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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
Letter to Editor
Full Version
Vomiting due to tramadol: a short report from the regional pharmacovigilance center, Western Nepal
Correspondence Address :
P.Subish M. Pharm, Assistant Professor, Department of Pharmacy / Pharmacology , Manipal Teaching Hospital/ Manipal College of Medical Sciences
Pokhara, Nepal. Email: subishpalaian@yahoo.co.in
Phone 00977-61-526420
Vomiting, Tramadol, Nepal
Tramadol is an atypical, centrally acting analgesic, having an inherent multimodal action on opoid receptors, as well as on noradrenergic and serotonergic receptors.(1) It is an effective analgesic in moderate, and in some cases, severe pain(2), and has a place in pain management, in patients who do not respond to simple analgesics, and in whom NonSteroidal Anti Inflammatory Drugs (NSAIDs) are contraindicated.(3) In comparative studies in postoperative and post trauma pain, 100 mg of tramadol given intramuscularly or intravenously, was equivalent to 5- 10 mg of morphine.(3) Unlike other opoids, tramadol is not usually associated with development of tolerance, physical dependence, or psychological addiction, and has a reduced incidence and severity of opoid adverse effects, particularly respiratory depression, ileus and constipation(1), (4)
However, it may increase risk of seizure in susceptible patients with a history of epilepsy, or patients on antiseizure drugs.(4) As with other opoids, nausea and vomiting remain as problems in tramadol too. In this short communication, the authors highlight on vomiting due to Tramadol, and narrate their experiences regarding the reports of vomiting due to tramadol.
The manipal Teaching Hospital (MTH) runs an Adverse Drug Reaction (ADR) monitoring program since September 2004. MTH is also recognized as the regional Pharmacovigilance center for ADR monitoring in the Western region of Nepal. Upon occurrence of an ADR due to a drug, it is reported to the Pharmacovigilance Center by Clinicians, Pharmacists and Nurses, by filling the ADR reporting forms. The ADR reports of tramadol induced vomiting received by the center till March 2006, are included in the analysis. The patient’s case records were also analyzed for detailed evaluation. The causality assessment was carried out as per the Naranjo algorithm. (5)
Altogether the center received a total of seven reports of vomiting due to tramadol during the study period. The details regarding the patients and the vomiting due to tramadol are listed in (Table/Fig 1).
Incidence of vomiting due to tramadol: The most frequent adverse gastrointestinal effects of tramadol are nausea (10% to 20%), and vomiting (3% to 9%). Vomiting has necessitated withdrawal of therapy in some patients(6),(7),(8). Nausea occurred in 24, 34 and 40% of patients, and vomiting occurred in 9, 13 and 17% of patients receiving the drug for up to 7, 30, and 90 days, respectively. Nausea and vomiting may occur more frequently with higher doses and following rapid intravenous injection. (9)
Clinical trials involving tramadol administration for up to 90 days in 550 patients, reported nausea in 24% to 40%, constipation in 24% to 46%, and vomiting in 9% to 17% of patients. Medical conditions and other medications were present in some cases. (10)
Causality assessment:
In order to prevent the occurrence of similar ADRs in the future, there is a need for establishing the causal relation ship between the drug and the ADR. Several scales are used to carry out the causality assessment. We used Naranjo algorithm, (5) one of the commonly used algorithms, to carry out the causality assessment. It is an algorithm that is used to categorize ADRs as possibly, probably, or definitely due to a certain drug. It is based on the score calculated on the basis of points given for each of ten questions that comprises the algorithm. On a scale of 13, if the score is greater than 9, then the adverse reaction is categorized as definitely caused by the particular drug. A score of (5-8) is categorized as probable, while a score of (1-4) is categorized as possible. We found that all the cases of vomiting had a ‘probable’ relationship with tramadol. We could not confirm the diagnosis, as we did not perform the rechallenge.
Management of vomiting due to tramadol:
Metoclopramide has been useful in treating nausea and vomiting due to tramadol administration. A slow titration schedule starting at 25 milligrams (mg) daily, then increasing by 25-mg increments every 3 days to a target daily dose of 150 mg (in 13 days) or 200 mg (in 16 days), was associated with a significantly lower incidence of discontinuation due to nausea and/or vomiting, as compared to a faster 10-day titration to 200 mg (22% versus 46%, respectively; p = 0.008 and 0.006, respectively) in a controlled study of subjects previously intolerant to tramadol.(6), (11)
Analgesic potency of tramadol:
In comparative studies in postoperative and post-trauma pain, 100 mg of tramadol given intramuscularly or intravenously was equivalent to 5–10 mg of morphine. However, in severe pain associated with either surgery or cancer, morphine was more effective than tramadol, and remains the drug of choice. In acute and chronic non-malignant pain, oral tramadol 100 mg is comparable to a combination of paracetamol and codeine (1000 mg/60 mg). There have been few direct comparisons of tramadol with non-steroidal anti-inflammatory drugs, but the efficacy appears to be similar. (3)
Conclusion
Our experience suggests that the decision to prescribe tramadol should not be a trivial one. Tramadol has a place in pain management for selected patients who have not responded to simple analgesics such as paracetamol or aspirin, and in whom NSAIDs are contraindicated. For most patients, a combination of paracetamol and codeine will be equally effective, and possibly better tolerated than tramadol. Prior to prescribing tramadol to a patient, one should keep in mind the gastrointestinal effects of tramadol, and also the other potential side effects such as increased risk of seizures etc.
Appendix 1- (Table/Fig 2)
The authors acknowledge Dr. Mukhyaprana Prabhu, Associate Professor, Department of Medicine, Kasturba Medical College, Manipal, Karnataka, India, for reviewing the initial version of the manuscript and suggesting modifications.
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