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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 Overweight And Obesity Among Women In An Urban Slum of Chennai
Correspondence Address :
Anuradha R.
Assistant Professor, Department of Community Medicine,
Saveetha Medical College, Thandalam,
Kanchipuram (Dist.), Tamilnadu, India.
E-mail: dr.anuhems@gmail.com
Mobile: 09884959653
Context: Obesity and overweight are creating a global epidemic. They are the risk factors for many non-communicable diseases. Once considered as a problem which was related to affluence, obesity is now growing fast in many developing countries. The prevalence of obesity is on the rise among the slum population.
Aims:To find out the prevalence of overweight and obesity among women aged 20 years and above in an urban slum of Chennai. To identify the risk factors which were associated with overweight and obesity in the above study population.
Settings and Design: An urban slum in Chennai, a cross sectional study.
Methods and Material: The present study was undertaken in an urban slum in Chennai city, among women aged 20 years and above. One slum was selected randomly and the households in the slum were sampled by a systematic random sampling method. A pre-designed and pre-tested questionnaire was used to collect information regarding the socio-demographic profile, the diet pattern , the intake of vegetables and fruits, the duration of television viewing in a day and the duration of sleep at night of the study subjects. Anthropometric data regarding height andweight was also taken. WHO Asian Classification of the body mass index (BMI) was used to classify the study population.
Statistical Analysis: The analysis was done using the Statistical Package For Social Sciences (SPSS), version 11.5. The prevalence was expressed in percentage and the Chi square test was used to find association with the factors.
Results: In the study population, the prevalence of overweight (BMI ≥ 23) was 27.7% (95% confidence interval [CI] 24.3–32.2) and the prevalence of obesity (BMI ≥ 25) was 19.8% (95% CI 16.5–23.6). A significant association was noted between overweight/obesity and higher educational level, higher socio-economic status, inadequate fruit intake, an increased duration of television viewing and a sleep duration of < 7 hours and >9 hours per night.
Conclusion: There is a rising prevalence of overweight and obesity among the urban slum women. The prevalence of overweight and obesity was found to be significantly higher among the slum women with inadequate fruit intake , increased duration of television viewing and a sleep duration of <7 hours and >9 hours per night. The prevention is economical and easy at an early stage, with the change occurring in the form of lifestyle modifications at an individual level with increasing awareness.
Body mass index, Obesity, Overweight
Introduction
Obesity and overweight are creating a global epidemic (1).They are the risk factors for many non-communicable diseases. Rapidly changing diets and lifestyles are fueling the global obesity epidemic. Once being considered as a problem related to affluence, obesity is now growing fast in many developing countries (2). In Asian populations, the health risks which are associated with overweight and obesity occur at lower levels of BMI than in North America or Europe (3),and now lower cutoff points for BMI are used to categorize overweight and obese conditions for the Asian populations (4). According to the National Family Health Survey-3 (NFHS-3) in India, overweight and obesity are three times higherin urban areas than in rural areas and are more common among women (5). The burden of the slum population and the magnitude of their health problems are on the rise. There is a rising prevalence of obesity among the slum population (6).There are not many studies on the prevalence of overweight and obesity in the urban slums of South India and so, this present study was carried out in an urban slum in Chennai.
The present study was a community based, cross sectional study carried out in an urban slum in Chennai among women aged 20 years and above from June 2009–August 2009. Ethical clearancewas obtained. From 10 zones of Chennai, zone five was randomly chosen by a lottery method. There were 66 slums in zone five, from among which one slum was randomly chosen by a lottery method and the slum was located in division 67 in zone five.
The sample size of 520 was calculated on the basis of a 15.6% prevalence rate of obesity among the urban slum women in North India (6). Antenatal women were excluded from the study .
The selected slum had a total population of 9089. The total number of women aged 20 yrs and above was 3125 and the total number of households was 1958 (source – updated family register of the selected slum).
In order to select the 520 women who were aged 20 years and above, the number of households which had to be surveyed in the selected slum was =1958 × 520/3125 = 326 .
The households were sampled by a systematic random sampling method. The sampling interval was calculated as follows: total number of households in selected slum Sampling interval = = 1958/326 = 6. number of households to be surveyed in the selected slum
The houses in the slum were numbered. The first sample household was selected randomly by choosing a number (by a lottery method) within the sample interval. The next household was identified by adding the sampling interval with the first randomly chosen number. In the present study, the first randomly chosen number was 4, and the first household which was surveyed was house number 4. The second household was 4 + 6 = 10 i.e., the 10th household. The subsequent households were selected by the same method till the expected sample size was reached. Informed consent was obtained from the study subjects. A pre-designed and pre-tested questionnaire was used to record the information regarding the socio-demographic profile, diet pattern, frequency of weekly intake of vegetables and fruits, the duration of television viewing in a day and the duration of sleep at night of the study subjects. Socio-economic status was determined by the Modified Kuppusamy Classification Scale (7).
Anthropometric data regarding height and weight was also taken. The weight of the respondents was measured by using a portable weighing machine. The individual was requested to stand still on the platform of the weighing machine, with the body weight evenly distributed between both the feet. Light indoor clothing was allowed to be worn, but the footwear was removed when the weight was measured. The scale was zeroed before weighing and it was also calibrated regularly during the study. The height was measured by using a portable stadiometer. The persons whose height had to be measured, stood in an erect position without any footwear and they were also asked to put their feet together and to look straight. The measuring tip was lowered to the head and the height was measured .
The body mass index was calculated as weight (in kilograms) ÷ [height (in meters)]2. The World Health Organisation (WHO) Asian Classification of BMI (4) (Table/Fig 1) was used to classify the study population.
The data entry was made in excel software in codes and the analysis was done by using the Statistical Package For Social Sciences (SPSS), version 11.5. The prevalence was expressed in percentage and the Chi square test was used to find the association with the factors.
In this study population, the prevalence of overweight (BMI > 23) was 27.7% (95% CI 24.3–32.2) and the prevalence of obesity (BMI > 25) was 19.8% (95% CI 16.5-23.6) (Table/Fig 2) .
Most of the overweight / obese women (42.7%) belonged to the age group of 30 to 39 years (Table/Fig 3). 42.2% of the women with a higher secondary level of education and above and 29.3% of the illiterate women were overweight/obese. A highly significant difference was noted between educational status and overweight/ obesity (p< 0.001) (Table/Fig 4) . As the socio-economic status increased, the prevalence of overweight/obesity was also found to increase and the difference was found to be statistically highly significant (p <0.001) (Table/Fig 5). There was no significant association between overweight/obesity and factors like occupation, religion, marital status and the type of family (Table/Fig 6).
No significant association was noted between the prevalence of overweight/obesity and the dietary pattern of the participant as far as a vegetarian and a mixed diet was concerned (p > 0.05), buta significant difference was noted between the fruits intake and overweight/obesity (p = 0.005) (Table/Fig 7).
There was an increase in the prevalence of overweight/obesity with an increase in the duration of television viewing and the difference was found to be highly significant (p < 0.001) (Table/Fig 8). The prevalence of overweight/obesity was 51.7%, 23.8% and 50% among those who had <7 hours, 7 to 9 hours and >9 hours of sleep per night respectively and the difference was found to be statistically significant (p=0.006) (Table/Fig 9).
The study was carried out in an urban slum of Chennai, to find out the prevalence of overweight and obesity among women aged 20 years and above. The prevalence of overweight was 27.7% (95% CI 24.3–32.2) and the prevalence of obesity was 19.8% (95% CI 16.5–23.6) . This was higher than the prevalence of obesity which was estimated by Misra et al (6) in females in an urban slum population in North India, which was 15.6% .
The prevalence of overweight/obesity was highest (42.7%) in the age group between 30-39 years and there was no significant association between the prevalence of overweight/obesity and age. Misra et al (6) found that there was a significant increasing trend in the prevalence of obesity with advancing age.
42.2% of the women with a higher secondary level of education and above and 29.3% of the illiterate women were overweight// obese. This was similar to the NFHS-3 (5) where the prevalence of overweight/obesity was higher among women with 12 or more years of schooling than among those with no education. A highly significant difference was noted between educational status and overweight/obesity. Shukla et al (8) also found a positive association between education and BMI.
In the present study, as the socio-economic status of the women increased, the prevalence of overweight/obesity was also found to increase and the difference was found to be statistically highly significant. Similarly, in urban Chennai, Mohan et al (9) reported a 20% prevalence of overweight/obesity among men and women who were aged 20 years and above and those who belonged to the low socio-economic group, while the middle socio economic group had a higher prevalence of overweight/obesity (35%) during the 1996-97 study.
No significant association was found between overweight/obesity and factors like occupation, religion, marital status and the type of family.
In the present study, no significant association was noted between the prevalence of overweight/obesity and the dietary pattern. Vadera et al (10) also reported that though overweight people were more in the group which consumed a mixed diet than in one which was strictly vegetarian, the difference was not statistically significant.
It was observed that overweight/obesity was more prevalent among those who consumed fruits less frequently and the difference was found to be statistically significant, but no significant association was found between vegetable intake and overweight/obesity. Many studies have shown the inverse association between fruit intake and overweight (11). In a study, the dietary patterns associated with a high intake of fruits and vegetables among Spanish adults were found to reduce the long-term risk of subsequent weight gain and obesity (12). Ledikwe et al. (2006), in their study on US adults, found that persons with a high fruit and vegetable intake had the lowest prevalence of obesity (13). Fruit consumption was found to have a significant negative relationship with the body weight status in all the age groups in men and women (14).
There was an increase in the prevalence of overweight/obesity with an increase in the duration of television viewing and the difference was found to be statistically highly significant . In a study conducted in North India, women who regularly watched television were found to be much more likely to be overweight and obese (15).
The prevalence of overweight/obesity was 51.7%, 23.8% and 50% among those who had <7 hours, 7 to 9 hours, and >9 hours of sleep per night respectively and the difference was found to statistically significant. Chronically reduced sleep times are associated with obesity (16). Patel et al found that compared to those who slept for an average of 7–8 hours per night, a sleep duration of less than 5 hours was associated with a higher body mass index (BMI) (17).
There is a rising prevalence of overweight and obesity among the urban slum women. The prevalence of overweight and obesity was found to be higher among the slum women with inadequate fruit intake, increased duration of television viewing and a sleep duration of <7 hours and >9 hours per night. The prevention is economical and easy at an early stage with the change occurring in the form of lifestyle modifications at an individual level with increasing awareness.
There is a rising prevalence of overweight and obesity among the urban slum women. The causes of obesity are complex and the response needs to be multi-faceted. Governments have a central role to create an environment that empowers and encourages behavioural changes by individuals, families and communities, to make positive, life-enhancing decisions on healthy diets and patterns of physical activity.
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