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

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Department of General Medicine,
Belgaum Institute of Medical Sciences,Belgaum, Karnataka,INDIA,
On 30 Nov 2018




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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
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On Sep 2018




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On Sep 2018




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On Aug 2018




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




Dr. Mamta Gupta,
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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

Important Notice

Original article / research
Year : 2009 | Month : June | Volume : 3 | Issue : 3 | Page : 1543 - 1547

Anthropometric Indices In Individuals Infected With Ascaris Lumbericoids In Iran

TAHERKHANI H*, SARDARIAN KH**, VAHIDINIA A**, RAJAEI S***, NAJAFI M**, ROSHANDEL G****

*(PhD), Associated professor,Dept of parasitology Golestan University of Medical Sciences.**(PhD), Hamadan University of Medical Sciences.***(MD), Golestan University of Medical Sciences.****(MD),Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences.

Correspondence Address :
Gholamreza Roshandel Number 77, Qabooseieh passage, Valiasr street, Gorgan, Golestan province,(Iran).E-mail: roshandel_md@yahoo.com

Abstract

Context: Ascaris Lumbericoids infection is more common in children and teenagers and in areas with poor sanitation or crowded living conditions. Largest of all the parasites inhabiting the human intestine it is also the most common of parasitic infections in developing countries. It has been reported to infect about one-fourth of the world population. Chronic ascariasis has been reported to adversely effect the growth rate and anthropometric indices in infected individuals of growing age.
Aims: The goal of this research was to evaluate the anthropometric indices in individuals infected with Ascaris in Hamedan province of Iran.
Settings and Design: This was a descriptive cross sectional study.
Methods and Material: Six hundred fourteen randomly selected individuals who were inhabitants of Hamedan province of Iran were chosen for this study. Stool samples of these individuals were collected and then experimented with Formel-Ether method to determine Ascaris Lumbericoids infection. Height and weight of these individuals were measured and compared with the indices related to NCHS. Demographic information of these individuals was entered into questionnaires and ultimately was analyzed with SPSS software.
Results: Out of the total study population, 16.5% of individuals were found to be infected with Ascaris. Out of the individuals infected with Ascaris, 1% were underweight. In the age groups of 6-10, 11-15, 16-20 years, 3.5%, 5.1% and 3.5% were found to be suffering from malnutrition, respectively.
Conclusion: Malabsorption in children might result in malnutrition. In this study, few individuals infected with Ascaris had malnutrition, thus Ascaris infection may not be an important cause of malnutrition among children in our area.

Keywords

Ascaris Lumbericoids, malnutrition, Anthropometric indices, Iran

How to cite this article :

TAHERKHANI H, SARDARIAN KH, VAHIDINIA A, RAJAEI S, NAJAFI M, ROSHANDEL G. ANTHROPOMETRIC INDICES IN INDIVIDUALS INFECTED WITH ASCARIS LUMBERICOIDS IN IRAN. Journal of Clinical and Diagnostic Research [serial online] 2009 June [cited: 2019 Sep 22 ]; 3:1543-1547. Available from
http://jcdr.net/back_issues.asp?issn=0973-709x&year=2009&month=June&volume=3&issue=3&page=1543-1547&id=534

Introductions
Most of the studies done in tropic and semi tropic regions of the world, clearly point towards an association between Protein-Energy malnutrition and the incidence of intestinal parasitic infections (1), (2). According to the estimates of year 1994, around 1471 million individuals around the world are reportedly infected by the intestinal parasite Ascaris (3). Current literature suggests Ascariasis to be the most common amongst the parasitic infections in developing countries (4). Chronic Ascariasis among growing children has been reported to adversely effect normal growth processes along with compounding the existing state of malnutrition, leading to inappropriate changes in the anthropometric indices of this group of children (5). According to some researchers, this parasite is responsible for disability in infected individuals and estimation of the amount of this disability is possible using Disability Adjusted Life Years (DALYs) index.

Aims and Objectives
The goal of this study was to evaluate the nutritional status using anthropometric indices as standard parameters amongst Ascariasis infected individuals living in Hamedan province of Iran.

Material and Methods

Fifteen out of 63 villages from central part of Hamedan were randomly chosen for the study. The cohort sample chosen from each village was in the same ratio as to the ratio of population of the individual village with respect to the total population of the fifteen villages chosen. Stool samples of the cohort population were collected and experimented by Formel-Ether method in the medical college of Hamedan. Weight of participating individuals was measured with precision of 100 grams with clothes and their length without shoes and with precision of 0.5 centimeters. Age of individuals according to records or as told was registered in questionnaires. For evaluating the nutritional condition of individuals between 2-20 years of age, anthropometric indices of weight for age (underweight index) length for age [nutritional shortness index: stunting], weight for length for [thinness index: wasting] and body mass index (weight/length) were used. For prediction of being underweight, nutritionally short and thinness the individual had to be under -2 SD the standard of length and weight of NCHS (recommended by WHO) (7), (8). For specifying thinness of individuals between 11-20 years of age, the weight for length standard of NCHS acted as a limitation, so the parameter of BMI for age was used (9), (4),(10). Individual being under 5th percentile of BMI for age and sex curve was used as a base for this purpose. For specifying over weight and obese individuals between 2-20 years of age, the BMI for age index was used (10). Being above 95th percentile was specified as obesity for this purpose (11). For evaluating nutritional status in individuals aged 21 years or more, BMI for age index was used. BMI of less than 18.5 was considered as protein-energy malnutrition [PEM], in the range of 25-29 was considered as being overweight and 30 or above was considered as obesity for this purpose (12).

The total population of the villages of central part of the Hamedan Province adds up to about 66,026. Six hundred fourteen individuals, who inhabited the area for at least 2 years duration, were chosen from 15 villages by cluster sampling method. Demographic details of each individual were obtained from family health files in health centers in these villages and entered in separate questionnaires.

Statistical Analysis
The data thus obtained was analyzed with SPSS software and with student t-test and chi-square test.

Results

The prevalence of Ascaris Lumbericoids in this study was 16.5%. The highest prevalence of this parasite was observed to be in the age group of 11-15 years [3.7%]. In the age group of 15 years or younger the parasite was found to infect 5.3% of the individuals. Out of all the individuals detected to be infected by Ascaris, 1% of them were found to be underweight with respect to their age. In the age ranges of 6-10, 11-15 and 16-20 years 3.5%, 5.4% and 3.5% of individuals were found to be suffering from mild and average malnutrition respectively.

Considering the data provided in (Table/Fig 1), it is observed that there is no significant difference between infected and non-infected individuals, in being underweight (P-value > 0.05). 12.8% of individuals infected with Ascaris were found to be underweight. (Table/Fig 2) depicts a statistically significant difference (P-value < 0.05) in being thin between infected (15.2%) and non-infected (11.6%) individuals. 21.3% of infected individuals were found to be short in height, but this was not found to be statistically significant in comparison to non-infected individuals (P-value > 0.05) (Table/Fig 3). Statistically significant difference in BMI was observed between infected and non-infected individuals (P-value < 0.05) (Table/Fig 4).

Discussion

Determining the effects of parasitic infections on occurrence of nutritional abnormalities [in infected individuals] is a necessary as they adversely effect public health (1),(2). Some researches show that Ascaris decreases intestinal absorption of nutrients in infected individuals (1). Suggested explanations for occurrence of this intestinal malabsorption include inhibitory effect of Ascaris, competition of parasite with host in absorption of nutrients and occurrence of some changes in normal histology of intestine (2). Additionally, reaction between behavioral factors and biological indices is also presumed to add to the state of malnutrition in individuals infected with this parasite.

Due to the mild nature and lower prevalence rate of Ascaris infection among the adults, most of the researches have been exploring the influences of chronic Ascariasis on growth and development of children. Ascariasis reportedly has negative influences on growth process in children (13), (15). This study reports mild to average malnutrition in various age groups. Prevalence of Ascaris in age group of 6-10 years was 1.1% and prevalence of malnutrition was 3.5%. Previous studies showed that Ascariasis is one of the main reasons of mal-nutrition (15), (16). Due to the multi-factorial etiology of mal-nutrition, it is not possible to single-handedly blame Ascariasis mal-absorption of nutrients in the digestive (12). But some researches do point towards a major role of Ascariasis in children suffering from mal-nutrition (17). Although children in this age group are more in infection with Ascaris especially its severe type (18), but quality of absorption of nutrients in this age range is better in comparison with adults (17). In this research it was specified that individuals infected with Ascaris are thinner than non-infected ones (P-value < 0.05). Some studies clearly indicate a relationship between infection with Ascaris and inappropriate growth of children (19), (20). But in some other studies this relationship was not observed [20, 21]. Individuals suffering from Ascariasis had a lower BMI index (P value < 0.05) as compared to the non-infected ones. This finding was similar to those of various other studies (22). Another similar study observed no remission in the nutritional indices of children after resolution of Ascariasis infection (23). But other studies report remission in nutritional indices of children just after treatment (24).

This study reports lower BMI and thinness indices for individuals infected with Ascariasis as compared to the non-infected ones. Some studies show that mild Ascariasis infections have no effect on intestinal absorption of nutrients (17). Conflicts exist among researchers regarding the determinant criteria for amount of severity of Ascariasis and reciprocate reactions between disease and nutritional factors (17). Some researches report improved growth rate among children suffering from co-existent malnutrition and Ascaris infection, after administration of anti-parasitic drugs [25, 26]. But some other researches do not show similar results (27).

Conclusion

Ascaris being the most common parasitic infection in developing countries (4) and due to its oft proven and considerable effects on public health [especially among children of growing age] (28), various controlling strategies have been studied (29). One of these studies report that single dose of anti-parasitic drugs can help cure patients and reduce environment infective resources (30). Controlling the infection in developing countries should be based on selection of appropriate treatment strategies that are adaptive with economic conditions and health policies (31).

Key Message

Ascaris infection may not be an important cause of malnutrition among children in our area.

References

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. World Health organization. Soil-Transmitted Helminthes, Report of a WHO Expert Committee on helminthiasis. WHO Report Series 1964; No. 277.
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. World Heath Organization. Control of Ascariasis, Report of a WHO Expert Committee, WHO Report series 1967; No, 379.
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. Chan MS, Medley GF, Jamison D, et al. The evaluation of potential global mortality attributable to intestinal nematode infections. Parasitology 1994; 109: 373-87.
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. World Health Organization. Physical status: the use and interpretation of anthropometry. 1995, Geneva: WHO.
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. Soekirma H, Hardinsyah J, Jus’at J, et al. Regional study of nutritional status of urban primary school children, West Jakarta and Bogar, Indonesia. Food Nutrition Bulletin 2002; 23: 31-40.
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. Tee ES , Khor SC , Ooi HE , Young SI , et al. Regional study of nutritional status of urban primary school children, Kuala Lumpur, Malaysia. Food Nutrition Bulletin 2002; 23: 41-47.
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. Centers for diseases control and prevention. National center for health statistics 2000. CDC growth charts for the United States: methods and development. Vital and Health Statistics 2002; Series 11, Number 246.
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. Must A, Dallal Ge, Dietz Wh. Reference data for obesity: 85th and 95th percentile of body mass index [wt/ht] and triceps skinfold thickness. Am J Clin Nutr 1991; 53: 839-46.
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. Cerf BJ, Rohde JE, Soesanto T. Ascaris and malnutrition in a Balinese village: a conditional relationship. Tropical and Geographical Medicine 1981; 33: 367-73.
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. Saldiva SR, Silveria AS, Philippi ST, et al. Ascaris-Trichuris association and malnutrition in Brazilian children. Paedatr Perinat epidemiol 1999; 1389-98.
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. Tripathy K, Gonzales F, Lotero H, et al. Effects of Ascaris infection on human nutrition. Am J Trop Med Hyg 1971; 20: 212-18.
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. Tripathy K, Gonzales F, Lotero H, et al. Malnutrition syndrome in ascariasis. Am J Clin Nutr 1972; 25: 1276-81.
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. Cornu A. Ascariasis and digestibility: A study in Cameroonian children. Available at: http://www.unu.edu/unupress/food/8f074e06.htm.
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