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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
Case report
Full Version
Paediatric Mandibular Fracture- An Enigma of its Own: A Case Report
Correspondence Address :
Dr. Pulkit Khandelwal,
Associate Professor, Department of Oral and Maxillofcial Surgery, OPD No. 307, Rural Dental College, PIMS-DU, Loni, Ahmednagar-413736, Maharashtra, India.
E-mail: khandelwal.pulkit22@gmail.com
Mandibular fractures are very rare in the paediatric age group; however, they remain the most common maxillofacial trauma occurring in children. A paediatric mandibular fracture can cause severe pain and discomfort for the patient. Due to the complex anatomy of the developing mandible, such as the presence of permanent tooth buds and its small size, the treatment of mandibular fractures in the paediatric age group differs markedly from that in adults. Treatment of maxillofacial fractures in the paediatric population has always been a challenge for the operating surgeon. Different treatment modalities for managing paediatric mandibular fractures include closed reduction or surgical intervention. Open/closed cap splint provides closed reduction and stabilisation of paediatric mandibular fractures without any risk of damage to permanent tooth buds. It is more commonly preferred over Open Reduction and Internal Fixation (ORIF) of the fractures. However, for highly displaced fractures, ORIF is the preferred treatment. In the present case report, the author present and describe the management of a mandibular symphyseal and medial pole of the right condyle fracture in a seven-year-old patient. Since the bone fragments were highly displaced and occlusion was severely deranged with an anterior open bite, conservative treatment using a cap splint was not considered. ORIF was performed under general anaesthesia. At the one-year follow-up, complete clinical and radiological bone healing was observed. Occlusion was satisfactory, and mouth opening was maintained. There was normal eruption of permanent teeth with no complications or delays associated with the eruption pattern.
Bone, Maxillofacial, Symphysis, Tooth, Trauma
A seven-year-old female patient was brought to the casualty Department by relatives with a suspected history of a motor vehicle accident and suffering from maxillofacial trauma. There was no neurosurgical or respiratory distress. She had upper lip oedema and a full-thickness facial laceration at the chin region (Table/Fig 1)a. Intraoral examination revealed a completely exposed highly displaced fracture with evident mobile fracture segments at the symphysis region (Table/Fig 1)b. The occlusion was severely deranged, showing an anterior open bite. Multiple teeth (51, 31, 32, 41, 42) were displaced and mobile, and avulsion of tooth 83 was present. Orthopantomogram (OPG) and Computed Tomography (CT) scan of the face (Table/Fig 1)c,d suggested a fracture at the symphysis and medial pole of the right condyle of the mandible. Since the bony fragments were highly displaced, conservative treatment using a cap splint was not considered, and ORIF was planned. The patient and relatives were informed about the condition and the need for surgery, and informed consent was obtained.
After obtaining preanaesthetic clearance, the patient was transferred to the operation theatre, and the surgery was performed. Interdental wiring was used to stabilise and reduce the mandibular fracture, and occlusion was achieved through slight manipulation. Tooth 51 was also stabilised using interdental wiring (Table/Fig 2)a. The fracture site was accessed through the existing degloving injury site, and the bone segments were anatomically reduced and fixed with 2 mm titanium miniplates placed close to the inferior border to avoid damaging the permanent tooth buds (Table/Fig 2)b. Meticulous multiple-layered suturing was performed (Table/Fig 2)c, resulting in satisfactory fracture reduction (Table/Fig 2)d. Postoperative OPG showed the reestablishment of the lower border of the mandible and no damage to any tooth or tooth bud (Table/Fig 2)e. The patient received active physiotherapy and was administered medications (Inj. Augmentin 300 mg i.v. BD, Inj. Metronidazole 30 mg/kg/day i.v. TDS, and Inj. Paracetamol 10 mg/kg TDS) intravenously for three days, followed by oral administration for the next two days. Regular wound support dressing was performed, with dressing changes twice daily. Suture removal took place one week postoperatively, and the patient was discharged without any complications on the same day. The patient was scheduled for regular follow-up visits. At the 3-month follow-up [Table/Fig 3]a-d, healing was uneventful clinically and radiographically, with adequate mouth opening (35 mm). At the one-year follow-up (Table/Fig 3)e-g, the fracture site was completely healed, as evident on OPG. Occlusion was satisfactory, and mouth opening was maintained (35 mm). There were no complications or delays associated with the eruption pattern of permanent teeth, and no functional deficits or limitations such as restricted mouth opening were present.
Maxillofacial fractures in the paediatric population are rare because of the protective environment provided by parents. Additionally, in the paediatric population, there is a wide coverage of adipose tissue over the bones in the maxillofacial region. The developing bones in children are very resilient with greater elasticity, and there is less pneumatisation of the growing maxillary sinus. These characteristic features make it more difficult for fractures to occur in developing bones, requiring a significant amount of energy (1). The incidence of facial bone fractures in children is approximately 10%, with the peak incidence occurring above the age of five (2),(3). In children, these fractures commonly present as undisplaced or greenstick fractures. Factors such as the relatively small size of the paediatric mandible, a relatively low tooth-to-bone ratio, the resilient nature of the maxillofacial bones, and the protected environment contribute to the low incidence of paediatric fractures (4). Mandibular fractures in children can result from trauma due to self-falls, motor vehicle accidents, sports injuries, etc., (5).
Paediatric maxillofacial fractures can be treated conservatively or surgically, depending on factors such as bone quality and density, degree of mobility and displacement between fracture segments, eruption status of teeth, presence of tooth buds, and chances of restricted bony growth (5),(6). Undisplaced or greenstick fractures are typically managed conservatively through closed reduction. For more complex or highly displaced fractures, open surgical treatment is recommended (7). However, the application of closed reduction or open surgical treatment for paediatric mandibular fractures remains controversial.
Closed reduction using cap splints stabilised with circummandibular wiring is the preferred conservative treatment method (6). It prevents damage to developing tooth buds and does not interfere with condylar growth. However, it has limitations and is suitable for undisplaced or slightly displaced anterior mandibular fractures only. Highly displaced or complex fractures of the mandibular symphysis require ORIF (8). During ORIF, care should be taken to minimise damage to tooth roots, developing tooth buds, or dental follicles by fixing screws along the lower border of the mandible (9). The use 10of minimally traumatic surgical techniques and careful fixation of miniplates at the lower border of the mandible is crucial to prevent damage to permanent tooth buds.
Restoring the continuity of a fractured bone is essential for achieving immediate function and normal bone development (10). Studies have shown that ORIF using monocortical miniplates and screws can effectively treat paediatric mandibular fractures with minimal complications (11). Examples include the use of a 4-hole 1.2 mm titanium miniplate for ORIF of a parasymphyseal fracture in a 13-month-old patient, resulting in satisfactory mouth opening and occlusion after a ten-month follow-up (12). Another case involved the surgical treatment of a mandibular symphysis fracture using ORIF with a 1.5 mm titanium plate, with the patient demonstrating no restriction in mandibular movements or limitations in mouth opening during follow-up (13).
In the present patient, the fractured bony fragments were significantly displaced, and there was a severe derangement of occlusion with an anterior open bite. Closed reduction with a cap splint and circummandibular wiring would not have provided enough stability and rigidity for proper fracture reduction. This approach could have resulted in malunion or contour deformities. Therefore, ORIF were planned and performed under general anaesthesia. During the ORIF procedure for paediatric mandibular fractures, there is always a risk of damaging the permanent tooth buds. To minimise this risk, miniplates were fixed very close to the lower border of the mandible, effectively protecting the tooth buds. At the one-year follow-up, complete clinical and radiological bone healing was observed. The occlusion was satisfactory, and there was no limitation in mouth opening. The eruption of permanent teeth occurred normally, without any complications or delays associated with the eruption pattern.
In the conservative treatment of highly displaced fractures, inadequate reduction can lead to malunion and contour deformities. Paediatric mandibular fractures can be effectively treated by ORIF using monocortical miniplates and screws, resulting in optimal outcomes with very few or no complications. All factors that can affect treatment outcomes should be assessed, and the most effective treatment plan should be formulated and executed to ensure the patient’s well-being with minimal complications.
DOI: 10.7860/JCDR/2023/67115.18674
Date of Submission: Aug 19, 2023
Date of Peer Review: Oct 16, 2023
Date of Acceptance: Oct 26, 2023
Date of Publishing: Nov 01, 2023
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• 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: Aug 23, 2023
• Manual Googling: Oct 18, 2023
• iThenticate Software: Oct 24, 2023 (9%)
ETYMOLOGY: Author Origin
EMENDATIONS: 6
- 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