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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Letter to Editor
Full Version
Development Of Post Tubercular , Bronchial Asthma –A Pilot Study
Correspondence Address :
Dr. Shetty Akhila .J. Associate Professor Department Of Pharmacology Kasturba Medical College, Manipal University,Light House Hill Road,Mangalore 575001,Email -shettyakhila@yahoo.com
Pulmonary impairment associated with obstructive airway disease is recognized as a common complication of advanced tuberculosis. Most patients suffering from tuberculosis with moderate to far advanced post treatment residual lung lesions exhibit symptoms of impaired pulmonary functions due to persistent airway obstruction but why do only a small proportion develop reversible airway obstruction to qualify for post tuberculosis bronchial asthma categorization? The present study was aimed to investigate if antitubercular drugs were involved in the pathophysiology of post-tubercular bronchial asthma. Asthmatic patients with past history of pulmonary tuberculosis who visited the hospital for treatment between Jan - Dec 2006 and 16 patients who had history of pulmonary tuberculosis and had successfully completed anti tubercular therapy but did not develop asthma were randomly chosen. During the study period there were 20 asthmatic patients with past history of antitubercular drug therapy. With 6 months of antitubercular therapy, 6 out of 20 pulmonary tuberculosis patients developed asthma (40%) and 9 out of 16 patients took 6 months of antituberculars but did not develop asthma (60%). p= 0.3, found not significant. With 8 months of antitubercular therapy, 14 out of 20 patients developed asthma (66.7%) and 7 out of 16 patients did not develop asthma (33.3%) . p= 0.5, found not significant. (Fishers test).
Conclusion : Anti tubercular drugs do not appear to play a role in the development of post tubercular bronchial asthma.
antitubercular drugs, posttuberculosis bronchial asthma.
Introduction
Tuberculosis is a global emergency needing aggressive control measures. Similarly bronchial asthma is a major global health problem affecting people of all ages. However, both these health problems do not reach peak of activity simultaneously due to different immunological mechanisms requiring Th 1 and Th 2 lymphocytes for mediating tuberculosis and asthma respectively. A proportion of pulmonary tuberculosis patients later develop asthma, after the enhanced Th l lymphocytes have been reduced to the normal level with anti-tuberculosis treatment (1). Co-occurrence of asthma and active tuberculosis is uncommon. Airway obstruction is one of the known complication / sequeal of tuberculosis (1), which on aggravation emerges as bronchial asthma.
Pulmonary impairment associated with obstructive airways disease is recognized as a common complication of advanced tuberculosis. Most tuberculosis patients with moderate to far advanced post-treatment residual lung lesions exhibit symptoms of impaired pulmonary functions due to persistent airways obstruction, but only a small proportion develop reversible airways obstruction to qualify for post- tuberculosis bronchial asthma categorization. Could the development of post tubercular bronchial asthma be related to antitubercular drugs?
The standard drugs used in treatment of tuberculosis are Isonicotinic acid hydrazide (H), Rifampicin ( R ), Streptomycin (S)and Pyrazinamide (Z ), these drugs are bactericidal. The bacteriostatic drugs are Ethambutol ( E )and Thiacetazone. The Reserve drugs are Capreomycin, Kanamycin, Amikacin and Fluoroquinolones which are bactericidal and Ethionamide, Cycloserine and clofazimine which are bacteriostatic (2).
But there are no reports on their toxicity on pulmonary system.
The study was conducted after approval from the institutional ethics committee. Data was collected and analysed in KMC Hospital Attavara after approval from the DMO / RMO and COO respectively.
Inclusion criteria:
1. Asthmatic patients as diagnosted by physicians using standard guidlings with past history of pulmonary tuberculosis belonging to category I / II and who had visited the hospitals for treatment between Jan - Dec 2006 (n=20).
2. Patients who had history of pulmonary tuberculosis, belonging to category I / II and had successfully completed anti tubercular therapy but did not develop asthma (n=16 randomly chosen).
Exclusion Criteria
Patients with irregular antitubercular treatment history.The hospital records of the patients who had bronchial asthma were analyzed retrospectively to check their anti- tubercular treatment history and 16 patients with past history of pulmonary tuberculosis and completed therapy and were sputum negative with no X Ray lung impairment and with no signs and symptoms suggestive of bronchial asthma were randomly choosen to serve as controls.
20 patients of ages between 35 –years developed post tubercular asthma between Jan-Dec 2006, male: female = 12 : 8 and 2 males were smokers ; 5 had family history of Asthma/allergy (25%). 19 patients (73%) had the first episode of asthma after stopping chemotherapy within 3 yrs. Among the 16 patients who did not develop bronchial asthma, male: female = 10: 6 and 3 males were smokers; 3 had family history of bronchial asthma (19%),. They were of ages between 38 –years (Table/Fig 1).
Fisher’s test was applied for statistical analysis. Level of significance was set at <0.05.
With 6 months of therapy, 6 out of 20 patients developed asthma (40%). 9 out of 16 patients took antituberculars for 6 months but did not develop asthma (60%). p= 0.3, found not significant. With 8 months of therapy, 14 out of 20 patients developed asthma (66.7%) . 7 out of 16 patients who took antituberculars did not develop asthma (33.3%) . p= 0.5, found not significant (Table/Fig 2).
For the year 2000 the burden of TB was 8.5 million (3). India accounts for nearly 30% of global tuberculosis burden annually (4). Post tuberculosis bronchial asthma is a separate clinical entity. The present study was conducted to observe if the development of post tubercular bronchial asthma was related to the anti tubercular drugs used by the pulmonary tuberculosis patients.
The mechanism of evolution of post-tuberculosis bronchial asthma is related to the immunopathogenesis of tuberculosis and bronchial asthma (5). The Th 1 and Th 2 sub-groups of T lymphocytes regulate development of tuberculosis and bronchial asthma and their levels are not enhanced simultaneously (5). The Th 1 lymphocytes preferentially produce and secrete IL-2 which stimulates T lymphocyte proliferation and Interferon –gamma formation. IFN-gamma in turn inhibits B cell activation and the resultant IgE synthesis. Thus IL-2 triggered pathway is responsible for the type IV hypersensitivity reaction (5),(6),(7). The Th 2 lymphocytes, produce and secrete IL-3, IL-4, IL-5, IL-9 and IL-13; the specific actions of these interleukins produce the characteristic inflammatory response of asthma (5),(6),(7).
The anti tubercular drugs do not seem to modulate the cell mediated immunity since the results of the study indicate that antitubercular drugs do not play a role in development of post tubercular bronchial asthma. The pathogenesis of development of post-tubercular bronchial asthma could be due to the retained cell mediated immunity to the possible presence of a few inactive M. tuberculi even after treatment.
Limitation of this study was its small numbers. It is hoped that following this larger data will be studied in the future.
Anti tubercular agents does not appear to play a role in the development of post tubercular bronchial asthma based on this pilot study but a larger data needs to be evaluated to answer this question.
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