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

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Dr Mohan Z Mani

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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."

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Professor and Head
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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.
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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 : April | Volume : 6 | Issue : 2 | Page : 301 - 302

Congenital Rubella Syndrome: It Still Exists in India

Satheesh K. Bhandary, M. Shwetha Shenoy, Vadisha Srinivas Bhat, Biniyam K., Vijaya Shenoy

1. Professor and Head, Department of ENT 2. Senior Resident, Department of ENT 3. Associate Professor, Department of ENT 4. Assistant Professor, Department of ENT 5. Prof and Head, Department of Paediatrics NAME OF DEPART MENT(S)/INSTITUTION(S) TO WHICH THE WORK IS ATTRI BUTED: K.S. Hegde Medical Academy, Deralakatte, Mangalore, India.

Correspondence Address :
M. Shwetha Shenoy
Senior Resident, Department of ENT,
K.S. Hegde Medical Academy Deralakatte, Mangalore, India.
Phone: 9964513913


We report here a case of congenital rubella syndrome in a child who presented with hearing loss, patent ductus arteriosus and coloboma of the eye. The child was evaluated and rehabilitated using high gain hearing aid. This case is reported to highlight the persistence of infections like rubella which can be eradicated by vaccination and thus are avoidable causes of congenital hearing loss.


Congenital rubella syndrome, Congenital hearing loss, Intrauterine infection

Maternal infection with rubella in the first trimester of pregnancy which results in congenital rubella syndrome (CRS). This is an important cause of blindness, deafness, congenital heart disease and mental retardation (1). An estimated 238,000 children are born worldwide with CRS each year, a majority in the developing countries. The report of overall incidence of rubella immunity mother during the first three months of pregnancy is 55%, and nearly 45% of women were susceptible to CRS (2). If primary rubella infection occurs during pregnancy, the rubella virus will cross the placenta, and induce fetal infection depending upon the time of gestation. Infection occurring in the first 12 weeks of pregnancy causes congenital rubella infection in 90%, with almost a 100% risk of congenital defects. From 13 to 17 weeks the risk of infection is about 60%, and risk of defects about 50%. From 18 to 24 weeks the risk of infection is about 25%, with hardly any risk of congenital defects (3).

Case Report

We are reporting here a case of a girl aged 4-years born to parents of non-consanguineous marriage who presented with the history of reduced hearing in both the ears since birth. Consequently there was also delayed development of speech. There was no history of ear discharge or ear ache. Antenatally, the mother gave history of having developed fever with rash in the fourth month of gestation. Rash was erythematous, non-pruritic localized to the hands and feet. No history of arthralgia. This was a self limiting episode which lasted for 4 days. No history of drug intake. Rest of the antenatal period was uneventful. This baby was delivered after Full term gestation by Lower Segment Caesarean Section. Indication for Caesarean section was cord entanglement around the neck and breech presentation. The child cried at birth. In the post-natal period, child had difficulty in feeding and respiratory distress. During evaluation child was diagnosed to have PatentSectionDuctus Arteriosus ( PDA).The child was treated initially for congestive heart failure. She had undergone ligation of the PDA at the age of 2 months. Presently the child is haemodynamically stable. On general physical examination, she had microcephaly. Ocular examination revealed a coloboma in the left iris [Table/Fig-1], squint and choroidoretinal coloboma. Examination of the nose showed a broad nasal tip. Both the nasal cavities were patent and rest of the nasal cavity was normal.

Ear examination revealed bat ear on the left side. Pre-auricular, post-auricular area external auditory canal, tympanic membrane were bilaterally normal. Child did not respond to tuning fork tests and to sound clinically. All investigative parameters within normal limits except for Rubella IgM positive (1.28) (<0.80) Rubella IgG positive 162 I Ul (<10). Otoacoustic emissions screening at birth was stated as PASS. Middle ear pathology was ruled out. Repeat otoacoustic emission (after 2 years): BORDERLINE.

BERA done at two separate instances showed NO PEAK EVEN AT 99 dB. A diagnosis of BILATERAL PROFOUND HEARING LOSS secondary to congenital rubella syndrome was made. With the help of Speech and Hearing department, high gain hearing aid was fitted and Audiology training and Speech rehabilitation was started. Now she is undergoing speech therapy and rehabilitation.


Rubella virus, a togaviridae, is a member of the genus Rubivirus. It is a RNA virus with an icosahedral capsid. The virus spreads by droplet infection. The primary infection is usually mild or subclinical characterized by a brief prodromal phase. Maculopapular rash are seen in the post-auricular area as well as over the body, accompanied by coryza and conjunctivitis, and arthralgia. It is a self limiting episode (4). However maternal infection can transfer the infection transplacentally and cause congenital defects in the fetus. During the period of maternal viremia the placenta may become infected causing necrosis and desquamation of the epithelium of the chorionic villi and the endothelium.

These culminate in placental hypoplasia and placentitis which in turn results in viral entry into the fetal circulation by embolic transport (5) CRS manifestations may be transient like purpura, permanent structural manifestations (deafness, central nervous system defects, congenital heart disease, cataract), or late-emerging conditions (diabetes mellitus) (6). Hearing loss occurs in 70-90% of CRS cases, and in 50% of these children it is the only sign of CRS, which is often not detected initially. It is like that the virus gains access to the inner ear through the blood supply of the stria vascularis and cystic dilation of the stria vascularis, and partial collapse of Reissner’s vestibular membrane is noted (5). If congenital heart disease is also present, treatment with loop diuretics and aminoglycosides may add to the hearing damage.

Ocular manifestation include Pigmented retinopathy, Cataracts: pearly, dense, nuclear, Microphthalmos and Iris abnormalities (5),(6), Direct viral damage of the septa of the heart may be the cause of the increased incidence of septal defects. The most common cardiovascular lesions are patent ductus arteriosus associated with infection 11 to 48 days after fertilization (5). Demonstration of sero conversion and presence of high IgM titres is the primary mode of diagnosis of acute rubella in pregnancy. IgM in a fetus indicates intrauterine infection. IgG is the only maternal immunoglobulin that is normally transported across the placenta (7).


Congenital rubella syndrome, though uncommon nowadays, is still present in India. Presentation is often associated with subtle eye and ear anamolies. Otorhinolaryngologists should consider congenital rubella syndrome as a cause for congenital deafness more so because it can be prevented by vaccination.


P Vijayalakshmi, et al. Prevalence of eye signs in congenital rubella syndrome in South India: A role for population screening. Br J Ophthalmol 2007; 91:1467–70.
P Vijayalakshmi, et al. Ocular Manifestations of Congenital Rubella Syndrome in a Developing Country. Indian J Ophthalmol 2002; 50: 307-11.
Deka D. Diagnosis of acute rubella infection during pregnancy. J Obstet Gynaecol India Vol. 56, No. 1: January/February 2006; 44-46.
Anne Gershan. Rubella (German Measels) In: Kasper, Braunwald (ed). Harrisons principles of internal medicine 16e.McGrawHill. Vol 1, 1152-54.
William Webster. Teratogen Update: Congenital Rubella. Teratology 58:1998; 13-23.
Felicity T, et al. Guidelines for surveillance of congenital rubella syndrome and rubella. Field test version, May 1999. gpv-documents.
Verma IC. Epidemiology, transmission, pathogenesis and laboratory diagnosis of maternal infection, rubella In: Deka D (ed). Congenital Intrauterine TORCH Infections. New Delhi. Jaypee Brothers.

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[Table / Fig - 1]
DOI and Others

DOI: JCDR/2012/3303:2031


Date Of Submission: Sep 18, 2011
Date Of Peer Review: Dec 26, 2011
Date Of Acceptance: Jan 18, 2012
Date Of Publishing: Apr 15, 2012

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