Article in PDF
How to Cite
Citation Manager
Readers' Comments (0)
Audio Visual Article Statistics
Link
to PUBMED
Print this Article
Send to a Friend
Advertisers
Access Statistics Resources
Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
Impact of COVID-19 on Pregnancy Outcome in the First Wave, Second Wave, and Third Wave of the Pandemic at a Tertiary Care Centre Mysuru, Karnataka, India: A Prospective Cohort Study
Correspondence Address :
BA Anupama Marnal,
Senior Resident, Department of Obstetrics and Gynaecology, JSS Medical College and Hospital, Agrahara, Mysuru-570004, Karnataka, India.
E-mail: anupamamarnal27@gmail.com
Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic has subjected us all to difficult times in managing patients, particularly pregnant women. Numerous studies have been conducted during each wave, but limited data is available on maternal and neonatal outcomes. Given that people must co-exist with COVID-19, it is crucial to enhance the understanding of antenatal patient management.
Aim: To compare the clinical presentation, co-morbidities, and maternal and neonatal outcomes among pregnant women with COVID-19 during the first, second, and third waves of the pandemic.
Materials and Methods: This prospective cohort study was conducted in the Department of Obstetrics and Gynaecology (OBG) at JSS Hospital, Mysore, Karnataka, India, from January 2020 to February 2022. A total of 33 expectant mothers with COVID-19 presented during the first wave (from January 30, 2020, to the end of February 2021), 50 expectant mothers with COVID-19 during the second wave (from March 2021 to the end of September 2021), and 19 expectant women with COVID-19 during the third wave (from January 2022 to the end of February 2022). Data were collected for each wave, and a comparison of different variables in all three waves was performed. Microsoft Excel was used for data entry, and analysis was conducted using Statistical Package for Social Sciences (SPSS) version 22.0. Chi-square test was employed to compare the different variables as a test of significance.
Results: The mean age of the expecting mothers in the first wave was 27.12±4.35 years, in the second wave was 25.86±3.98 years, and in the third wave it was 24.61±3.98 years, with a p-value=0.103. Symptoms like cough, cold, running nose were highest in the second wave (22 cases, 44.0%), followed by breathlessness in 6 (12.0%) cases, and fever, chills, myalgia, generalised weakness, vomiting in 45 (90.0%) cases. Hypertensive disease of pregnancy was highest in the first wave (8 cases, 24.2%). In the first, second, and third waves, a total of 23 (69.7%), 30 (60.0%), and 12 (63.1%) individuals, respectively, did not have any co-morbidities. The majority of women in the first wave 18 (54.6%) cases and second wave 27 (54.0%) cases were multigravida, while in the third wave, they were primigravida 14 (73.7%) cases. Pre-term deliveries 22 (44.0%) cases and intrauterine deaths 8 (16.0%) cases were highest in the second wave. There was a higher frequency of Preterm Premature Rupture of Membranes (PPROM) and Premature Rupture of Membranes (PROM) in the first wave 6 (18.2%) cases. Neonatal Intensive Care Unit ( NICU) admission of babies was found to be highest in the third wave 8 (42.1%) cases, compared to the first two waves. There was no statistically significant association between these parameters and the waves of the pandemic. The mean Haemoglobin (Hb) levels of the study subjects were least in the first wave, compared to those in the rest of the waves (p-value=0.499). Mean Erythrocyte Sedimentation Rate (ESR) levels were significantly lower in the first wave (p-value=0.041), and C-reactive Protein (CRP) was highest in women in the second wave (p-value=0.036).
Conclusion: It is important that always study the features of the disease over a period of time so that the management protocols can be modified.
Coronavirus disease-2019, Laboratory investigations, Maternal outcome, Neonatal outcome, Pregnancy
Due to the outbreak of the COVID-19 caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), a global health crisis has been created (1). Many countries have observed a three-wave pattern, with the first wave starting in January 2020, followed by the second wave in late March 2021 (2), and the third wave in January 2022 (3). The first case of COVID-19 was reported in India in January 2020 (4). “In pregnant women, existing co-morbidities such as hypertension, diabetes, high maternal age, and obesity have been recognised as risk factors for severe COVID-19 disease during pregnancy” (5),(6). The present study was conducted to assess the maternal and neonatal outcomes in women with COVID-19 disease during the first, second, and third waves of the pandemic at a tertiary care centre in Mysuru, India.
A prospective cohort study conducted in the Department of Obstetrics and Gynaecology at JSS Hospital, Mysuru, Karnataka, India. from January 2020 to February 2022. It included 33 expectant mothers who presented with COVID-19 during the first wave of the pandemic from January 30th, 2020, to the end of February 2021, 50 expectant mothers with COVID-19 in the second wave from March 2021 to the end of September 2021, and 19 expectant women with COVID-19 in the third wave from January 2022 to the end of February 2022. Institutional Ethical Committee (IEC) clearance was obtained before the start of the study. A total of 102 pregnant women were enrolled.
Inclusion criteria: Pregnant women who tested positive for COVID-19 by COVID-19 Real Time-Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) in any trimester, irrespective of gestational age, parity, and any associated co-morbidities in all the waves, were included in the study.
Exclusion criteria: Pregnant patients lost to follow-up and those with a negative COVID-19 status, patients in the puerperal period with COVID-19, and non pregnant female patients were excluded.
Study Procedure
The COVID-19 test results were obtained from the microbiology records, and the remaining data were obtained from the study subjects through interviews conducted when they were admitted to the hospital. Maternal outcomes included demographic details, obstetric details, co-morbidities, biochemical investigations, and mode of delivery. Neonatal outcomes included gestational age at delivery (term/preterm), NICU admissions, and COVID-19 results.
Statistical Analysis
Data was entered into MS Excel and analysed using SPSS version 22.0. To compare the different variables, the Chi-square test was used as a test of significance. A p-value of <0.05 was considered statistically significant.
In the present study, all the subjects in the second wave were symptomatic. Symptoms such as cough, cold, and running nose were highest in the second wave, accounting for 22 (44.0%) cases, followed by fever, chills, myalgia, generalised weakness, and vomiting, which were reported in 45 (90.0%) cases. These symptoms were more prominent in the second wave compared to the first and third waves (Table/Fig 1).
In the second wave, 3 (6%) children tested positive for RT-PCR, while none of the children in the first and third waves were RT-PCR positive (Table/Fig 2).
The majority of women in the first wave 18 (54.6%) and the second wave (27, 54.0%) were multigravida, while in the third wave, the majority were primigravida 14 (73.7%) (p-value=0.089). There was no statistically significant association between preterm delivery, PPROM, PROM, Intrauterine Device (IUD), and the waves of the pandemic (Table/Fig 3).
The majority of deliveries in all three waves were emergency Lower (Uterine) Segment Caesarean Section (LSCS). Preterm vaginal deliveries were highest in the second wave, accounting for 08 (16%) cases. Foetal distress and previous LSCS were the most common indications for LSCS (Table/Fig 4).
The mean Hb levels of the study subjects were the lowest in the first wave compared to the other waves (p-value=0.499). Mean ESR levels were significantly lower in the first wave (p-value=0.041), and CRP levels were highest in women in the second wave (p-value=0.036) (Table/Fig 5).
During the first wave, India registered a low number of COVID-19 positive cases per million people. However, the scenario unexpectedly changed in the second wave, with more than 400,000 confirmed cases per day, resulting in severe consequences (7). Studies have identified numerous double mutant and triple mutant strains of SARS-CoV-2 in different regions of India (8),(9).
All the participants in the second wave were symptomatic in the present study. In a study by Singh V et al., during the second wave, 10 women had moderate disease and four had severe disease, compared to two women with severe disease during the first wave (10). There were four cases of maternal mortality due to COVID-19 pneumonia, all of which occurred during the second wave, and none of the individuals were vaccinated for COVID-19 infection (10). Mahajan NN et al., described advanced rates of severe COVID-19, admissions to the ICU or high dependency unit, case fatality rate, and maternal mortality ratio during the second wave of the pandemic (11). In a study by Chaudhary D et al., the requirement for mechanical ventilation was higher during the second wave compared to the first wave among COVID-19 positive pregnant women. Additionally, the maternal death rate was significantly higher during the second wave compared to the first wave (12). Kadiwar S et al., also suggested that pregnant and peripartum women experienced more severe illness in the second wave of the COVID-19 pandemic compared to the first wave (13). In the study by Singh V et al., the most frequently associated co-morbidities were hypertensive disorders, diabetic disorders, and anaemia. There was no significant difference in the frequency of these co-morbidities between the two waves (10). Mahajan NN et al., reported similar findings (11).
The majority of women in the first wave 18 (54.6%) and the second wave 27 (54.0%) were multigravida, while in the third wave, the majority were primigravida 14 (73.7%). Preterm deliveries were highest in the second wave, accounting for 22 (44.0%) cases, and there were eight cases of intrauterine deaths or stillbirths (16.0%). The frequency of PPROM and PROM was higher in the first wave, with 6 (18.2%) cases. NICU admissions of babies were highest in the third wave, with 8 (42.1%) cases, compared to the first two waves. In the study by Singh V et al., during the first wave, with a mean gestational age at delivery of 34.65 weeks, 35 (27.78%) women had preterm delivery, while during the second wave, with a mean gestational age at delivery of 33.80 weeks, 21 (24.71%) women had preterm delivery (10). Chaudhary D et al., also observed similar findings in their study, with high rates of preterm deliveries among COVID-19-affected pregnant women (12). Many reviewers have described the high incidence of preterm births among pregnant women with COVID-19, but the exact cause remains unclear in these studies (5),(14),(15). “The rate of NICU admissions was also high, being 21.31% and 33.33%, respectively, during the two waves (14),(15). Allotey J et al., have also concluded that pregnant women infected with COVID-19 are more likely to give preterm birth and have a higher incidence of neonatal admissions to the ICU” (5). However, the rate of intrauterine and neonatal deaths remained low during both waves, and no neonatal deaths secondary to COVID-19 infection were seen in the present study.
The majority of deliveries in all three waves were emergency LSCS. Preterm vaginal deliveries were highest in the second wave, with 8 cases (16%). Foetal distress and previous LSCS were the most common indications for LSCS. This is in accordance with the study by Singh V et al., which found that the caesarean section rate was significantly higher during the second wave compared to the first. Several studies have reported a high rate of caesarean sections during the pandemic [16-18]. The reasons for this could be several factors, such as more women opting for caesarean section in isolated areas and maternal concerns about respiratory function.
Limitation(s)
More pregnant women need to be included in future studies. The present study was conducted at a single center, and a multicenter study should be conducted to obtain a broader perspective. Additionally, vaccination was not included as a factor in the present study.
Comparison of all three waves has made us realise that COVID-19 can present with different symptoms. Preterm vaginal deliveries and intrauterine deaths were highest in the second wave. Neonatal COVID-19 infection was only observed in the second wave, but the incidence remained low. However, by comparing all three waves, the authors were able to assess the changes in clinical presentation, co-morbidities, and maternal and neonatal outcomes in women with COVID-19 disease.
DOI: 10.7860/JCDR/2023/64160.18638
Date of Submission: Apr 12, 2023
Date of Peer Review: Jun 14, 2023
Date of Acceptance: Aug 29, 2023
Date of Publishing: Oct 01, 2023
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Apr 20, 2023
• Manual Googling: Jun 23, 2023
• iThenticate Software: Aug 25, 2023 (23%)
ETYMOLOGY: Author Origin
EMENDATIONS: 7
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com