Article in PDF
How to Cite
Citation Manager
Readers' Comments (0)
Audio Visual Article Statistics
Link
to PUBMED
Print this Article
Send to a Friend
Advertisers
Access Statistics Resources
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 Role of Magnesium Sulphate in Tuberculous Meningitis
Correspondence Address :
Dr P.K.Maheshwari Prof.& Head, Neurology Divison, P.G.Department of Medicine, S.N.M.C.,Agra-282003 (INDIA) Phone: 9997026852 E-mail: pkmaheshwari2011@gmail.com
Context: Magnesium sulphate (MgSO4) has been studied for its beneficial role in traumatic brain injury (TBI) and ischaemic cerebral infarcts as it decreases the oxidative stress and increases the cerebral perfusion. The present study was done for evaluating its role in tuberculous meningitis (TBM).
Aims: To study the role of intravenous magnesium sulphate in tuberculous meningitis.
Methods and Material: The present study had 40 cases of tuberculous meningitis which comprised of 20 cases of group A(n-20) as contols for the study group B (n-20). The study group (Group B) was given intravenous magnesium sulphate 2 gm six hourly for 7 days additionally than the control group (Group A) which was treated with steroids and anti-tubercular drugs. The outcome was measured by using the Barthel Index (BI) and the Modified Rankin Scale (MRS) on the first day, the seventh day and after six weeks. The cases with arteritis in the two groups were compared separately.
Statistical analysis: The results were analyzed by using the SPSS software and the unpaired t-test with p-values.
Results: The means of the changes in the MRS and the BI of the Groups A and B were not statistically significant. When the means of the changes in the BI and the MRS were compared in the arteritis cases of the two groups separately, they were found to be statistically significant with a p value <0.05.
Conclusions: Magnesium sulphate had a statistically significant role in TBM with tuberculous arteritis and it had a statistically nonsignificant role in TBM without arteritis.
Tuberculous Meningitis, Magnesium Sulphate, Barthel Index, Modified Rankin Scale, Arteritis
Introduction
Magnesium has an important role in the homeostatic regulation of the pathways which are involved in brain injuries (1). During the normal physiological processes, magnesium acts as a non-competitive inhibitor of the NMDA receptors (2) and it thereby regulates the calcium influx (3). In TBI, there is a depletion of magnesium and its homeostatic control on the NMDA receptors is lost, leading to a massive influx of calcium, causing neuronal degeneration and cell death (1). The therapy with magnesium sulphate reduces the oxidative stress after a traumatic brain injury TBI in humans (4). In subarachnoid haemorrhage patients who underwent temporary cerebral artery occlusion for the clipping of the cerebral aneurysms, the treatment with magnesium sulfate dilated the leptomeningeal arteries and enhanced the collateral blood flow and the tissue oxygenation (5). Magnesium sulphate is a potent cerebral vasodilator due to calcium channel antagonism in the vascular smooth muscle cells and its effects on the myosin-binding proteins that regulate muscle contraction (6),7]. Consequently, magnesium sulphate typically increases the cerebral perfusion (8),(9),(10). Various studies are available on the role of magnesium sulphate in TBI and cerebrovascular accidents, but no study is available on its role in TBM.This study was designed to study the neuroprotective role of magnesium sulphate in TBM.
The study was done at a tertiary care centre of north India between 2008-2009 on patients with tubercular meningitis who were admitted in the Department of Medicine or were referred from other departments. This study was approved by the Medical College Ethical Committee. After taking the informed consent of the patients and after explaining about the prognosis and the side effects to the patients and their relatives, the patients were asked for a detailed clinical history.
A diagnosis for definite TBM was made in cases where the CSF smear or culture was positive for AFB or where the PCR was positive for AFB. In the absence of the above criteria, the diagnosis of the most probable TBM was based on the clinical features (history and examination) which was suggestive of meningitis, while the cerebrospinal fluid examination was suggestive of predominant lymphocyte cells, rise in the protein levels with low CSF sugar or ratio of CSF sugar to simultaneously measured blood sugar value less than 60% and head CT scan suggestive of exudates, hydrocephalus and arteritis.
An unmarked, sealed envelope which contained directives for group A and B were prepared in advance and they were drawn at random. Group A (n=20) was given the standard therapy only and Group B (n=20) was given the standard therapy plus intravenous magnesium sulphate (2 gm, 6 hourly which was diluted with 100 ml of normal saline for 7 days). All the patients were followed for a minimum period of 6 weeks and often for longer, whenever it was possible after their discharge. A clinical assessment of the neurological state of the all the patients was done by using the Barthel Index (BI) (11) and the Modified Rankin Score (MRS) (12) on days 1, 7 and 42. The parameters of BI are feeding, bathing, grooming, dressing, bladder and bowel control, toilet use, transfer (bed to chair and back), mobility and stairs. The parameters of MRS include the degree of disability and the level of assistance which the patients need.
The maximum number of cases were in the 2nd to 3rd decades of life [Table/Fig 1]. The common symptoms in both the groups were fever (85%), headache (74%) and vomiting (62%). The presence of infarction was further confirmed by doing a CT scan or MRI of the brain (if the CT scan was inconclusive). There was no significant difference between the groups in the clinical presentation, as the symptoms and signs were found to be equally distributed among the groups [Table/Fig 2]. The means of MRS and BI of the two groups on the 1st, 7th, and the 42nd day signified the progressive clinical improvement in both the groups [Table/Fig-3]. The mean of the MRS change in Group A from day 1 to day 7 and that from day 1 to day 42 was 0.89 + 0.59 and 1.5 + 0.69 respectively. Though there was more change of MRS in Group B, the mean fall from days 1–7 was 1.17 + 0.55 and that from days 1–42 was 1.80 + 0.70 as compared to Group A, but it was not statistically significant [Table/Fig 4].
The change of MRS in Group B with arteritis was more as compared to that in Group A with arteritis and it was statistically significant [Table/Fig-5]. The mean of the BI change in Group A from the 1st to the 7th day and that from the 1st to the 42nd day was 11 + 15.44 and 17.25 + 22.03 respectively. Though there was more change in BI in Group B, the mean of the change from days 1–7 was 13 + 13.22 and that from days 1–42 was 32 + 25.31 as compared to Group A, but it was not statistically significant [Table/Fig 6]. The changes of BI in Groups A (n=5) and B (n=7) who had arteritis.were compared and it was found that the change of the Barthel Index in Group B was more as compared to that in Group A. This was statistically significant [Table/Fig 7].
The present study showed the significant role of magnesium sulphate (MgSO4) in cases of TBM with vasculitis and it has proved its neuroprotective role. The outcome was measured in terms of BI and MRS. The changes in BI and MRS were not statistically significant in the two study groups. In the cases of TBM with vasculitis among the two groups, the changes in BI and MRS were statistically significant (p ≤0.05), thus establishing the bene- ficial effect of magnesium sulphate in TBM with arterits. The incidence of cerebral infarction which is secondary to TBM is reportedly 6%–47% (13). It can lead to a permanent neurological disability in the survivors of TBM. Magnesium sulphate may be a cost effective neuroprotective therapy as it decreases the morbidity which is associated with cerebral infarcts. The limitations of the present study were its small sample size and the non availability of a radiological follow-up with CT/MRI of the brain sequentially. Further studies with larger sample size are needed for establishing the role of MgSO4 in TBM with vasculitis. This study was supported by various animal and human studies which were available, on the role of magnesium sulphate in the central nervous system. A decline in the ionized magnesium concentrations in rat brain was observed after a brain injury, that correlated with the neurological outcome and the behavioural deficits in rats (14). A significant positive and linear correlation was established between the ionized magnesium levels which were measured at 24 h after the injury and the motor outcome at 1 and 2 weeks (15). Many studies in rats have shown that the treatment with magnesium after a brain injury had neuron-protective effects on the motor and the behavioural outcome [1,16-18] in a dose-dependent manner [19,20]. The cortical damages were attenuated
after the treatment with magnesium in rats (21). Magnesium, which was administered at 24 hours, improved the motor outcome and the behavioural parameters in rats with brain injuries (22),(23). Magnesium reversed the persistent motor and cognitive deficits with the reduction of the post-traumatic stress and anxiety after brain injuries in rats.
In conclusion, the present study showed that MgSO4 was beneficial in TBM with vasculitis, but further studies with larger sample sizes are needed for establishing its role.
Date of Submission: Apr 09, 2012
Date of Peer Review: May 12, 2012
Date of Acceptance: May 25, 2012
Date of Publishing: Jun 22, 2012
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com