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

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Dr Bhanu K Bhakhri

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Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
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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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"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."



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Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
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Professor and Head
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Saraswati Dental College
Lucknow
On Sep 2018




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Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




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Best regards,
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Muzaffarnagar Medical College,
Muzaffarnagar.
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,
"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.
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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 : October | Volume : 3 | Issue : 5 | Page : 1779 - 1783

Impact Of Ethnicity Upon Body Composition Assessment In Iranian Northern Children

VEGHARI G*, ASADI J**, ESHGHINIA S***

*,***Assistant Prof. of Nutrition, **Assistant Prof. of Clinical Biochemistry. Dept. of Biochemistry and Nutrition in Golestan University of Medical Sciences.(Iran).

Correspondence Address :
Gholamreza Veghari,Biochemistery and
Metabolic Disorders Research Center
and Golestan Cardiovascular Research
Center,Golestan University of Medical
Sciences -School of Medicine Gorgan
(IRAN)
Postal address: School of Medicine – Gorgan (IRAN)
Tel:+98-171-4421651 Fax:+98-171-4421289
E-maile :grveghari@yahoo.com

Abstract

Objective: This study was designed to determine secular growth among rural children between two ethnic groups (Sisstanish and Non-Sisstanish ) in north of Iran.
Methods: We chose 20 villages from 118 by cluster and simple sampling. All of 25-60 months old children in this area were considered in this study. Sample size was 1569 cases (632=Sisstanish and 937=Non- Sisstanish). Height, weight and personal identification were recorded by questioner. BMI percentile and under -1sd, -2sd and -3sd from NCHS were used for comparison. X2 test and T.test were used to analyze by software SPSS.
Results: Sisstanish children were 900 g lighter and 4.39 cm taller than non-Sisstanish among all of age groups. T.test is significant between two groups based on weight and height (P<0.05). Stunting and underweight were observed in Sisstanish group 23% and 5.9% respectively more than in non-Sisstanish by –2sd criterion. There is a significant difference between two groups by stunting (P<0.05). Overweight (1.52%) and obesity (12.4%) were shown in Sisstanish group more than in non-Sisstanish group and Statistical differences is significant between them based on obesity (P<0.05).
Conclusion: Secular growth in two groups is disproportionate and in Non-Sisstanish group is better than Sisstanish group. Sisstanish children suffer from severe height deficit and BMI high. Thereby, malnutrition is the most health problem in rural area in the north of Iran and nutritional intervention is necessary for solving these problems.

Keywords

Height, Weight, Children, Ethnic, Iran

Introduction
Human health depends on both genetics and ecological factors but second factors is more effective than the first one (1),(2).

World children suffer from Protein Energy Malnutrition (3) and UNICEF (4) reported that one-third of children were stunting in development countries in 2000. Obesity is another health problem in world (5). Several studies in different countries (6),(7),(8),(9) showed obesity trend increases in world. Some agents affect on obesity, sach as metabolic factors, low physical activity, high TV watching , computer playing, high calorie diet and high income (9),(10),(11),(12),(13),(14),(15) .

Growth monitoring is one of the important method to detect malnutrition and growth disorders in children (16).Anthropometry is universally applicable, inexpensive and non-invasive method. It is available to assess of the proportion of size and composition of the human body. It shows both health and nutritional status and it predicts performance of health and survival. Short stature and underweight causes disability. High BMI (Body Mass Index) percentile values in children can help us in identifying and selecting children at risk and in assigning the children who will probably suffer from overweight or obesity in adulthood. This health information can help those children who are at risk and them need close monitoring or intervention.

Several micronutrients such as zinc, iron, iodine, selenium, vitamin A, B12 and B9 take part as the ingredient of some enzyme, hormone and their activities. Lack of above nutrients can be effect on the bodies metabolism and physical growth trend (17),(18). Sayari (19) studies showed the high prevalence of malnutrition among Iranian children in 1996 and 1998. He reported that in comparison with 28 provinces, Golestan children’s weight and height were in the first and thirteenth rank, respectively.. There isn’t any concord between the trend of height and weight growth. Another study (20) showed that children suffer from stunting more than wasting in this region. Obesity in Iranian children is as a health problem, too (21).We carried out this study among 25-60 months age children in a rural area of Gorgan (Golestan province center). Gorgan district is a capital city and located in mountain–side in north of Iran and south east of Caspian Sea. The most of people living in this area are farmer and several ethnic groups living in this region. The main ethnic groups are: Fars(native), Turkman and Sisstani..of 9576 of people living in this area are 25-60 months age (22). Sisstanish people who had immigrated from south-east to north of Iran about 30 years ago. Due to the restriction in executing epidemiological projects, there was not any study on the secular growth differentiation between ethnic groups in this area up till now; therefore it was necessary to design a research project about it. The aims of this study is to examine the trend of secular growth , underweight , stunting and BMI status among 25-60 months age children between two ethnic groups.

Material and Methods

This study is a descriptive-crossectional that carried out in villages of Gorgan (North of Iran). Villages were chosen by cluster and simple sampling. We have chosen 20 villages from 118. All of the 25-60 months age children were chosen as a sample. Data was collected by health system staffs in this region. The number of samples was 1569 cases (632=Sisstanish and 937=Non-Sisstanish). Height, weight and birth date were recorded. Children’s height was measured in a standing posture without shoe and 4 parts of body (heel, scapula, back of the head) attached to the wall. The weight, without clothes and shoes, was measured with scales confirmed by WHO. Weight and Height were measured with o.1 kg and 0.1 cm accuracy (23). The collected data was complied and fed into computer and the Statistical Package for Social Sciences Package version 13, was used to analysis. The National Centers for Health Statistical (NCHS) (24),(25) standard was used for comparison the groups. Under 2 standard deviation (-2SD) from median of normal community (NCHS) computed as a start point of malnutrition (26,27) .Anthropometric Indexes in this study were defined following scale: Underweight: weight-for-age. Stunting: Height-for-age. BMI: weight-for –height square.

The BMI percentiles (28),(29) were used to classify subjects as follows: under weight, <5th BMI percentiles; healthy weight, 5th–84th BMI percentiles; overweight, 85th–94th BMI percentiles; or obese, ≥95th BMI percentiles.

In this study the ethnicity was defined as follow: Sisstanish ethnic group: This group have immigrated from Sisstan and Bluchestan province (Locate in South east of Iran) to this area are residing in a particular rural area. Non-Sisstanish ethnic group: People who are resided in this region since long time ago. Chi-2 test and T.test were used for comparison of frequency and mean of groups respectively. Statistical significance was defined as P-value <0.05.

Results

Sisstanish boys are 900 g lighter and 4.7 cm shorter than non-Sisstanish boys (Table/Fig 1) .The mean of BMI is more than in Sisstanish group (0.5 kgm-2). There is a statistical significant differences between two ethnic groups based on weight and height in all of age groups as well as for all boys ages combined. T,test is significant only in 37-48 months old based on BMI criteria.(P<0.05).

Sisstanish girls are 400 g lighter and 4.1 cm shorter than non-Sisstanish girls .The mean of BMI is more than in Sisstanish group (0.5 kgm-2). There is a statistical significant differences between two ethnic groups from 37 months age by weight and from 31 months based on height and BMI in 37-48 months age .(P<0.05).

Stunting in Sisstanish boys based on –1sd ,-2sd and -3sd is 36%,24% and 8.6.% more than Non-Sisstanish boys respectively and Chi-2 test is significant between two groups in all of criteria (P<0.05) (Table/Fig 2) .Underweight in Sisstanish boys based on –1sd ,-2sd and -3sd is 24%, 4.3% and 0.3% more than Non-Sisstanish boys respectively and Chi-2 test is significant between two groups in all of criteria (P<0.05).

Stunting in Sisstanish girls based on –1sd ,-2sd and -3sd is 35.6%, 24.6% and 10.6% more than Non-Sisstanish girls respectively and Chi-2 test is significant between two groups in all of criteria (P<0.05). Underweight in Sisstanish girls based on -1sd ,-2sd and -3sd is 27.3% , 7.2% and 0.8% more than Non-Sisstanish girls respectively and Chi-2 test is significant between two groups in -1sd and -2sd criteria (P<0.05).There is insufficient number about –3sd for x2 test by underweight.

BMI>95% in Sissnanish boys is 8.6% and BMI equal 85-94% is 3.4% more than non-Sisstanish. BMI>95% in Sisstanish girls is 14.4% and BMI equal 85-94% is 0.3% more than non_Sisstanish .Statistical differences is significant between two groups based on BMI>95% (P>0.05)(Table/Fig 3).

Discussion

Stunting and underweight are two health problems among northen children of Iran. They suffer from stunting more than underweight. Overweight and obesity are others problems in this area. Other researchers reported under and over nutrition in their studies (30),(31),(32),(33).Sayri (19) study on the under 5 years old children among 28 provinces in Iran showed that Golestan province has the 1st and 13th ranks by weight and height growth respectively. Shykholeslam (34) and Rounaghi (35) founded trace elements deficiency in some areas of Iran. Prevalence of malnutrition in Sisstanish group is higher than Non-Sisstanish group. Other studies (33),(36),(37),(38) showed that ethnic groups in a community have nutritional variety together. Several factors, like culture, economy, literacy, food habit and poor health can effect on nutritional situation in an area (32), (33), (38).

Mean of weight and height of Sisstanish children is lower than Non-Sisstanish but obesity in Sisstanish group is higher than Non-Sisstanish. Danubio (39), Freedman (40) and Ogden (8) in United States reported the difference in prevalence of obesity among ethnic groups. Wickramasinghe (41) in his study showed that genetic factors effect on secular growth and we should consider them in anthropometry. Rush (42) recommended using FFM (Free Fat Mass) instead of BMI in field study. Fredriks (43),(44) believes that separate Growth Chart is necessary for Moroccan and Turkish children that living in Netherlands.

The results of this study showed that Sisstanish children are overweight and obese, despite high prevalence of stunting. Further studies are necessary for growth monitoring with regard to ethnicity in this region. Several micronutrients, like zinc, iron, iodine, selenium, vitamin A, B12 and B9 take part in structure of some enzymes, hormones and their activities. Lack of mentioned nutrients can change the body metabolism and physical growth trend (17),(18),(45). Somatic growth in boys is better than girls. Others (46),(47) reported that prevalence of malnutrition in girls is higher than boys.

Finally, this study shows that underweight, stunting and obesity are as health problems among children in north of Iran. Various races have different nutritional problems. Nutritional status in non-Sisstanish group is better than Sistanish. With regard to high prevalence of under nutrition and high prevalence of obesity among Sisstanish children, BMI criteria doesn’t have an enough acceptability to determine obesity in population with height deficit. Although malnutrition resulting from height failure in Sisstanish children is higher than non-Sisstanish children ,but high prevalence of obesity among Sisstanish children is a question that we should answer it. We don’t know what causes this problem. We suppose that Sisstanish children are either genetically shorter in stature, malnourished or some combination of these factors when are compared to the non-Sisstanish children. These data show that comparisons of anthropometric measurements with an international standard, like NCHS standard, is only a part of the view that healthcare professionals and nutritionists must take. Local ethnic, genetic and other factors are also at play and need to be emphasized before proper healthcare measures can be under taken.

Acknowledgement

The outer would like to thank all the medical and administrative staff working in Primary Health Care Centers for their valuable assistance during the field study.

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