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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
Coronary Artery Disease risk factors in Type 2 Diabetes mellitus with metabolic syndrome in the urban South Indian population
Correspondence Address :
Priya.K.Dhas
Assistant professor
Department of Biochemistry
Penang International Dental College
Chinnaseeragapadi, Salem – 636 308
Phone numbers: 9944234840
E-mail address: priya.pidc@yahoo.co.in
Introduction:
Insulin resistance increases the risk of developing metabolic syndrome, a major cause of dyslipidaemia and heart disease. Metabolic syndrome is a cluster of metabolic risk factors that come together in a single individual. Hence, in the present study, the occurrence of metabolic syndrome among type 2 diabetes mellitus patients by the WHO criteria has been carried out. The risk factors were compared between patients with type 2 diabetes mellitus, with and without metabolic syndrome.
Materials and Methods:
Eighty seven, age matched, type 2 diabetic patients who attended a diabetic clinic were included in this study. They were grouped as diabetic patients with metabolic syndrome and diabetic patients without metabolic syndrome, based on the WHO criteria. The biochemical parameters like fasting blood sugar (FBS), post prandial blood sugar (PPBS) and lipid profile were estimated by using diagnostic kits. The bloodpressure (BP) was measured and the body mass index (BMI) and the atherogenic index of plasma (AIP) were calculated. Statistical analysis was done by the Student’s t test.
Results:
The occurrence of metabolic syndrome among the type 2 diabetic patients was 33%. A significant increase was seen in triglycerides (TGLs), very low density lipoproteins (VLDLs), the TGL/HDL ratio, AIP, BP and BMI and a decrease was observed in the high density lipoproteins (HDLs) of type 2 diabetic patients with metabolic syndrome when compared with the type 2 diabetic patients without metabolic syndrome.
Conclusion:
The significant increase in the TGLs, the TGL/HDL ratio, AIP, BP and the BMI of diabetic patients with metabolic syndrome when compared to the type 2 diabetic patients without metabolic syndrome, predicts that patients with type 2 diabetes mellitus with metabolic syndrome are at a higher risk level for coronary heart disease (CHD).
Metabolic Syndrome, Atherogenic Index of Plasma, Coronary Heart Disease
The incidence of type 2 diabetes mellitus is rising worldwide, mostly due to the increasing prevalence of obesity and a longer life expectancy (1). Insulin resistant patients are at an increased risk of developing metabolic syndrome, a major cause of heart disease and dyslipidaemia (2).Metabolic syndrome is a combination of medical disorders that increase the risk of developing cardiovascular disease and diabetes. The factors which are characteristic of metabolic syndrome, which is also known as dysmetabolic syndrome X, are abdominal obesity, atherogenic dyslipidaemia, raised blood pressure, insulin resistance with or without glucose tolerance and the proinflammatory and the prothrombotic states(3), (4). Several organizations have proposed a slightly different criteria for metabolic syndrome(5),(6),(7),(8). Insulin resistance is considered as the underlying abnormality in this syndrome. The pathogenesis is still unclear, although environmental factors such as diet and physical activity, coupled with still largely unknown genetic factors, clearly interact to produce this syndrome (9). Central obesity is the key feature of this syndrome, reflecting the fact that the syndrome’s prevalence is driven by the strong relationship between waist circumference and increasing adiposity (10). Reports suggest that BP levels are strongly associated with the degree of insulin resistance (11). It has been reported that insulin resistance might be involved in the pathogenesis of primary hypertension, in up to 40-50% of the cases (12). Hence, in the present study, type 2 diabetes mellitus patients were grouped as those with metabolic syndrome and those without metabolic syndrome, based on the WHO criteria. Therisk factors were compared between patients with type 2 diabetes mellitus, with and without metabolic syndrome.
Eighty seven, age matched, type 2 diabetic patients who attended a diabetic clinic were included in this study. The biochemical parameters like FBS, PPBS and lipid profile were estimated using Bayer’s diagnostic kits. FBS and PPBS - Glucose oxidase Peroxidase method Total Cholesterol – Cholesterol oxidase peroxidase method Triglycerides – Glycerol 3 phosphate oxidase method HDL cholesterol – Phosphotungstate method LDL and VLDL - Friedewald’s formula. VLDL = TGL/5, LDL = Total cholesterol – (HDL+VLDL).
The blood pressure was measured by using a standard sphygmomanometer. The BMI was calculated as the weight (kg) divided by the height squared (m2) and AIP was calculated by using the Czech online calculator of atherogenic risk.
The patients were grouped as diabetic patients with metabolic syndrome and diabetic patients without metabolic syndrome, based on the WHO criteria. Metabolic syndrome was defined clinically, based on the presence of impaired fasting blood glucose and any two of the following a. Blood Pressure: ≥ 140/90mmHg b. Dyslipidaemia : TGL >150mg/dl and HDL < 35 mg/dlc. Central obesity: BM I >30kg/m2 Inclusion criteria: Age between 40-60 yrs, type 2 diabetes mellitus Exclusion criteria: Smokers, Alcoholics, Liver disease, kidney disease.
Statistical analysis
The data were analyzed by using the SPSS version 11.0. Student’s t test was used to find the significant difference between the various parameters among the groups. Ethical issues: The purpose of the study was explained to all the participants and their consent was obtained. The requisite clearance of the institutional human ethics committee was obtained.
Our report revealed that 33% of the type 2 diabetic patients had metabolic syndrome, as shown in (Table/Fig 1). As shown in (Table/Fig 2), a significant increase was seen in TGL and VLDL and a decrease was observed in HDL in the type 2diabetic patients with metabolic syndrome when compared with the type 2 diabetic patients without metabolic syndrome. No significant change was observed in the fasting and post prandial blood sugar and the cholesterol levels among the study groups.
(Table/Fig 3) depicts the cardiovascular risk in both the groups. A significant increase was seen in the TGL/HDL ratio and in the AIPwhen compared to the LDL/HDL ratio in the type 2 diabetic patients with metabolic syndrome when compared with the type 2 diabetic patients without metabolic syndrome.
(Table/Fig 4) shows that a significant increase was seen in the BMI and BP in the type 2 diabetic patients with metabolic syndrome when compared with the type 2 diabetic patients without metabolic syndrome.
The increased risk of cardiovascular disease which is associated with metabolic syndrome has many causes, but dyslipidaemia plays a prominent role in it. Both the metabolic syndrome and type 2 diabetes, are commonly associated with an abnormal lipoprotein phenotype which is characterized by increased TGL, decreased HDL and an accumulation of small dense LDL particles (the so- called atherogenic dyslipidaemia phenotype). The levels of LDL c are often normal (13). A number of lipid related parameters have been used to predict the risk of coronary artery disease (CAD). According to Grover, either the ratio of LDL/HDL or TGL /HDL is the best related predictor of future cardiovascular events (14). Later, TGL /HDL were shown to be a more accurate predictor of coronary heart disease (15). The logarithamatically transformed ratio of plasma TGL to HDL c correlated closely with the LDL particle size and could serve as an indicator of the atherogenic lipoprotein phenotype(16). AIP indicates a balance between the actual concentration of plasma TGL and HDL, which predetermine the direction of the cholesterol transport in an intravascular pool ie the flux of newly produced cholesteryl esters by lecithin cholesterol acyl transferase ( LCAT) towards atherogenic LDLs or beneficial HDLs(17) . Clinical studies have shown that AIP predicts cardiovascular risk and that it is an easily available cardiovascular risk marker and a useful measure of the response to treatment (18).
Obesity, which is reported to play a key role in the pathogenesis of metabolic syndrome, promotes inflammation, hypertension and dyslipidaemia, thus leading to the development of type 2 diabetes mellitus and atherosclerosis (19). Moreover, a higher BP is a strong risk factor for cardio vascular diseases (CVD) (20). Abdominal fat which is associated with central obesity, a characteristic feature of the metabolic syndrome, is a major source of the excessive flux of free fatty acids which are known to have pro-arrhythmic properties. The prolonged release of free fatty acids is implicated in the development of type 2 diabetes, since it promotes insulin resistance and the associated loss of pancreatic β cell function (21).
Patients with type 2 diabetes mellitus are at an increased risk of cardiovascular morbidity and mortality. The significant increase in TGL, the TGL/HDL ratio, AIP, BP and the BMI of diabetic patients with metabolic syndrome when compared to the type 2 diabetic patients without metabolic syndrome, predicts that patients with type 2 diabetes mellitus with metabolic syndrome are at a higher risk level for CHD. This is in agreement with the fact that insulin resistanceinduces several metabolic changes such as hyperglycaemia, dyslipidaemia and perhaps to a lesser extent, hypertension, which all contribute to the development of atherosclerosis (22). The clinical management should be focused on multifactorial intervention to address all the associated cardiovascular risk factors.
Patients suffering from type 2 diabetes mellitus with metabolic syndrome are more prone to cardiovascular disease. The atherogenic index of plasma (log TGL/HDL) is a good marker for cardiovascular risk.
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