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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
Knowledge, Attitude and Perception about Neurodevelopmental Disorders among Pregnant Women: A Cross-sectional Study
Correspondence Address :
Abha Khisty,
Assistant Professor and PhD Scholar, Department of Neuropaediatrics, Dr. D.Y. Patil
College of Phsyiotherapy, Pimpri, Pune-411018, Maharashtra, India.
E-mail: abha.khisthy@dpu.edu.in
Introduction: Neurological Developmental Disorders (NDD) reflect disruptions of neuroanatomic structure or psychophysiological function and place a child at-risk for developmental, cognitive, emotional, behavioural, psychosocial and adaptive challenges. The common NDD are Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), tics disorder, intellectual disabilities, Specific Learning Disorders (SLD), motor disorders and communication disorders. The purpose of the study was in agreement with the literature overviewed, which suggests, the prevalence of NDD is high in children. Complications that happen during the antenatal or perinatal period, and the awareness of the same in pregnant women is significantly low.
Aim: To know about the knowledge, attitude and perception of NDD among pregnant women.
Materials and Methods: This cross-sectional study was conducted at Dr. D.Y. Patil College of Physiotherapy, Pimpri, Pune from September 2020 to February 2021 on pregnant women with informed and voluntary consent. A total of 200 primigravida women were included and women with complicated pregnancy were excluded. A self-constructed questionnaire was prepared and administered. It had three domains of total 21 items- the knowledge domain with eight questions, the attitude domain with seven questions and the perception domain with six questions. Descriptive statistics were used to analyse the results.
Results: b>Total 200 women were included, mean age was 25.6±2 years. A 24% of the women had heard about the term NDD and only 13% of them knew its meaning. Attitude of pregnant women, where 79.5% were aware about infections, use of drugs and alcohol and smoking during pregnancy can lead to harmful effects on the foetus. Perception of NDD, where 84% women believed that good health of the mother during pregnancy can prevent NDD, 91.5% believed that a proper diet and nutrition during pregnancy plays a role in prevention.
Conclusion: The study concluded that, only 24% have ever heard of the term NDD and only 13% were aware of the meaning of it. While 79% of the pregnant women knew about the importance of antenatal care, significantly less pregnant women had knowledge about NDD and only few of them were aware about the possible signs of NDD.
Autism, Awareness, Cerebral palsy, Learning disorder
Neurodevelopment is an apparent relation between genetic, neurological and behavioural processes across the developmental lifespan. Any disturbance in this process by any internal or external factors will have risk of neurodevelopmental disorders and disability (1). Neurological developmental dysfunctions reflect disruptions of neuroanatomic structure or psychophysiological function and place a child at-risk for developmental, cognitive, emotional, behavioural, psychosocial and adaptive challenges. The common NDDs are ADHD, ASD, tics disorder, intellectual disabilities, SLD, motor disorders and communication disorders (2).
The SLD is a neurodevelopmental disorder that impedes the ability to learn or use specific academic skills (e.g., reading, writing and arithmetic), which is the foundation of other academic learning (3). Prevalence of specific learning disability in India ranges from 5%-15%. Lack of awareness among parents and school teachers continue to pose a significant issue (4),(5). The above study concluded that SLD is highly prevalent and remains undiagnosed due to lack of awareness among teachers and parents (6). Cerebral Palsy (CP) describes a group of permanent disorders of the development of movement and posture causing activity limitations. It excludes motor disorders of spinal, peripheral nerve, muscular or mechanical origin (7).
Pregnancy is a period during which a foetus develops inside a woman’s womb or uterus. It’s divided into three trimesters. Trimester 1 lasting for first 12 weeks, trimester 2 from 13th to 28th week and the last trimester from 29th to 40th week. Each trimester has those problems which can cause NDD. Hyperemesis gravidarum, which is commonly observed in first trimester is a severe type of vomiting which has got deleterious effect on the health of mother and might even lead to problems in carrying day to day life (8),(9). Other condition like pre-eclampsia which is a multisystem disorder of unknown aetiology characterised by development of hypertension to extent of 140/90 mmHg or more with proteinuria after the 20th week in a previously normotensive and non proteinuric woman (10). Study by Pariente G et al., reported that women with pre-eclampsia have increased levels of inflammatory cytokines (IL-6, IL-12) which cause structural and functional changes in the endothelial cells (11).
Prelabour Rupture of the Membranes (PROM) is the spontaneous ruptures of membranes any time beyond 28th week of pregnancy (12),(13). Before the onset of labour and the foetal inflammation associated with it has an adverse effect on brain development, thus, increasing the NDD outcome in children (8),(14). If the mother received two tetanus doses in last pregnancy and mother gets pregnant again within three years than only one dose is recommended and is called as booster dose. Others are Hepatitis B vaccine, Influenza vaccine, Hepatitis A vaccine (15). The purpose of the study, in agreement with the literature overviewed (D’Alessandro A), which suggests, the prevalence of NDD is high occurring, due to complications that happen during the antenatal or perinatal period, and the awareness of the same in pregnant women is significantly low, hence the study’s objective is to know about the attitude, knowledge and perception of NDD among pregnant women (16).
In accordance with the increased prevalence of various prior literatures, the need for the awareness of neurological disabilities in pregnant women is necessary due to the increased mortality and morbidity of neonatal infants due to the either negligence or prior precautions taken. Due to this reason, it is essential to increase the knowledge of the infections such as TORCH (Toxoplasma gondii; Other agents, such as syphilis, parvovirus B19, varicella zoster virus, and listeria; Rubella; Cytomegalovirus, Herpes simplex virus-2) infection and pregnancy complications such as neonatal jaundice, preterm delivery, pre-eclampsia, hyperemesis gravidum, miscarriage, placental previa and other deficits to reduce the incidence of a NDD. Through dedicated diagnostics and regular prenatal and postnatal follow-up and to adapt to the necessary precautions given by the healthcare workers, it can help improve the awareness of NDD during their childbearing ages and of the various complications during the trimesters of their pregnancy (17).
Hence, the present study was conducted to find out the attitude, knowledge and perception of NDD among pregnant women.
This cross-sectional study was conducted at Dr. D.Y. Patil College of Physiotherapy, Medical College and Research Centre, Pimpri, Pune, Maharashtra, India, from September 2020 to February 2021. A written informed consent for voluntary participation in the study was taken and study was initiated after receiving the Institutional ethical clearance. (Institutional Ethical Clearance (Number-DYPCPT/ISEC/09/2021).
Inclusion criteria: Women from first, second and third trimester with conception having single or multiple parity, with educational status of Secondary School Certificate (SSC) and age group from 21 to 30-year-old were included in the study.
Exclusion criteria: Those women who were unwilling to participate in the study, mother diagnosed with psychological illness, mother diagnosed with other cognitive and behavioural illness and those with prolonged medical illness including Human Immunodeficiency Virus (HIV), Tuberculosis (TB) and Systemic Lupus Erythematosus (SLE) were excluded.
Sample size calculation: Sample size calculation was done using WinPIPE Software version 11.34, Confidence interval and mean of previous study by Serena J Counsell, was used to estimate the sample size (13):
Formula for sample size calculation: N=z2pq/e2
Where, N=Sample size; z=Confidence interval at 95% (Standard value on 1.96) pq=Variance of population (0.05); e=Allowable error (5%)
Sample size calculated using above formula was formulated as 200.
Questionnaire
Demographic data (age, gravida, parity) was obtained from all the participants.
The study parameters included knowledge, attitude and perception about NDD in pregnant women and to assess this, a 21-Item self-constructed questionnaire was made. This questionnaire was constructed by authors themselves with help of experts in the field of community rehabilitation physiotherapy. Internal validity and reliability (r=0.8) was assessed and it was administered to the participants included in the study.
The questionnaire was then divided into three domains:
Knowledge domain: is defined as ability of knowing and recognising various disorders as risk factors during pregnancy. It has eight questions addressing on awareness of importance of antenatal check-ups and vaccinations, the impact of injuries during delivery which can lead to mental adversities in children, speech difficulty and physical disability including CP.
Attitude domain: is defined as understanding of various risk factors of neurodevelopmental disorders. It includes seven questions regarding understanding pregnancy related complications and risk factors leading to neurodevelopmental disorders. The questions were framed to understand, if the pregnant females were aware about the which leading to neurodevelopmental disorder, including hypertension, infections, pregnancy induced diabetes, thyroid.
Perception domain: is defined by considering preventive steps to avoid such events during pregnancy. It has six questions which evaluates the application of knowledge into preventing the adverse events during pregnancy so as to avoid further occurrence of neurodevelopmental disorders. The questions in this domain are focused on preventive measure for developmental disorders which includes intake of vitamin B12 during pregnancy, counselling, and adequate nutrition during pregnancy.
Interpretation: The questionnaire had a subjective scoring system as Yes or No.
Statistical Analysis
Descriptive statistics were reported and frequency distribution in terms of percentages was reported. The data was analysed using WinPipe software version 11.34.
Total 200 women were included in present study. The mean age was 25.6±2 years, minimum age being 21 and maximum being 27. Distribution of education which indicates that 57% of the women were Higher Secondary Certificate (HSC) pass, 26.5% were Senior Secondary Certificate (SSC) and 16.5% were graduate, number of times females got pregnant 50% conceived for the first time, 33.5% conceived for the second time and 13.5% conceived for the 3rd time and distribution of pregnant females by their trimester and it can be seen that 42.5% of the females were in their 3rd trimester, 41.5% were in their second and 16.00% in their first trimester (Table/Fig 1).
(Table/Fig 2) represents the knowledge about NDD, 79% of the women were familiar with the importance of antenatal care during pregnancy, 41.00% were aware about the impact of injuries during delivery and its adversities on the foetus, 44% have seen a child with a NDD and 43% are aware that if a child does not make eye contact, there is need for medical consultation.
The current study was conducted on 200 pregnant women to assess the knowledge, attitude and perception of NDD among pregnant women from the antenatal care, where a self-constructed questionnaire consisting of 21 questions divided among the domains of knowledge, attitude and perception was circulated. During the study, pregnant women from age 21 to 30 self-attested the questionnaire. A 57% of them were of HSC qualification and 42.5% being in their third trimester. When it comes to knowledge about NDD, in Sharma P et al., suggested that there is a need to increase the level of awareness regarding the knowledge about vaccinations (3).
In the current study, women showed highest understanding about the significance of antenatal check-up and vaccinations to be taken during pregnancy and 44.5% pregnant women have seen a child with a type of NDD, whereas a significant number of pregnant women did not know the meaning of NDD and the symptoms associated with the same. A previous study by (Kliegmen RM and St. Geme J) (2) showed a lack of awareness and recognition of autism.
The current study supports the previously mentioned study as it indicates lower level of knowledge regarding the signs and symptoms of autism (5). While assessing attitude of pregnant women towards NDD in the current study, about 76% of pregnant women have shown awareness about the various infections, use of drugs and alcohol and smoking during pregnancy have harmful effects on the foetus (6). About 60% of pregnant women showed high level of awareness about the co-morbidities such as diabetes mellitus, thyroid and hypertension during pregnancy and their adverse effects on the foetus and merely 36.5% of pregnant women were aware about the risk of pregnancy at an older age and as low as 20% and 29.5% of pregnant women were aware regarding the signs and symptoms of CP and ADHD, respectively (7),(8).
The final domain that was assessed after knowledge and attitude was perception, 91.5% of pregnant women believed that proper diet and nutrition is helpful in prevention of NDD which indicates that healthier food choices can improve foetal and maternal health leading to reduction of long term complications in Maher GM et al., (10). An 86% of pregnant women believed that good health of the mother throughout the pregnancy helps in prevention of adversities on the foetus. A 61.5% of pregnant women have perceived that apprehension of early symptoms can help avert the likelihood of NDD. Scarcely, 47.5% of women believe the deficiency of folic acid and vitamin B12 can be a harmful aspect leading to NDD, in an antecedent literature it concluded that folic acid is believed as a vitamin supplement but not consumed compulsorily during the peri-conceptional period. About 56% of pregnant women failed to perceive the magnitude of parent counselling in order to prevent NDD (10).
Limitation(s)
Limitations of the present study was small sample size and inter and intra-reliability of the questionnaire was not assessed.
Incorporating antenatal education has shown to impact on possible NDD. Given the limited scope of expansion of present study, findings may still be useful for clinical educators to conceptualise such educational programs for the benefit of community at large. The present study also concludes that women were not aware about risk factors of neurodevelopmental disorders. Future studies with larger sample size can be conducted for better outcome.
DOI: 10.7860/JCDR/2022/49714.15928
Date of Submission: Apr 03, 2021
Date of Peer Review: Jul 09, 2021
Date of Acceptance: Dec 02, 2021
Date of Publishing: Feb 01, 2022
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
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