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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
Pre-Donation Deferral of Whole Blood Donors in District Transfusion Centre
Correspondence Address :
Dr. Girish C.J.
Assistant Professor
“Guarimane” 4th Cross, 60 Feet Road
Vinobanagar, Shimoga 577201
Phone: 09972034266
E-mail: girishcj@gmail.com
Background: Blood transfusion saves lives and improves health, but millions of patients who need transfusion do not have timely access to safe blood. Pre-donation donor selection is done for the safety of the blood donor and recipient.
Aims: Primary objective of this study was to record and document the current rate and reasons for donor deferral in our District Transfusion Centre.
Methods and Material: Study was conducted on whole blood donors (voluntary/replacement), arrived for donating blood at our blood bank, during 1st January 2009 to 31st December 2010. The donor selection was done by pre-donation screening tests like questionnaire followed by physical examination and haemoglobin estimation. The deferred donor’s data was analysed. Results: Out of 9113 blood donors who came to donate blood, 94.81% were eligible for donation and 5.19% blood donors were deferred. The deferral rate among male population (401/8870 cases, 4.52%) and female population (72/243 cases, 29.63%) were observed. Most common cause of deferral in our study was hypertension (189, 39.95%), followed by anaemia (92, 19.45%), low body weight (43, 9.09%).
Conclusions: Hence studying the profile of blood donors will help to identify sections of the population which could be targeted, to increase the pool of voluntary blood donors and also to guide and provide the necessary essential database for the policy design and programme implementation.
Pre-donation deferral, Blood donors, Donation, Anaemia
INTRODUCTION
Blood transfusion saves lives and improves health, but millions of patients who needs transfusion do not have timely access to safe blood. It is estimated that donation by 1% of the population (10 per 1000 population) is generally the minimum needed to meet a nation’s most basic requirements for blood; the requirements are higher in countries with more advanced health-care systems (1). National AIDS Control Organization’s (NACO) statistics show that the annual rate of blood donation in India is about 7.4 million units, against the requirement of 10 million units (2). The state of Karnataka contributes about 500,000 units, with 62% coming via voluntary blood donation (3). Pre donation donor selection is done for the safety of the blood donor and recipient. Various causes of the pre-blood donation deferral need to be studied systematically to improve the donation rate. Monthly statistics sent to the drug controller exclusively includes transfusion transmitted diseases data and excludes other major causes of deferral. Deferral is a painful and sad experience for blood donor as well as the transfusion centre and it necessitates additional efforts towards new recruitments. Moreover, deferring prospective donors often leaves them with negative feelings about themselves as well as the blood donation process (4). Most of the previous studies carried out concentrated mainly on blood groups and transfusion transmitted diseases, however very few studies are published regarding the pre-blood donation deferral. Primary objective of this study was to record and document the current rate and reasons for donor deferral in our District Transfusion Centre.
Study was conducted on whole blood donors (voluntary/ replacement), arrived for donating blood at our blood bank, during 1st January 2009 to 31st December 2010. The donor selection was done by pre-donation screening tests like questionnaire followed by physical examination and haemoglobin estimation. The donors who were fit according to the Directorate General of Health Services guidelines, Ministry of Health and Family Welfare (2003) (5), were asked to donate blood. Deferred donors data was analysed with respect to age, sex, type of donor and causes for deferral which were also categorised into permanent and temporary causes based on the curability of the condition.
Out of 9113 blood donors who came to donate blood, 8640 (94.81%) were eligible for donation and 473 (5.19%) blood donors were deferred. The deferral rate among male population (401/8870 cases, 4.52%) and female population (72/243 cases, 29.63%) were observed (Table/Fig 1). Deferral rate among female population was 6.5 times higher than the male population. Deferred donor age group ranged from 18 to 55 years with a mean age 30.09 years. Average age of the deferred female donors (23.68 years) was less than the male donors (31.24 years). The deferred donors were divided according to the age group as shown in the (Table/Fig 2). Deferral rate was highest among 18-30years age group (270, 57.08%) followed by 31-40 years (132, 27.90%), 41-50 years (57, 12.05%) & 51-60 years (14, 2.95%). Highest deferral rate among male (270/401, 50.87%) and females (66/72, 91.66%) were seen in 18-30 years age group. Most common cause of deferral in our study was hypertension (189, 39.95%), followed by anaemia (92, 19.45%), low body weight (43, 9.09%), DM (31, 6.55%), medication (28, 5.91%), hypotension (26, 5.49%) and other causes (64, 13.53%) including previous donation, chronic medical illness, previous surgery, menstruation, breast feeding, typhoid, allergy, immunisation, drug abuse, lymphadenopathy, alcoholism, tattooing.
Out of the total 473 deferrals, 237 cases were due to permanent causes and 236 were due to temporary causes. Highest Deferral rate in younger age group 18-30 years (189/237, 79.74%) included temporary causes, while permanent causes were seen in older age group 31-60 years (155/236, 65.67%) Refer (Table/Fig 3).Common deferral causes in younger population 18-30 years age group were anaemia, low weight and hypotension. Common deferral causes in older population 31-60 years age group were hypertension and diabetes mellitus (Table/Fig 4).
Safe donor selection is the first step towards safe transfusion services. National and international efforts are on to ensure safe blood supply through screening, education and strict criteria laid down by the Directorate General of Health Sciences, Ministry of Health and Family Welfare (2003) (5) and Eligibility criteria for blood donation American Red Cross (6).
Deferral rate ranged from 5.6-35.6% across the world in previous studies, however low incidence are reported from Manipal (7) (5.2%), Rabeya (8) (5.6%), Bangalore (9) (5.84%) in concordance with our study (5.19%). Higher deferral rate are seen in both national and international regions like Singapore (10) (14.4%), Lucknow (11) (16.4%), Maiduguiri (12) (17.7%) and Trinidad and Tobago (13) (35.6%). Variation in deferral rate can be attributed to multiple factors such as: an higher incidence of first time donorsin Singapore (10), in turn resulting in detection of relatively higher permanent (neurological diseases & chronic hypertension) and temporary (sexually transmitted diseases) deferral causes; During the study period at Lucknow (11) compulsory blood screening for transmittable viral disease like hepatitis was not universally followed but past history of jaundice was included as an exclusion criteria; Cut-off point of haemoglobin was not operational, inviting more number of anaemic donors resulting in higher deferral rate in Maiduguiri (12). Higher prevalence of high risk sexual activity in Trinidad & Tobago (13) was a major cause for deferral. Apart from this, variation in donor selection criteria like weight, age, haemoglobin percentage, donation interval, high risk sexual activities, endemicity of transmittable diseases and imposition of religious restriction on donation of human parts including blood could have summated to the deferral.
Delhi (14), Bangalore (9) & Manipal (7) studies showed that female donor population was very low which was similar to our study and can be attributed to ignorance, fear, lack of awareness and motivation among females. Most common cause of deferral was anaemia among females (9),(13),(15) reflecting ill health, poor nutritional status and higher prevalence of anaemia which is also observed in our study. Categorization of deferred donor population into temporary and permanent groups is essential for optimising donor re-recruitment and retention in the long run. The major temporary deferral causes were anaemia and low weight (8),(9),(14) including in our study. Evaluation and management of anaemia and recruitment to donate at a later date is pivotal in ensuring donor retention (7).
Lower age group donors were rejected mainly because of temporary causes (18-30years, 189/270, 70%) and higher age group donors were rejected mainly because of permanent causes (40-60 years, 58/71, 81%).
Most common cause of deferral was hypertension accounting for 39.95% in contrast with other studies. (2),(11),(13) Probable reasons for this could be fear of phlebotomy, sight of blood, first-time donation and white coat hypertension. Moreover, hypertension being a modern epidemic which often goes undiagnosed and is an incidental finding in most cases. (16) Hypertension was the most common cause of deferral among permanent causes in our study and also in other studies (9),(14) conducted in India. This signifies hypertension as the major under diagnosed epidemic in Indian population.
Recruitment of fresh donors by organising voluntary donation camp requires manpower, money, motivation of donors and precious time. All these can be curtailed by calling back the temporarily deferred donors after correction of their cause as done in the previous study in maiduguiri (12) where nearly 70% came back and donated blood.
In Shaz (17) study, donors aged more than 60 years were allowed to donate, but our guidelines restrict donating blood beyond age group. There is a need to study the incidence of permanent deferral causes in this age group verses screening cost verses benefits of procuring blood.
Differing deferral causes in different locality, socio-economic status, age group and sex are of vital significance in formulating and modulating policies towards modern blood transfusion services. Hence studying the profile of blood donors will help to identify sections of the population which could be targeted to increase the pool of voluntary blood donors and also to guide and provide the necessary essential database for the policy design and programme implementation. Among temporary causes for deferral, anaemia and low weight are the two most common causes in both males and females which can be easily alleviated by proper nutritious supplement. So we have suggested to state blood council to properly maintain the records of all the deferred donors with their causes, and ask them to return for blood donation after correcting their illness. The deferral data is not widely recorded and reported to policy makers for transfusion services. If collected and studied in a systematic way it will definitely improve the collection of blood from prospective blood donors. The older age group blood donors have higher number of diabetes mellitus, so they must be screened stringently before blood donation. Similar studies involving larger population, stringent screening methodologies involving more parameters are needed for the upliftment of the blood donation rate and quality.
Dr. Chidananad P.S., Assistant Professor, SIMS, Shimoga.
Staff of Blood Bank, District Mc.Gann Hospital, SIMS, Shimoga.
ID: JCDR/2012/3755:1841
FINANCIAL OR OTHER COMPETING INTERESTS: NONE.
Date of Submission: Nov 30, 2011
Date of Peer Review: Dec 26, 2011
Date of Acceptance: Dec 30, 2011
Date of Publishing: Feb 15, 2012
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