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
Comparison Of Povodine-Iodine Versus Savlon For Pre-Catheterization Cleansing And The Association Of Bacteriuria With Its Antibiotic Susceptibility In Catheterised Patients Of The Surgical Ward
Correspondence Address :
Dr Shobha K.L Professor Department of Microbiology
Melaka Manipal Medical College
Manipal 576104 E.Mail: shobhamicro@yahoo.com
Background:Urinary tract infection is one of the most common nosocomial infections, and urinary catheterization is the most frequent predisposing factor. Nosocomial infections associated with urinary catheters may increase the mortality rate upto three times. These infections also pose a considerable financial burden. Different methods for urinary tract infection prophylaxis have been proposed for patients who undergo continuous catheterization. This study compared the disinfection of the genital area with Povodine –Iodine or Savlon (Chlorhexidine and Cetrimide) before inserting the Foley’s catheter with respect to the quantitative results of the urine culture and sensitivity to commonly used antibiotics.
Methods:Hundred inpatients who underwent clean continuous catheterization with the Foley’s catheter post operatively in the surgical ward, were divided into groups ‘A’ and ‘B’.Group ‘A’ and group ‘B’ consisted of 50 patients each. Group ‘A’ patients were directed to use povodine –iodine as a disinfectant for pre-catheterization cleansing, and group ‘B’ was directed to use savlon. The control group included 50 post operative patients, those who were not on urinary catheters. The urine sample was collected shortly after the catheter was inserted, and the samples with no growth on the culture plate were only included in the study. Patients with a previous history of urinary tract infection or with growth on the culture plates collected from urine immediately after catheterization, and patients with congenital urinary tract anomaly, were excluded from the study. Catheter samples were collected using a sterile needle and syringe. Urine samples collected on the third and fifth day of catheterization were processed and considered to be culture positives if the count was >10(4) organisms per milliliter of urine. Midstream urine samples were collected from the postoperative patients without urinary catheters. Organisms were identified by conventional biochemical methods, and susceptibility to antimicrobial agents was tested by the Kirby-Bauer standardized disc-diffusion technique.
Results: 14% patients in group A and 16% in group B developed bacteriuria and candiduria by the end of the 5th day of catheterization. Females had higher rate of bacteriuria than males, following three days and five days of catheterization in both the groups (Group A female: male bacteriuria ratio on third day was 2(8%):1(4%) and on fifth day 4(16%): 3(12%).Group B female:male bacteriuria ratio on third day and fifth day were 2(7.62%):1(4.16%) and 5(19.23%:3(6.25%). None from group A and one from group B presented with symptoms. .Klebsiella species was the commonest organism isolated, followed by candida species and E.coli. Our study showed no significant difference between disinfecting with Povodine –Iodine or Savlon in the pre-catheterization cleansing procedure and the occurrence of bacteriuria..Microorganisms were sensitive to cephalosporins and amikacin, and were resistant to commonly used antibiotics like Trimethoprim-sulfamethoxazole, ampicillin and gentamicin. None of the controls had any bacteriuria.
Interpretation: Performing catheterization by a proper aseptic procedure using available disinfectants should be thought as a preventive measure, and use of appropriate antimicrobial drug therapy with developing drug resistance should also be considered during treatment.
Bacteriuria, urinary catheters, surgical ward
Introduction
Urinary tract infection (UTI) is one of the most common nosocomial infections(1)(2), and urinary catheterization is the most frequent predisposing factor(3) in eighty percent(1) of patients. In another study, all of the nosocomial urinary tract infections were associated with the (Foley’s) catheter. There is also a strong prevalence of UTI in catheterized females(5).In spite of a change from open to closed drainage systems, more than 30% of catheterized patients develop UTI[(2),(3),(4),(5),(6) but many remain asymptomatic(7). Nosocomial infections associated with urinary catheter may increase the mortality rate upto three times(7). These infections also pose a considerable financial burden(8).In the current study, comparison of Povodine-Iodine versus Savlon for pre-catheterization cleansing and the association of bacteriuria with duration of catherization were analysed . Causative organisms and their antibiograms for catheter associated bacteriuria in a surgical ward at Kasturba Medical College Hospital, Manipal, were studied.
Hundred inpatients in the age group of 19 years to 60 years, admitted to the surgical ward at Kasturba Medical College hospital, Manipal, were included in the study. A prospective study was conducted in the period from November 2005 to July 2006. The study group was divided into group ‘A’ and ‘B’. Consent was taken from the patients before the procedure, and the patients were divided into two groups. The first male patient was included in group ‘A’ and the second male patient was included in group ‘B’. Similarly, the first female patient was included in Group ‘A’ and the second female patient was included in Group ‘B’. No other criteria was considered in the division of groups. Our study did not include any blinding methods .Exclusion criteria in our study included patients with a history of urinary tract abnormalities, and patients with a history of previous urinary tract infection and the first urine sample collected immediately after catheterization showing significant bacteriuria. Group ‘A’ consisted of 50 patients with 25 females and 25 males, and group ‘B’ consisted of 50 patients with 24 females and 26 males. 50 patients with 25 females and 25 males in the age group of 18 to 60 years who underwent surgery, but were not on urinary catheters postoperatively, were the controls. Group ‘A’ Patients were directed to use Povodine –Iodine IP5% W/V ( Available iodine 0.5% W/V) (Wockhardt limited ,Aurangabad , India), and group ‘B’ was directed to use Savlon 1% ( Chlorhexidine IP 0.75% and cetrimide IP 0.15%, Isopropile alcohol IP 0.04% , purified water QS ) (Kasturba medical college pharmacy,Manipal,India) for pre-catheterization cleansing. Male patients were injected 2ml of 2% lidocaine jelly into the urethral meatus before inserting the Foley’s catheter, and for female patients, the Foley’s catheter was lubricated with lidocaine jelly before inserting the catheter. Urine cultures and urine analysis were carried out immediately after catheterization on the third day and fifth day of insertion of the catheter, with a total of 3 samples from each patient. Catheter samples were collected by using a sterile needle and syringe, and the urine was processed and considered culture positive if the count was >10(4) organisms per milliliter of urine .Urine samples were refrigerated immediately after collection, and were kept for no longer than an hour before being plated with a calibrated loop onto blood agar, CLED medium and MacConkey’s agar. The plates were incubated at 370 C aerobically, and were read after 24 hours of incubation. The presence or absence of bacteria or fungus, the number of colonies, and the isolated types were identified according to the conventional biochemical methods described by Weaver and colleagues(9). Susceptibility to antimicrobial agents were tested by the Kirby-Bauer standardized disc–diffusion technique(10) . Mueller-Hinton agar (Hi-Media,Mumbai ,India) was used for the inoculation of readymade antibiotic discs(Span Diagnostics,Surat,India) .The density of the organisms was adjusted to approximately 10(8) colony –forming units by comparing its turbidity with that of 0.5 Mc Farland opacity standard. Control strain E.coli ATTC 25922 was used in the antibiotic discs quality control. Zones of complete growth inhibition around each of the discs were carefully measured. The interpretation of zone size into susceptible or resistant was based on the Kirby- Bauer interpretation chart. The inclusion criteria were that patients with their urine samples collected and inoculated into culture plates shortly after the catheter insertion, and those showing no growth on the culture plates, were only included in the study. Patients with a previous history of urinary tract infection, those with growth on the culture plates after they were inoculated with urine collected immediately after catheterization, and patients with a history of urinary tract abnormality, were excluded from the study.
A prospective study of hundred inpatients divided into groups ‘A’ and ‘B’, with 50 patients in each group, were included. Females had higher rate of bacteriuria than males, following three days and five days of catheterization in both the groups. None from group A and one from group B presented with symptoms. Females had higher rate of bacteriuria than males following three days and five days of catheterization in both the groups. (Table/Fig 1) The most common organism isolated was Klebsiella species in both males and females, followed by Candida species , E.coli and other organisms ( 3 strains, each organism had only one strain each and it was grouped as others) (Pseudomonas species 1, Citrobacter species 1, Coagulase negative staphylococcus species 1 strain).[Table/Fig1] .
Mid stream urine collected from the control group, when processed, did not grow any organisms on the culture plates. Organisms isolated were sensitive to cefotaxime and amikacin.Most of the strains were resistant to ampicillin,and Trimethoprim-sulfamethoxazole (Table/Fig 2)
Our finding showed that 14% of patients in group A using povodine –iodine, and 16% in group B using Savlon as disinfectant for pre-catheterization cleansing, developed bacteriuria . The number of cases of bacteriuria increased with the longer duration of catheterization. This study was in concordance with the study conducted by Kunin CM and Stamn WE et al(11)(12) The study conducted by Stamm WE et al , Coropeti EA et al , Shoefr AJ et al and Hilton P et al, showed that more than 30% of patients developed catheter associated bacteriuria(2),(3),(4),(5),(6). A study conducted by Garibaldi et al showed that risk of bacteriuria increased by 5% for each additional day the catheter is in situ(11) . Our study showed an overall 15% bacteriuria which was in concordance with the study conducted by Raz R et al (12) , who had 12.3% patients having bacteriuria in the surgical ward .There was correlation between duration of catheterization and occurrence of bacteriuria (P<0.05)
14% patients in group A and 16% in group B had developed bacteriuria and candiduria by the end of the 5th day. None from group A and one from group B presented with symptoms. Platt R et al(7) and Paul A et al(13) in their study, found that more than 90% of the infected patients were asymptomatic. Our study also had the same findings .Out of 15 patients with bacteriuria, only one presented with symptoms. Group A on the third day, had 2 females and one male with bacteriuria, and on the fifth day, 4 females and 3 males presented with bacteriuria (Female: Male bacteriuria , 4:3). Group B on the third day had 2 females and 1 male with bacteriuria, and on the 5th day, 5 females and 3 males presented with bacteriuria ( Female:Male bacteriuria ,5:3). Females were more prone to develop bacteriuria than males.This study was in concordance with the study conducted by Hussain et al (14)and Jespen OB et al(5). Klebsiella species was the commonest organism isolated, followed by candida species and E.coli. Our study showed no significant difference between disinfecting with Povodine –Iodine or Savlon in pre-catheterization cleansing in preventing bacteriuria, probably because the number of cases of bacteriuria were very few . Microorganisms were sensitive to cephalosporins and amikacin, and resistant to commonly used antibiotics like Trimethoprim-sulfamethoxazole (TMP/SMX), ampicillin and gentamicin.
The results of this study showed no significant difference between the two disinfectants when compared, Povodine –Iodine or Savlon in pre-catheterization cleansing and the prevention of bacteriuria. Performing catheterization with proper aseptic procedure, using available disinfectants, should be thought as the preventive measure, and use of appropriate antimicrobial drug therapy with developing drug resistance should also be considered during treatment
1. Povodine –Iodine or Savlon in pre-catheterization cleansing and the prevention of bacteriuria.
2. Females had higher rate of bacteriuria than males
3. Klebsiella species was the commonest organism isolated from both groups
4. Microorganisms were sensitive to cephalosporins and amikacin.
- 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