Article in PDF
How to Cite
Citation Manager
Readers' Comments (0)
Audio Visual Article Statistics
Link
to PUBMED
Print this Article
Send to a Friend
Advertisers
Access Statistics Resources
Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Case report
Full Version
Sacral Agenesis- Its Urological Impact and Management
Correspondence Address :
Dilip Kumar Pal,
244, Acharya Jagdish Chandra Bose Road, Kolkata, West Bengal, India.
E-mail: urologyipgmer@gmail.com
Sacral agenesis is a rare developmental disorder, in which there is absence of part or all of two or more sacral vertebral bodies. It is mostly associated with dysfunction of bowel, bladder and neuromuscular system of lower limbs. Voiding impairment (neurogenic bladder), Vescico-Ureteric Reflux (VUR) together with urinary tract infection contribute to renal injury. Here authors are reporting an 11-year-old female, who was diagnosed to have sacral agenesis with anorectal malformation at the age of six months, leading to anal transpositioning done at that age, she presented to the Urology Department with acute kidney injury. On evaluation, she was found to have overactive bladder with increased bladder capacity and bilateral grade 5 VUR. After recovery from acute kidney injury with conservative management and catherization, she was discharged with the advice of clean intermittent catheterization and anticholinergic drug. On follow-up, she was doing well. Early diagnosis and long term follow-up is required in the patients having sacral agenesis with multidisciplinary team including urologist, as these patients may develop lower urinary tract symptoms, VUR and kidney injury at any time in their growth period.
Bilateral pelvicalyceal system, Colostomy closure, Neurogenic bladder
An 11-year-old girl presented to Urology Department with complaints of recurrent Urinary Tract Infection (UTI), persistent dribbling of urine and constipation for last one year. She was a known case of sacral agenesis with anal vestibule for which she was operated at the age of six months (anal transposition and transverse colostomy) and at the age of 14 months (colostomy closure). After which, she was lost to follow-up of primary treating physician. She was apparently well till the age of 10 years, after which she had recurrent episodes of UTI. There was no significant family history and no history of consanguineous marriage in the family. There was no maternal history of diabetes.
On examination, she was febrile, urinary bladder was palpable, buttocks were flattened (Table/Fig 1), external genitalia was excoriated and wet. Anal opening was in normal position with decreased anal tone and rectum loaded with hard stool (on per-rectal examination).
On evaluation, her blood analysis showed low haemoglobin (Hb-7.6 gm%), leukocytosis (14,500/cumm) and creatinine: 2.5 mg/dL. Ultrasonography (USG) of Kidney ureter and bladder (KUB) showed bilateral hydro-uretero-nephrosis and thickened irregular bladder wall with significant post void urine. Her urine analysis showed plenty of pus cells with Escherichia coli (colony count > one lakh per milliliter) on culture (antibiotic was given according to drug sensitivity). Sacral agenesis with absent ala of left side of sacrum seen in X-ray film and Voiding Cystourethrogram (VCUG) revealed bilateral grade 5 Vesico-Ureteric Reflux (VUR) as per International Reflux Grading System (Table/Fig 2). Magnetic Resonance Imaging (MRI) of lumbosacral spine showed Type-III sacral agenesis with low lying cord with evidence of meningomyelocele (Table/Fig 3).
On further evaluation with Urodynamic Study (UDS), she had detrusor overactivity and increased bladder capacity during the filling phase and strong detrusor contraction and obstructive pattern during voiding phase of micturition. After catheterization, her serum creatinine came down to normal level then she was advised for Clean Intermittent Catheterization (CIC) along with anti-cholinergic drugs (oxybutynin 5 mg/day) and a laxative.
The patient was followed-up three monthly on out-patient basis with serum creatinine, urine culture and USG KUB, which were with in normal limits, apart from dilated bilateral pelvicalyceal system and ureters (due to VUR) on USG, which was also decreased when compared with previous USG images. Patient was doing well on CIC and anti-cholinergic drug, with no lower urinary tract symptoms.
Sacral Agenesis (SA) is defined as the absence of part or all of two or more vertebral bodies. It is a rare developmental anomaly of sacrum and frequently associated with bladder dysfunction (1). Overall incidence of SA is 0.09-0.43% and occurs in about 0.1-0.25 per 10,000 pregnancy with its strong association with maternal diabetes mellitus (2). It is mostly associated with other abnormalities, such as maldevelopment of the bones or joints of the lower limb and anorectal malformation (3). SA was described as a part of spectrum of sacrococcygeal malformations, known as caudal regression syndrome (4). SA may be associated with homeobox gene abnormalities and currarino triad (1),(5),(6).
Renshaw classification of SA:
Type I: Unilateral agenesis of sacrum or coccyx.
Type II: Iliac bone articulates with S1, distal sacrum not developed.
Type III: Total SA, iliac bones articulate with lowest lumbar vertebrae.
Type IV: Total SA, iliac bones fuse posteriorly (7).
Usually it has a bimodal presentation, with more than 75% presents in early infancy and the remainder detected between four and five years of age due to failed attempts of toilet training. Common urological presentations are voiding dysfunction and recurrent urinary tract infection (2). The underlying lesion is usually overlooked, as they have normal sensation and minimal or no bony deformity in the lower limbs.
Due to total or partial absence of sacrum, injury occurs to the nerve fibres that pass through the bony canal of sacrum and supply the bladder , bowel, anus and sensory and motor fibres of lower limbs (8). Patient may present with constipation, urinary incontinence, recurrent urinary tract infections and even renal injury as storage and voiding of urine occurs at abnormally high pressure due to neurogenic bladder (2). Urodynamic study (UDS) may show either upper motor and/or lower motor type of bladder injury, but about 25% of patients may not find any sign of denervation (9). VUR may be associated with both types of lesion but more due to detrusor overactivity. VUR can be diagnosed by VCUG. VUR is graded by International Reflux Grading System into five grades (10).
Here, authors present a known case of SA with vestibular anus, who lost follow-up of primary treating physician and ultimately presented to our Urology Department with recurrent urinary tract infection (UTI) due to bilateral grade 5 vesico ureteric reflux (VUR) with neurogenic bladder at the age of 11 year. She was managed with CIC and anti-cholinergic drugs. And she was doing well on follow-up.
In one retrospective study of 43 patients having SA, majority of the patients required CIC for the management of their neurologic bladder and none had developed end-stage renal disease (11). In one case report by Sharma S et al simalar case was reported in a 7-year-old boy where radiograph of lumbosacral area of spine showed an abnormal sacrum (12). Usually, treatment consist of anti-cholinergic for bladder overactivity or CIC with sympathomimetic for bladder underactivity. After initiation of treatment, urinary tract of these patients should be monitored on follow-up otherwise they may develop VUR or hydronephrosis leading to renal damage. These patients may require ureteric reimplantation (if high grade VUR present), augmentation cystoplasty with or without bladder neck continence surgery in order to maintain low bladder filling pressure and adequate bladder capacity to prevent renal damage in long run.
Authors reported a case of a girl, who was initially diagnosed to have SA due anorectal malformation at the age of six months. Anorectal malformation corrected at the same time (six months of age). But after a prolonged period, she presented to the urology department with kidney injury due to recurrent UTI, on evaluation found to have neurogenic bladder with bilateral grade 5 VUR. The patient was fortunately not presented at this age with chronic kidney damage showing the importance of initial evaluation after diagnosis and regular follow-up of these group of patients by multidisciplinary team including paediatrician, neurologist and urologist.
10.7860/JCDR/2021/49045:15165
Date of Submission: Feb 16, 2021
Date of Peer Review: Apr 26, 2021
Date of Acceptance: May 21, 2021
Date of Publishing: Jul 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Feb 22, 2021
• Manual Googling: Apr 24, 2021
• iThenticate Software: Jun 10, 2021 (4%)
ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com