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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 Prospective Study of Children Who were Admitted for Diabetes Mellitus at a Jamaican Hospital
Correspondence Address :
Prof. Dalip Ragoobirsingh Biochemistry Section, Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Mona Campus, Kingston 7, Jamaica W.I. Tel: 876-927-2290; Fax: 876-977-3823. Mobile: 1-876-509-0523. E-mail: dalip.ragoobirsingh@uwimona.edu.jm
Background: Type 1 diabetes mellitus is the predominant form of youth onset diabetes, and a majority of hospital admissions of this group of patients is usually due to a poor control of diabetes.
Objective: This study was undertaken to determine the prevalence of type 1 diabetes mellitus in children who were admitted to the Bustamante Hospital for Children in Jamaica over a ten year period.
Methods and Materials: A medical records study was conducted over this ten year period.
Results: These showed that there were 77,679 admissions, of which 85 were for type 1 diabetes mellitus. Fifty (50) percent of the latter was between 8-12 years old. Female diabetic patients were twice as that of the males.
Conclusion: It appears that one in every thousand children who were admitted to this institution were admitted for type 1 diabetes mellitus, and that girls between the ages of 8-12 years were more at risk.
Diabetes mellitus, Admissions, Children, Hospital
INTRODUCTION
The Caribbean island of Jamaica has an area of 11,460 square kilometers and a population of just over 2.7 million, which is predominantly of Afro-origin. From the most recent census, 27.32% of the population was found to be under 15 years of age (1). Diabetes mellitus is one of the most common diseases which is prevalent in school-going children. Type 1 diabetes mellitus is the predominant form of youth onset diabetes, accounting for most of the cases of diabetes with an onset before 20 years of age (2), (3). In the Caribbean, the estimated prevalence rate of type 1 diabetes in children under 15 years of age ranged from 6.4 per 10,000 in Puerto Rico to 0.3 per 10,000 in Haiti in 1997 (4). In Jamaica, the prevalence of diabetes among persons who were aged 25-74 years has been estimated to be 12% to 16% (5), (6), and a point prevalence of 17.9% was found in the 15 years and above age group of the population (7).
The SEARCH study for Diabetes in Youth, one of the largest to examine this phenomenon, estimated that the prevalence of diabetes in the United States residents, who were less than 20 years old in 2001 was 1.82 per 1,000 persons, with 15% of the 10-19 years olds having type 2 diabetes mellitus (8). In a study which was done by Tulloch-Reid et al , type 1 diabetes was found to be the most common form of diabetes in Jamaicans with youth onset diabetes, with 22% of the participants who were studied having type 2 diabetes (9).
The hospitalization in children and adolescents with diabetes is associated with a high individual burden and high social costs (10), (11). The data on the hospitalization of diabetic paediatric patients is scarce. We undertook this study to examine the admission rate of type 1 diabetic patients who were under the age of 13 years old at the Bustamante Hospital for Children in Jamaica.
The hospital notes in the medical records of all the children with diabetes mellitus who were admitted to the Bustamante Hospital for Children (both the newly diagnosed patients and subsequent admissions) for the period from 1985-1995 were examined. The Bustamante Hospital for Children is a children’s hospital in Kingston, Jamaica. It was established in 1963 and it serves approximately 35,887 outpatients and 70,331 casualties per year. It has 283 including 5 intensive care unit beds (12).
The information which was collected included the basic demographic data, the pattern of the admissions, the reasons for the admissions, the existing picture or previous history of an infectious disease, the immunization status and the family history of diabetes mellitus. The patients were placed in three broad categories according to their ages: 0-3 years, 4-7 years and 8-12 years.
77, 679 admissions were recorded at the Bustamante Hospital for Children between 1985 and 1995. Approximately 0.11% of these were for type 1 diabetes mellitus. One-half (50.0%) of the latter was between ages 8-12 years old; while 37.5% and 12.5% were recorded for the 4-7 years and the 0-3 years age groups respectively (Table/Fig 1).
In the overall diabetic population, 62.5% were females as compared to their male counterparts (37.5%). Three-quarters (75.0%) of the patients had an existing or a previous history of an infectious disease and 68.8% were fully immunized, while 31.3% had no record of being immunized. Just under two-thirds (62.5%) of the total diabetic population had a history of diabetes mellitus within the immediate family.
The relatively low prevalence of type 1 diabetes mellitus which was observed in this preliminary study was consistent with the results of scientifically organized international studies (13). These have shown that it was unknown or rare in certain groups and that the highest rates occurred in Caucasian populations.
Type 1 diabetes accounts for almost all the diabetes cases in children who are less than 10 years of age (14). The hospitalization of children and adolescents with type 1 diabetes mellitus results in high expenditures which amount to 63-80% of the total direct costs (15). Icks et al., found that the diabetic children and adolescents in Germany had an approximately three times higher hospitalization risk and three times more hospital stay than the age-matched non-diabetic subjects in the general population (16). Amongst 650 type 1 diabetic children in Sydney, a majority of the admissions were due to the poor control of diabetes (17). High glycosylated haemoglobin levels and hypertension were identified by Moss et al., as the predictive factors for the hospitalization for 777 diabetic patients under the age of 30 years, who lived in Wisconsin, United States (18). Reducing hospitalization is a main goal in the structured treatment of childhood diabetes, and it is a major outcome indicator in the diabetes quality management (19), (20).
The high incidence which was seen in the 8-12 years age group concurred with the results of a majority of population studies (13). These had demonstrated age peaks in the clinical presentation of type 1 diabetes mellitus, one of a particular magnitude which occurred in the 10-13 years age group (21). In a study which was done by Icks et al., of the 5,874 diabetic patients from 61 paediatric centers who were between 1 and 19 years of age, who were treated in 1997, 52% were males. In our study, 62.5% of the diabetic patients were females (16). Lipton et al., examined the risk factors for 216 African-American and Latino children who were diagnosed with type 1 diabetes mellitus, who were under the age of 18 years, over a 6 year period and found that females were twice as likely to be hospitalized as males (22). In California, a study which was done by Cohn et al., found increased hospitalization rates among young girls as compared to boys in a cohort of 2,889 type 1 diabetic children who were aged 0-18 years during 1991 (23). These authors suggested that the underlying cause may be biological or behavioural (24).
The high incidence of the existing picture or a history of infectious diseases within our diabetic population is not unusual. Epidemiological studies provide circumstantial evidence for a possible causative role of viral infections in type 1 diabetes mellitus (24). Among the viruses that have been implicated are rubella, mumps and human coxsackie virus B4. Experiments which were done by using animal models support the possible aetiological role of certain viruses in the genetically susceptible host (25),(26). Yang et al;reported that infectious diseases are associated with a large and transient increase in the risk of type 1 diabetes in paediatric patients during 42 days after the infection (26).
Type 1 diabetes is preceded by autoimmunity against the insulin-producing islet β-cells [27,28]. The development of islet autoantibodies and type 1 diabetes is influenced by both genetic and environmental factors, and the detection of islet autoantibodies in members of the affected families helps in identifying a minority of the individuals who have a markedly elevated risk of type 1 diabetes (29). In a study which was done by Tulloch-Reid, which examined the prevalence of diabetes and other autoantibodies in patients with recently diagnosed youth onset diabetes in Jamaica, GAD65 was found to be the most common diabetes-associated autoantibody in patients with type 1A diabetes (30). Children who had a first-degree relative with type 1 diabetes were at the highest risk for young-onset type 1diabetes (28).
There was a reported genetic predisposition in approximately two-thirds of the type 1 diabetic patients in this study. Family studies have shown the existence of strong genetic components in type 1 diabetes mellitus as well as in type 2 diabetes mellitus (31). The susceptibility in type 1 diabetes mellitus is conferred by the genes in the HLA-D region of the major histocompatibility complex on chromosome (32). The genes in this complex control the immune responses. It is believed that an individual inherits a susceptibility to develop either type 1 or type 2 diabetes mellitus and that one or more non-generic and presumably environmental factors can eventually precipitate the overt clinical disease.
It appears that one in every thousand children who were admitted at this institution had type 1 diabetes mellitus, and that girls between the ages of 8 and12 years were more at risk. The reduction in the hospital admissions of paediatric diabetic patients in Jamaica and the cost of diabetes care are of critical importance because of the increasing health care expenditures and the incidence rates of childhood diabetes. Further studies could examine the reasons for which the type 1 diabetic patients are hospitalized and the length of the hospital stay.
We gratefully acknowledge the kind assistance of Ms M. Cross, T. Genus, Dr. L. Gabay and the staff in the Records Office at the Bustamante Hospital for Children who assisted in collecting the data. Also, the statisticians who helped us with the analysis of the data. Finally, Ms. T. Smith who typed the manuscript.
Date of Submission: Nov 30, 2011
Date of Peer Review: Dec 06, 2011
Date of Acceptance: Feb 21, 2012
Date of Publishing: Jun 22, 2012
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