Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
For authors, the manuscripts can be uploaded online through an easily navigable portal, on other hand, reviewers appreciate the systematic handling of all manuscripts. The way JCDR has emerged as an effective medium for publishing wide array of observations in Indian context, I wish the editorial team success in their endeavour"



Dr Bhanu K Bhakhri
Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dematolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


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

Important Notice

Case report
Year : 2009 | Month : December | Volume : 3 | Issue : 6 | Page : 1928 - 1930

Bilateral Thumb Replantation - A Case Report

KHANDELWAL S

MS (Gen Surg), M. Ch. (Plastic Surgery) (Asst. Prof.of GeneralSurgery) Department(s) and institutions:Department of General Surgery,Sri Aurobindo Institute of Medical Sciences Indore, Madhya Pradesh 453 111(INDIA)

Correspondence Address :
Dr Sharad Khandelwal, MS (Gen Surg)M. Ch.(Plastic Surgery) Assistant Professor,Department of GeneralSurgerySri AurobindoInstitute of Medical Sciences, Indore,SanwerRoad, Indore, Madhya Pradesh 453 111(INDIA)Phone No: + 91-731 -2591131(R), 0-9755880888(M)
E-mail: drskhandelwal@sify.com

Introduction
Bilateral thumb amputation is a very rare, serious and disabling injury. The literature has revealed only a few cases of bilateral thumb amputation (1), (2). Because of the importance of the thumb, as well as the possibility of achieving very high survival rate and best functional recovery, microsurgical replantation efforts of detached thumbs must be made (2), (5). The present report describes a case of bilateral thumb replantation with a brief review of literature.

Case Report

A thirty years old male was admitted to the hospital 4 hrs after the accidental amputation of both of his thumbs while working on a thresher machine. There were no associated injuries to other parts of the body, hands or fingers. He brought both of his amputated thumbs to the hospital, but they were not in an ideal condition. Local examination revealed that the amputation of both of his thumbs had occurred at the level of the base of the proximal phalange. Crushing effects could also be seen over the local soft tissues and they were more on the left hand. Both of his amputated thumbs showed avulsion injury along with avulsed tendons as well (Table/Fig 1) (Table / Fig 1a and 1b). After proper counseling and explanation about the prognosis and the outcome of the operation, bilateral thumb replantation using a microvascular surgical technique was done. First of all, bony fixation using K - wire was done, followed by microvascular repair of the digital arteries, veins, nerve and tendons and these were done using 8-0 and 10-0 sutures. Lastly, other soft tissues and skin were approximated in place. A similar procedure was done on the other thumb as well (Table/Fig 2)(Table / Fig 2a, and 2b). I preferred to replant the right thumb first as he was a right handed person. The total time taken for both thumb replantations was 8 hrs. The right thumb was replanted about 6 hrs after amputation and the left one was replanted 10 hrs after amputation.

His left thumb (replanted 10 hrs after amputation) developed signs of vascular compromise within 48 hrs of operation and needed re-exploration but it was a futile attempt and finally, on the 5th postoperative day, the left thumb was partially reconstructed over the viable bony stump using a groin flap. After 3 weeks, the groin flap was divided and the left thumb was reconstructed (Table/Fig 3)(Table / Fig 3a, 3b and 3c). Follow up done 3 months after the oper showed that the patient was able to perform about 80 percent of his work with his right thumb, namely; he was able to hold a pen, was able to drive a two wheeler, etc. The left thumb was also partially cosmetically acceptable to the patient.

Discussion

Bilateral thumb amputation is very rare, without involving other digits or hand (1), (2). Literature showed that there were only few reported cases of bilateral thumb amputation. Hou SM et al (1992) reported 2 cases of bilateral severance of thumbs as a case report (1). Soucacos PN, et al (1994) reported 3 cases of bilateral thumb amputation from a series of 71 patients with thumb amputations (2).

Replantation aims to restore the amputated part to its anatomical site, while preserving its function and appearance. In the past 200 years, successful the replantation of amputated digits has gradually moved from fantasy to reality. William Balfour performed the first successful fingertip reattachment in 1814 and Thomas Hunter ha got the credit for the first thumb replantation which he performed in the following year. With the development of the operating microscope by Julius Jacobson and Ernesto Suarez in the early 1960s, replantation became easier (3).

Replantation of digits and thumbs are a common practice (4), (5). Replantation has become the state of the art reconstruction for an amputated thumb with more than 90% chances of survival of the replant. Thumb replantation is associated with a very high survival rate regardless of the mechanism of injury or the level of amputation and should be attempted in all cases (5), (6). Re-explration for vascular compromise may be needed and in such conditions, an early re-exploration for vascular problems yields a high salvage rate and should be performed in all cases as and when needed (5) Even though replantation surgery has now become a routine procedure, it remains a delicate and demanding surgery which requires adequate training and expertise in microsurgical techniques. Well-defined selection criteria for replantation procedures have evolved over the past few years, including definitive guidelines for thumb, single digit, multiple digit and mid-palm amputations. For more complex cases, other techniques including transpositional microsurgery and various secondary reconstructive procedures such as toe-to-hand transfer are now available (7).

Most of the times, replantation of an injured / amputated thumb is not feasible in such conditions; toe / great toe / big toe - to hand transfer / thumb transfer may be considered as a reconstruction option in appropriately selected patients; this may be done immediately as one stage transfer or a delayed procedure with its own merits and demerits (7), (8), (9), (10). Another way to salvage an amputated thumb / digits is by temporary implanting the amputated part at an ectopic location (forearm, groin, axilla, foot, etc), followed by its replantation to its anatomic site as a second stage replantation procedure (11), (12). Temporary ectopic implantation of amputated parts provides an alternative procedure for the salvage of the amputated thumbs when associated with extensive soft tissue damage in which immediate replantation is not feasible (11), (12).

Because of the importance of the thumb, and also as thumb replantation is associated with a very high survival rate regardless of the mechanism of the injury or the level of the amputation and the possibility of achieving the best functional recovery; microsurgical replantation efforts of the detached thumbs should be attempted in all cases (1), (2), (5), (6). The present case showed the best results of right thumb replantation, while the left thumb which was replanted later, had longer ischaemia time which might havebeen the cause of the failure of the replant and needed re do operations.

References

1.
Hou SM, Liu TK. Bilateral severance of thumbs: report of two cases. J Formos Med Assoc. 1992; 91:90-3.
2.
Soucacos PN, Beris AE, Malizos KN, Touliatos AS. Bilateral thumb amputation. Microsurgery. 1994; 15:454-8.
3.
Langdorf Mark I, Kahn J Akiva. Replantation: eMedicine Specialties > Emergency Medicine > Trauma and Orthopedics. Updated: Sep 14, 2009Available from: http://emedicine.medscape.com/article/827648-overview
4.
Cheng GL, Pan DD, Qu ZY, Lin B, et al. Digital replantation. A ten-year retrospective study. Chin Med J (Engl). 1991; 104:96-102.
5.
Sharma S, Lin S, Panozzo A, Tepper R, et al. Thumb replantation: a retrospective review of 103 cases. Ann Plast Surg. 2005; 55:352-6.
6.
Rosson GD, Buncke GM, Buncke HJ. Great toe transplant versus thumb replant for isolated thumb amputation: critical analysis of functional outcome. Microsurgery. 2008; 28:598-605.
7.
Soucacos PN. Indications and selection for digital amputation and replantation. J Hand Surg Br. 2001; 26:572-81.
8.
Yu Z, Huang Y. Sixty-four cases of thumb and finger reconstruction using transplantation of the big toe skin-nail flap combined with the second toe or the second and third toes. Plast Reconstr Surg. 2000; 106:335-41.
9.
Feng C, Liu M, Feng P. Bilateral three-toe transplantation with dorsalis pedis flap and first web space flap for damage injury in the hands. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2005;19:525-7 [Article in Chinese]
10.
Ray EC, Sherman R, Stevanovic M. Immediate reconstruction of a nonreplantable thumb amputation by great toe transfer. Plast Reconstr Surg. 2009; 123:259-67.
11.
Graf P, Gröner R, Hörl W, Schaff J, et al. Temporary ectopic implantation for salvage of amputated digits. Br J Plast Surg. 1996; 49:174-7.
12.
Li J, Ni GH, Guo Z, Fan HB, et al. Salvage of amputated thumbs by temporary ectopic implantation. Microsurgery. 2008; 28:559-64.

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