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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
Management of Post-traumatic Arthritis (Chronic Foot Pain) with Ayurvedic Intervention: A Case Report
Correspondence Address :
Dr. Sheetal Uttam Roman,
Professor and Head, Department of Kriya Sharir, Dr. D.Y. Patil College of Ayurved and Research Centre, Sant Tukaram Nagar, Pimpri, Pune, Maharashtra, India.
E-mail: sheetal.roman@dpu.edu.in
Post-traumatic arthritis accounts for 12% of osteoarthritis cases, with conventional management focusing primarily on symptomatic relief. The present case demonstrates significant effectiveness of integrated Ayurvedic management in chronic post-traumatic foot pain with the combination of internal medications and Jalaukavacharana (leech therapy) addressing both local and systemic aspects, offering a promising alternative for managing chronic post-traumatic arthritis. A 35-year-old male presented with chronic left foot pain, stiffness, and cold sensitivity persisting for 2.5 years following an accidental fall. Conventional treatments provided only temporary relief. Clinical examination revealed plantar tenderness, restricted foot movements, morning stiffness, and Visual Analogue Scale (VAS) pain rating of 8/10 with dorsiflexion limited to 10°. Based on Ayurvedic diagnosis of vatarakta, the patient received oral medications (Kaishor Guggulu, Amrutadi Guggulu, Eranda Taila, and Guduchi decoction) and Jalaukavacharana (leech therapy) on the ankle joint. After 1.5 months of treatment, complete symptom resolution was achieved with VAS decreasing to 0/10, elimination of morning stiffness, improved dorsiflexion to 20°, normal walking without pain, and no cold sensitivity. The successful outcomes highlight the potential of traditional Ayurvedic approaches in addressing complex musculoskeletal conditions.
Guggulu, Leech therapy, Pain, Stiffness
A 35-year-old male presented to the Ayurveda Outpatient Department (OPD), with chronic left foot pain, stiffness, and symptoms aggravated by cold exposure following a stair fall 2.5 years prior resulting in a left foot sprain. Despite conventional treatments with topical medications including diclofenac ointment, oral Non Steroidal Anti-Inflammatory Drugs (NSAIDs), and 15-day ultrasound therapy under physiotherapist supervision, he experienced only temporary relief. The patient denied family history of arthritis or autoimmune conditions. Symptoms worsened in cold weather, mornings, and after prolonged walking, making his occupation as a supervisor in hospitality industry requiring moderate standing and walking increasingly difficult.
Clinical Findings
The patient presented with mild swelling in the left foot without visible deformity or colour changes on inspection. Palpation revealed tenderness in the plantar region with normal local temperature and pain on deep palpation. Range of motion assessment showed restricted foot movements with pain during dorsiflexion and plantarflexion, with dorsiflexion limited to 10°. The patient reported morning stiffness that gradually improved throughout the day. Pain was rated at 8/10 on the VAS. On laboratory investigations, complete blood count results were within normal limits, while Erythrocyte Sedimentation Rate (ESR) was slightly elevated at 28 mm/hr and serum uric acid levels were at 6.8 mg/dL. Rheumatoid factor tested negative. X-ray of the left foot revealed no significant abnormality.
Assessment and Diagnosis
The primary causative factor was an accidental fall from stairs, and aggravating factors included cold weather and physical exertion. Post-traumatic arthritis triggered by acute trauma. It evolves into chronic Post-Traumatic Osteoarthritis (PTOA) or Post Traumatic Arthritis (PTA) when initial symptoms persist beyond six months post-injury (1). This denotes primary vitiation of Vata (vyana vayu) with secondary Kapha involvement, affecting the rakta, mamsa and kandara, while disrupting the raktavaha and mamsavaha srotas. Based on trauma history, chronic symptoms and elevated uric acid, the condition was diagnosed as Vatarakta with vitiated Vata-Rakta-according to Charaka samhita Vatarakta is a condition induced by Vata and Rakta dushti , where blocked Vata (Avarana by vitiated Rakta) results in shoola (pain), daha (burning), shopha (swelling), and raga (discoloration) in extremities and inflammatory symptoms (2). According to Sushruta Samhita, Abhighata (trauma/injury) causes Rakta dushti and Vata aggravation, which results in inflammatory tissue destruction (3).
Therapeutic Intervention
The management was divided into two phases.
Phase 1: External Therapy: Jalaukavacharana (Leech Therapy) performed on the next day: Blood-letting therapy was performed on the left ankle (Table/Fig 1).
After disinfecting the area, two leeches were applied to the ankle joint surface and later removed using turmeric powder. Approximately, 70-80 mL of blackish blood was extracted, indicating Vata predominance in Ayurvedic diagnosis. Post-procedural care was done once the leech was removed it was stimulated to regurgitate the sucked blood by applying turmeric powder at its oral end. After that the leeches were cleansed by immersing them in turmeric water for disinfection. After this process, the leeches were placed in fresh water. Meanwhile, at the bite site, haemostasis was achieved, the wound was properly cleaned, and a sterile dressing was applied using a gauze impregnated with turmeric. The patient was advised to keep the limb elevated for some time and to avoid straining at the site.
Phase 2: Internal Medications (Table/Fig 2): All the medications were started on the 2nd day the leech therapy was done.
The patient showed significant improvement with the prescribed treatment regimen (Table/Fig 3) (4).
The patient experienced improvement in the symptoms of pain, movement, stiffness, mobility was enhanced as mentioned in (Table/Fig 3) over a period of one and half month. After the course of treatment (Table/Fig 4), there was a noticeable decrease in swelling over the lateral area of the ankle, indicating a significant clinical improvement. The soft-tissue prominence has clearly diminished, indicating that the affected area’s oedema or inflammation has effectively resolved. This progress is a result of the ongoing healing process and the favourable therapeutic response.
Currently, the patient is having no complaint and no reoccurrence of the symptoms.
The present case demonstrates the successful management of chronic post-traumatic foot pain using an integrated Ayurvedic approach. The direct correlation of symptoms of post-traumatic arthritis with that of Vatarakta provided the basis for the treatment protocol.
Jalaukavacharana (leech therapy) played a pivotal role in managing this condition. Its therapeutic efficacy is attributed to bioactive salivary components such as hirudin, hyaluronidase, bdellins, and eglins, which exert analgesic, anti-inflammatory, anticoagulant, and vasodilatory effects through complementary mechanisms (5). Hyaluronidase enhances tissue permeability and microcirculation, while hirudin inhibits thrombin and platelet aggregation (6). Evidence from systematic reviews supports these mechanisms; a meta-analysis of randomised controlled trials demonstrated significant reductions in knee pain, improved physical function, and decreased joint stiffness in osteoarthritis patients by leech therapy (7). Another meta-analysis confirmed meaningful pain relief and functional improvement following leech therapy (8).
The Vatarakta management principle given in samhita involves Snehana, Virechana, Srotoshodhana (channel purification), and Raktaprasadana (blood purification). The two important formulations from Bhaishajya Ratnavali that are recommended in Vatarakta Chikitsa are Kaishor Guggulu and Amrutadi Guggulu. Guggulu (Commiphora mukul), Guduchi (Tinospora cordifolia), and Triphala are the main ingredients in both preparations; Guggulu is the most effective medication for treating Medavruta Anila (Kapha-obstructed Vata) because of its Anabhishyandhi, Snigdha, and Sroto Shudhikaraka (9).
Kaishor Guggulu, as referenced in Bhaishajya Ratnavali (Vatarakta Rogadhikara), additionally contains Triphala, Guduchi, Vidanga (Embelia ribes), Trikatu (Shunthi, Pippali, Maricha), and Danti (Baliospermum montanum)- a Rookshana and Tikshna combination that reduces pathological Kapha and Meda accumulation in the srotas, while the Ushna and Tikshna constituents of the formula act as potent Srotoshodhaka, restoring normal channel patency (9). Kaishor Guggulu was selected for its anti-inflammatory, analgesic, and Raktashodhaka properties. Its key constituent, guggulsterone from Commiphora mukul, suppresses NF-κB activation by inhibiting IκBα phosphorylation, thereby reducing Cyclo-Oxygenase-2 (COX-2) and other pro-inflammatory mediators (10). A 2022 review further confirmed NF-κB pathway inhibition across multiple models (11). Amrutadi Guggulu (Bhaishajya Ratnavali, Vatarakta Adhikara), wherein Guduchi constitutes the dominant ingredient, leverages the dual Tridoshahara and Vataraktanashaka property (12),(13). Tinospora cordifolia in Amrutadi Guggulu tablet the formulation provides synergistic immunomodulatory effects by downregulating COX-2, Inducible Nitric Oxide Synthase (iNOS), and Janus Kinase/Signal Transducer and Activator of Transcription (JAK/STAT) signaling, along with pro-inflammatory cytokines such as Interleukin-6 (IL-6), Tumour Necrosis Factor Alpha (TNF-α), and Vascular Endothelial Growth Factor (VEGF) (14). Clinical studies have shown significant improvement in pain, swelling, and function with Kaishor Guggulu, supporting its therapeutic utility (15).
Eranda Taila (castor oil) was included for its Vatashamaka and Amapachana properties it is classically indicated in Vatarakta and other diseases arising from Vata vitiation. Ricinoleic acid, its active component, activates EP3 prostanoid receptors, enhancing intestinal motility and facilitating toxin elimination (16). Experimental studies also demonstrate its analgesic and anti-inflammatory effects, comparable to capsaicin, via modulation of neurogenic inflammation (17). This dual systemic and local action supports its use in Ama-related and Vata-Rakta disorders.
Guduchi (Tinospora cordifolia) decoction was used as an adjuvant for its anti-inflammatory and immunomodulatory effects. Studies show suppression of IL-6, TNF-α, Prostaglandin E2 (PGE2), and Nitric Oxide (NO), along with downregulation of COX-2, iNOS, and JAK/STAT signaling (13). It also reduces cytokines such as IL-1β, TNF-α, IL-6, and IL-17, preventing joint and bone damage in arthritis models (18). Transcriptomic evidence indicates modulation of Th17 cell responses, explaining its role in autoimmune inflammation (19).
A case study similar to the symptoms was found but the line of treatment differed by the internal medications and the external applications of oil massage and Poultice which also provided relief (20). This single case study limits generalisability due to individual variations. Future research requires randomised controlled trials, large-scale diverse population studies, and evidence-based integrative approaches comparing Ayurvedic and conventional treatments.
The present case report demonstrates the significant effectiveness of integrated Ayurvedic management in chronic post-traumatic foot pain diagnosed as Vatarakta, achieving complete symptom resolution within 1.5 months where conventional treatments had failed over 2.5 years. The combination of Jalaukavacharana (leech therapy) with specific herbal medications effectively addressed both local and systemic aspects of the condition, with marked improvements in pain, range of motion, and functional ability.
Ethical Consideration: Written informed consent was obtained from the patient for Jalaukavacharana (leech therapy) and for publication of the present case report.
Authors’ contribution: SSB: Conceptualisation, writing, visualisation, editing; MMT: Conceptualisation, study design, resources, review; SUR: Supervision, Analysis.
DOI: 10.7860/JCDR/2026/86128.24393
Date of Submission: Dec 29, 2025
Date of Peer Review: Feb 21, 2026
Date of Acceptance: Jun 21, 2026
Date of Publishing: Sep 01, 2026
Author declarati on:
• 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: Feb 12, 2026
• Manual Googling: Jun 13, 2026
• iThenticate Software: Jun 17, 2026 (1%)
ETYMOLOGY: Author Origin
EMENDATIONS: 7
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