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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 High-grade Anterior Cruciate Ligament Tear: A Case Report on Integrating Physiotherapy and Ayurvedic Therapy
Correspondence Address :
Dr. Mayank Rai,
Postgraduate Scholar, Mahatma Gandhi Ayurved College, Hospital and Research Centre, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Salod (H), Wardha-442001, Maharashtra, India.
E-mail: nrmankumayank@gmail.com
Anterior Cruciate Ligament (ACL) tears are frequently managed surgically in conventional medicine; however, some patients seek alternative treatments due to personal preferences or contraindications. This case presents a 55-year-old male who suffered a high-grade complete ACL tear following a road traffic accident and fall. Despite recommendations for surgical intervention from multiple allopathic surgeons based on Magnetic Resonance Imaging (MRI) findings, the patient opted for an integrative approach combining Ayurvedic herbal and Panchakarma therapies with physiotherapy. The Ayurvedic treatment aimed to reduce inflammation, promote tissue regeneration, and enhance joint stability, utilising herbal medicines and therapeutic procedures such as snehana (oleation), basti (therapeutic enema), alepa (external application), and upanaha swedana (poultice). Concurrently, physiotherapy focused on strengthening the surrounding musculature, improving Range of Motion (ROM), and enhancing functional mobility. Over the treatment period, the patient experienced substantial pain relief, reduced knee swelling, and significant improvement in functional ability, enabling a return to daily activities without surgical intervention. This case underscores the efficacy and feasibility of an integrative approach in managing ACL tears, providing a holistic non surgical option for patients who are reluctant or unsuitable for conventional surgical interventions.
Joint stability, Oleation, Physiotherapy, Therapeutic enema
A 55-year-old male patient came to the Outpatient Department (OPD) of Kayachikitsa with the chief complaint of chronic pain and swelling in his right knee joint, along with difficulty in walking, standing, sitting, and climbing stairs since seven months. The patient gave the history of road accident and fall in two feet deep trench seven months back. Patient told he stood up immediately after the fall and twisted his right knee. He immediately took the allopathic surgeon, consultancy and have been suggested MRI investigation. On investigation, MRI showed high-grade complete tear involving the proximal segment of the ACL, along with other abnormalities. The patient took advice of various surgeons, all of whom suggested that surgery was the only option. However, the patient was not willing to undergo surgery, so he approached Ayurvedic treatment and visited the OPD.
An examination of the patient was done (Table/Fig 1),(Table/Fig 2).
Upon knee examination, swelling (grade III) and tenderness (grade III) around the knee were present, with limited ROM due to diffuse pain and injury. The Lachman test, anterior drawer test, and pivot shift test (1) were positive, indicating an ACL tear.
Investigation/radiological examination: Standard tests, such as Complete Blood Cont (CBC) and blood sugar measurements, were within normal ranges.
An X-ray showed no significant abnormalities. An MRI confirmed a high-grade complete tear involving proximal segment of ACL with retraction of torn end, associated with mild bulking of PCL. Mild anterior tibial translation for the distance of 6 mm was also observed, along with moderate soft-tissue oedema involving the proximal 2/3rd of the right leg. Additionally, there was mild to moderate joint effusion with periarticular soft-tissue oedema.
Diagnosis: The MRI confirmed the case of an ACL tear.
After completion of total of 21 days of treatment protocol (Table/Fig 3),(Table/Fig 4),(Table/Fig 5), patient achieved full ROM in the knee and was able to walk without pain or instability (Table/Fig 6),(Table/Fig 7) (2).
During both 1st and 2nd follow-ups, the patient was able to walk without pain and instability, with noticeable improvement in the movement of the knee joint. 1st follow-up of the patient was taken on 30 days after treatment, and last follow-up was taken 60 days after treatment.
Ligaments, tendons, and corresponding muscles keep the knee joint stable. Between 25% and 50% of knee injuries are caused by ACL damage (3). It is believed that the main passive restriction on tibial anterior translation with respect to the femur is the ACL. The ACL, due to its specific position, enhances knee rotational stability in the frontal and transverse planes (4). A pop is frequently heard, followed by pain; the knee becomes oedematous due to blood from the cruciate ligament haemorrhage and effusion, and knee pain develops. The diagnosis is confirmed by computed tomography, MRI, or X-rays (5). Management of ACL injury mainly suggests ligament repair by invasive surgical procedures. In this case, the patient was not willing for surgery so he approached for Ayurveda treatment.
According to the signs and symptoms, an Ayurveda treatment protocol for Snayugatavata can be followed, as described under vatavyadhi. The first detailed description of Sanyugata Vata is provided by Va¯ gbhata and Acharya Sushruta. They establish a number of therapeutic procedures, including Snehana (oleation), Upanaha (poultice), Agnikarma (therapeutic heat), Bandhana, and Unmardana (6). Janubasti (knee oil pooling) with Murivenna oil, followed by local oleation and steam, is adopted to give stability to the knee joint by its potential effects. Murivenna oil has shown its potential in promoting healing and tissue repair by alleviating pain, reducing inflammation, and improved joint mobility (7). Kottamchukadi churna Upanaha Sweda, the application of a warm herbal poultice directly on the affected area, is a combination of herbs like Musta, Eranda, and Rasna, which are known for their anti-inflammatory, analgesic, rejuvenating properties, and promotion of tissue repair. These herbs penetrate the skin and exert therapeutic effects on the injured tissues (8).
Lakshadi Guggul is a traditional Ayurvedic formulation known for its potential benefits in treating joint disorders. This herbal compound is primarily composed of Laksha (Purified Leadwort), Guggul (Commiphora mukul), and other medicinal plants (9). It is reputed for its anti-inflammatory and analgesic properties, which help alleviate pain and improve joint function. Mustamarmani Kashay is used as Anupana with Lakshadi Guggul and is believed to reduce inflammation, alleviate pain, and promote healing of the ligament. Musta (Cyperus rotundus) and Marmani (various Ayurvedic herbs used in joint and tissue health) are the key components known for their anti-inflammatory and analgesic properties (10). The Tablet Hadjod possesses significant anti-inflammatory and analgesic effects. It is known to promote bone healing and regeneration, enhancing the recovery process of bone tissues, which can be beneficial for ligament repair and strengthening (11). Ingredients in Gandha taila, ingredients like Ashwagandha (Withania somnifera) and Bala (Sida cordifolia), help reduce inflammation and alleviate pain and swelling associated with ACL tears. where as Shatavari (Asparagus racemosus) and Laksha (Laccifer lacca) promote bone health and support the repair and strengthening of ligaments (12). Additionally, milk enhances the absorption of the active compounds in Gandha taila and provides essential nutrients like calcium and vitamin D, which are crucial for bone health and recovery (13).
Physiotherapy done for its potential benefits by focusing on reducing pain and swelling, maintaining ROM, and preventing muscle atrophy through open-chain exercises such as leg extensions, ankle pumps, and hip abduction/adduction. Transition to strengthening exercises, including closed-chain activities like leg press, lunges, static cycling, and leg curls. Incorporate quadriceps setting, hamstring curls, and hip bridges to improve muscle strength and joint stability (14),(15).
The combination of Ayurvedic oral and external therapy with physiotherapy has provided significant improvement in this ACL injury. Similar cases showing the results and improvements observed in the patient’s condition following the treatment (Table/Fig 8) (7),(16),(17).
The inference from the case study on the integrated management of ACL tears is that a comprehensive approach, combining Ayurveda intervention and physical therapy, significantly improves functional recovery and long-term joint stability. Emphasising early diagnosis and tailored treatment plans, the study highlights the importance of a multidisciplinary Ayurveda approach in minimising complications and enhancing overall outcomes for ACL injury patients. Thus further research is needed to confirm these results with greater accuracy.
DOI: 10.7860/JCDR/2024/73857.20328
Date of Submission: Jun 26, 2024
Date of Peer Review: Aug 16, 2024
Date of Acceptance: Sep 06, 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: Jun 28, 2024
• Manual Googling: Aug 19, 2024
• iThenticate Software: Sep 05, 2024 (2%)
ETYMOLOGY: Author Origin
EMENDATIONS: 8
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