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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
Case report
Full Version
Management of Accidental Chin Staining Following Silver Diamine Fluoride Application in a 24-Month-Old Girl: A Case Report
Correspondence Address :
Vipul Chandraprakash Lodha,
A-1602, Bhumiraj Hermitagw, Sector 18, Sanpada, Navi Mumbai, Maharashtra, India.
E-mail: vipullodha1313@gmail.com
Silver Diamine Fluoride (SDF) is a clear liquid that combines the remineralising effects of fluoride with the antibacterial effects of silver. It is a promising therapeutic agent for managing carious lesions in young children and those with special care needs. However, a major complication of SDF is black staining of the skin, mucosa, lips, tongue, and cheeks if improperly applied. This case report presents a complication following SDF application and its management. A 24-month-old girl presented with decayed teeth in the upper back tooth region of the jaw, and SDF application was performed on tooth no. 54 and 64. However, due to the child’s extremely negative behavior and movement during the application of SDF, staining occurred on the chin and lower lip a few hours later. Watchful observation, patient reassurance, and follow-up led to adequate patient management.
Caries arrest, Casein phosphopeptide-amorphous calcium phosphate, Dental caries, Early caries, Tooth remineralisation
A 24-month-old girl presented with a chief complaint of decayed teeth in the upper left and right back tooth region. No history of pain or swelling was reported with the decayed teeth. There was no relevant past medical history. The patient was bottle-fed until the age of 18 months, and no sugar was given to the child. The patient occasionally used fluoridated toothpaste (500 ppm) for brushing teeth. The Frankl’s behaviour rating was definitively negative (1).
During the examination, the mother was asked to hold the child due to her definitely negative behaviour. It was observed that teeth 54 and 64 had occlusal surface caries. There was no pulpal involvement, abscess, or mobility associated with these teeth. Radiographs were not taken as the caries only involved enamel and dentin, and the child’s behaviour was extremely negative. The treatment plan involved interim 38% SDF application until the child’s cooperation could be achieved, followed by Glass Ionomer Cement (GIC) restoration.
During the next appointment, the patient’s behaviour was extremely negative (--), so the mother was asked to stabilise the child. Petroleum jelly was applied to the lips, tongue, buccal mucosa, palate, and skin. A drop of SDF was dispensed into a dappen dish and loaded onto the applicator tip. After proper isolation with a cotton roll, SDF was applied to tooth no. 54 for 2-3 minutes, and the same procedure was repeated with tooth no. 64 (2). The patient was discharged from the dental clinic after the application of SDF.
After three hours, the patient reported black stains on the chin and lower lip via telephonic communication (Table/Fig 1)a. Photographs of the stains were obtained from the parents. After proper evaluation, the parents were informed about the accidental staining caused by SDF and reassured that the stain would disappear within a week. The patient was followed-up every day until the stain completely disappeared. In three days, the staining reduced (Table/Fig 1)b, and on the 7th day, the black stain had completely disappeared (Table/Fig 1)c. The caries on teeth 54 and 64 were arrested with the help of SDF.
A remineralising paste containing Casein PhosphoPeptide-Amorphous Calcium Phosphate (CPP-ACP) (3) was recommended for home application two to three times a day. The patient was advised to avoid sugar between meals and reduce free sugar consumption in the diet. Other home care measures, such as brushing twice a day with toothpaste containing an optimal fluoride concentration and an adequate amount of toothpaste, were also explained (Table/Fig 2).
Dental caries, being the most common chronic infectious disease of childhood, is caused by the interaction of bacteria with food substrates in the oral environment (4). Newer minimally invasive methods of caries management include CPP-ACP, Chlorhexidine (CHX) application, varnish application, SDF application, and stabilised aqueous silver fluoride solution (AgF) (5), among others.
SDF combines the remineralising effects of fluoride and the antibacterial effects of silver (253,900 ppm). SDF is used to arrest dental caries in both children and adults. Fluoride helps promote the remineralisation of hydroxyapatite in enamel and dentin. It has also been shown to reduce Streptococcus mutans (S. mutans) in treated surfaces (6). Treatment with SDF is non invasive as no removal of carious tissue is necessary before the application of SDF (7). This suggests that dental practitioners do not need to remove caries from patients’ teeth during treatment with SDF. The lesion depth of a demineralised tooth surface decreases after the application of SDF and also slows down the progression of lesions. A recent meta-analysis concluded that SDF effectively arrests caries, and this conclusion is strongly supported by high levels of evidence (8).
Demineralised tooth surfaces become black after SDF application. Staining of carious lesions black and a metallic taste are the two most commonly reported complications following SDF application. The reaction of silver phosphate and silver sulfide forms a reactive product that causes black staining after application (8). Accidental contact of SDF with the lips or skin results in rapid red-brown discoloration, which may take several weeks to disappear. SDF has the ability to stain clothes and skin. Although it does not cause pain or damage, the stains caused by SDF are not easily washed away. On the skin, the stains typically disappear in around seven days, while stains on clothes are permanent (9). These complications are transient and self-manageable.
Prior to the application of SDF, written informed consent was obtained, which includes information about the benefits and risks of SDF. In cases of complications like this, it is important to address the patient’s fears and calmly explain the transient nature of the problem. Such communication is better done in person rather than over the phone, as it allows for answering multiple questions and providing reassurance. If the issue of soft tissue staining is not promptly addressed with attention given to the child and parent, it can lead to a frenzied situation involving consultation with multiple specialists such as a pediatrician, general physician, dermatologist, and cosmetologist, resulting in unnecessary and exhausting communication. The authors would like to emphasise that such a complication has not been reported, and this case can provide evidence to alleviate patients’ fears and serve as a guide to approach this treatment with caution.
According to Gao SS et al., the rate of caries arrest with 38% SDF was 86% at six months, 81% at 12 months, 78% at 18 months, 65% at 24 months, and 71% at or beyond 30 months. The overall proportion of arrested dental caries after SDF treatment was 81% (95% CI, 68% to 89%; p<0.001). Staining of arrested lesions black was the only complication reported among the 19 studies included in the systematic review (10). Nowadays, SDF is also used alone or in combination with other biological approaches such as a topical fluoride application, Atraumatic Restorative Technique (ART), interim therapeutic restorations, and Hall technique preformed metal crowns (11),(12). In a randomised trial by Ballikaya E et al., in 2021 on Molar Incisor Hypomineralisation (MIH), both SMART sealants and SDF showed similar effectiveness in reducing hypersensitivity and arresting enamel caries in hypomineralised molars (13).
In different community-based dental programs, SDF is used as a non invasive strategy to treat dental caries (14). Potassium iodide (KI) helps prevent staining by precipitating excess silver ions as white silver iodide. A systematic review by Roberts A et al., stated 2that the application of KI after SDF might have the potential to reduce staining caused by SDF (15). However, the authors cannot verify if KI has the potential to reduce mucosal or dermal staining as seen in this case. Therefore, it is recommended that in the event of such a complication, the use of KI may provide further possibilities for managing dermal and mucosal staining, in addition to reassurance.
As an alternative treatment to control decay, the American Dental Association recommends semi-annual application of fluoride varnish as an effective measure in the primary and permanent dentition of children and adolescents (16). The ART is another alternative for caries control; however, it does not involve the use of SDF, whereas SDF has shown strong caries arresting, collagen preserving, and antibacterial effects that may not be achieved by Resin-Modified Glass Ionomer Cement (RMGIC) alone. In this case, the primary goal was to arrest active dentin caries because the patient’s age and behavior were not suitable for definitive restoration; therefore, this interim treatment was selected. Another alternative could be treatment under sedation or general anaesthesia.
To our knowledge, this is the first case report mentioning staining on the skin caused by SDF application. Adequate patient reassurance about the reversible nature of staining is necessary. Follow-up plays an important role in the management of such mishaps as it allows the clinician to determine whether the treatment provided needs to be modified.
DOI: 10.7860/JCDR/2023/65801.18360
Date of Submission: Jun 03, 2023
Date of Peer Review: Jul 05, 2023
Date of Acceptance: Aug 19, 2023
Date of Publishing: Sep 01, 2023
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: Jun 05, 2023
• Manual Googling: Jul 13, 2023
• iThenticate Software: Aug 16, 2023 (11%)
ETYMOLOGY: Author Origin
EMENDATIONS: 7
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
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