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

Users Online : 73956

AbstractMaterial and MethodsResultsDiscussionConclusionAcknowledgementReferencesDOI and Others
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

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"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."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




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.
Knowledge is treasure of a wise man. The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
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,
Bengaluru.
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 ones 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
Consultant
(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 journalsNo manuscriptsNo 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

Important Notice

Original article / research
Year : 2011 | Month : June | Volume : 5 | Issue : 3 | Page : 526 - 528

Effect of Age and Sex on QRS Axis Deviation of Healthy Indian Population and Its Clinical Significance

SHIVETA BANSAL, RAJIV ARORA

Corresponding Author. Associate Professor Department of Physiology Gian Sagar Medical College, Banur,Patiala, Punjab,India.

Correspondence Address :
Shiveta Bansal, Assistant Professor Department of Physiology Gian Sagar Medical College, Banur, Patiala, Punjab, India. Ph – 09988221826 E-mail ID: shiveta26@rediffmail.com

Abstract

Introduction: Electrocardiogram from 150 apparently healthy adults in the age group of 20–80 years, were analyzed using Schiller Cardiovit AT 1,3 channeled ECG machine to study the impact of increasing age and sex on QRS Axis deviation. The mean electrical axis was recorded in frontal plane for QRS complex using the Hexaxial Reference system.

Result: It was observed that there occurred highly significant leftward shift of QRS frontal plane axis with increase in age. This shift of QRS axis was also found on comparison among malesand females of the three groups separately. However there was no significant variation of QRS frontal plane axis with sex in any of three age groups.

Conclusion: It was concluded from the present study that age influences the prevalence of electrocardiographic variations and the diagnostic criterion for abnormality must be based upon the sound understanding of the normal electrocardiogram.

Discussion: The leftward shift of the frontal QRS axis with age was attributed to increased left ventricular wall thickness.

Keywords

ECG, QRS Axis Deviation, Hexaxial Reference System, Age, Sex

The process of normal aging in the absence of disease is accompanied by a myriad of changes in body systems. Health and lifestyle factors together with the genetic make-up of an individual determine the response to these changes. In India, the absolute size of the aged population is considerable. The projected figures (for >65 years) for the year 2000 and 2010 are 8% and 9% respectively. The influence of age and sex on ECG measurements has been documented from as far back as 1961(1) .

With advancing age, degenerative changes occur in heart muscle and its conduction system. Some of the pathways of pacemaker system may develop fibrous tissue and fat deposits. The SA node loses some of its cells. Aging has been shown to be associated with significant left ventricular wall thickness .The purpose of the present study was to determine the presence and extent of sex and age differences in QRS axis deviation in an adult population.

Material and Methods

The present study has been conducted on 150 healthy individuals (both male and female) in age group of 20–80 years. Individuals found free of any cardiovascular abnormality were taken up for the study. The ECG was recorded in supine position and fasting state. These were divided into 3 groups depending upon the age:- Group A 20–39 years = 50 Group B 40–59 years = 50 Group C 60–80 years = 50 All the subjects were interviewed in accordance with the pro forma enclosed and detailed history and clinical examination were taken. Informed consent was taken from the study participants.

Detailed History
Complete history with special emphasis on cardiovascular system such as history of pain in the chest, dyspnoea, palpitation, oedema feet were noted.

Clinical examination
Careful general physical examination was carried out, parti- cularly cardiovascular examination to exclude any cardiovascular disease.

Electrocardiogram:
Electrocardiograph Machine:A conventional 12 lead electrocardiogram was recorded on Schiller Cardiovit AT 1, 3 channeled ECG machine. The machine has four stainless steel electrodes and six precordial suction electrodes. 12 lead ECG was recorded which includes:

1. 3 bipolar limb leads- L I, L II and L III 2. 3 augmented unipolar limb leads - aVR, aVL, and aVF; 3. 6 unipolar chest leads- V1, V2, V3, V4, V5 and V6

A great care was taken to avoid the presence of any conducting material in the vicinity of electrocardiogram machine. The electrocardiogram was recorded in supine position and fasting state. The sensitivity of the machine was so adjusted that a potential difference of 1mV caused a deflection of 10 mm. As a routine the paper speed used during the procedure of recording the electrocardiogram was 25mm/sec.

Electrical Axis:The mean electrical axis was recorded in frontal plane for QRS complex. The method for determining the mean QRS axis in frontal plane was based on the Hexaxial Reference system which is formed by a combination of two triaxial reference systems, one formed by the three standard leads and the other by the three unipolar extremity leads.

Axis deviation:The normal axis lies between –30° and +110°. Within the range of normal (–30° to +110°), left axis deviation (0 to –30°) represents a normal horizontal heart position; and right axis deviation (+75° to +110°) represents a normal vertical heart position.

Statistical consideration:All the data was analyzed statistically.

Results

(Table/Fig 1) (Table/Fig 2) represents the distribution of the study participants according to age and sex respectively.

(Table/Fig 3) shows mean and SD of QRS axis in the three groups A, B and C. The result shows that with increasing age mean QRS Frontal plane axis shifts towards left. On using ANOVA test, F value comes out to be 11.46 which shows HS inter-group difference (p <0.01). On comparing group A with B, t value is 1.46, which is NS (p>0.05), A with C t value is 4.17 which is HS (p<0.01) and B with C the difference is again HS (p<0.01), with t value of 3.24.

(Table/Fig 4) shows mean and SD of QRS axis in males of the three groups A, B and C. The result shows that with increasing age mean QRS Frontal plane axis shifts towards left. On using ANOVA test, F value comes out to be 6.94 which shows HS inter-group difference among males (p <0.01). On comparing group A with B, t value is 1.27 which is NS (p>0.05), A with C t value is 3.58 which is HS (p<0.01) and B with C the difference is S (p<0.05), with t value of 2.20.

(Table/Fig 5) shows mean and SD of QRS frontal plane axis in females of the three groups A, B and C. The result shows that with increasing age, mean QRS frontal plane axis shifts towards left. On usingANOVA test, F value comes out to be 6.92 which shows HS intergroup difference among females (p <0.01). On comparing group A with B, t value is 0.32 which is NS (p>0.05), A with C t value is 2.62 which is S (p<0.05) and B with C t value is 2.59 which is again S (p<0.05).

(Table/Fig 6) shows comparison of QRS Frontal plane axis between males and females of the three groups. On comparing males and females of groups A, B and C, statistical analysis shows result to be NS (p >0.05) with t value of 1.73, 0.87 and 1.49 respectively.

Discussion

In this study, 150 healthy individuals (both male and female) in age group of 20–80 years were physiologically analyzed on the basis of QRS axis deviation. Changes in QRS frontal plane axis with age and sex were noted and statistically analyzed. The conclusion of the present study was compared with those of previous studies and results were drawn.

Ewy GA (1979)(2) has conducted similar studies on different ethnic groups. He concluded that the incidence of left axis deviation in the Indian schoolchildren is more than ten times the incidence reported in other populations of normal children of comparable age.

Bressan et al (1998) (3) and Xie et al (2000)(4) have also reported similar results of leftward shift of QRS frontal plane axis.

Assantachai et al (2002) (5) concluded that the most common electrocardiographic abnormality in normal older men was left axis deviation and was found consistently more often than in older women.

The deviation of heart electrical axis to a more left position with increasing age was also supported in studies by Varlamova and Evdokimov (2003) (6) Wu et al (2003),(7) Devkota et al (2006)(8) and Chermnykh and Loginova (2006)(9).

Surawicz B (2009) (10) concluded that the mean frontal plane electrical axis, determined by the vector of the maximal (dominant) QRS deflection, depends on age and body habitus . It shifts to the left with increasing age.

The leftward shift of the frontal QRS axis with age is attributed to increased left ventricular wall thickness which is due to (i) decreased number of myocytes (due to necrosis and apoptosis) but increased left ventricular myocyte size,(ii) altered growth factor regulation, (iii) focal collagen deposition.

Conclusion

In the present study, it was observed that there occurred highly significant leftward shift of QRS frontal plane axis with increase in age. This shift of QRS axis was also found on comparison among males and females of the three groups separately. However there was no significant variation of QRS frontal plane axis with sex in any of three age groups.

It was concluded from the present study that age influences the prevalence of electrocardiographic variations and the diagnostic criterion for abnormality must be based upon the sound understanding of the normal electrocardiogram.

Acknowledgement

The authors are thankful to the Department of Physiology, Government Medical College, Patiala, Punjab for providing the requisite infrastructure for the study.

References

1.
. Macfarlane PW. Age, sex, and the ST amplitude in health and disease. J Electrocardiol 2001;34(Suppl):235-241.
2.
. Ewy et al. Electrocardiographic axis deviation in Navajo andApache indians. Chest 1979;75;54-58
3.
. Bressan M, Bortolan G, Cavaggion C, Fusaro S. Normal electrocardiogram in the aged. G Ital Cardiol 1998;28(1):22-8.
4.
. Xie ZW, Wang C, Li MX. Electrocardiographic QRS waves of healthy Chinese population with different ages and sexes. Hunan Yi Ke Da Xue Xue Bao 2000; 25(1):58-62.
5.
. Assantachai P, Panchavinnin P, Pisalsarakij D. An electrocardiographic survey of elderly Thai people in the rural community. J Med Assoc Thai 2002;85(12):1273-9.
6.
. Varlamova NG, Evdokimov VG. Age markers on EKG. Adv Gerontol 2003;11:76-9.
7.
. Wu J, Kors JA, Rijnbeek PR, Van Herpen G, Lu Z, Xu C. Normal limits of the electrocardiogram in Chinese subjects. Int J Cardiol 2003;87(1):37-51.
8.
. Devkota KC, Thapamagar SB, Bista B, Malla S. ECG findings in elderly. Nepal Med Coll J 2006;8(2):128-32.
9.
. Chermnykh NA, Loginova TP. Functional characteristics of the cardiovascular system of old people-inhibitants of the north. Adv Gerontol 2006;18:59-65.
10.
. Surawicz B . AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram. Circulation 2009;119:e235-e240.

DOI and Others

JCDR/2011/1312

JCDR is now Monthly and more widely Indexed .
  • 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
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com