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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
CT Severity Score in COVID-19 Patients and its Association with Diabetes Mellitus and Hypertension: A Retrospective Study
Correspondence Address :
Dr. Harshit Kumar Koshta,
Flat No. 105, Achleshwar Mansion, Lalitpur Colony, Lashkar, Gwalior-474009, Madhya Pradesh, India.
E-mail: koshta06@gmail.com
Introduction: The Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China, in December 2019. It is thought that, people who have Diabetes Mellitus (DM) and Hypertension (HTN) are more likely to get a severe COVID-19 infection. High-resolution Chest Computed Tomography (HRCT) has been shown to provide immediate results with high sensitivity and specificity for determining the severity of COVID-19 infection and lung involvement.
Aim: To determine the association between chest CT Severity Scores (CTSS) and DM and HTN in COVID-19 patients.
Materials and Methods: This retrospective observational study was conducted in the Department of Radiodiagnosis at, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India. The duration of the study was one month, from July 2020 to August 2020. Based on the degree of lung involvement seen on HRCT chest scans. A total of 100 patients (68 males and 32 females) with COVID-19 infection were given a quantitative CTSS. The patients were divided into groups with mild, moderate, and severe lung involvement based on the CTSS. The Chi-square test was used to assess the relationship between DM, HTN, and CTSS. The data was analysed using Statistical Package for Social Sciences (SPSS) version 17.0.
Results: The mean age of study participants was 45.7±15.95 years. A total of 72 (72%) of the participants were of normal weight, 8 (8%) were overweight or obese, and 20 (20%) were underweight. COVID-19 patients with a co-diagnosis of DM (61.9%) or HTN (69.2%) had more severe lung involvement than COVID-19 patients without DM (19%) or HTN (21%). DM and HTN were found to be significantly associated with severe lung involvement (p-value <0.01).
Conclusion: Diabetic and hypertensive patients are more likely than non diabetic and non hypertensive patients to develop the severe form of COVID-19 and have a higher CT lung involvement score. DM and HTN should be considered as risk factors for the severity of COVID-19 disease.
Computed tomography, Coronavirus disease-2019, Lung involvement, Severe acute respiratory syndrome coronavirus 2
Since, the outbreak of COVID-19 began in Wuhan in December 2019 (1), it has spread to every region of the globe, including low income nations. Co-morbidities like HTN, DM, obesity, Cardiovascular Disease (CVD), Cerebrovascular Accident (CVA), pulmonary infections, Chronic Obstructive Pulmonary Disease (COPD), asthma, Chronic Kidney Disease (CKD), and cancer are clearly linked to an increase in severity and/or mortality in COVID-19 patients, according to new research (2). Amid patients infested with the SARS-CoV-2, DM and hyperglycaemia are self-determining predictors for mortality and morbidity (3). The conventional nasopharynx/oropharynx Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) testing has been fraught with delays and low sensitivity. Early detection and quantification of lung involvement are made possible by imaging. The ability of chest X-rays to detect the presence and extent of COVID-19 infection-related lung involvement is limited. HRCT, on the other hand, has been shown to provide immediate results with high sensitivity and specificity for determining the severity of COVID-19 infection and lung involvement (4). Data regarding the association of co-morbidities with the severity of COVID-19 is lacking in the Indian subcontinent. Hence, the present study was conducted with the aim, to determine the association between chest CTSS, DM and HTN in COVID-19 patients.
This retrospective observational study was conducted in the Department of Radiodiagnosis, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India. The duration of the study was one month, from July 2020 to August 2020. Statistical analysis was done in September 2020. Approval was taken from the Institutional Ethics Committee of Gajra Raja Medical College (146/IEC-GRMC/2020).
Inclusion criteria: Irrespective of age and sex, all patients of COVID-19 positive presented to the department were included in the study.
Exclusion criteria: Contraindications to HRCT study like antenatal patients, Claustrophobic or patients with anxiety disorder aggravated by CT were excluded from the study.
Study Procedure
The diagnosis of COVID-19 infection was deemed confirmed by the RT-PCR results. A multidetector 128-slice CT scanner (Siemens Somatom Definition AS) was used for the lung. The association between diabetes and HTN and COVID-19 severity was determined by retrospectively collecting and analysing the data from 100 HRCT lung studies, that were carried out between July 2020 and August 2020, i.e., during the first COVID-19 wave. Based on the degree of lung lobe involvement, a quantitative CT score was calculated (0: 0%; 1: 75%; range: 5 from 0 for each lobe; range of global scores: 0-25). The patients were divided into three groups based on the CTSS: mild (0-8/25), moderate (9-15/25), and severe (>15/25) lung involvement (5). The CTSS of the lung parenchyma involvement was compared between diabetic and non diabetic patients and hypertensive and non hypertensive patients. Using CTSS as evidence, the analysed data were used to confirm the hypothesis that, the severity of COVID-19 lung involvement in diabetic and hypertensive patients is greater.
Statistical Analysis
The data were entered into Microsoft Excel for statistical analysis, and the SPSS version 17.0 (IBM, Armonk, NY) was used to evaluate the results. The Chi-square test was used to determine whether severe COVID-19, DM, or HTN were associated. A p-value <0.05 was deemed statistically significant.
There were 68 (68%) males and 32 (32%) females among those 100 patients. The mean age of patients was 45.7±15.95 years. A total of 72 (72%) of the participants were of normal weight, 8 (8%) were overweight or obese, and 20 (20%) were underweight. It was observed that, 21 (21%) of the 100 patients had DM, and 13 (13%) had high blood pressure. According to the CTSS classification, more than half 51 (51%) of the 100 COVID-19 patients had a milder form of lung involvement; 21 patients (21%) had a score between 8 and 15, which indicated moderate lung involvement; the remaining 28 patients (28%) had severe lung involvement. According to CTSS scores, 48 (60.8%) of the 79 patients without DM had a mild form of the disease, 16 (20.3%) had a moderate form, and 15 (19%) had a severe form of lung involvement. It was observed that, 3 (14.3%) diabetics had a mild disease, 5 (23.8%) had a moderate disease, and 13 (61.9%) had a severe disease (Table/Fig 1).
The proportion of patients with a severe form of COVID-19 lung involvement was higher in patients with DM (61.9%) compared to patients without DM (19%) (p<0.01). 2 (15.4%) of the 13 people with HTN had mild disease, 2 (15.4%) had moderate disease, and 9 (69.2%) had severe disease (p=0.001) (Table/Fig 2).
Diabetes mellitus appears to have a significant impact on COVID-19 patient’s clinical outcomes, as evidenced by previous study (6). The International Diabetes Federation (IDF) said in a statement that, diabetic patients with COVID-19 have symptoms that are similar to those of other COVID-19 patients. According to some reports, CT imaging results can be used to determine the severity of COVID-19 pneumonia because they differ between Intensive Care Unit (ICU) patients, non ICU patients, and recovered patients (4). CT lung parenchymal involvement score was more in diabetics than those without diabetes (7). In a Chinese Centre for Disease Control (CDC) study of 44,672 COVID-19 patients, the case fatality rate for diabetics was 7.3%, compared to 2.3% for those without diabetes (8). SARS-CoV-2 has been shown to down-regulate the Angiotensin-converting Enzyme 2 (ACE2) protein (9), which may 15account for the poorer clinical outcomes of COVID-19 patients with diabetes. Onder G et al., conducted a study among Italian patients, and the most common co-morbidity for COVID-19 deaths, followed by Ischaemic Heart Disease (IHD) (30%), was diabetes, which accounted for 126 of the 355 COVID-19 deaths (35.5%) (10). Wang G et al., study says that, diabetes was more common in severe COVID-19 patients than in non severe patients (10.8% vs 5.4%) (11). Wang D et al., conducted a case series on 138 consecutive Wuhan patients and found that, patients who required ICU treatment (n=36) had a higher risk of diabetes than patients who did not (n=102) (22.2% vs 5.9%) (12). Wu C et al., a study on 201 COVID-19 patients, of which 84 (41.8%) had developed Acute Respiratory Distress Syndrome (ARDS) (13). Diabetes was more common in ARDS patients than it was in those without the condition. ARDS was more common in people with co-morbidities like DM, which led to death. Patients with COVID-19 also suffered greatly from HTN. The CTSS was higher in those with HTN than in those without HTN, found by a study carried out by Honardoost M et al., (14). A study by Fang L et al., showed that, patients with HTN are at higher risk for severe COVID-19 infection (15). Another study by Yang Q et al., showed HTN leads to increased mortality in patients with COVID-19 (16). The present study confirms that, the presence of co-morbidities in COVID-19 patients was linked to worse outcomes and a more severe course of illness.
Limitation(s)
For measuring the pulmonary involvement and severity, quantitative and semi-quantitative methods have been used which may have certain subjectivity.
The current study has demonstrated that, the patients with DM and HTN are more likely to develop the severe form of COVID-19, which has a higher CT lung involvement score, thus, accepting the hypothesis. To avoid potentially fatal complications, COVID-19 patients must therefore, be closely monitored for glucose and blood pressure. DM and HTN should be considered risk factors for the severity of COVID-19 disease, and the best way to reduce morbidity and mortality is to avoid COVID-19 sources, as much as possible.
DOI: 10.7860/JCDR/2023/63166.18055
Date of Submission: Feb 01, 2023
Date of Peer Review: Apr 07, 2023
Date of Acceptance: Apr 21, 2023
Date of Publishing: Jun 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: Feb 06, 2023
• Manual Googling: Mar 14, 2023
• iThenticate Software: Apr 20, 2023 (17%)
ETYMOLOGY: Author Origin
EMENDATIONS: 6
- 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