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

Users Online : 93015

AbstractCase ReportDiscussionReferencesDOI and Others
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

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"

Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."

Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."

Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
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.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
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
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
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.
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)
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

Case report
Year : 2012 | Month : February | Volume : 6 | Issue : 1 | Page : 113 - 115 Full Version

Acute Aortic Thrombosis with Massive Intestinal and Lower Limbs Ischaemia in a Girl with Down Syndrome

Published: February 1, 2012 | DOI:
Hamdi Hameed Almaramhy

Corresponding Author.

Correspondence Address :
Hamdi Hameed Almaramhy
Assistant Professor of Pediatric Surgery
Head, Department of Surgery
Maternity and Children Hospital,
Al Madinah Al Munawarah, Saudi Arabia


Patients with Down syndrome may have an increased risk of venous and arterial thrombotic events. Despite these, some argued that there is no increased risk of prothrombotic conditions in trisomy 21 and the thrombosis is usually due to other associated risk factor. Here a report of a 3-year-old girl, known case of Down syndrome, with a past history of atrioventricular septal defect (AVSD) repair at the age of 4 months developed acute aortic thrombosis with massive intestinal and lower limbs ischemia without obvious cause.


Acute aortic thrombosis, Down syndrome, Lower limbs ischemia. Massive intestinal ischemia

Thromboembolic events in children, especially after the neonatal period, are rare and most of these are venous (1). Patients with Down syndrome may have an increased risk of venous and arterial thrombotic events (2),(3),(4). Despite these, some argued that there is no increased risk of prothrombotic conditions in trisomy 21and the thrombosis is usually due to other associated risk factor (5).

Herein, the author presents a child with Down syndrome with complete aortic and superior mesenteric artery (SMA) occlusion with resultant mesenteric and bilateral lower limb ischaemia without evident cause. There is no such incidence reported in literature till now describing acute extensive multi-focal thrombotic events in a child or adolescent with Down syndrome.

Case Report

A 3-year-old girl, known case of Down syndrome, with a past history of atrio-ventricular septal defect (AVSD) repair at the age of 4 months was admitted with repeated non-bilious vomiting and diarrhea for 4 days. There were no other associated symptoms in the systemic review. She was not known to have any other medical illness, and was not on any medications. On examination, she was conscious, oriented, and afebrile. Systemic examination was unremarkable except for median sternotomy scar. Her initial electrolytes results demonstrated hyponatremia (125 mEq/L). She was diagnosed as a case of gastroenteritis with moderate dehydration and was treated with IV fluids. On 3rd day, she became hypotensive, irritable and developed a fever of 40o C, convulsions and bluish discoloration of her both lower limbs. She was shifted to the PICU with a diagnosis of meningitis. Lumbar puncture and brain CT results were normal. Following day, she developed abdominal pain and distension with bloody diarrhea. She looked sick, irritable, pale, tachypenic, hypotensive (65/35 mm Hg), and tachycardiac (pulse 160/min). She was intubated and started on inotropes. Abdomen became more distended, tense, tender guarding with absent intestinal sounds. Lower limbs became pale, cold and pulse less. Laboratorty study showed WBC (6.9 Ă— 109 / L), Hb (8.6 gm/dl), PLT (57 Ă— 109 / L), Glucose (6.3 mmol/L), and Alb (15 gm/L). Blood gas analysis Case Report Paediatric Surgery Section showed metabolic acidosis. Factor V leiden , anti-thrombin III deficiency and anti-phosphlipid antibody were negative. Duplex scan of the abdomen and both lower limbs showed no signal in aorta and femoral arteries. Echocardiography demonstrated good cardiac function with no vegetation or thrombus in the heart or aortic arch. Contrast and volume enhanced CT angiography for the aorta demonstrated complete aortic and superior mesenteric artery occlusion and patent IVC (Table/Fig 1). She was diagnosed to have bowel ischaemia (Table/Fig 2),(Table/Fig 3), renal infarction (Table/Fig 4) and lower limb ischemia.

After adequate re-suscitation, the patient was subjected to laparotomy which revealed extensive small bowel necrosis, necessitating resection of the necrosed segment, followed by exteriorization of the proximal and distal ends. Stomach, Duodenum and colonwere normal. In the same setting, the vascular surgeon performed bilateral femoral artery exploration and retrograde aorto-iliac thrombectomy, resulting in good inflow and back flow. Fasciotomies for lower limbs were also done. 2.5 U of t-PA was infused into both superfacial femoral arteries. Good pulses reappeared in both lower limbs and heparin was continued post-operatively. After 48 hours, 2nd look laparotomy showed another ileal segament became gangrenous so it was resected, and both bowel ends are exteriorized and abdomen was closed. Central intravenous line was inserted for TPN purpose. On the 5th post-operative day, the exteriorized proximal segment of the bowel became black and the left leg revealed progressive ischaemia. She was taken for laparotomy which revealed that 15 cm of juejenum were ischaemic which was resected and both ends were exteriorized. At the same time, left above-knee amputation was done.

After 10 days inotropes were discontinoued, patient was extubated and vital signs were maintained. Her nutrition was maintained via TPN. One month later, she developed severe sepsis due to systemic candidiasis. The patient arrested and expired due to severe sepsis.


Thrombotic diseases are less frequent in children than in adults, but may result in severe morbidity and mortality. Thrombosis is commonly involve the venous system than the arterial one .The incidence of venous thromboembolism is 5.3 per 10.000 hospital admissions or 0.7 per 10.000 children and the mortality rate is 2.2% (6). Complete aortic occlusion is even rarer but potentially catastrophic entity. Acute aortic occlusion bears an early mortality of 31–52% (7). An acute thromboembolic event has not been reported in studies of post-operative repair in Down syndrome following repair of AVSD (8), (9), except one case of aortic thrombosis in a patient with Down syndrome has been reported recently (5). This case was a 14-year-old boy with Down syndrome with repaired AVSD who presented with sudden onset of bilateral lower limb ischaemia. Transesophageal echocardiography detected a thrombus in the right atrium. The patient had complete occlusion of the infrarenal abdominal aorta with occlusion of superior mesenteric artery with extensive bowel necrosis and multiple areas of infarctions at the right kidney and bilateral lower limb ischaemia.

Thrombosis in a child warrants investigation of potential underlying prothrombotic conditions. These include abnormalities of the inherited anti-coagulant factors including protein C, protein S, antithrombin, and factor V Leiden, as well as acquired disorders such asantiphospholipid antibodies and prothrombotic mutations (10). Despite the fact that congenital heart disease is considered as an acquired risk factor for thrombosis, a follow up of more than 100 patients after AVSD repair, with 24 (48%) of them having Down Syndrome failed to identify thrombosis or intra-cardiac thrombus as a cause of mortality, reported to be 10.7% (9). Similar reports are recorded by various researchers (10),(11),(12). Although, there are many reported cases of Down syndrome and thrombotic events; in most of them identifiable risk factor were present (13),(14),(15). On the other hand some reports could not find thrombotic risk factor (16), (17). This raises concern whether Down syndrome is a risk factor or not. In this case report, no cause was identified for the sudden arterial occlusion despite extensive investigations for possible causes. This case report highlights an unusual manifestation of Down syndrome in a child with previous uneventful repair of an AVSD. The likely cause for this extensive thrombosis in our patientremains obscure. Is it Down syndrome itself? Is it the dehydration? Or it is a rare prothrombotic disorder.

Several proteins encoded on chromosome 21 are associated with an increased risk for vascular diseases. These include α-chains of collagen type VI, superoxide dismutase I, the interferon gamma receptor, and cystathionine β-synthase (2). In addition to these, a variety of haematologic abnormalities have been described in Down syndrome including an increased rate of laeukamoid reactions, neonatal polcythemia, thrombocytopenia and abnormal polymorphonuclear laeukocytic precursor cells, abnormal nailbed capillary morphology, high pulmonary vascular resistance, congenital heart disease, abnormalities of the retinal vessels, and primary intimal fibroplasia (3), (4). In addition to that Down syndrome is associated with other vasculopathies. Autopsy finding in Down syndrome syndrome with cerebrovascular disorder revealed presence of fibrous hypertrophy of the arterial intimal walls, the tunica media was atrophic and internal elastic lamina was tortuous and duplicates (18). Due to certain religious and legal issue, the autopsy of the deceased was not performed; although sometimes autopsy discloses certain unrevealed facts.

In conclusion, a case is reported with Down syndrome who developed extensive arterial thrombosis with no evidence of clear risk factor. This may indicate that Down syndrome itself may be a risk factor for thrombosis.


Gibson BB-MP. Thrombosis in children.British Paediatric Surveillence Unit, Royal College of Paediatrics and Child Health. 17th annual report. 2003.pdf.
Cramer SC, Robertson RL, Dooling EC, Scott RM. Moyamoya and Down syndrome. Clinical and radiological features. Stroke 1996 Nov; 27(11):2131-35.
Scholl T, Stein Z, Hansen H. Laeukemia and other cancers, anomalies and infections as causes of death in Down’s syndrome in the United States during 1976. Dev Med Child Neurol 1982 Dec;24(6):817-29.
Dai AI, Shaikh ZA, Cohen ME. Early-onset Moyamoya syndrome in a patient with Down syndrome: case report and review of the literature. J Child Neurol 2000 Oct;15(10):696-99.
Mohan UR, Mangat JS, Sutaria N, Franklin RC. Saddle arterial embolus in a patient with Down syndrome. Pediatr Cardiol 2006 Jan;27(1):117-21.
Andrew M, David M, Adams M, Ali K, Anderson R, Barnard D, et al. Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE. Blood 1994 Mar 1;83(5):1251-57.
Babu SC, Shah PM, Nitahara J. Acute aortic occlusion--factors that influence outcome. J Vasc Surg 1995 Apr;21(4):567-72.
Boening A, Scheewe J, Heine K, Hedderich J, Regensburger D, Kramer HH, et al. Long-term results after surgical correction of atrioventricular septal defects. Eur J Cardiothorac Surg 2002 Aug;22(2):167-73.
Malec E, Mroczek T, Pajak J, Januszewska K, Zdebska E Results of surgical treatment of congenital heart defects in children with Down’s syndrome. Paediatr Cardiol 1999 Sep;20(5):351-54.
Marz W, Nauck M, Wieland H. The molecular mechanisms of inherited thrombophilia. Z Kardiol 2000 Jul;89(7):575-86.
Baciewicz FA, Jr, Melvin WS, Basilius D, Davis JT. Congenital heart disease in Down’s syndrome patients: a decade of surgical experience. Thorac Cardiovasc Surg 1989 Dec;37(6):369-71.
Kameyama T, Ando F, Okamoto F, Haneda M, Sasahashi N, Nishigaki Y, et al. Long term follow-up of atrioventricular valve function after repair of atrioventricular septal defect. Ann Thorac Cardiovasc Surg 1999 Apr;5(2):101-06.
Leno C, Mateo I, Cid C, Berciano J, Sedano C. Autoimmunity in Down’s syndrome: another possible mechanism of Moyamoya disease. Stroke 1998 Apr;29(4):868-69.
Tateishi A, Mitsui H, Oki T, Morishita J, Maekawa H, Yahagi N, et al. Extensive mesenteric vein and portal vein thrombosis successfully treated by thrombolysis and anticoagulation. J Gastroenterol Hepatol 2001 Dec;16(12):1429-33.
Gururaj A, Hardy D, Al-Gazali LI, Sztriha L, Roos A, Nork M. Are the strokes in moyamoya syndrome associated with Down syndrome due to protein C deficiency? Brain Dev 2002 Oct;24(7):719-22.
Gaggero R, Donati PT, Curia R, De NM. Occlusion of unilateral carotid artery in Down syndrome. Brain Dev 1996 Jan;18(1):81-83.
Sohal AS, Sundaram M, Mallewa M, Tawil M, Kneen R. Anterior spinal artery syndrome in a girl with Down syndrome: case report and literature review. J Spinal Cord Med 2009;32(3):349-54.
Nagasaka T, Shiozawa Z, Kobayashi M, Shindo K, Tsunoda S, Amino A. Autopsy findings in Down’s syndrome with cerebrovascular disorder. Clin Neuropathol 1996 May;15(3):145-49.

DOI and Others

DOI: JCDR/2012/3843:1884


Date of Submission: Jul 23, 2011
Date of Peer Review: Oct 10, 2011
Date of Acceptance: Dec 23, 2011
Date of Publishing: Feb 15, 2012

JCDR is now Monthly and more widely Indexed .
  • 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
  • Google
  • Popline (reproductive health literature)