Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
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Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
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Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

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.
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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)
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.
On April 2011

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
On Jan 2020

Important Notice

Original article / research
Year : 2011 | Month : August | Volume : 5 | Issue : 4 | Page : 718 - 720

The Value of the Indian Diabetes Risk Score as a Tool for Reducing the Risk of Diabetes among Indian Medical Students

Anand Vardhan, Adhikari Prabha M.R., Kotian Shashidhar M., Neha saxena, Sandhya Gupta, Amruta Tripa thy

1. Medical students, Department of medicine, Kasturba Medical College, Mangalore a unit of Manipal University. 2. Corresponding Author. 3. Associate Professor of Statistics, Department of medicine, Kasturba Medical College, Mangalore a unit of Manipal University. 4. Medical students, Department of medicine, Kasturba Medical College, Mangalore a unit of Manipal University. 5. Medical students, Department of medicine, Kasturba Medical College, Mangalore a unit of Manipal University. 6. Medical students, Department of medicine, Kasturba Medical College, Mangalore a unit of Manipal University

Correspondence Address :
Dr. Prabha Adhikari M.R., Professor of Medicine
Kasturba Medical College Hospital, Attavar
Mangalore 575001, India.
Fax: 0824-2443203
Mobile: 9880991290


Introduction: Diabetes Prevention Programme (DPP), LOOK AHEAD trial, Indian Diabetes Prevention Programme have clearly established the benefits of lifestyle interventions coupled with education in reducing diabetes and CVD risk We conducted a study on the effect MDRF-Indian Diabetes Risk Score as a motivational tool for lifestyle change with special reference to physical activity and caloric intake among medical students.

Materials and Methods: The study was conducted on 150 medical students who were given their IDRS scores and laboratory values of Fasting plasm glucose and fasting lipid profile. IDRS was recalculated after 6 months. Change in total caloric intake, duration of exercise, pedometer counts and waist circumferencewere recorded before and after giving them their lab reports and risk score.

Results: After conveying the IDRS and lab reports, there was a significant decline in IDRS (from 36+ 10 to 31.2 + 11), waist circumference (85.4 + 7.4 cm to 84.1 + 7.2), caloric intake (from 1994 + 154 calories to 1817 + 152 ), physical inactivity score in IDRS (from 26 + 4.7 to 21 + 3.6) with increase in pedometer counts from 4628 + 432 to 9410 + 264.

Conclusion: Calculating diabetes risk by using MDRF-IDRS improved physical activity, decreased caloric intake and waist circumference significantly among medical students and is a useful motivational tool for lifestyle change.


IDRS, Diabetes, Medical students

The prevalence of type-2 DM is increasing in all the populations worldwide (1). It is a major risk factor for death and numerous non fatal complications which pose a large burden to the patients and their families. The WHO reports suggest that over 19% of the world’s diabetic population resides in India. This means that currently India has 35 million diabetic subjects, the number of which is projected to rise to 80 million by the year 2030 (2). In Diabetes Prevention Programme, a multicentre clinical research study was aimed at discovering whether life style intervention or the treatment with metformin prevents or delays the onset of diabetes was done. The life style intervention group showed a 58% reduction in the risk of diabetes as compared to a 31% risk reduction in case of the group which received metformin (3). Look ahead trial a life style intervention, a recent multi-centre randomized clinical trial which compared the effects of intensive lifestyle intervention (ILI) and diabetes support and education DSE, control group) on the incidence of major CVD events in 5145 individuals withtype 2 diabetes, showed that the lifestyle intervention produced and maintained significant weight losses and improvements in fitness in individuals with type 2 diabetes (4). Across four years of followup, those in ILI had better overall levels of glycaemic control, blood pressure, HDL-C and triglycerides and they thus spent considerable time with a lower CVD risk. The Indian Diabetes Prevention Programme also has shown similar results (5). This emphasizes the fact that life style modifications, namely dietary changes and increased physical activity can reduce the incidence of diabetes mellitus.

The Indian Diabetes Risk score (Table/Fig 1) The Indian Diabetes Risk Score (Table/Fig 1), which was devised by the MadrasDiabetes Research Foundation (MDRF) is an efficient diabetes screening tool which takes family history, waist circumference, age and physical activity into account (6).Thus, the high risk individuals can be identified by using the IDRS and by systematic counseling and intervention, it can be used as an efficient tool to reduce the risk in diabetics. A study was planned to check the value of IDRS as an educational tool for reducing the diabetes risk score among Indian medical students.

Material and Methods

Study setting: Kasturba Medical College, Mangalore

Study participants: Medical students who gave informed consent

Sampling method: Convenient sampling

Study Duration: 6 months

Sample size calculation: The sample size was calculated by using our a pilot study by keeping a p-value of <0.05 with a power of 90%, assuming that 40% of the students would have a moderate to high risk score. It was found to be 150.

Outcome measures: Change in total caloric intake, change in waist circumference change in duration of exercise, pedometer counts & change in the mean risk score.

Statistical analysis: Waist circumference, caloric intake, duration of exercise, the mean risk score was compared by using the paired t-test.

150 medical students (75 males and 75 females) who gave informed consent were selected and their IDRS was calculated by using a validated questionnaire which comprised of family history, dietary habits and their physical exercise details. Their waist circumference also was measured. Their fasting plasma glucose profile and lipid profile were also done. They were informed about the risk score and the lab reports. They were subdivided into high risk (risk score of 60 and above), moderate risk (risk score of 30-50) and low risk (risk score below 30) groups according to their risk scores. The moderate and the high risk groups were followed up and any change in the modifiable parameters of the risk scores was noted after 3 months.


Out of the 150 students who took part in our study, about 33% were in the moderate to the high risk category (Table/Fig 2). 22% had minimal physical activity and 77% had moderate physical activity, while 1% had strenuous physical activity. About 9 % of them had an increased waist circumference, thus indicating abdominal obesity. 10% had one diabetic parent and both the parents of 2% of the students were diabetics (Table/Fig 3).

Age had no role in the risk score of this group, as all of them were well below 35 yrs, the mean age being 21 + 2 years. After intervention, changes were observed in the modifiable parameters were as follows, there was a reduction in the mean abdominal circumference by 1.47 + 1.14 cm. There was an increase in the physical activity as evidenced by an increase in the hours which were spent at a gymnasium and the increased number of steps as observed by the pedometer counts. There was a reduction in the mean calories by 176 ± 87 kcal in the dietary intake. All these factors contributed to the reduction of the mean risk score from 36 to 31 (Table/Fig 4).


The results of our study showed that IDRS is a useful tool to identify high risk individuals who can be targeted for the annual screening for diabetes and for dyslipidaemia screening. Our study also showed that giving the risk score to individuals changed the health behaviour of the students, as shown by the caloric reduction by nearly 200 calories, the doubling of physical activity as measured by a pedometer, a reduction in the waist circumference and a reduction in the IDRS score .Several long term lifestyle intervention studies have suggested several methods of improving the lifestyle (5)(6)(7). Carbohydrate counting, counting the percentage weight reductionand the step count are the common methods which are adapted in various life style intervention programmes such as the diabetes prevention programme (3), the LOOK AHEAD trial and the Indian DPP study and most of them used multiple sessions of education and motivation for the first 6 months and even more expensive methods if the goals were not achieved after 6 months (5)(6)(7). Yu et al studied the economic impact of 1% weight loss in type 2 diabetes and concluded that one year’s total healthcare cost declined by 213$ per person (8). Wolf et al evaluated the cost of 12 months of lifestyle intervention as compared to the standard care and found that the net cost per person was 328$ per year, which could be negated by lesser hospital admissions and lesser health care costs (9). However, in the Indian DPP study, the life style interventions included a 7% weight loss, a 150 minutes activity goal/ week, fat gram counting in addition to calorie counting and tool box for meal replacement with as many as 16 sessions in the 1st 6 months, while the LOOK AHEAD trial included a 7% initial weight loss, a 175 minutes per week activity goal, a 24 group and individual sessions in the 1st 6 months,18 sessions for the 7th–12th months, caloric counting with the inclusion of fat gram counting and a portion controlled diet (5)(6), (7) .In our study, the simple method of giving the IDRS and the lab reports helped us in achieving an increase in the physical activity and reduction in the calorics . However, the cost of doing the lipid profile and fasting blood glucose assessment for everyone would negate the benefit of the money which was spent for individual or group sessions. However, assessing the IDRS and evaluating the lipid profile and fasting blood glucose in individuals in the moderate to the high risk groups would be cost effective. Also, convincing the low risk group to prevent an increase in thewaist circumference and to maintain physical activity would be the strategy which would keep young people in the low risk category. However, our study was conducted among medical students with good knowledge. Convincing the non medical youth to adopt a healthy lifestyle would be more difficult. A separate study on the calculation of IDRS in multiple groups of people of various age groups and its effect on the lifestyle modifications is warranted. Our study is limited by the fact that we did not repeat the blood tests and measure the percentage weight change as in the DPP and the LOOK AHEAD trials. Future trials should be planned with strong study designs with control groups.


Calculating the IDRS and motivating the high risk people to undergo fasting blood glucose and lipid profile assessment helps them to modify their life styles. Our study also showed that the risk score alone did not motivate the group. Abnormal lab reports (mainly the lipid profile) along with the risk score made them to believe the risk score. Hence, we recommend that every individual above 20 years should be assessed for the risk of developing diabetes by calculating the IDRS and those with a moderate to high risk score must have their fasting blood sugar and lipid profile assessed annually, which could motivate them to adhere to life style changes.


MDRF for motivating us to use IDRS ITREOH supported by a training grant from Fogarthy foundation for training us in research methodology ICORTA for training us in NCD Pratik Sahoo, Abrar Ahmad and Atul Bajaria for technical help.


Lindstorm J, Tuomihelto J. The diabetes risk score-a practical tool to predict type-2 diabetes risk. Diabetes care 2003;26;725-731.
Wild S, Roglic G, Green A, et al. Global prevalence of diabetes, estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27:1047–53.
The Diabetes Prevention Program Research Group. The Diabetes Prevention Program: design and methods for a clinical trial in the prevention of type 2 diabetes. Diabetes Care 1999; 22:62
The Look AHEAD Research Group. Long Term Effects of a Lifestyle Intervention on Weight and Cardiovascular Risk Factors in Individuals with Type 2 Diabetes: Four Year Results of the Look AHEAD Trial. Arch Intern Med. 2010 September 27; 170(17): 1566–1575.
Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijay V; Indian Diabetes Prevention Programme (IDPP); Diabetologia. 2006 Feb;49(2):289-97.
Mohan V, Deepa R, Deepa M et al. A simplified Indian Diabetes Risk Score for screening undiagnosed diabetic subjects. J. Assoc. of Physicians of India 2005; 53:759-763
Look Ahead research group: look AHEAD( Action for Health in Diabetes): design and methods for a clinical trial of weight loss for prevention of cardiovascular disease in diabetes. Con Clin Trials 2003; 43-50.
Yu AP, Wu EQ , Birnbaum HG ,E mani S, Fay M, Pohl G. The short term economic impact of body weight change among patients with type-2 diabetes who were treated with anti-diabetic agents; analysis by using claims, laboratory and medical record data. Curr med Res Opin 2001; 23(9): 2157-69
Wolf AM, Siadaty M, Yaeger B, Conaway MR, Crowether J Q, Nadler JL. Bovbjerk VE. Effects of lifestyle intervention on healthcare costs. Improving control with activity and nutrition. J Am Diet Assoc 2007; 107 (8): 1365-73.

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