Article in PDF
How to Cite
Citation Manager
Readers' Comments (0)
Audio Visual Article Statistics
Link
to PUBMED
Print this Article
Send to a Friend
Advertisers
Access Statistics Resources
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 Series
Full Version
Efficacy of Nirgundi Lepa in the Management of Vatakantaka (Plantar Fasciitis): A Case Series
Correspondence Address :
Dr. Yogesh Yadav,
Postgraduate Scholar, Department of Shalya Tantra, Mahatma Gandhi Ayurveda College Hospital and Research Centre, Salod, Hirapur, Wardha-442001, Maharashtra, India.
E-mail: dryogeshyadav00@gmail.com
Plantar fasciitis, or Vatakantaka, is a common cause of heel pain characterised by inflammation and swelling in the plantar fascia, leading to discomfort. Standard treatments often yield poor results, which has motivated research into new therapies. The present case series includes 10 patients (five males and five females) with plantar fasciitis who were treated with a topical application of Nirgundi Lepa twice a day for four weeks. Pain levels were assessed using the Visual Analogue Scale (VAS), and foot function was evaluated with the Foot Function Index (FFI) at baseline, two weeks after treatment, and at the conclusion of the study. Nirgundi Lepa was applied to the feet of both limbs, resulting in a reduction in pain and an improvement in foot function. VAS scores decreased by an average of 65%, and the FFI-related symptom improvement rate increased to 55%. The therapeutic effects observed during the follow-up period were sustained, with minimal recurrence of symptoms. The present case series illustrates the utility of Nirgundi Lepa in patients with plantar fasciitis, positioning it as an effective non surgical modality for managing heel pain. Further research is needed to confirm these results and assess their value in clinical practice.
Analgesics, Calcaneus spur, Foot function index, Heel pain, Inflammation, Non invasive, Pain management
Plantar fasciitis, known as Vatakantaka in Ayurvedic terminology, is a common cause of heel pain that significantly impacts daily activities and quality of life (1). It involves degenerative irritation and microtears of the plantar fascia at the medial calcaneal tuberosity, often due to overuse or biomechanical factors such as flat feet, high arches, limited ankle dorsiflexion, prolonged standing and excessive foot pronation or supination (2). Although the condition is marked by inflammation, it predominantly features degenerative changes, including granulation tissue and collagen disarray.
Conventional treatments, including Non Steroidal Anti-Inflammatory Drugs (NSAIDS), physical therapy and orthotics, provide varying degrees of relief but may have limitations and side effects (3). Diagnostic imaging, such as ultrasound and Magnetic Resonance Imaging (MRI), often shows thickening, tears and calcifications in the fascia, indicating a non inflammatory, degenerative process. Ayurveda offers alternative remedies, such as Nirgundi (Vitex negundo) Lepa, known for its anti-inflammatory and analgesic properties (4),(5).
Plantar fasciitis is prevalent among runners, older adults and individuals with a high body mass index, significantly affecting their quality of life and daily functions (6). It accounts for 10% of injuries in runners and 11-15% of foot symptoms in adults (7).
Total of 10 patients presented with complaints of severe heel pain, especially in the morning, with an average duration of 4.5 months. This pain was aggravated by prolonged standing (Table/Fig 1). It caused difficulty in walking and performing daily tasks. None of the patients had significant medical histories or family histories of similar conditions. They led active lifestyles, regularly walking and standing due to occupational requirements (farmer, housewife, businessperson, teacher). All patients had tried over-the-counter pain medications like NSAIDs, with limited relief, and used orthotic insoles, which provided temporary relief from the symptoms of Vatakantaka (plantar fasciitis).
Physical examinations revealed tenderness at the medial calcaneal tuberosity in all patients, a positive Windlass test (8), and limited ankle dorsiflexion due to pain. The diagnostic assessment included a physical examination, noting tenderness and a positive Windlass test, while imaging was not performed due to the clear clinical presentation.
The therapeutic intervention involved the topical application of Nirgundi Lepa. Fresh Nirgundi leaves were collected from the study Institute’s Herbal Garden. The leaves were washed with water, then blended with one-fourth of the water to create a thick paste-like consistency (Table/Fig 2). Approximately 50 milliliters of water was added to 200 grams of Nirgundi leaves. This standard preparation leverages the anti-inflammatory and analgesic properties of Vitex negundo.
The patient was asked to first clean their legs with clean water. In a comfortable sitting position, Nirgundi Lepa was applied to the affected area to a thickness of approximately 0.5-1 mm, as shown in (Table/Fig 3). This dosage was intended to ensure that the entire inflamed region of the plantar fascia was adequately covered, maximising the contact between the Lepa and the skin to facilitate absorption and therapeutic action. The Nirgundi Lepa was kept on until it dried, after which the patient was asked to wash their legs with lukewarm water. The same treatment was continued twice daily for four weeks. Applying the Lepa in the morning and evening ensured that the active compounds remained in contact with the affected area throughout the day and night, promoting continuous anti-inflammatory action and pain relief.
Observations were recorded using the VAS pain score (Table/Fig 4) and the FFI (Table/Fig 5) of patients with Vatakantaka (plantar fasciitis) during the interventional period on day 0 (before intervention), day 14, day 28 and follow-up was conducted after 28 days on the 8th week (Day 56).
At the start of the treatment, the mean VAS score (9) for pain among the patients was 8.5. By the end of the four-week treatment period, the mean VAS score had decreased to 3.0, representing a 65% reduction in pain (Table/Fig 6). In addition to the VAS scores, physical examinations conducted showed a marked decrease in tenderness at the calcaneal tuberosity, a common site of pain in plantar fasciitis.
From the patient’s perspective, there was a notable improvement in both pain and functionality, as measured by the Foot Function Index (FFI) (10),(11). The FFI assesses foot impairment associated with pain, disability and activity limitation. It is a self-administered index composed of 23 items divided into three subscales: pain (9 items), disability (9 items) and activity limitation (5 items), all scored on a Likert scale from 0 to 10. The total score is then calculated as a percentage using the formula: (total score/230) × 100 = _%.
Initially, the mean FFI score was 85. After four weeks of treatment, the mean FFI score improved to 38, reflecting a 55% improvement in foot function (Table/Fig 7). Patients reported an enhanced ability to perform daily activities, reduced pain during walking and standing, and an overall improved quality of life.
Follow-up was conducted on the 8th week (day 56), and reassessment was performed using VAS and FFI scores. Intervention adherence was assessed through patient self-reporting, showing high tolerability with no adverse events reported.
Plantar fasciitis typically resolves with non surgical methods, yielding a high resolution rate. However, individual responses vary due to differences in pathology, body types and lifestyles. Traditional treatments focus on reducing inflammation through methods such as NSAIDs, rest, corticosteroids and orthotic interventions. Alternatively, some therapies aim to address the underlying degeneration, often by inducing acute inflammation to initiate healing. These may include autologous blood or platelet-rich plasma injections, shock-wave therapy, or surgical options (12).
Agnikarma (thermo-cauterisation) is considered the gold standard Ayurvedic management for Vatkantak, showing significant results in patients (13). Agnikarma performed with Panchdhatu Shalaka is more effective compared to the use of Madhuchista (beeswax) (14). Raktamokshan, either through Siravedh (15) or Jalaukavcharan (leech therapy), is also recommended. Jalaukavcharan is particularly effective, as it acts locally and its saliva contains various enzymes with anti-inflammatory properties (16). Eranda Tail Nitya Virechan combined with Kolakulathadi Upanaha has shown relief in heel pain in a case series involving 20 patients (17).
Pinda Thaila Abyanga, Rasnadi Sweda, followed by the application of Hingwadi Lepa, resulted in a 75% resolution of symptoms in 40% of patients (18). Similarly, the present study found that a Lepa made from Nirgundi reduced VAS scores and improved the FFI in patients with plantar fasciitis.
The active compounds in Nirgundi, such as flavonoids, alkaloids and terpenoids, exhibit significant anti-inflammatory effects by inhibiting proinflammatory cytokines and enzymes (19). Additionally, Nirgundi’s analgesic properties complement its anti-inflammatory actions, providing relief from pain associated with musculoskeletal disorders. This dual action makes it a promising natural remedy for various forms of musculoskeletal discomfort.
Limitations of the present case series include the small sample size and the need for larger randomised controlled trials to confirm these findings.
The findings of the present case series suggest that Nirgundi Lepa is a promising non invasive treatment for plantar fasciitis, providing significant pain relief and improved functionality. These results imply that Nirgundi Lepa could be integrated into clinical practice as an effective alternative to conventional treatments. Future research should focus on larger, randomised controlled trials to confirm these findings and explore the long-term benefits and potential mechanisms of action of Nirgundi Lepa.
DOI: 10.7860/JCDR/2024/73449.20226
Date of Submission: Jun 10, 2024
Date of Peer Review: Jul 18, 2024
Date of Acceptance: Jul 29, 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 17, 2024
• Manual Googling: Jul 20, 2024
• iThenticate Software: Jul 27, 2024 (10%)
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