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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 prevalence of obesity and hypertension in urban Tamilnadu
Correspondence Address :
Manmohan Gupta
4/1-B, Next to Rotary Hall,
Sahadevapuram,
Salem (Tamilnadu)- 636007
Email: dr_manmohangupta@yahoo.com
Mobile no.: +919952661975
Background: Obesity and hypertension are undesirable outcomes of changing lifestyles and behaviours especially in traditional societies in many developing countries which have experienced rapid and unplanned urbanization. Objective: To know the prevalence of obesity and hypertension in an urban adult population of Salem, Tamilnadu.
Materials and Methods:
An observational cross-sectional study in the Salem town of Tamilnadu was carried out by using a predesigned and a pretested schedule. 10 hospitals of the Salem town were selected randomly, after making a list of all the hospitals. Every 10th adult patient was selected in the hospital OPD clinic, till the number reached 30 during a 2 week duration. Consent was taken before the study. 263 respondents (94 females and 169 males) were selected for the analysis out of 300 adults. The Epi Info software was used for the analysis. The Chi-square test, t test and the Pearson’s correlation tests were used for studying the significance.
Results: The age range was 18 to 85 years; the majority (79.8%) was above 35 years of age. The waist circumference (WC) was positively correlated with the body mass index (BMI) and the systolic blood pressure. Females had a significantly higher BMI value than the males. Based on the internationally recommended BMI cut-off points, 44.9% respondents were found to be pre-obese and 19.0% were obese. The estimated risk for the females to have an increased metabolic risk was 9.4 times that of the males. 60.8% persons had abdominal fat accumulation, based on the waist to hip ratio. 43.3% persons were hypertensive. A significantly higher proportion of males were severely hypertensive than the females.
Conclusion:
The females were at an increased risk of obesity, but the males were at increased risk of hypertension. Age was found to be a stronger risk factor for obesity and hypertension.
Obesity, Hypertension, Body Mass Index, Waist Circumference, Waist to Hip Ratio
Like many developing countries, India today faces the dual burden of the diseases caused by poverty as well as the diseases caused by affluence. Urbanization and the adaptation of the westernized life style is one of the reasons(1) for a rapid epidemiological transition. There is an increase in women’s employment due to economic pressure. The gainful employment of women which ensures an increase in the income, may lead to better nutrition for themselves(2),(3). Improved health facilities, increase in the income, availability of food and decrease in physical activity have contributed to this epidemic form of overweight and obesity, especially in the urban areas of the developed and the developing countries(4). With the rapid urbanization in recent years, there has been a boom in the consumption of fast foods in India which are the causes of obesity(5). The first adverse effects of obesity to emerge in the population in transition are hypertension, hyperlipidaemia and glucose intolerance while coronary heart diseases and the long term complications of diabetes, such as renal failure, begin to emerge several years later(6).
This study was a small effort to assess the obesity and hypertension in the urban population of Salem, one of the important towns of Tamilnadu, India.
An observational cross-sectional study in the Salem town of Tamilnadu was carried out by using a predesigned and a pretested schedule. 10 hospitals of the Salem town were selected randomly, after making a list of all the hospitals. Every 10th adult patient was selected in the hospital OPD clinic till the number reached 30 during a 2 week duration. Consent was taken before the study.263 respondents (94 females and 169 males) were selected for the analysis out of 300 adults.
A predesigned and a pretested schedule was used for obtaining the information, after taking the consent. The socio-demographic information as well as the information about the habits and addiction was collected. After the interview, blood pressure readings and anthropometric measurements (height, weight, waist circumference and hip circumference) were taken.
As recommended by a WHO Study Group(7), the blood pressure readings were taken from the right arm of all the patients in a sitting position. The Korotkoff sounds phase I (the pressure at which the sounds were first heard) were taken as the Systolic Pressure (SBP) and the phase IV sounds (the pressure at which the sounds were first muffled and then disappeared) were taken as the Diastolic Pressure (DBP). Based on the blood pressure measurements, the persons were classified(8) as Normal (SBP <130 mm Hg and DBP <85 mm Hg), High Normal (SBP = 130-139 mmHg or DBP = 85-89 mm Hg), Hypertension (HT) Stage I (mild HT with SBP = 140-159 mmHg or DBP = 90- 99mmHg), HT Stage II (moderate HT with SBP = 160-179 mmHg or DBP = 100-109 mmHg), HT Stage III (severe HT with SBP≥180 mm Hg or DBP ≥110mmHg).
The waist circumference (WC) was measured in centimetres at the midpoint between the lower border of the rib cage and the iliac crest. The hip circumference (HC) was measured in centimetres at the widest part below the iliac crest. Height was measured in centimetres by using a height measuring scale and weight was measured in kilograms by using a weighing machine. The body mass index (BMI) and the waist to hip ratio (WHR) werecalculated. Based on the WHO classification of overweight and obesity(9), the persons were classified as Normal (BMI = 18.5- 24.99), Pre-obese (BMI = 25-29.99) and Obese (BMI ≥30). Fat accumulation was considered if the WHR was >0.85 for females and >1 for males(10).
The persons were grouped according to the WC as No Risk (WC < 88 cm for females and < 102 cm for males) and Increased Metabolic Risk (WC ≥ 88 cm for females and WC ≥ 102 cm for males)(11).
The analysis was done with the help of the Epi Info software. Descriptive statistics, Pearson’s correlation, the Chi-square test, the odds ratio, the comparison of means (t-test) and the comparison of proportions (z-tests) were used as and when required, to find thesignificance. p values which were ≤ 0.05 were taken as the critical level of significance. 263 completely filled schedules were analyzed.
Out of 263 respondents, 35.7% were females and 64.3% were males. The age range was 18 to 85 years most of the persons (79.8%) were above 35 years of age.
With the Pearson’s correlation tests, age showed a significant positive correlation with WC (p < 0.01), HC (p < 0.05), SBP (p < 0.001) and DBP (p < 0.01). WC was positively and significantly correlated with HC (p < 0.001), Weight (p < 0.001), BMI (p < 0.001) and SBP (p < 0.05). Height had a significant positive correlation with WC (p < 0.01) and weight (p < 0.001).
The mean and standard deviations for the different variables are shown in (Table/Fig 1) .Females had a significantly higher BMI value than the males (p < 0.01).
A total of 155 (58.94%) patients were hypertensive or prehypertensive (having high normal blood pressure). Out of these, 63.2% were males and 36.8% were females. Males (12.4%) were significantly higher in proportion (z value: 2.2; p = 0.03) than the females (4.3%) among 25 (9.5% of 263) severe hypertensive patients (Table/Fig 2).
A significantly larger number of females had an increased metabolic risk than the males (p < 0.001) [Table/Fig-3]. The estimated risk for the females to have an increased metabolic risk was 9.4 times (odds ratio = 9.4; 95% confidence limit = 5.14-17.17) as compared to the males.
A significantly (p< 0.001) higher proportion of females (91.5%) had abdominal fat accumulation than the males (43.8%) [Table/Fig-3]. For the females, the estimated chance to have abdominal fat accumulation was 13.8 times (odds ratio = 13.8; 95% confidence limit = 6.30-30.23) as compared to the males.
63.9% of the subjects were found to be overweight (obese or pre-obese) and 19.0% were obese. The females (28.7%) were significantly higher in proportion (z value: 2.99; p = 0.0028) than the males (13.6%) among the obese persons (Table/Fig 3).
No female had substance abuse (alcohol and tobacco). Out of the 169 males, 9.5% were using tobacco alone, 17.7% were using alcohol alone and 26% were found to be using both tobacco and alcohol. As compared to these four groups of males (no substance abuse, only smoking, only alcohol, both), a significant proportion (p < 0.05) of females was found to have metabolic risk and abdominal fat accumulation.
In the present study, 300 subjects were interviewed and 263 (94 females and 169 males) were analyzed. Based on the BMI cut-off points,70.2% females and 60.4% males were found to be overweight (obese or pre-obese), whereas in a National Family Health Survey (NFHS-3)(12), it was found that 15.9% males and 23.5% females were overweight. A study from south India(13) showed that the prevalence of overweight was 22.3% among the males and 35.4% among the females.
In a study on the urban areas of Haryana, Tamilnadu, Assam, Maharashtra, Kerala and Delhi(14), 30.9% males and 38.7% females were found to be overweight. In all the studies, a significantly larger number of females were found to be obese than the males which is similar to the findings of the present study.
A study by Azadbakht L et al(15) showed consistent results with the present study, that obesity based on the BMI parameters and central obesity based on the WHR parameters were higher in women than in the men (67% women vs. 29% men for obesity and 93% women vs. 74.1% men for central obesity). But in a study on the urban Asian Indian population in Chennai(16), the prevalence of generalized obesity (based on BMI) was 45.9% (women: 47.4%; men: 43.2%, not significant), while that of abdominal obesity (based on WC) was 46.6% (women: 56.2%; men: 35.1%, significant difference). In another study by Hajian-Tilaki KO and Heidari B(17), the prevalence rates of obesity and overweight (based on BMI) were 18.8% and 34.8% respectively. The prevalence rate of central obesity (based on WC) was 28.3%. In both the genders, particularly in the women, the rate of obesity was increased by the increasing age. In the present study also, the WC (central obesity) was well correlated with age.
Waist circumference was a better anthropometric measurement than BMI to predict metabolic morbidities, at least in the older aged people, as WC was better correlated with SBP, weight and age in the present study. BMI was not well correlated with age and blood pressure. This finding is consistent with the observation of Mohan and Deepa(18), that abdominal adiposity which was assessed by using waist circumference was considered to be more appropriate to predict metabolic disorders than the generalized adiposity which was assessed by BMI.
Hypertension was present in 25% of the urban population of India, in a study by Gupta R(19). Mehta NJ(20) found that hypertension was 19.1% in the elderly population. But in the present study, 43.3% persons were hypertensive, which was much higher than that which was found in other studies. Ghose et al(21) found an association of body fat and fat distribution with blood pressure, as was found in this study. The WC was found to be positively and significantly correlated with SBP.
More females were at increased metabolic risk and having abdominal fat accumulation than the males, even though the males had substance abuse. But severe hypertension was seen more commonly in the males. Increasing age was a strong risk factor for the development of obesity and hypertension. The present studyshowed a higher prevalence of obesity and hypertension than that which was found in other urban areas of the country. Whether it is real or whether it is caused because of the differences in sample size and study design needs to be explored further by undertaking more studies which cover a larger population.
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