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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
A Study on Femoral Neck Anteversion and Its Clinical Correlation
Correspondence Address :
Dr. T. Srimathi,
2-A, Kamakshiamman Nagar ,Kozhumanivakkam,
Mangadu,Chennai -600122.
Phone: 9551053442
E-mail: arima_tamil@yahoo.co.in
Aim: To measure the angle of anteversion of femoral neck in both gender types and on both sides and to correlate it clinically.
Materials and Methods: This study was carried out to determine the average femoral neck anteversion in Indian population. The angle was measured mechanically on 164 dry femora 88 right and 76 left intact, dried adult human femora (unpaired) with 81 male type bones and 83 female type bones were studied by conventional methods. The results obtained were statiscally analysed.
Results: The angle between centre head neck line to transcondylar line was measured using goniometer in 164 dry bones and the mean value was 9.8 deg. The mean value was 9.49 deg on the right side and 10.13 deg for the left side femora with a standard deviation of 1.66 and 1.50 respectively showing a higher angle in the left side femora. A statistically significant difference of 0.64 was found for the angle of anteversion between the right and left side bones with a ‘p’ value of <.001. The mean value of male type bones was 9.78 deg and 9.79 deg of female type bones with a standard devation of 1.70 and 1.54 respectively. Though the value was higher in the female type bones, no statistically significant difference was found for the angle of anteversion between the male-and female-type bones in the present study. 7.9% bones were in the range of 0-8°, 54.2% bones were in the range of 8-10°, 21.9% were in the range of 10-12°, 15.8% bones had angle more than 12° showing most bones with a value of anteversion in the range of 8-10°.
Conclusion: Any increase or decrease in the angle of femoral anteversion is associated with various clinical conditions. It increases in Perthes disease, cerebral palsy, anterior poliomyelitis, postural defects, apparent genu valgum, external tibial torsion, flat foot, and intoing. The decreased femoral torsion has been shown to be associated with toing out, rickets, chondrodystrophy. The data established in this study will be useful for various orthopaedic procedures and diagnosis, in the fields of General Human Osteology and Forensic anthropology.
Angle of anteversion, Femur, Torsion angle
Introduction
Femoral nek anteversion describes the angle subtended by the femoral neck with reference to the transcondylar plane of the distal end of the femur and is usually 15° to 45°. This along with the neck shaft angle, hip axis length, femoral neck width influence the risk of femoral neck fracture. Femoral neck anteversion angle has to be taken into consideration when reduction and fixation is selected as a method of treatment (1). If the axis of the neck inclines anterior to the transcondylar plane, the angle of torsion is called anteversion, anterotation; simlarly, if it points posterior to the transcondylarplane, it is called retroversion, retrotorsion. If the axis is in the same plane of transcondylar axis then it is called neutral version. In the past few decades, researchers worldwide have used various methods to measure the angle. They have measured the angle mechanically on cadaveric bones as well as in patients by using roentgenography , ultrasound, computerised tomography and MRI. Earlier studies (2) revealed that the angle varies in populations.and also according to the method adopted. Thus the data from western countries may not be applicable to Indian population. Hence the anteversion for Indian population was calculated using dry bones.
164 dried adult human femora (unpaired) – 88 right and 76 left, with 81 male type bones and 83 female type bones were studied. Any femur that showed a significant bony or arthritic deformity was excluded from the study. Each femur was placed with the posterior surface of its condyles and greater trochanter touching a smooth horizontal surface. The centre head neck line and retrocondylar line were determined. The Kingsley Olmsted method was followed to determine the angle of femoral torsion in our study. Centre head-neck line: Centre of head was the centre of maximum anteroposterior thickness of head of femur. The centre of neck was the centre of maximum anteroposterior thickness at the base of the neck. Both these points were determined with the help of sliding caliper and were marked on the surface of head and neck respectively. The line passing through these points was the centre head-neck line (Table/Fig 1).
Retrocondylar line: It passes through posterior most points of both condyles of femur (Table/Fig 2). The horizontal limb of a goniometer was fixed at the edge of the experimental table. The vertical limb was held parallel along the axis of the centre of head and neck of the femur. The horizontal surface represents the retrocondylar axis and the plane of reference against which the anteversion is measured with the help of the axis of head and neck of the femur. The angle subtended was recorded to the accuracy of 1° (Table/Fig 3). The angle was measured in all 164 femora.
The results obtained after measurement of the femoral neck anteversion angles in dry bones was tabulated and analysed. (Table/Fig 4),(Table/Fig 5),(Table/Fig 6),(Table/Fig 7)
156retrocondylar line and method 2- anterior head trochanter line and retrocondylar line. These two methods gave significantly different mean angles, method-1 8.68° (+/-6.37) and method-2 16.34 ° (+/- 7.7) (5). In the present study the angle between centre head neck line to transcondylar line was measured using goniometer in 164 dry bones and the mean value irrespective of the side and gender type was 9.8° (Table/Fig 4). Femoral neck anteversion was measured using 300 dry bones and compared with CT, X-ray, and Clinical methods. (6) The mean value by dry bones on the right side (147 bones) was 7.3°, and on the left side (153 bones) mean value was 8.9° with a statistically significant difference (p=0.04). The mean angle of the left side was higher than the right side. Analysis of 30 bilateral hips showed the mean anteversion angle of the femoral neck to be 16.31°. On the right side the mean anteversion angle of the femoral neck was 16.01° and that on the left was 16.61° (7). In the present study also,the mean value was 9.49° for the 88 right side femora with a standard deviation of 1.66 and for the 76 left side femora mean value was 10.13° with a standard deviation of 1.50, showing a higher angle in the left side femora (Table/Fig 4). A statistically significant difference of 0.64 was found for the angleof anteversion between the right and left side bones in the present study also with a ‘p’-value of <.001 (Table/Fig 7). One hundred and eighty two adult Indian dried femora, hundred and four male and seventy eight female were studied. The average anteversion was 11.32 ± 0.37 and 21.23 ± 0.39 on the left & right sides respectively in male dried bones and 11.02 ± 0.34 and 20.87 ± 0.35 on the left and right sides respectively in female dried bones. Statistical analysis using paired ‘t’ test revealed significant (p<0.0001) greater average anteversion in male bones & right-left variations, being greater on the right side. It was statistically significantly (p<0.0001) higher on the right side and showed sexual dimorphism, being greater in males in comparison with female subjects (8).
Unpaired 92 dry femurs, 50 of female and 42 of male devoid of any gross pathology were used to measure the femoral neck angle (FNA) by Kingsley Olmsted method.The mean anteversion in male bones was 10.9°. In females, it was 13.6° (9). Statistical analysis revealed greater angle in the females as compared to males. In a study of 30 bilateral hips. The mean anteversion angle for males was 17.43° and that for females was 14.84° showing a statistically significant difference for the angle of anteversion between the male-and female-type bones (7). In the present study the mean value for 81 male type bones was 9.78° with a standard devation of 1.70 and the mean value for 83 female type bones was 9.79° with a standard devation of 1.54 (Table/Fig 4) Though the value was higher in the female type bones, the difference was not statistically significant (Table/Fig 7) Femoral neck anteversion was measured using 300 dry bones. Retroversion was observed in 9.33% bones. Neutral or almost neutral version (-1 to +1°) was found in 7.33% bones. 15.3% of the bones were in the range of 0-5°, 42.3% range of 5.1 -10°, 21.3% of the bones were in the range of 10-15°,11.6% of bones had angle >15°. (6) In the present study also, 7.9% bones were in the range of 0-8°,54.2% bones were in the range of 8-10°, 21.9% were in the range of 10-12°,15.8% bones had angle more than 12° showing most bones with a value of anteversion in the range of 8-10°.Range with Percentagewise distribution according to the side is represented in (Table/Fig 5) and gender type is represented in (Table/Fig 6).
Abnormal femoral neck anteversion sometimes can be associated with many clinical problems ranging from harmless intoeing gait in the early childhood, to disabling osteoarthritis of the hip and the knee in the adults. Accurate measurement of femoral neck anteversion is important for orthopaedic diagnosis and for selection of patients and planning before derotation osteotomy of femur (10),(8). Any increase or decrease in the angle of femoral anteversion is associated with various clinical conditions. The increased angle of anteversion is associated with failure of treatment of CDH, Perthes disease, cerebral palsy, anterior poliomyelitis, postural defects, apparent genu valgum, external tibial torsion, flat foot, and intoing. The decreased femoral torsion has been shown to be associated with toing out, rickets, chondrodystrophy (11),(12). Proximal femoral geometry was studied morphologically and radiologically in 75 pairs of dried femora. The impact of these findings on future implant design was evaluated. The anteversion angle was found to be 13.68° (13). In the present study the angle was measured in 164 dry bones and the mean value irrespective of the side and gender type was 9.8°. It is important to determine a standard value of the angle of anteversion in a particular population by a method that is accurate and easily reproducible. Estimation of anteversion on dry bone is considered to be the most accurate method (6). Different investigators have used various methods to determine FNA on dry bones. The Kingsley Olmsted method has been used in large number of bones by various authors and is considered the most accurate one (10),(6). Hence this method was followed to determine the angle of femoral torsion in our study.
In the present study the mean femoral neck anteversion was 9.8°. The value was higher on the left side than the right a statistically significant difference. There was no significant difference between the male and female type bones. Most i.e 54.2% bones had the range of 8° to 10° of femoral neck anteversion. Therefore this study will be of use in the fields of orthopaedic surgery to diagnose various hip pathologies and in planning derotation osteotomy of femur, forensic anthropology to determine the racial variations of the femoral anteversion and also to the anatomists.
DOI: JCDR/2012/3794:1981
Financial OR OTHER COMPETING INTERESTS:
None.
Date of Submission: Oct 24, 2011
Date of Peer Review: Dec 04, 2012
Date of acceptance: Dec 25, 2012
Date of Publishing: Apr 15, 2012
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