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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
Declining Age of Onset of Type 2 Diabetes Mellitus in the North-West Punjabi Population
Correspondence Address :
Mrs. Sukhraj Kaur (PhD student)
Lecturer, Department of Biochemistry
Government Medical College Amritsar, Punjab, India
E-mail: sukhrajkaur2005@yahoo.co.in
Phone No.919646142606
Context: Diabetes mellitus, an inherited metabolic disorder which is associated with devastating complications, is one of the biggest burdens on the society, in terms of the expenditure of money on health care and wastage of the prime years of life. The increasing prevalence of diabetes mellitus is attributed to adverse lifestyles like obesity and physical inactivity and this is prevalent even among school going children, thus making them vulnerable to the disease at an earlier age.
Aim: The present study was designed to decipher the prevalence of type 2 diabetes mellitus in various age groups of the north west Punjabi population.
Settings and design: The subjects were selected by conducting a door to door survey of a few villages of the border belt of Amritsar and the Tarn Taran district. One patient of diabetesmellitus was considered as one family unit and the offsprings of these diabetic patients, who were siblings amongst themselves were recruited for the study.
Material and Method: All the selected families were required to fill up a consent form by the head of the family. Fasting samples of the participating families were collected and analyzed for fasting plasma glucose, glycated haemoglobin, complete lipid profile, serum insulin and C-peptide. Statistical analysis was done by using the Student’s t test. Results and conclusions The prevalence of diabetes mellitus in the north-west Punjabi population was found to be 25%. IFG was more prevalent in females as compared to the males and the age of onset of diabetes mellitus was observed to decline both in males and females, as was evident from its occurrence in the age group of 19-24 years.
Diabetes Mellitus, Age of Onset, North-West Punjabi Population
Diabetes mellitus is one of the most common, non-communicable, inherited metabolic disorders. It is associated with devastating micro-vascular and macro-vascular complications. In the year 1995, about 19 million of Indians were suffering from type 2 diabetes and it has been projected that the number will increase and may reach up to 57 million by the year 2025, out of the total 300 million diabetic individuals of the world, thus making India the diabetic capital of the world. The increasing prevalence of type 2 diabetes mellitus which occurs globally is attributed mainly to adverse lifestyle factors (1). Obesity and decreased physical activity are the key components in the causation of the adverse effects which lead to diabetes, coronary heart disease and many other related disorders. However, in the recent decades, the world is facing a threat from the early onset of type 2 diabetes mellitus as is evident from the increasing incidence of this disease in children and adolescents (2) (3)(4). This has great implications for the health care burden in any country. Within a few decades, type 2 diabetes has changed from being a disease of the elderly and the affluent to being a disease of the young and poor (5)(6). Indians are moreprone to develop type 2 diabetes than many other groups. Only limited information is available on the genetic factors, but a number of other predisposing risk factors are present at a much higher level in Indians. As far as the genetics of the disease is concerned, the HLA-DQ genes are the strongest risk markers for type I diabetes (7), although their influence may be modified by other MHC genes. Research is going on with regards to some candidate genes as the markers of risk for type 2 diabetes mellitus. These include peroxisome proliferator-activated gamma (PPAR-γ) and transcription factor 7 like 2 (TCF7L2) (8)(9)(10)(11)(12) (13). Keeping in view the magnitude of the disease, it’s expression at an early age and its status as an inherited disorder, the present study was conducted in the north-west Punjabi population to study the prevalence of type 2 diabetes mellitus in a young age group i.e. the age group of 19 to 24 years.
The present study was conducted in the Department of Biochemistry, Government Medical College, Amritsar (Punjab). The subjects were recruited by conducting a door to door survey of a few villages ofthe border belt of Amritsar and the Tarn Taran district. Each diabetic individual was considered as one family unit and the offsprings of these individuals, who were siblings amongst themselves were recruited for the study. Written consent was taken from these diabetic individuals for the inclusion of their families in the study and the individuals were free to leave the study at any point. Only the individuals who gave their consent were included in the study. These individuals were advocated about the consequences of diabetes mellitus i.e. micro and macro vascular complications. The diabetic individuals were given dietary and lifestyle modifications. The blood samples of the families who were willing to participate in the study were collected by conducting community camps on a fixed date, at a fixed common place such as a gurudwara or the Panchayat Bhawan of the village. The patients were advised to observe an overnight fast. To comply with the instructions, the samples were collected early in the morning. Seven ml of venous blood was collected under aseptic conditions and was divided into three vials. The vial containing the anti coagulant was used for the estimation of plasma glucose (14), the second vial containing the sample along with EDTA was used for the estimation of glycated Hb15 and the blood sample in the third vial was allowed to clot and serum was separated from it for the estimation of the lipid profile (15), serum insulin (16) and the c-peptide levels (17). Theresults which were obtained were statistically analyzed by using the Student’s ‘t’ test.
RESULTS AND DISCUSSION
It was observed that every fourth family had a history of type 2 diabetes mellitus (Table/Fig 1), either in the present or in the past generation. Out of 250 families who had a family history of type 2 diabetes mellitus, 47 families refused to join the study while the remaining 203 families were enrolled for the present study. The offsprings of these families (n=203) who were siblings amongst themselves and belonged to the 10 to 50 years age group were included in the present study. Out of a total number of 613 siblings, 335 were males and 278 were females. The siblings were further subdivided into 4 groups according to their ages i.e. group I- ≤18 years, group II- 19 to 35 years, group III- 36 to 45 years and group IV- more than 45 years of age. The maximum number of siblings belonged to the age group II i.e.19 to 35 years (n=407) (Table/Fig 2).While all the siblings were subdivided on the basis of the fasting plasma glucose levels as normal, IFG and diabetic (Table/Fig 3), it was observed that a higher percentage (5.8%) of females were suffering from diabetes mellitus at a younger age i.e. up to 18 years as compared to age matched males (1.36%). Likewise, the percentage of females having IFG (15.68%) was much higher as compared to the males (5.47%) in the same age group, thereby suggesting the need for extensively educating the females about lifestyle modifications especially those who fell in the IFG range to prevent the rate of conversion of these individuals to the diagnosed cases of diabetes mellitus. Almost an equal proportion of males (n=28, 12.72%) and female siblings (n=24, 12.83%) in this age group were diabetic. This finding was suggestive of the occurrence of diabetes at an early age in the north- west Punjabi population. Also, it was observed that both the male and female siblings were equally likely to get the disease in the 19-35 years age group. A similar trend was observed in other age groups as well, with regards to the fact that more female siblings were suffering from IFG than the male siblings. More females were diabetic in the age group of <19 years (n=3, 5.88%) and more than 35 years (n=13, 36.11%) than the males.
A comparison of various parameters such as glycated Hb, serum insulin and c-peptide in these individuals showed a statistically significant increase in the siblings with IFG and diabetes as compared to the normal individuals (Table/Fig 4). However, a comparison of these parameters between the male and female siblings of each age group, who were either normal or who had IFG or diabetes did not reveal any statistically significant variation. The changes in the fasting glucose, glycated Hb, serum insulin and c-peptide values were of great help in diagnosing the siblings with IFG, as per the ADA guidelines. All these individuals were found to be normolipidaemic (Table/Fig 5).
The siblings in the age group of 19-35 years were further subdivided into three sub groups of 19-24 years, 24-30 years and >30 -35 years. In the age group of 19-24 years, it was observed that 7.14% males and 9.09% females were diabetic, thus suggesting the occurrence of diabetes before 24 years of age. 16.27% males and 11.90% females in the age group of 24-30 years age range and 16% males and 21.62% females in the 30-35 years age range were found to be diabetic. From the data which were collected, it was very clear that the females were more prone to this disease as compared to the males and that the percent of individuals suffering from this disease increased with advancing age (Table/Fig 6). Twelve percent of the siblings (both males and females) had an IFG in theage range of 19-24 years and the very existence of the individuals with IFG at an early age (<24 years) (Table/Fig 6) was a matter of concern in the present study. The levels of fasting plasma glucose, glycated Hb, serum insulin and c-peptide showed a statistically significant increase in these individuals with IFG as compared to the normal individuals and hence were of diagnostic value as per the ADA guidelines. The raised insulin and c-peptide levels in these individuals were suggestive of the increased synthesis and secretion of insulin, maybe in response to the increased fasting plasma glucose levels. (Table/Fig 7). All these individuals were normolipidaemic (Table/Fig 8). All the individuals with IFG were suggested to make life style modifications. The diabetic individuals were also advised to make life style modifications along with pharmacological intervention. Work is in progress to evaluate the impact of lifestyle modifications on the regulation of the blood sugar levels.
The data of the north-west Punjabi population which were analyzed till date is suggestive of the fact that in this population, the age of onset of diabetes mellitus is declining (19-24 years), both in males and females. It was observed in the present study that the females were more prone to the disease as compared to the males.
Diabetes mellitus has devastating complications Childhood obesity and environmental factors play a role The age of onset of type 2 diabetes mellitus is declining
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