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
Red Cell Distribution Width and Platelet Indices in Women with Pre-eclampsia: A Cross-sectional Study
Correspondence Address :
Manuja Naik,
D/o Naga Naik, Mandibele Road, Vijayapura, Devanahalli Taluk, Bengaluru Rural-562135, Karnataka, India.
E-mail: manuja.naik05@gmail.com
Introduction: To determine the prognosis and fetomaternal outcome in eclampsia and pre-eclampsia, a simple and cost-effective approach is to assess the Red cell Distribution Width (RDW) and platelet count. RDW, Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and platelet markers such as Mean Platelet Volume (MPV) have been the subject of research.
Aim: To compare the variation of RDW, NLR, PLR, and platelet indices between women with pre-eclampsia and gestational age-matched healthy controls.
Materials and Methods: A cross-sectional study was conducted among 208 pregnant women (104 with pre-eclampsia and 104 controls) at the Department of Obstetrics and Gynaecology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India, from January 2020 to June 2021. RDW, NLR, PLR, and platelet indices were analysed after obtaining detailed history, conducting clinical examinations, and relevant investigations. An Independent t-test was used as a test of significance to identify the mean difference between the two quantitative variables.
Results: The RDW among cases was 17.05±4.01, whereas among controls, it was 15.09±1.86. The mean age of subjects among case group was 25.72±4.741 years, while in the control group it was 23.25±3.803 years. There was a significant difference in mean Red cell Distribution Width- Coefficient of Variation (RDW-CV) between the two groups. The MPV among cases was 9.86±1.14, while among controls, it was 8.92±1.40 (p-value=0.001). The PDW among cases was 11.30±2.20, and among controls, it was 12.72±3.50. The mean NLR among cases was 5.92±4.94, whereas among controls, it was 4.59±2.22. There was a significant difference in mean platelet count, MPV, PDW, and NLR between the two groups.
Conclusion: According to the findings of the current study, RDW, NLR, and MPV were all shown to be higher in women with pre-eclampsia. Additionally, pre-eclamptic women consistently exhibited decreased PDW and platelet counts.
Mean platelet volume, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio
Hypertensive Disorders of Pregnancy (HDP) are one of the leading causes of maternal and neonatal morbidity and mortality worldwide. The reported incidence of Pregnancy Induced Hypertension (PIH) in India ranges from 5% to 15% (1). These disorders form a deadly triad in conjunction with haemorrhage and infection, significantly contributing to maternal morbidity and mortality (2). To be defined as HDP, one of the following criteria has to be fulfilled American College of Obstetricians and Gynaecologists (ACOG) classification (3):
• Gestational hypertension: Two or more Blood Pressure (BP) readings of 140/90 mmHg or higher measured at least six hours apart after the 20th week of pregnancy in a woman who was previously normotensive without proteinuria.
• Pre-eclampsia (PE): Hypertension during pregnancy with proteinuria (2+ by dipstick, or >300 mg in 24-hour urine).
• Severe PE: Serum creatinine ≥1.1 mg/dL, platelet count <1 lac/L, liver enzymes >80 IU/L, BP ≥160/110 mmHg, blurred vision, headache, shortness of breath, epigastric pain.
Haematological parameters that may get deranged in some women with HDP include numerical and functional platelet anomalies such as platelet dysfunction and thrombocytopenia, as well as alterations in Haemoglobin (Hb) and erythrocytic parameters such as increased Haematocrit (HCT) and Microangiopathic Haemolytric Anaemia (MAHA). A limited number of studies have examined platelet indicators such as MPV, PLR, NLR, and RDW in pre-eclampsia (4),(5),(6),(7),(8),(9). Some investigations, particularly in patients with severe cases of pre-eclampsia (4), have revealed a statistically significant rise in NLR and MPV in this condition. Contrarily, a study by Toptas M et al., found no statistically significant differences in MPV or PLR between patients with severe pre-eclampsia and healthy pregnant or non pregnant controls (8).
Alterations in RDW and a decrease in platelet count are proportional to the severity of the disease. Assessing RDW and platelet count is a simple, cost-effective, and sensitive method to determine the prognosis and fetomaternal outcome in eclampsia and pre-eclampsia. Hence, the present study was conducted to compare variations in RDW, NLR, PLR, and platelet Indices between women with pre-eclampsia and gestational age-matched healthy controls.
This cross-sectional study was conducted from January 2020 to June 2021 in the Department of Obstetrics and Gynaecology at Bangalore Medical College and Research Institute, Begaluru, Karnataka, India. Ethical clearance was obtained from the Institutional Ethical Committee (BMCRI/PG/352/2019-20), and patients fulfilling the inclusion criteria were enrolled after obtaining informed consent. Based on a previous study by Gogoi P et al., the mean RDW in pre-eclampsia patients was reported as 17.14±2.7, while in the control group, it was 16.19±2.0 (4). The intended sample size was 192, but authors included 208 patients.
Inclusion criteria: Preeclamptic pregnant women aged 18 to 40 years, between 28 and 42 weeks of pregnancy were included in the study.
Exclusion criteria: Patients who were unwilling to provide informed consent, those with a history of ruptured membranes, anaemia, infections, fever, complete Haemolysis, Elevated liver enzymes, and Low Platelets (HELLP) syndrome, multiple pregnancies, eclampsia, and women with additional co-existing morbidities like diabetes, hypothyroidism, chronic hypertension, collagen vascular disease, renal disease, and ischaemia heart disease were excluded from the study.
Study Procedure
The diagnosis of pre-eclampsia was based on ACOG guidelines (2017) (3), which required a blood pressure of ≥140/90 mmHg on two occasions measured four hours apart after 20 weeks of pregnancy, along with any of the following features: thrombocytopenia, renal insufficiency, impaired Liver Function Test (LFT), pulmonary oedema, cerebral or visual disturbances. The control group included healthy pregnant women at similar gestational ages.
A total of 104 pregnant women diagnosed with pre-eclampsia according to ACOG guidelines were included as cases, while another group of 104 normotensive pregnant women were included as controls. Data was collected using a prestructured questionnaire that included patient personal data, medical history (noting the severity of pre-eclampsia symptoms such as blurred vision, upper abdominal pain, vomiting), obstetric examination, blood pressure measurement, urine albumin estimation using a dipstick test, and a 24-hour urine sample. Venous blood samples were collected from all subjects using 2 mL Ethylenediamine Tetra-Acetic Acid (EDTA) tubes. Complete Blood Count (CBC) was analysed using a Sysmex XN analyser. RDW, NLR, PLR, and platelet indices were analysed and compared.
Statistical Analysis
The data were analysed using Stastistical Packages for Social Sciences (SPSS) version 22 software. Categorical data were presented as frequencies and proportions, while continuous data were presented as means and standard deviations. An independent t-test was used as a test of significance to identify the mean difference between two quantitative variables. A p-value <0.05 was considered statistically significant.
The study group enrolled 208 women, with 104 women in the pre-eclampsia group and 104 gestational-age-matched healthy pregnant women in the control group. The mean age of women with pre-eclampsia was 25.7±4.7 years, while in the control group, it was 23.25±3.8 years (p=0.002). The mean haemoglobin levels in the study and control groups were 12.1±1.27 g/dL and 11.49±1.37 g/dL, respectively (p=0.005) (Table/Fig 1). Among the participants, 55 women had non severe pre-eclampsia, whereas 49 had severe pre-eclampsia. The mean NLR was higher in women with pre-eclampsia compared to women in the control group (5.92±4.94 versus 4.59±2.22; p=0.016).
The RDW in women with pre-eclampsia was 17.05±4.01, while in the control group, it was 15.09±1.86 (p=0.001) (Table/Fig 2). The NLR in non severe pre-eclampsia was 5.65±4.99, which was lower than the NLR in severe pre-eclampsia (6.22±4.93); however, the differences were not statistically significant (Table/Fig 3).
As presented in the present study, similar age, distributions were observed in studies by Bawore SG et al., and Kashyap D et al., where they reported 25 (20-36) years and mean age 26.22±3.64 years as the age of normotensive women, and 28 (18-37) years and mean age 25.35±3.59 years in pre-eclamptic women, respectively [10,11]. In the present study, the mean gestational age at admission was 37.1 weeks among cases and 38.4 weeks among controls. In the study by Kashyap D et al., the mean gestational age was 35.7±3.24 weeks among cases and 36.82±2.27 weeks among controls (11). Regarding parity, there was no significant difference between the two groups in the present study. In the study by Sachan R et al., most of the women were primigravida, with 39.2% in the control group, 61.8% in non severe pre-eclampsia, and 68.8% in severe pre-eclampsia (12). In terms of RDW, the mean RDW among cases in the present study was 15.64±2.08, compared to 14.91±1.64 among controls (11). These findings were similar to the present study. Sachan R et al., reported a mean RDW of 15.05±0.46 among NSPE, 15.05±0.46 among SPE, and 12.96±0.51% among controls, showing a significant increase in RDW among pre-eclampsia cases compared to controls (12). This finding aligns with the present study. It is speculated that inflammation may contribute to the elevated RDW levels in pre-eclampsia, as interleukin-6 levels rise due to inflammation, hindering erythrocyte maturation (4). Regarding platelet count, the mean platelet count among cases in the present study was 267±75.9 (109/L), while among controls it was 288±76.3 (109/L). There was a significant difference in mean platelet count between the two groups. Agrawal N et al., observed that the mean platelet count among cases was 280.4±80.4 (103/mm3) and among controls was 253.8±65.6 (103/mm3) (13).
In terms of MPV, the present study reported a mean MPV of 9.86±1.14 among cases and 8.92±1.40 among controls, showing a significant difference between the two groups. Kashyap D et al., observed that the mean MPV among cases was 12.19±1.38 and among controls it was 12±1.68 (11). In a person with a low platelet count, a high percentage of big platelets (high MPV) indicate that the bone marrow is actively manufacturing platelets and swiftly releasing them into the bloodstream. In contrast, the MPV may be low in persons with low platelet counts as a result of a bone marrow-related illness. The present study shows MPV is increased MPV in pre-eclampsia observed in the present study aligns with Giles et al., (14). However, a contrasting study suggested that platelet count and MPV cannot predict the risk of pre-eclampsia (4). Regarding PDW, the mean PDW among cases in the present study was 11.30±2.20, while among controls it was 12.72±3.50, showing a significant difference between the two groups. Kashyap D et al., also reported a similar finding in their study, with a mean PDW of 18.31±4.57 among cases and 18.66±4.38 among controls (11).
Limitation(s)
It was a single centre study. Multicentre studies are needed to confirm these findings. The cross-sectional study design does not allow for the determination of predictors of pre-eclampsia and the prognostic value of RDW and platelet indices in patients with pre-eclampsia.
The parameters RDW, NLR, and MPV were all found to be higher in pre-eclamptic women, according to the findings of the current study. Measuring RDW, NLR, MPV, platelet count, and PDW during prenatal follow-up may be helpful in predicting pre-eclampsia in high-risk women. Among the platelet indices, PLR was the only one that could distinguish between mild and severe pre-eclampsia.
DOI: 10.7860/JCDR/2023/63781.18405
Date of Submission: Feb 26, 2023
Date of Peer Review: Apr 27, 2023
Date of Acceptance: Jul 14, 2023
Date of Publishing: Sep 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: Mar 09, 2023
• Manual Googling: May 05, 2023
• iThenticate Software: Jun 12, 2023 (10%)
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