Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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On Sep 2018

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"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

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Muzaffarnagar Medical College,
On Aug 2018

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MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
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Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
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Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

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.
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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)
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.
On April 2011

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
On Jan 2020

Important Notice

Case report
Year : 2007 | Month : April | Volume : 1 | Issue : 2 | Page : 65 - 68 Full Version

Late Presentation Of Amniotic Band Syndrome A Case Report

Published: April 1, 2007 | DOI:

Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareily Road, Lucknow, 226016, UP, INDIA

Correspondence Address :
Dr. Sunil Kumar, Professor,
Department of Radiodiagnosis,
Sanjay Gandhi Postgraduate Institute of Medical Sciences,
Raebareily Road, Lucknow, 226016, UP, INDIA. Telephone: + 91 522 2668700 Ext-(O) 2565


Amniotic band syndrome is a term used interchangeably to Streeter’s dysplasia and refers to a continuous spectrum of manifestations occurring due to intrauterine rupture of amnion. The disease may be characterised by simple soft tissue constriction bands to amputation of digits or more severely of the whole limb due to dysplastic vasculature. Due to digital amputation the condition is also known as pseudo-ainhum. This is a rare condition. Therefore, we report a case wherein at the age of five years there are constriction bands in the right leg while amputation was noted in toes and in the right index and middle finger.

Streeter's dysplasia, which is also known as amniotic band syndrome, is a rare abnormality that manifests itself at birth in the form of ring-like constrictive bands either in the upper or in the lower limbs and occasionally in the trunk (1). These annular defects occur in varying degrees of severity, ranging from superficial circumferential grooves in the skin to amputation of a part or the whole of a limb. A vascular insult occurring very early in the gestation prior to 26 days is considered to be the causative factor. Associated defects with amniotic band syndrome include hydranencephaly, porencephaly, craniofacial abnormalities, and spinal dysraphism (2). We report a case of amniotic band syndrome with multiple bands involving both the upper and lower limbs with varying degrees of tissue loss distal to the constrictive bands.

Case Report

A five-year-old male child presented with the chief complaints of multiple constrictive rings in both upper and lower limbs. The child was the first bornof his parents and delivered full term at home through a normal vaginal birth. The constrictive rings noticed since birth were present on the right lower limb (Table/Fig 1), toes (Table/Fig 2), and fingers of right upper extremity (Table/Fig 3).
These rings were shallow at birth but gradually became deeper. Local examination revealed a deep constrictive circumferential groove at these sites. To begin with, there were no neuro-vascular symptoms in the parts distal to the bands. Subsequently, from the age of two-years, he complained of a tingling sensation in the toes and fingers. This was followed by amputation of tissues distal to constrictive bands by the age of 4½ years.
The psychomotor milestones of the child were normal. No contributory family history was present. Maternal obstetric history was not suggestive of any antenatal insult to the foetus. A skeletal survey revealed a deep groove at the lower ends of the tibia and fibula in the right leg.
The groove was confined to the skin and the subcutaneous tissues, the bones being normal in this area. There was loss of both soft tissue and bone in the digits of the right hand and both the feet. The fibrous band in the right leg was excised and Z-plasty done. Subsequent development of the leg and foot was normal. For the amputated digits, reconstructive surgery was offered. The parents however, declined the same due to financial constraints.


The prevalence of amniotic band syndrome among live births is estimated to be around 7.7:10,000 (3). Among abortuses it may be as high as 178:10,000 (5). It affects males and females in the same proportion. Most of the cases are sporadic, with no recurrence in siblings or children of affected adults (4).

Pillay and Hesketh (6) reported the largest series of 40 cases from Singapore and concluded that the disease is more common in the Malaya people of the Far East. In the lower extremities, the incidence is a little higher than the upper extremity. The usual sites for these annular grooves are the distal parts of the limbs. These grooves typically occur in fingers, toes, forearms, and legs. Occasionally, these are found above the knees and elbows. A rarer site is the trunk. These rings may be very shallow involving the skin and subcutaneous tissues only or they may be deeper and involve the deep fascia. involving (1).

The condition is idiopathic. Maternal trauma, oophorectomy during pregnancy (7), intrauterine contraceptive device (8) and amniocentesis (9) and familial incidence of connective tissue disorders (Ehler-Danlos syndrome) (10) are some of the implicated etiopathological factors. Lockwood C et al suggested the role of a teratogenic insult as one of the factors causing the disorder (11). The cause of the malformations in the amniotic band syndrome remains controversial. These may be due to focal developmental errors in the formation of limb connective tissue. According to Torpin et al, the rupture of the amnion without the rupture of the chorion leads to transient oligohydramnios due to loss of amniotic fluid through the initially permeable chorion (12). The foetus passes from the amniotic to the extra embryonic coelom through the defect and comes in contact with ‘sticky’ mesoderm on the chorionic surface of the amnion. This leads to entanglement of the foetal parts and skin abrasions. Entanglement of the foetal parts causes constriction rings and amputations, whereas skin abrasions can lead to disruption defects, such as cephaloceles. Further, swallowing of the bands will cause asymmetric clefts on the face (12).
The most common finding in the amniotic band syndrome is the constriction rings of the fingers and toes (13). It occurs in 77 percent of foetuses with multiple anomalies (5). The association of abnormalities, such as clubfeet, anencephaly, cleft lip, cleft palate, cleft face, rib clefting, gastroschisis, omphalocele, bladder exstrophy, and imperforate anus, should be regarded as strong evidence and should arouse the suspicion of the amniotic band syndrome. The visualization of amniotic bands attaching to a foetus with restriction of motion on prenetal ultrasonography is diagnostic of the condition. This precludes the need for foetal karyotype (5),(14). The visualisation of amniotic bands or sheets in the absence of foetal deformities should by no means lead to the diagnosis of the amniotic band syndrome since several types of membranes, such as folds of amnion and extra-amniotic pregnancies (15) may be seen in normal pregnancies (14).
The differential diagnostic considerations include ammiotic folds, short umbilical cord syndrome and extra-amniotic pregnancy. Ammiotic folds which are recognized by prenatal ultrasonography as reflecting membranes floating freely in the amniotic fluid. They have been reported in patients who had instrumentation of the uterine cavity resulting in intrauterine scars or adhesions. The foetus is mo


Mohan VV, Sharma OP, Gupta SK. J Postgrad Med 1980;26:132–4.
Allington NJ, Kumar SJ, Guille JT. Clubfeet associated with congenital constriction bands of the ipsilateral lower extremity. J Pediatr Orthop 1995;15(5):599–603.
Buyse ML. Birth defects encyclopedia. Cambridge (MA): Blackwell Scientific Publications; 1990.
Seeds JW, Cefalo RC, Herbert WNP. Amniotic band syndrome. Am J Obstet Gynecol 1982;144:243.
Nyberg DA, Mahony BS, Pretorius DH. Diagnostic ultrasound of fetal anomalies. Littleton (MA): Year Book Medical Publishers; 1990.
Pillay VK, Hesketh KT. Intra-uterine amputations and annular limb defects in Singapore. J Bone Joint Surg Br 1965;47:514–9.
Tanaka O, Koh T, Otani H. Amniogenic band anomalies in a fifth-month fetus and in a newborn from maternal oophorectomy during early pregnancy. Teratology 1986;33:187–93.
Csecsek K, Szeifert GT, Papp Z. Amniotic bands associated with early rupture of amnion due to an intrauterine device. Zentralbl Gynakol 1987;109:378–41.
Kohn G. The amniotic band syndrome: a possible complication of amniocentesis. Prenat Diagn 1987;8:303–5.
Young ID, Lindenbaum RH, Thompson EM, et al. Amniotic band syndrome in connective tissue disorders. Arch Dis Child 1985;60:1061–3.
Lockwood C, Ghidini A, Romero R, et al. Amniotic band syndrome: reevaluation of its pathogenesis. Am J Obstet Gynecol 1989;160:1030–3.
Torpin R. Fetal malformations caused by amnion rupture during gestation. Springfield (IL): Charles C Thomas; 1968. p. 1–76.
Fiedler JM, Phelan JP. The amniotic band syndrome in monozygotic twins. Am J Obstet Gynecol 1983;14:863–4.
Burton DJ, Filly RA. Sonographic diagnosis of the amniotic band syndrome. AJR 1991;156:555–8. Jeant

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