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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
Electrosurgery VS 40% Salicylic Acid in the Treatment of Warts
Correspondence Address :
Dr Sudhakar Rao K.M.
C-9 staff quarters, SN Medical College,
Bagalkot - 587101. Karnataka.
Phone: 9972315388.
E-mail: drkmsudhakarrao@gmail.com
Context:
Verruca Vulgaris is the common skin disease in dermatology practice. The clinical management of Verruca vulgaris is often challenging. Multiple modalities of treatment are currently existing, but none of them is singularly effective.
Aim:Comparative study between electrosurgery and 40% salicylic acid in the treatment of warts.
Settings and Design:
This is a randomized single blind prospective study.
Methods and Materials: The study was carried out for 12 months and it included 60 patients. Patients with genital warts, immuno compromised patients and pregnant females were excluded from the study.
Statistical Analysis Used:chi square test.
Results: There were 60 cases of warts. Electrosurgery was used in 30 cases with complete clearance in 27 cases. 40% salicylic acid was used in 30 cases with complete clearance in 5 patients.
Conclusions: Electrosurgery treatment in warts is the best when compared to 40% salicylic acid.
Warts, Electrosurgery, 40% Salicylic acid
Introduction
Warts are the common the viral infections that are encountered in dermatological practice, caused by DNA tumour virus that belong to family Papova viridae (1). Though there are many modalities in the treatment of warts, none of them is singularly effective in the treatment of all types, thus it is rightly acknowledged that treatment of warts is not merely a science but an art, the multitude of therapies that have been described so far and those which are undertrial reflect the imperfection and inadequacy of the existing modalities conforming the HPVs the title of ‘treatment nuisance’. Current treatments for verrucae involves destruction of the infected cells be physically or chemically damaging it and the decision regarding which treatment to use would depend on the size, location, number, type, age of the patient, risk of scarring and patients commitment to the therapy. Warts are benign epidermal proliferations that have been recognized for thousands of years (2). Until 19th century genital warts were believed to be a form of Syphilis or Gonorrhea (3). It was coined by Melnick in 1962 to denote a group of DNA viruses that comprises the papilloma, polyoma, and vacuolating viruses (3)
Study
Design Prospective randomized double blind study 60 consecutive patients with warts attending department of dermatology and venereology were subjects for the study. Sixty patients were randomly selected by envelope method. Study was done over a period of one year.
Inclusion Criteria Patients presenting with all morphological types of warts irrespective of age, sex and duration were included in the study.
Exclusion Criteria
Patients with genital warts, immunocompromised patients and pregnancy were excluded from the study. A detailed history regarding the age, sex, occupation, duration of disease, family history of disease was obtained. A thorough dermatological examination was done taking care to note morphology and distribution of warts. All cases were diagnosed by paring. Written consent was obtained from all the patients. Clearance from the special ethical committee was obtained for the study. The two modalities tried were: (a) Electrosurgery (b) 40% Salicylic acid Thirty cases were selected randomly under each group, each patient was followed up monthly for a period of six months and results were compared at the end of 6 months.
(a) Electrosurgery
Prior to the electrosurgery, the procedure was explained to the patient in detail to remove apprehension. The procedure was carried out in Minor-OT with adequate lighting. The operator and assistant wore mask to prevent exposure to smoke born microbes. Preparatory to electrosurgery, the lesion and surrounding skin was cleaned with povidine-iodine. Alcohol was not used because of the potential for alcohol to ignite with electrosurgery.1% lidocaine with epinephrine was used for local anaesthesia. The procedure was undertaken with the patient in lying down position. After removal of the wart, the base was again cauterized until bleeding stopped completely. The wound was dressed with sterile gauze. Follow-up was done every month for 6 months.
(b) 40% Salicylic Acid
The reagent was applied carefully avoiding normal skin using a sharpened matchstick for a period of 1 week and the patient was trained thus to do it at home. Occlusion was done over palms and soles. The lesions were treated for a period of 3 months or the disappearance of the lesions whichever is earlier. After the disappearance of the lesions, the patient was followed up every month for a period of 6 months The results were assessed as follows: “Complete clearance” is defined as total clearance of warts, with no evidence of residual warts. “Partial clearance” is defined as improvement in the number and or size of warts, but without complete eradication of warts.” No improvement” is defined as warts in which there is no reduction in number or size or worsened with treatment. All patients were followed-up monthly for a period of 6 months. Reappearance of warts, at the sites of earlier lesions during follow up was considered as “Recurrence”. Statistical Analysis Used:Chi Square test.
In electrosurgery group of 27 patients (90%) had “complete clearance”. Three patients had “recurrence” as shown in (Table/Fig 1) and (Table/Fig 2). In 40% Salicylic acid group 5 patients had “complete clearance”. Three patients had “recurrence”. In 20 patients there was “no improvement” and 2 had “partial clearance” as shown in (Table/Fig 3) and (Table/Fig 4). As per the statistical analysis electrosurgery treatment is superior to the 40% Salicylic acid treatment(P < 0.001)
Electrosurgery
In the present study out of 30 patients subjected for electrosurgery, there was “complete cure” in 27 patients (90%) and in 3 patients there was “recurrence”. Chang et al (4) in their study of 302 patients with warts, 11 patients were treated with electro-cautery. Eight patients had complete clearance (72.2%). As compared to above study, in the present study shows higher rate of complete clearance. This could be attributed to more number of patients in the present study. Alexander Berman (5) used electro-surgery for 2 patients with flat warts, found “complete clearance” in both patients. The above study had no recurrence in comparison to present study; this could be attributed to less number of patients in the above study. In the present study all types of morphological warts are subjected to Electrosurgery, while in the above study only flat warts are subjected to electrosurgery.Samuel K et al (6) used electrosurgery for 100 patients of condylomata, found complete clearance in 59 patients. Among them 41% patients had recurrence. In comparison to above study, the present study shows higher rate of complete clearance.The reason being all the patients in the above study had condylomata and in this study electrosurgery was done to all morphological types of warts except genitals.
40% Salicylic acid
In the present study, out of 30 patients in which 40% salicylic acid was utilized, there was complete clearance in only 5 patients. In 20 patients (66.6%) there was no response, 2 (6.66%) patient had partial clearance and in 3 patients (10%) there was recurrence. Haribhakti et al (7) found 40% salicylic acid applied daily was useful in few cases of warts and have also mentioned them to be more useful when combined with other agents. Sandipan Dhar et al (8) in his study of 100 patients of warts over hands and feet, complete clearance was seen in 82.1% of warts on hands, 46.7% of palmar warts, 54.5% of warts on feet, 84.2% of plantar warts and 57.1% of warts on hands and feet. Overall success rate was 70% with 16.5% salicylic acid and 16.5% lactic acid in flexible collodion. As compared to the above study, percentage of “complete clearance” in the present study is very less (16.6%). This could be attributed to lactic acid, flexible collodion in above study. Flexible collodion increases efficacy of salicylic acid in the above study. Chang et al (4) in his study of 302 viral wart patients, 13 patients were subjected to 17% topical salicylic acid. Out of 13 patients, 5 patients used it in combination with liquid nitrogen. Three of the patients showed complete clearance, 2 patients showed partial clearance, no response in two patients and 6 were defaulters. As compared to the present study, percentage of complete clearance in above study is high. This could be attributed to less number of patients, 2 patients applied liquid nitrogen, salicylic acid and increased number of defaulters for follow-up in above study. Bourke et al (9) in his study of 225 patients with warts 43%, 37% and 26% had complete clearance who were treated every 1,2 and 3 weeks respectively with combination of liquid nitrogen, 16.5% salicylic acid and 16.5% lactic acid in flexible collodion. As compared to the above study percentage of complete clearance is less in the present study. This could be attributed to additive effect of liquid nitrogen, flexible collodion, lactic acid in the above study and less number of patients enrolled in present study. Berth Jones et al (10) in his study of 300 viral wart patients, 57% and 62% had complete clearance from single freeze and double freeze technique respectively. Wart paint (16.5% salicylic acid, 16.5% lactic acid in flexible collodion was applied daily by subjects. As compared to above study, percentage of complete clearance in the present study is less. This could be attributed to liquid nitrogen, 16.5% lactic acid flexible collodion and more number of subjects are enrolled in the above study. Steele et al (11) his study of 57 patients with viral warts, 19(66%) of active treatment (60% salicylic acid and mono-chloroacetic acid crystals) had complete clearance compared with 5 of placebo group. 24 (83%) of the active group compared with 15(54%) of placebo group were cured after 6 months. In the present study percentage of “complete clearance” is less as compared to above study; this could be attributed to higher percentage of salicylic acid and mixing it with mono-chloroacetic acid crystals in the above study.
Warts or verrucae are one of the commonest conditions in dermatological practice.Though spontaneous cure is known in warts it is not possible to wait for the same. Though there are many modalities of treatment there is no specific treatment because the selection of modality depends on the size, location, type of lesions, chances of side effects and patient’s willingness to treatment.In view of the absence of a universally specific treatment many modalities of therapy exist and many remedies are added frequently. In the present study percentage of complete clearance is high in electrosurgery as compared to 40% Salicylic acid.As per statistics electrosurgery treatment is superior to 40% Salicylic acid treatment.
DOI: JCDR/2012/3495:1849
FINANCIAL OR OTHER COMPETING INTERESTS: NONE.
Date of Submission: Oct 24, 2011
Date of Peer Review: Dec 15, 2011
Date of Acceptance: Jan 05, 2011
Date of Publishing: Feb 15, 2012
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