demanding faster rehabilitation due to economic considerations. After ruling out other modalities of treating such a large wound and considering the economic limitations of the patient, authors opted for the approximation of the wound via this innovative approach.
The use of a tourniquet, as demonstrated in this case, may be a valuable tool in treating DFUs, particularly in low-income countries where access to advanced technologies may be limited. The tourniquet allows for a gradual approximation of the wound edges, bringing them closer together over time and ultimately leading to complete wound healing. The use of a tourniquet may be more cost-effective than other methods of wound closure, making it an attractive option for low-income countries where resources may be scarce. Additionally, the rehabilitation and healing in this patient were achieved fairly early compared to other modalities, although a detailed study with a larger sample size is required to comment on the efficacy of this principle. A thorough search of available literature revealed a lack of similar reports where a tourniquet was used for the approximation of a large wound. This signifies the novelty of the method and emphasises the need for further research regarding this technique.
Overall, the tourniquet appears to be a useful and practical tool in the treatment of DFUs and may provide an alternative for clinicians in resource-limited settings. Further research is needed to fully understand the potential benefits and limitations of this approach and to determine its place in the treatment algorithm for DFUs or any wound that requires gradual approximation.
DOI: 10.7860/JCDR/2023/63969.18347
Date of Submission: Mar 09, 2023
Date of Peer Review: May 06, 2023
Date of Acceptance: May 30, 2023
Date of Publishing: Aug 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: Mar 15, 2023
• Manual Googling: Apr 13, 2023
• iThenticate Software: May 19, 2023 (8%)
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