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

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On Sep 2018

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Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
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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Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
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On Sep 2018

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On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

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

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
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
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
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.
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)
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

View Point
Year : 2011 | Month : November | Volume : 5 | Issue : 7 | Page : 1489 - 1492 Full Version

A Medical Humanities Module for the Faculty Members of the KIST Medical College, Imadol, Lalitpur

Published: November 1, 2011 | DOI:
P Ravi Shankar, Rano M Piryan, BMS Karki

1. M.D., Department of Medical Education KIST Medical College Lalitpur, Nepal. 2. M.D., Department of Medicine KIST Medical College Lalitpur, Nepal. 3. M.D., Director Academics KIST Medical College Lalitpur, Nepal.

Correspondence Address :
P Ravi Shankar
KIST Medical College
P. O Box 14142
Kathmandu, Nepal.


Introduction: Medical humanities (MH) are using subjects which are traditionally known as the humanities to pursue goals in medical education. A medical humanities (MH) module for the faculty members and the medical/dental officers was conducted at the KIST Medical College, Lalitpur, Nepal from March to August 2008. The study obtained participant feedback on the module, identified the module’s strengths and weaknesses, and obtained suggestions for improvement among others.

Methods: Twelve, small group activity-based sessions were held on Sunday afternoon from 1.30-3.30 pm by using literature excerpts, paintings, case scenarios, small group work and roleplays. There were about thirty participants. At the end of the module, feedback was obtained from the selected participants by using focus group discussions (FGD). Written transcripts were prepared and analyzed for key themes under different subheadings.

Results: The FGD participants felt that MH was a very important topic which was often found to be missing in medical education. They felt that there were problems with the seating arrangements and that working around a table would be more productive. The literature which was used was difficult and the standard of English was high. The participants were uncomfortable with the role-plays, especially those which dealt with the sexual and reproductive issues.

Conclusion: The module was appreciated by the participants. The small group learning strategies were interesting and effective. Similar sessions can be conducted for the faculty and the medical/dental officers of other medical schools in Nepal and south Asia.


Faculty, Medical Humanities, Nepal, Small group

The shortcomings of modern medicine which is dominated by science, technology and management, were recognized in the 1960s and 1970s (1). Medical Humanities (MH) has been defined as ‘an interdisciplinary, and increasingly international endeavour that draws on the creative and intellectual strengths of diverse disciplines, including literature, art, creative writing, drama, film, music, philosophy, ethical decision making, anthropology and history, in pursuit of medical educational goals’ (2). MH uses humanities subjects to explore the specific experiences of health, disease, illness, medicine and health care, the doctorpatient relationship and the clinical consultation as an arena for human experience (3). MH involves the human experiences of medicine which are seen through the humanities and are reflected philosophically (4).

MH has been shown to have a number of advantages in the education of future doctors. The literature may provide insights into the common shared human experiences and it may highlight the individual differences and emphasize the individuality of each human being (5). The literature can also introduce the students to problematic life situations (6). MH can encourage creativity among doctors by stimulating new ways to solve clinical problems and by dealing with the uncertainty in the clinical practice (7).

MH programs are common in the developed nations. MH programs are however not common in South Asia. A voluntary MH module was conducted at the Manipal College of Medical Sciences, Pokhara, Nepal (8),(9). The KIST Medical College (KISTMC) is anew medical school which is affiliated to the Institute of Medicine (IOM), Tribhuvan University. An MH module was conducted for all the faculty members and the medical and dental officers of the institution.

The details of the module are provided in the Methods section. The present study was conducted with the following objectives: to obtain participant feedback on the module, to identify the module’s strengths and weaknesses, to obtain suggestions for improvement and information about the proposed place of MH in the health profession education.

Material and Methods

The Medical Humanities (MH) module was conducted from the beginning of March till the beginning of August 2008 on Sunday afternoons from 1.30-3.30 pm. The faculty members of both the basic science and the clinical departments and the medical/ dental officers participated in it. The thirty module participants were divided into three groups of ten participants each. Literature excerpts, paintings, case scenarios, small group work and role-plays were the learning modalities. Twelve sessions were conducted. The sessions were not conducted on certain Sunday afternoons due to different reasons. Hence, only 12 sessions were conducted over a 24 week period. The various topics which were covered were empathy, the patient, the care giver, the doctor-patient relationship, breaking bad news and euthanasia, obtaining informed consent, abortion, patient participation in clinical research, dealing with the HIV-positive patient, dealing with the mentally ill and women and medicine.

A written participant feedback by using a structured questionnaire was obtained at the end of each session. At the end of the module, a feedback was obtained from selected participants by using focus group discussions (FGD). A written informed consent was obtained from all the FGD participants. Three FGDs were conducted with each group till there was a saturation of themes. The FGD was conducted by using a semi-structured guide and the first topic to be covered was the importance of Medical Humanities in Medical Education, as perceived by the participants. The FGDs were recorded by using a video camera. Written transcripts were prepared by using the video recordings and they were analyzed for key themes under different subheadings. The FGDs were conducted during November-December 2008 by the authors.


A total of 30 faculty members and medical/dental officers participated in the module. Twelve members were males and 18 were females. Twelve participants were doctors, four were medical officers, two were dental officers and 12 were from the basic science faculty (doctors and non-doctors). Due to clinical and other commitments, certain members could not attend all the sessions. Seventy percent of the faculty members attended all the sessions and the remaining attended at least 8 of the 12 sessions. The median rating score for the sessions was 7 (maximum 10). The participants felt that the objectives of the sessions were clearly delineated (score 4, maximum 5) and that the literature and the art excerpts, the case scenarios and the role-plays were relevant to the session objectives to the extent of 80%. They felt that the facilitators fulfilled their roles effectively and that the sessions would be important for their future practice/teaching (median score 4, maximum 5).

(Table/Fig 1) shows the demographic characteristics of the FGD participants. Four participants were males and six were females, which roughly corresponded to the gender distribution of the faculty and the medical officers in the institution. The number of clinical faculty members who were involved in the FGD was low.

Importance of MH in medical education: The participants felt that MH was a very important topic and that it would help the students in dealing better with the patients. Some opined that humanities were missing in medicine and that the medical practice should be within the accepted norms and values. In Nepal, there is a huge gap between the doctors and the patients and due to various factors, the doctors devote less time for the patients. MH may help in developing a more holistic approach towards sickness and health.

(Table/Fig 2) shows the selected verbatim comments of the respondents about different topics. The second topic which wascovered was the participants’ overall perception about the module. The participants felt that the two hour duration was long and that one hour to 75 minutes may be a proper duration. They felt that each topic could be covered in two sessions if needed. The sessions were a good opportunity to learn and the group discussion and group work was highly appreciated.

(Table/Fig 3) shows the sessions with learning objectives and the dates on which they were held. With regards to the specific sessions, the one on ‘Obtaining informed consent’ was useful in conducting research projects. The session on ‘euthanasia’ introduced new perspectives for the participants.

Group dynamics: The seating arrangement was not proper and the groups did not sit facing each other around a table. So, sometimes it was difficult to have conversations and to organize group work. The group dynamics was satisfactory and there were no barriers between the group members.

The learning modalities which were used: The literature which was used, was felt to be difficult, as the standard of English was high. The use of simpler scenarios, especially from Nepal, was recommended. The paintings which were used were fine, but their link with the session objectives were not sometimes clear. The case scenarios were relevant. The problems were noted and role plays were used. The participants were not comfortable with the role-plays which explored sexual and reproductive issues. The activities and flip chart presentations were better appreciated.

Possible use in teaching and practice: The doctors felt that the module could be useful in their future practice. The module covered the areas which often did not receive the attention that they deserved. The small group activities and the learning methods which were used could be helpful in student learning. Flip charts could be a powerful resource for teaching-learning.

Teaching MH to the health science students: The FGD participants felt that MH should be taught to the health sciencestudents. Some felt that it should be a part of the curriculum, while others felt that it could be voluntary initially and could later be introduced into the curriculum. They also felt that all the agreed formal assessment should not be carried out.

Suggestions for improving the future sessions: Each session should not be of more than 75 minutes duration. Not more than two activities should be used per session. More paintings and literature excerpts from the Nepalese context can be considered. The total number of topics which are covered should not be more than eight.


The participant feedback at the end of each session was positive. The FGDs also revealed that the participants had a positive opinion about the module. They were aware about the importance of MH in the medical education and the medical practice.

MH programs in the developing nations: In the west, MH was developed to counteract the adverse effects of an overemphasis on science. In the developing countries, an opera was used to teach MH, as in Sao Paulo, Brazil (10). At the Marmara Medical School in Turkey, the ‘human in medicine’ course is a part of the preclinical curriculum (11).

The doctor-patient relationship: In Nepal and other south Asian countries, the society and other norms favour a more authoritarian or doctor-centred doctor-patient relationship (12). Many patients are illiterate. Another factor which hindered the doctor-patientcommunication was language, with most doctors communicating in English, while the patients did not usually understand English. MH could help in having a better doctor-patient relationship, reducing aggression and improving patient satisfaction.

Interdisciplinary learning: Interdisciplinary learning is widely used to educate health professionals. At the National University of Ireland, Galway Medical School professionalism is taught in an interdisciplinary manner; integrating the learning objectives of health informatics,understanding health and illness in society, medical law and ethics (13).

Positive points about the module: During our afternoon MH sessions, the faculties from the clinical and basic science departments and from the dental sciences had the opportunity to interact together and learn from each other. The module was interactive and it used small group learning strategies and activities which were appreciated by the participants. Using humanities in medical education was not common and the participants enjoyed taking a ‘new’ look at the arts. The module was enjoyable and it was a refreshing break from the routine.

Problems with the module: The seating arrangement could not be properly organized during the initial days, as there were logistic and other difficulties. We addressed this issue and arranged the group work around a table, both during Sparshanam and the MH session for students (14). At present, we are not using literature excerpts in the student MH module. The authors’ experience with English as the language of MH learning has been exploredin a recent blog article (15). At present, the participants use either English or Nepali or a mixture of both languages during the student MH sessions.

The participants were not comfortable in discussing sexual and reproductive issues in the role-plays. Based on the feedback which was obtained from the participants after each session, the subsequent sessions during the faculty module were modified with a greater emphasis on small group work, clinical case scenarios and presentations (15).

Limitations: A feedback, using FGD, was obtained only from a limited number of respondents. The information about the module was obtained by using only the participant feedback at the end of the session and the FGD and it was not compared with other sources. Since only a limited number of participants were involved in the FGD, the views and opinions which were obtained may not be representative of the entire group. There was a delay in publishing the findings of the study.


The module was appreciated by the participants. The small group learning strategies which were used were found to be interesting and effective. Similar sessions can be conducted for the faculty and the medical/dental officers in other medical schools in Nepal and south Asia.


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