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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
Type of Refractive Errors among School Going Children from District Kathua, Jammu, India
Correspondence Address :
Priyanka Sodani,
Associate Professor, Department of Ophthalmology, GMC, Kathua, Jammu, India.
E-mail: priyankasodani1979@gmail.com
Introduction: Worldwide refractive error remains one of the most common causes of visual impairment in children. Uncorrected refractive error can lead to long term effect on academic progression and employment opportunities. The study was conducted in remote area of district of Kathua, Jammu, India.
Aim: To estimate type of refractive error among children and its association with demographic characters.
Materials and Methods: The descriptive, cross-sectional, observational, hospital-based study was carried out in Out Patient Department (OPD) of Ophthalmology, Government Medical College, Kathua, Jammu, India. The study of population included 351 children of age 5-16 years with complaint of diminution of vision. Examination included visual acuity recording, slit lamp, fundus examination and dilated retinoscopy. Inferential statistics was calculated using Open Epi version 3.01.
Results: Out of 1582 children, 351(22.18%) children had refractive error. Their mean age was 12.52±2.87 years. The refractive errors were more common in the age group 13-16 years (61.5%), followed by 9-12 years (29.9%), and 5-8 years (8.51%). Refractive errors were more in males (56.12%) as compared to females (43.87%); 247 (70.37%) children had refractive error in both the eyes, whereas 104 (29.6%) had it in one eye. Astigmatism was most common (50.14%) followed by myopia (40.45%), hypermetropia (7.4%) and amblyopia (1.99%). Maximum astigmatism was seen in 13-16 years (56.25%) followed by 9-12 years (34.09%) and least in 5-8 years (9.65%).
Conclusion: A high percentage of refractive errors in the study indicate that school health services should be strengthened and implemented effectively.
Astigmatism, Hypermetropia, Myopia
Global estimates on childhood blindness show that there are 1.4 million and 17.52 million children suffering from blindness and moderate to severe visual impairment, respectively (1). Approximately, 73% of world blind children live in low-income countries and 27 lacs are estimated to be in India (2). Refractive error is one of the most common causes of treatable blindness (3). These school going children between 6-15 years represent 25% of the population in developing countries (2).
Refractive error can affect the performance of school going children in studies, sports and other extracurricular activities. Moreover, school age group children can understand their problem and convey it (4). Vision 2020- the right to sight initiative to estimate avoidable blindness has given high priority to correction of refractive errors and placed it with in the category of childhood blindness (5). Moreover, the establishment of the World Health Organisation (WHO) refractive error working group, the inclusion on the task force of vision 2020 of national and international Non Governmental Development Organisations (NGDOs) and professional bodies focusing on refractive errors, and a number of population-based studies on refractive error in children, has highlighted the importance of refractive error interventions in prevention of blindness (6). Approximately, 80% of children can be taken care of before the stage of complete blindness (7). The common types of refractive errors in children are myopia, hypermetropia, and astigmatism (8).
There is significant variation in refractive error across geographical, racial, age, ethnic boundaries and it has extensive impact on strategies utilised in addressing uncorrected refractive errors (8). The burden of uncorrected refractive error among children attending the ophthalmology OPD was high. This public health challenge required urgent attention and there has been lack of comprehensive data on refractive error from this region. Keeping all these in mind and to address the need of developing more sustainable eye care health services at primary and secondary level, this study was conducted. The objective of this study was to determine frequency of refractive error among children and also to estimate different types of refractive error and their association with demographic characters like age and gender.
The descriptive, cross-sectional, observational, hospital-based study was conducted in OPD of Ophthalmology, Government Medical College, Kathua, Jammu, India from February 2019 to March 2020. Approval for this study was taken from the Institutional Ethical Committee (IEC/GMCK/01/Pharma dated: 18-02-2020). The study was conducted in full accords with the tenets of the declaration of Helsinki.
Inclusion criteria: A 5-16 years of children who attended the ophthalmological OPD during the study period were included in the study. Demographic details including age and gender of study population were recorded. All the children between the age group 5-16 years shaving complaints of the diminution of vision were included in the study. Children wearing spectacles complaining of diminution of vision (due to change in refractive error) were included in the study. The refractive error of the eye with worse Best Corrected Visual Acuity (BCVA) was taken into consideration.
Exclusion criteria: Children having low vision due to ocular problem other than refractive error were excluded from the study.
Study Procedure
All the children attending eye OPD during the study period underwent routine ophthalmological examination including visual acuity recording, slit lamp examination and fundus examination. Retinoscopic examination was performed under dilatation. The eyes were dilated using homatropine eye drops administered 2-3 times at 10-15 minutes of interval, objective refraction was carried out and documented. Postcycloplegic refraction done after three days of dilatation and type of refractive error was noted.
For the analysis, children were divided into three groups- that are 5-8 years, 9-12 years and 13-16 years based on age. Diagnosis of myopia was made if Spherical Equivalent (SE) refraction was ≥0.5 Dioptre Sphere (DS) in one or both eyes. Hyperopia was diagnosed when SE was ≥+1.00DS and astigmatism when cylindrical power was ≥±0.5Dcyl in either eye.
Statistical Analysis
Data was entered in Microsoft excel. Descriptive statistics was expressed in form of number and percentages. Inferential statistics was calculated using Open Epi version 3.01. Chi-square was used as test of significance and p-value <0.05 was taken as statistically significant.
Out of 1582 children who attended ophthalmological OPD, 22.18% (351) children (5-16 years of age) were confirmed to have refractive error and were included in the study. The mean age of participants was 12.52±2.87 years. The refractive errors were more common in the age group 13-16 years (61.5%) and the least were seen in the age group of 5-8 years (8.51%) (p-value=0.34). The refractive errors were more in males (56.12%) as compared to females (43.87%) (Table/Fig 1). Out of 351 participants, 247 (70.37%) had refractive error in both the eyes whereas 104 (29.6%) participants had refractive error in one eye.
Of all the refractive errors, astigmatism was most common (50.14%) followed by myopia (40.45%). Maximum patients of astigmatism were seen in age group of 13-16 years (56.25%) and least in 5-8 years (9.65%). Similarly, myopia and hypermetropia was common in age group of 13-16 years. Amblyopia was also common in older age groups (Table/Fig 2). Among clinical types of astigmatism, myopic astigmatism was seen in 139 patients (39.60%) and compound astigmatism was detected in only five patients (1.42%) out of total refractive error. Further analysis of data revealed that there was male predominance in certain type of refractive errors like myopia, hypermetropia whereas myopic astigmatism was seen more in females of age group 9-12 years as compared to males in that age group. Otherwise, astigmatism was more common in males (52.84%) as compared to females (47.15%). Out of 7 amblyopic patients, 5 (71.42%) were females (Table/Fig 3).
Uncorrected refractive error and its consequences have profound effects on the overall development of children, most importantly on educational and psychological development (7). In India, though many efforts have been put forth, there is still a big burden of visual impairment due to refractive errors (9). It can be because of shortage of resources and insufficient facilities especially in rural areas (10). In present study, the mean age (±Standard deviation) of study population is 12.52±2.87 years. The frequency of refractive error was 22.18% in participants Kerkar S et al., and Biswas J et al., also reported 24.28% and 23.67% of refractive error among children, respectively in their studies (4),(11). Both the results are comparable with current study. Higher prevalence in their studies could be due to the fact that these were hospital-based studies. Moreover, refractive error constituted 22% of ocular morbidity in a study by Gupta M et al., which was attributed to the urban setting of the population (12). The present study also calculated a higher frequency of refractive errors which can be due to the fact that this is hospital-based study and moreover, it is recently converted from district hospital to associated hospital, New Government Medical College, Kathua. It is the first tertiary hospital for the district Kathua and all nearby villages. This could have added available medical facilities for the population. Higher prevalence can be due to lack of awareness among parents to detect them earlier. However, low prevalence rates were found by Aggarwal D et al., (5.20%) and Pavithra MB et al., (7.03%) in their studies (13),(14). Much variation in prevalence of refractive errors has been reported from abroad like 21.1 % by He M et al., 9.4% by Yared AW et al., and 11.6% by Kawuma M and Mayeku R, (15),(16),(17). Such a variation in prevalence of refractive errors in different part of India as well as other countries can be attributed to different socio-economic class, different race, gender, geographical area and type of study population.
Higher percentage of refractive error is found in the age group of 13-16 years (61.5%) and lowest in age group of 5-8 years (8.5%) in present study. It was observed that there is an increase in the overall percentage of refractive errors with advancing age which is consistent with the studies done by Pavithra MB et al., and Shakeel T and Mittal SK, (14),(18). Among study participants, overall refractive error was more common in males i.e., 197 (56.12%) as compared to females i.e., 154 (43.87%). However, the frequency of refractive error was more common in females in the age group of 5-8 years in the present study. Similarly, Padhye AS et al., and Sriram C and Raj J, also found in their studies that boys had higher risk of uncorrected refractive error (19),(20) whereas Naimi S et al., and Pavithra MB et al., showed more female preponderance for refractive errors (7),(14). In current study, most common refractive error found was astigmatism (50.14%) and followed by myopia (40.45%) and then hypermetropia (7.4%). It was comparable with the results found by John DD et al., in their study where astigmatism contributed 60% of refractive error as compared to myopia which constituted about 40% (21). Results of current study were also comparable with the study conducted by Hazarika HN et al., which reported astigmatism as most common refractive error (55% of total) followed by myopia (34% of total) and then hypermetropia (11% of total) (22). Based on clinical types, myopic astigmatism was more common in this study. Higher frequency of astigmatism in the present study can be related to frequent itching due to high incidence of allergic conjunctivitis in this dry and dusty area which needs further evaluation. Astigmatism was found out to be common in the age group of 13-16 years (56.2%) and the least was seen in the younger age group (9.65%). Similarly, myopia was more common in 13-16 years of age group (68%) and was least in 5-8 years of age group (6.30%). Though there was no association between age of students and frequency of refractive errors. Pavithra MB et al., and Triveni C et al., also found high prevalence of refractive errors in older age groups (14),(23). Higher prevalence of myopia among older age groups can be related to certain factors like increase in literacy rate and increase in duration of study hours and change in lifestyle as concluded in previous studies (19),(24).
Limitation(s)
The major limitation of the study is that it was hospital-based.
The present study indicates that children are at high risk for developing refractive errors. Such a high percentage of refractive errors in hospital-based study indicates that school health services should be strengthened and implemented effectively. Periodic screening in school and in preschool should be carried out to detect refractive errors as early as possible, corrective measures may be recommended at the earliest time possible. Teachers, parents and various stakeholders should be educated regarding eye healthcare, so that childhood visual impairment and blindness can be avoided. High frequency of astigmatism was found in this study which require further research on factors associated with it.
DOI: 10.7860/JCDR/2023/59150.17766
Date of Submission: Jul 18, 2022
Date of Peer Review: Sep 27, 2022
Date of Acceptance: Jan 03, 2023
Date of Publishing: Apr 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. No
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