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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
Moebius Syndrome Misdiagnosed as Duane Retraction Syndrome: A Case Report
Correspondence Address :
Dr. Neha K Sethi,
Department of Ophthalmology, Guru Gobind Singh Medical College and Hospital, Faridkot-151204, Punjab, India.
E-mail: neha.knew@gmail.com
Moebius syndrome and Duane Retraction Syndrome (DRS) are Congenital Cranial Dysinnervation Disorders (CCDDs) characterised as congenital, non progressive groups of diseases caused by abnormal development of cranial nerve nuclei or their axonal connections. Due to their overlapping features, distinguishing between these disorders can be challenging, leading to potential diagnostic oversights. This is a case report of a 10-year-old female with Moebius syndrome misdiagnosed as DRS. She had 6th and 7th nerve palsies with exposure keratopathy. Probably the cause for misdiagnosis was the presence of an abduction deficit-a characteristic shared by both disorders. Additionally, it is crucial to examine the facial nerve, as it is exclusively affected in Moebius syndrome. DRS is significantly more common than Moebius syndrome; the rarity of Moebius syndrome might contribute to the misdiagnosis. Conducting a thorough examination is essential for differentiating between these conditions, thereby facilitating comprehensive management.
Congenital cranial dysinnervation disorders, Congenital facial palsy, Exposure keratopathy, Strabismus
The 10-year-old female, diagnosed with left-eye (OS) DRS since five years, presented to the ophthalmology OPD for the first time with OS diminution of vision, watering, redness, and long-standing inability to close her left eye. The patient was systemically stable. There was no significant family or past history. Her Best Corrected Visual Acuity (BCVA) was 6/9 and 6/36 in the right eye (OD) and left eye (OS) respectively. OS had uncorrected hypermetropia of +2.75D with anisometropic amblyopia. The anterior segment examination was normal except in OS, showing Superficial Punctate Keratopathy (SPK). Intraocular pressure and fundus examination were normal in both eyes (OU).
OU abduction was restricted and suggestive of abducens nerve palsy; the visual axis was parallel in the primary gaze. Palpebral fissure height was the same in both abduction and adduction in both eyes; and importantly there was no globe retraction on adduction or abduction as shown in (Table/Fig 1). OS had lagophthalmos, poor Bell’s phenomenon, mild corneal exposure keratopathy, and SPK on the cornea inferiorly in the left eye. She had a mask-like facial appearance. Examination of the seventh nerve revealed left facial palsy- no forehead furrows, no forehead wrinkling on the left-side, inability to close the left eye against resistance, deviation of the angle of the mouth to the right-side as shown in (Table/Fig 2). The rest of the central nervous system, cranial nerve, and systemic examination were normal. The Magnetic Resonance Imaging (MRI) of her brain was also normal.
The diagnosis of the patient was revised as Moebius Syndrome as she had bilateral sixth and left seventh nerve palsy. She improved with medical treatment for exposure keratopathy including lubricants (eyedrop carboxymethylcellulose 0.5%- QID), antibiotics (eyedrop moxifloxacin 0.5%-TDS), and night eye-taping. After one week of treatment, she had no SPK, decreased congestion, and vision improved to 6/24.
Authors report a case of Moebius syndrome (with OS facial and bilateral abducens palsy) misdiagnosed as OS DRS. Moebius syndrome is a congenital condition characterised by unilateral or bilateral facial and abducens nerve palsy with an incidence of 1 in 250,000; most often sporadic (1),(2). Patients suffering from this rare disease present with mask-like faces, deviation of the angle of the mouth, especially during smiling, lagophthalmos with or without exposure keratopathy, horizontal gaze palsies with intact vertical gaze, and normal palpebral fissure height with horizontal eye movements. It may also involve other cranial nerves, neurodevelopmental abnormalities of the limb and pectoral region, and autism (2).
On the other hand, DRS is a congenital complex strabismus with an incidence of 1 in 10,000; 10% of cases are familial (1). It is characterised by a limitation of abduction or adduction of the eye (most commonly type 1 DRS with abduction limitation), retraction of the eyeball, and shortening of the palpebral fissure on attempted adduction due to co-contraction of horizontal recti (1),(3).
A major difference between Moebius syndrome and DRS is the presence of facial palsy in Moebius syndrome while the 7th nerve is unaffected in DRS. It is postulated that the cause of misdiagnosis was the abduction deficit in both eyes, which is a common feature of Moebius syndrome and type 1 DRS (the most common type). Additionally, the failure to determine the patient’s facial nerve function, DRS being much more common than Moebius syndrome, and the probable ignorance of Moebius syndrome (which is rare) on the part of the previous treating ophthalmologist may have contributed to the misdiagnosis (4). Also, although the vertical palpebral fissure height was constant in horizontal gazes, OS lagophthalmos was mistakenly interpreted as OD retraction in present case patient.
The management of both Moebius syndrome and DRS depends on the severity of squint. Strabismus surgery can help provide a parallel visual axis in at least the primary position with the surplus goal of improvement of visual motility in horizontal gazes. For Moebius syndrome, ocular management should additionally include prevention and treatment of exposure keratopathy due to associated 7th nerve palsy. Furthermore, support from a neurologist, paediatrician, plastic surgeon, counsellor, and physiotherapist is also required for managing the non ocular manifestations of the disease (5),(6),(7). This latter aspect of management is likely to be neglected if such a misdiagnosis is made. (Table/Fig 3) summarises the differences between Moebius syndrome and DRS (1),(2),(3),(4),(6),(8).
Moebius syndrome (being a rare disorder) and DRS (relatively more common) may have overlapping clinical features, like abduction deficit. Therefore, a thorough examination, especially of facial nerve function, can help clinch the diagnosis and form the basis for comprehensive management of Moebius syndrome. The statement above reports a case of Moebius syndrome misdiagnosed as DRS.
DOI: 10.7860/JCDR/2024/73975.20319
Date of Submission: Jul 03, 2024
Date of Peer Review: Jul 24, 2024
Date of Acceptance: Sep 10, 2024
Date of Publishing: Nov 01, 2024
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: Jul 04, 2024
• Manual Googling: Jul 26, 2024
• iThenticate Software: Sep 09, 2024 (10%)
ETYMOLOGY: Author Origin
EMENDATIONS: 7
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
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