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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
Clinicoepidemiological Profile of Otorhinolaryngological Diseases among Patients Aged 5-15 Years- A Retrospective Study
Correspondence Address :
Dr. Asha Saikia,
Postgraduate Trainee, Department of ENT and Head and Neck Surgery,
Assam Medical College, Dibrugarh, Assam, India.
E-mail: ashasaikia23.as@gmail.com
Introduction: Ear, nose and throat diseases are some of the common causes of absenteeism among the school going children and can contribute to various co-morbidities. The most common among the Ear, Nose, Throat (ENT) diseases in school going children is hearing impairment due to ear wax or different types of otitis media which can be prevented with early detection and intervention. Upper respiratory tract infections also predispose a child to complications such as tonsillitis, sinusitis along with otitis media that can lead to morbidities like hearing impairment and learning disability.
Aim: To determine the prevalence of ear, nose and throat diseases among the school going children and their clinico-epidemiological profile.
Materials and Methods: This retrospective study was carried out in a tertiary care centre, Assam Medical College and Hospital, Dibrugarh, Upper Assam, India during the period of January 2019 to December 2019. Study included all the 1525 children within age group of 5-15 years attending the ENT Outpatient Department (OPD). Data was obtained from the outdoor register and the history sheets. Data collected was age, sex, religion and distribution of diseases according to site. Number of children having ear, nose, throat or neck diseases were calculated using Microsoft Excel software 2013, version 15.0.
Results: Majority of the cases studied were found to be in the age group of 5-10 years (54.1%). ENT diseases were more common in boys (54.2%) than in girls (45.8%). Diseases of the ear (55.9%) were most common, followed by oral cavity and throat (19.3%), nose and Paranasal Sinus (PNS) (18.2%) and neck (6.6%). The most common diseases in ear were Chronic Suppurative Otitis Media (CSOM) and presence of earwax, while sinusitis and allergic rhinitis were more prevalent in diseases of nose and PNS. Pharyngitis and tonsillitis were more commonly found among the diseases of oral cavity and throat.
Conclusion: These diseases are a major burden in the school going children resulting in their absence from school, low academic and extracurricular performance and other outdoor activities. Keeping an eye on this aspect, a structured and systematic school health program can be designed in collaboration with state health system, so that it can be properly followed-up and needed treatment can be initiated with the help of state government cost.
Co-morbidities, Hearing impairment, School children
India, being the second most populous country of the world, is home to more than 400 million children forming about 35% of its total population (1). Respiratory tract infections are quite common in children and are common cause of absenteeism from school (2). In a study conducted in Loni, Maharashtra, ENT diseases were more prevalent among the male (53.2%) children with diseases of auditory system (57.3%) being the most common group of ENT problems (3). Morbidity associated with auditory system include hearing impairment which obstructs the overall development. Among the numerous studies carried out to find out the prevalence of hearing impairment in children, the prevalence among children with ear disease was 16.5% in a study carried out in rural population of South India by Rao RP et al., 2002 (4). In a study conducted in Yemen, the prevalence of CSOM in this age group was 7.4%, which was significantly associated with disabling hearing impairment (5). Allergic rhinitis has a profound impact on the daily lives of children, causing irritability, sadness, impairment of sleep, fatigue and impairment of cognition and memory in children (6). These conditions may predispose a child to complications which further contribute to morbidity affecting the performance at school and thus their future. However, early detection and intervention of these diseases can reduce the burden of morbidities (7).
Hence, this present retrospective study was conducted with the aim to determine the prevalence of ear, nose and throat diseases among the school going children and their clinico-epidemiological profile.
This retrospective study was carried out on all the patients in the age group of 5-15 years, attending the ENT and Head and Neck Surgery OPD of Assam Medical College and Hospital, Dibrugarh, Upper Assam, India, during the period of January 2019 to December 2019. The data was analysed during August 2020 to October 2020.
Inclusion criteria: All patients of school going age group (5-15 years) attending Department of ENT and Head and Neck Surgery during the study period were included in the study.
Exclusion criteria: Patients with incomplete data records were excluded.
All 1525 children attending the ENT OPD within the study period were included. Data was obtained from the outdoor register and the history sheets. Number of children having ear, nose, throat or neck diseases was calculated and was tabulated according to age, gender, religion and distribution of the diseases according to site (ear, nose and throat).
Statistical Analysis
Data were entered in Microsoft Excel Worksheet 2013, version 15.0 and computer based analysis was performed using Microsoft Excel 2013. The categorical variables were summarised as proportions and percentages.
There were a total of 1525 patients in this age group during this period. Maximum number of cases 825 (54.10%) were in the age group of 5-10 years and were Hindus 1194 (78.3%) with male to female ratio 1:18 (Table/Fig 1). Maximum ENT diseases occur in the ear 853 (55.9%) followed by oral cavity 294 (19.3%), throat and nose and paranasal sinus 277 (18.2%) (Table/Fig 2).
Earwax 243 (28.5%) was the most common among ear diseases, sinusitis 83 (30%) and allergic rhinitis 51 (18.4%) among diseases of nose and paranasal sinuses, pharyngitis 117 (39.8%) followed by tonsillitis 85 (28.9%) were the most common among oral cavity and reactive lymphadenitis 61 (60.4%) was the most common among diseases of neck (Table/Fig 3).
The patients diagnosed with earwax, acute otitis media, otomycosis, otitis externa, otitis media with effusion and eustachian tube block were treated conservatively. Cases of safe CSOM were relieved with conservative management, but the cases of unsafe CSOM were initially treated conservatively but later had to undergo mastoid exploration. Foreign body in the ear was removed either under general or local anaesthesia depending on the co-operation of the child. The lacerations were repaired and the sinus tract in preauricular sinus, keloid, pseudocyst and sebaceous cyst in the ear were excised.
Cases of allergic rhinitis, sinusitis, Upper Respiratory Tract Infection (URTI), Inferior Turbinate Hypertrophy (ITH) and vestibulitis were given conservative management. Adenoidectomy was done in children with adenoids. Septoplasty was done in five cases of Deviated Nasal Septum (DNS) and the rest cases of DNS showed symptomatic relief on conservative management. One case of nasal polyp showed reduction in size and relief of symptoms with topical and systemic steroids. Rest cases of polyp underwent Functional Endoscopic Sinus Surgery (FESS) with polypectomy. Foreign body in the nose was removed either under General Anaesthesia (GA) or Local Anaesthesia (LA). Excision of the nasopharyngeal angiofibroma was done in the two cases. Twenty patients presenting with epistaxis had history of nose pricking, trauma due to self fall and road traffic accidents. They were managed conservatively. Three children with epistaxis had bleeding disorders and were referred to paediatrics of better management.
Patients with pharyngitis, parotitis, aphthous ulcer and glossitis were given symptomatic treatment. Cases of acute tonsillitis were managed conservatively and those with chronic tonsillitis underwent tonsillectomy. Mucocele and nasolabial cysts were excised. Only four of the tongue bite injury cases needed repair, while the rest cases were given topical antibiotic ointment and were healed as the lacerations were not more than 1-1.5 cm. Foreign bodies in oesophagus were removed via oesophagoscopy.
Reactive lymphadenitis and submandibular sialadenitis were given systemic antibiotics and were relieved. Neck abscesses were drained by Hilton’s method. Those diagnosed to be tubercular lymphadenitis were advised to start anti-tubercular drugs under Directly Observed Treatment, Short-course (DOTS). Excision of schwannoma and lipoma was done under GA. Cystic hygroma was kept under observation.
In this study, overall ENT diseases were found to be more common in boys (52.2%) than in girls (45.8%), which is similar to various literature (1),(8). Diseases were more common in the age group of 5-10 years, which is contradictory to a study in Kishanganj, Bihar (2). ENT diseases were found to be more prevalent in Hindu religion in this study.
Diseases of ear were found to be the major burden in this paediatric age group, followed by oral cavity and throat, and then nose and PNS, which complies with other studies (2),(3). Ear wax, followed by CSOM is the most common morbid conditions of the ear which if not treated accurately may lead to hearing impairment. This high prevalence in this study corresponds with that of another study (4),(9). A study also found that not only bacterial middle ear infection, but major factors such as hereditary and consanguinity also plays an important role in hearing impairment among school-going children (10).
Pharyngitis followed by tonsillitis were the most common diseases in patients complaining of sore throat in the study, which contradicts other studies (2),(3). Organisms responsible for tonsillitis include streptococcus pyogenes and beta haemolytic streptococci. If not treated in acute phase of tonsillitis it may lead to complications like peritonsillar abscess, other deep neck space infections, acute rheumatic fever, glomerulonephritis and septicaemia (8).
Nasal obstruction and rhinorrhoea are the most common complains in children with diseases of nose and PNS. The most common ones are allergic rhinitis and adenoids. Recurrence of adenoids can lead to chronic nasal obstruction and obstructive sleep apnea (8).
These diseases are a major burden in the school going children resulting in their absence from school, low academic and extracurricular performance and other outdoor activities (11). School health programmes can help in creating awareness among the teachers and parents for early detection of the diseases and early treatment of the same to reduce the co-morbidities which require further treatment in tertiary care centres. Keeping an eye on this aspect, a structured and systematic school health program can be designed in collaboration with state health system, so that they can be properly followed-up and if needed treatment can be initiated on state government cost.
Limitation(s)
The results of this study were applicable only in the population attending the ENT outdoor of the tertiary care centre as it was done without taking a control group. As it was a retrospective study, further follow-up of the patients also could not be done.
In the present study, ear wax and CSOM were the most common ear diseases affecting this population which on early intervention can prevent the child from hearing impairment and its consequences which include impaired speech, language and cognitive skills. Nasal obstruction due to rhinitis and adenoids can lead to obstructive sleep apnea, which may lead to day time sleepiness, inactivity thus affecting performance in school. These diseases are a major burden in the school going children resulting in their absence from school. School health programmes can help in creating awareness among the parents for early detection and immediate treatment of the diseases to reduce the co-morbidities which require further treatment in higher centres.
DOI: 10.7860/JCDR/2022/47916.16216
Date of Submission: Nov 28, 2020
Date of Peer Review: Jan 05, 2022
Date of Acceptance: Jan 20, 2022
Date of Publishing: Apr 01, 2022
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? NA
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA
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• iThenticate Software: Feb 17, 2022 (7%)
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