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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
Original article / research
Full Version
The Study Of 50 Cases Of The Foreign Body Of The Tracheobronchial Tree
Correspondence Address :
goyal D K
Background and Aim.: The lower respiratory tract extends from the vocal cords to the
bronchus. Any type of foreign body can accidentally lodge at this site and it can become a life
endangering emergency. This study was done in the region of Bikaner, Rajasthan, where the
people are involved in the farming of peanuts and watermelon, and their children are prone
to the inhalation and the lodging of peanuts and the seeds of watermelon in the respiratory
tract. The adults and the elderly are used to chewing supari and they keep supari in their
mouth while sleeping. So, they are prone to the inhalation and the lodging of supari in the
respiratory tract.
Material and Methods: This is a prospective study which has been done on 50 cases of
foreign body lodging in the respiratory tract. The patients who had symptoms of respiratory
distress, stridor, the intercoastal retraction of the muscles and a history of chocking,
underwent clinical examination of the chest for unequal air entry. Chest X-ray and rigid
bronchoscopy were done in these patients. These patients were classified according to their
age incidence, gender, rural/ urban status and the type of foreign body and its location.
Results: The minimum age of the patients was 1.5 years and the maximum age was 75 years.
78% patients were males and 22% patients were females, while 83% patients were from rural
areas and 17% were from urban areas. The most common type of foreign bodies which were
lodged, were peanuts, followed by supari, watermelon seeds, stones and balloons. The
commonest location of lodging was the right bronchus.
Discussion: The bronchus is the commonest location for foreign body lodging in Bikaner due
to the life style of the people in that place. The people of this region grow peanuts in their
farms and their children are prone to choking by the lodging of peanuts in their bronchus.
The adults and the elderly are used to chewing supari and they keep supari in mouth during sleeping.
foreign body, bronchus, trcheobronchial tree
The upper respiratory tract is involved in food intake and respiration. During deglutination, the larynx prevents the entry of food particles into the trachea, whose sole function is respiration.
Any accidental entry of a foreign body into the trachea can cause a chocking sensation and a cough reflex can remove it. But in small
children, the habit of eating while playing can cause the inhalation of foreign bodies and in adults, this happens due to bad habits like
keeping the supari in the mouth while sleeping.If the foreign body gets lodged in the larynx, the trachea or the main bronchus, it can cause complete anoxia which can cause the death of the patient in three minutes before the patients can reach the hospital. But in most of the cases,the foreign body gets impacted in one side of
bronchus. These types of patients have complaints of cough, dyspnoea, respiratory distress and the intercoastal retraction of the
muscles. On examination, these types of patients are found to have unequal air entry. The chest xray shows the collapse of the lung. These types of patients have to undergo rigid bronchoscopy
and the removal of the foreignbodies have to be done. This procedure is life saving and there iscomplete resolution of symptoms.
This study was a prospective study of 50 cases of suspected foreign bodies in the bronchi of the patients. They underwent rigid bronchoscopy and their results were analyzed according to the
type of foreign body, age incidence, the side of the bronchus, gender and rural/urban status. The equipments which are required for rigid bronchosopy are bronchoscopes of various sizes from 4mm to 8mm, peanut forceps, cup forceps and suctions of various sizes, light sources and fibro-optic cables.
Out of the 50 cases, 30 cases (60%) were of peanut lodging, 10 (20%) cases were of supari lodging, 6 (12%) cases were of watermelon seed
lodging and 1 (2%) case each of balloon, gram and stone lodging and growth. In 38 (76%) cases, the foreign body was lying in the right
bronchus, in 10 (20%) cases, it was lying on the left side and in 1 (2%) case each, it was lying in the trachea and the larynx. 48 (96%) patients were children in the age group of 1.5-10 years and 2 (4%) were of the elderly age group above 70 years. 43 (86%) cases are males and 39 (78%) cases are rural cases.
In our study on 50 cases of foreign body lodging, the maximum number (60%) of patients had peanut as the foreign body. In most of the
cases, the foreign body lay in the right bronchus (76%). 96% of the cases were in the age group of 1.5-10 years. Most (86%) of the patients were males and most were from rural areas (78%). This finding is consistent with those from the study conducted by Gulati S P.Groundnut was found to be the commonest type of foreign body which was lodged in the tracheobronchial tree in Northen India (1).
Burten E M et al in their study in USA, noted that 2/3 of the patients were males, which is comparable to the results of the present study (2). Tokar B et al (Turkey) also observed that
the most common type of foreign body which was lodged in the tracheobronchial tree was of vegetable origin i.e seeds or peanuts like in the present study (3). As in this study, Ibrahim Sersar S et al also observed in a study in Egypt,that a majority of the patients were in the age group of 3-10 years and mostly, the foreign body
which was lodged was of vegetable origin (4).Mohamad AA studied 20 cases of foreign body lodging in the tracheobrochial tree at Mali and
reported that 90% of the patients were children.In 75% cases, the foreign body was of vegetable origin, which was comparable to the results of our study. But the male patients in his study were only 55%, which was in contrary to those found in the present study (86%) (5). Asif M et al, did a study on 81 patients of foreign body
lodging in the tracheobronchial tree and reported that most often, groundnuts were found to be the foreign bodies which were lodged (55.6%)and the age incidence for this was found to be 93.8% in the group of 1-15 years (6). These results were comparable to those found in our study. Mahafza T and Khader Y studied 524 cases of foreign body lodging in the tracheobronchial tree and found that the most common site for foreign body impaction was the right bronchus (60.9%) and that the male to female ratio was 3:2, which was in contrast to that found in our study. The right bronchus was found to be involved in 76% of the cases and 86% of these were males (7). Fennira H et al studied 31 cases of foreign body lodging in the
tracheobronchial tree and reported that 74% of those were males and that in 55% of the cases,the right bronchus was the site of lodging (8).Cataneo AZ studied 164 cases of foreign body lodging and found that 57% of those were males and that 84% were under the age of 15 years (9).
On the basis of the tracheobronchial anatomy, an
inhaled foreign body is more likely to enter the
right bronchial tree than in the left, in children of all ages. However, the variability in the position of the carina with respect to the mid-trachea may explain why this right-sided preference is less marked in children as compared to adults (10).To prevent delayed diagnosis, characteristic symptoms, signs and radiological findings of FBA should be checked in all suspected cases.
As the clinical and radiological findings of FBA in the delayed cases may mimic other disorders,the clinician must be aware of the likelihood of FBA. Regardless of the radiological findings,
bronchoscopy should be considered in patients with an appropriate history (4). Foreign body inhalation is one of the life threatening
emergencies. It may happen at any age:however, most of these accidents occur in children, especially in those below the age of
five years. Foreign body inhalation is more common in male patients, mostly below five years of age. Chocking is the commonest
symptom and decreased air entry on auscultation is the typical examination finding. Peanuts have been found to be the commonest type of foreign body (6). We conclude that a negative history,
clinical examination and chest x-ray do not necessarily exclude aspirated foreign body material. Bronchoscopy is the most effective
diagnostic and therapeutic modality which can be used to prevent the complications which are related to neglected foreign body aspiration. In addition to children, teenagers and adolescents
are also not immune to this problem. We recommend an early referral to an appropriate hospital on suspicion of any lodging or if the
symptoms persist. However, preventive measures remain the best means of protecting these children (11). In our opinion, rigid
bronchoscopy is a relatively safe procedure and it should be carried out in children whenever symptoms like persistent cough, chest infection or stridor persist despite proper antibiotic therapy (12). We emphasize the necessity to promote preventive measures by informing all parents and physicians on the risks of foreignbody aspiration. Early diagnosis can save much trouble in children (8). In addition to providing more information and education on the
prevention of laryngotracheal and bronchial foreign bodies, better management requires the better training of the medical personnel and the improvement of the technical facilities (13). In general, small, round crunchy foods pose a risk of choking. Since prevention is the most essential key to deal with these types of injuries,
more efforts in the public education of the caregivers is warranted. Foreign body aspiration is difficult to diagnose in children. Misdiagnosis as asthma and respiratory infection can delay the
treatment, which may cause intrabronchial granuloma (14). We therefore suggest early bronchoscopy in all suspicious cases. Parents
should be cautious when giving peanuts and watermelon seeds to their children.
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