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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
Research Protocol
Full Version
Evaluation and Correlation of Vitamin D Levels and Jaw Bone Mineral Density in Premenopausal and Postmenopausal Female Patients Undergoing Implant Therapy: Protocol for a Cross-sectional Study
Correspondence Address :
Ekta Mukesh Kanojia,
Shri Kripa Azad Chowk, Sadar, Nagpur, Wardha, Maharashtra, India.
E-mail: drektak227@gmail.com
Introduction: Vitamin D deficiency is one of the most common nutritional deficiencies worldwide. The amount and quality of bone at the implant installation site have an impact on the implant’s prognosis however, the effects of menopause on jaw bone remain unknown. Few studies have looked at the prevalence of vitamin D deficiency in India’s general population, but none have looked at the link between vitamin D deficiency (osteoporosis) and postmenopausal women’s jaw Bone Mineral Density (BMD). This is the first study of its sort in India to look at postmenopausal women’s vitamin D levels and jaw BMD.
Need of the study: The present study would enhance the relationship between vitamin D levels and BMD in premenopausal and postmenopausal females and will help to conclude the effect of menopause on bone quality and quantity which should be considered in dental treatment.
Aim: To evaluate and correlate vitamin D levels and jaw BMD in pre and postmenopausal females undergoing implant therapy.
Materials and Methods: This cross-sectional study will include 50 partially or completely premenopausal (n=25) and postmenopausal females (n=25) having edentulous anterior and posterior maxillary and mandibular jaws. Females will be tested to evaluate their vitamin D levels and jaw BMD with Cone Beam Computed Tomography (CBCT) and results will be recorded in Hounsfield Units (HU) using Planmeca romexis viewer software. Chi-square test and Students t-test will be used.
Bone density, Cholecalciferol, Oestrogen levels, Osteoporosis
Vitamin D insufficiency affects around one billion people around the world (1). Vitamin D deficiency can be caused by a lack of sunlight or a dietary deficiency. It is also limited to elderly people who have chronic illness (1). Lower dietary calcium and vitamin D levels have resulted in inadequacy in postmenopausal women, potentially increasing bone loss. Vitamin D levels in serum range from 30-55 ng/mL on average. A level <20 ng/mL has been judged insufficient, while a range of 20-30 ng/mL has been regarded as inappropriate (1).
Intake of proper vitamin D and calcium nutrition is usually regarded as the cornerstone of osteoporosis prevention and treatment. Supplementing with vitamin D and calcium has a proven advantage in elder postmenopausal women, with or without the intake of calcium and vitamin D supplementation, has been found to enhance BMD (as demonstrated in spine density and decreased bone loss at the hip bone), as well as decrease bone turnover and non vertebral fractures (2). Subclinical vitamin D deficiency has been associated with bone density loss in postmenopausal women (2).
Postmenopausal women have lower oestrogen levels, leading to a significant bone mass reduction, known as postmenopausal osteoporosis (3). There are roughly 30% of postmenopausal women in the United States and Europe having osteoporosis, with 40% of these women experiencing atleast one fragility fracture over their remaining lives (3).
Osteoporosis has been linked to an increased rate of tooth loss and loss of the tooth-supporting alveolar bone, in addition to a greater incidence rate of hip, spine, and wrist fractures (3).
The quantity of inorganic minerals in our bones is normally measured using BMD. Mineralised bone is vital for maintaining bone strength and is required in the event of fractures or the prevention of disorders such as osteopenia and osteoporosis. The BMD levels are affected by a variety of factors, including gender, age, inheritance, bone-loss disorders, alcohol consumption, sedentary lifestyle, BMI, and low vitamin D levels. BMD is affected by other diseases like diabetes and hypertension (4). After reaching peak bone mass between the ages of 18 years and 20 years, the skeletal maturation process is complete, and thereafter, BMD levels begin to fall. Because osteoporosis and low bone mass are less common in men than in premenopausal and postmenopausal women (4).
Teeth loss can cause jaw bone neuromuscular instability, lower masticatory efficiency, vertical dimension loss, and poor aesthetics (5). Now-a-days, the rehabilitation of oral tissue and function with a dental implant is proven to be effective and predictable (5). The prognosis of an implant is influenced by its BMD (both quantitative and qualitative) at the implant placement site (6). Bone amount, which can be assessed more precisely by many X-rays Computed Tomography (CT) systems, is an important determinant for implant placement feasibility and the potential for bone grafting (7).
As a result, CBCT, which is more objective and reliable, may be the ideal radiographic tool for morphological and qualitative characterisation of residual bone, and it has been utilised in the majority of investigations. The software programme in CT machines determines the HU, which vary from -1000 (air) to 3000 (enamel) (7).
The correlation of vitamin D level and menopausal condition on jaw bone about its BMD for dental implant therapy has not been well-documented therefore this study will be conducted with the following objectives:
• To evaluate the vitamin D levels amongst premenopausal and postmenopausal females.
• To evaluate the jaw BMD amongst premenopausal and postmenopausal females using CBCT.
• To estimate the correlation among the following variables- age of the premenopausal and postmenopausal group, vitamin D levels, BMD.
REVIEW OF LITERATURE
Vitamin D and BMD are critical for sustaining the structure and function of bones (1). When a woman reaches menopause, her body’s vitamin D levels begin to dwindle. Similarly, the menopausal status of the women was found to be substantially linked with BMD. In comparison to postmenopausal women, women in their reproductive years had significantly higher BMD (1). This emphasises oestrogen’s function in bone maintenance, calcium management, and its direct relationship with vitamin D levels (1). Labronici PJ et al., compared vitamin D levels to BMD in postmenopausal women with and without fractures. After correcting for age, the results revealed a strong association between vitamin D levels and BMD (1).
A study by Munakata N et al., looked at the impact of menopause on BMD and mandible width, and concluded that menopause has an effect on bone quality and quantity in the partially edentulous molar region of the mandible, which should be considered in dental treatment for postmenopausal women (6). Suganthan N et al., conducted their study on that BMD of hip bones were assessed by Dual-energy X-ray Absorptiometry (DEXA) and blood samples were taken to evaluate vitamin D levels and they concluded that because their study revealed a higher vitamin D deficiency prevalence among postmenopausal women with suspected osteoporosis (8). So to prevent fracture, treatment of vitamin D deficiency with supplementation is essential. Khan AW et al., in their research focused on the influence of menopause on vitamin D levels and BMD, as well as the relationship between the two (9). They also discovered that women in their reproductive years had much higher BMD than those after menopause. For women with vitamin D deficiency and low BMD, calcium and vitamin D supplementation, as well as frequent sun exposure and dietary adjustments, are indicated.
A review was done by Man PW et al., and Mezquita P et al., on the relationship between BMD and blood vitamin D levels in the Chinese population. Low BMD is linked to the prognosis of hip fractures in Chinese individuals, as low vitamin D levels are linked to low BMD (10),(11). In 2001, postmenopausal women were the subjects of a similar study. Vitamin D insufficiency was found to accelerate bone loss and was a major factor in increasing the risk of fractures, which increased the likelihood of osteoporosis in otherwise healthy postmenopausal women. Another study by Harinarayan CV et al., was conducted concerning vitamin D and BMD in premenopausal and postmenopausal women (12). Women of reproductive age and postmenopausal women with low BMD levels were shown to have low vitamin D levels. Patients with vitamin D deficiency and low BMD were given vitamin D and calcium supplements to prevent diseases like osteoporosis, osteoarthritis, and ostopaenia later in life.
Postmenopausal females with compromised bone conditions should be routinely examined for vitamin D levels. This will help the clinician to get an accurate knowledge and understanding of the patient’s condition. Accordingly, implementing various therapies to increase BMD can be advocated in patients undergoing dental implant therapy.
Vitamin D testing should be done regularly in postmenopausal females who are undergoing dental implant therapy and have a compromised bone condition, so that concrete decision can be made about whether or not to start Vitamin D supplementation/therapy as a routine to increase BMD. And its implications affect the treatment’s overall planning and prognosis.
It is a cross-sectional study, which will be conducted in the Department of Prosthodontics, Crown and Bridge, Sharad Pawar Dental College, Sawangi (Meghe), DMIMS DU, Wardha and duration of the study will be two years. Ethical approval for this study has been obtained by the Institutional Review Board {Ref no:DMIMS(DU)/IEC/2022/777}.
Inclusion criteria:
• All premenopausal and postmenopausal females either edentulous or partially edentulous and willing to participate in the study.
• No history of oophorectomy or hysterectomy
• Patients indicated for an implant-supported restoration.
• The patient should not have any medical conditions (besides osteoporosis) that would make implant treatment more complicated.
• They should have no local disease or condition that could interfere with implant treatment, such as periodontal disease, endodontic problems, caries, occlusal problems, tooth fracture, or tooth wear, as well as bony lesions.
Exclusion criteria:
• Hyperparathyroidism, renal dystrophy, oophorectomy, and skeletal bone disorders significantly affect bone metabolism.
• As well as the usage of bone-related medications such as corticosteroids, oestrogens preparations, bisphosphonates, and vitamin D supplements.
• Uncontrolled diabetes, uncontrolled hypothyroidism, the habit of smoking, alcoholics
• Pregnancy
• Psychological instability
• Cancer radiation and chemotherapy
• History of radiation therapy to the jaws
• Habit of bruxism
• Bad oral hygiene which continues despite motivating treatment.
Sample size calculation: Cochran formula for sample size estimation:
n=Z2a/2P(1-P)
Where,
Za/2 is the level of significance at 5% i.e., 95% Confidence interval=1.96
p=0.02 Khan AW et al., (9)
E=Error of Margin=6%=0.06
n=1.962×0.02×(1-0.02)/ 0.062=20.91
=25 patients are needed in each group and so total sample size of 50 will be considered.
This study will be conducted on 50 female patients including 25 premenopausal females and 25 postmenopausal females with partially or completely edentulous anterior and posterior regions of both maxillary and mandibular jaw. Females will be tested to evaluate their vitamin D levels. Electrochemiluminescence is being used to determine vitamin D levels in the blood. BMD measurement of the jaw will be measured with CBCT and recorded in HU using Planmeca viewer software.
Statistical Analysis
Chi-square test, Students t-test will be used. The level of significance at 5% i.e., 95% Confidence interval=1.96 will be considered in the study. Software used will be Statistical Package for Social Sciences (SPSS) version 27.0, GraphPad Prism and 7.0V.
DOI: 10.7860/JCDR/2023/58804.17664
Date of Submission: Jul 07, 2022
Date of Peer Review: Aug 05, 2022
Date of Acceptance: Nov 06, 2022
Date of Publishing: Mar 01, 2023
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
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jul 08, 2022
• Manual Googling: Oct 18, 2022
• iThenticate Software: Nov 04, 2022 (22%)
ETYMOLOGY: Author Origin
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