A comparative study on the turnaround time of article processing in dermatology journals: A need for improvement of this aspect in Indian journals.

INTRODUCTION: Submission and publishing of research articles in scientific journals is a multistep process that should be efficient and swift. OBJECTIVE: To compare the editorial, peer review and publication time between Indian dermatology journals and international dermatology journals. METHODS: Three Indian (Indian Journal of Dermatology, Venereology and Leprology; Indian Journal of Dermatology and Indian Dermatology Online Journal) and three international (International Journal of Dermatology; the Australasian Journal of Dermatology and Dermatology [Karger]) dermatology journals were identified for this study. Information pertaining to time to acceptance, time to publication and the total time to publication were extracted for original articles, case reports and letters to the editor published in issues from January 2017 to December 2017. RESULTS: The mean total time to publication in the order for Indian Journal of Dermatology, Venereology and Leprology, Indian Dermatology Online Journal, Indian Journal of Dermatology, International Journal of Dermatology, Dermatology and Australasian Journal of Dermatology were 12.61, 12.50, 9.14, 7.92, 7.13 and 6.52 months respectively. While time to acceptance and time to publication were the longest in Indian Journal of Dermatology (7.01 months) and Indian Dermatology Online Journal (8.99 months), respectively, Indian Journal of Dermatology, Venereology and Leprology was found to have the maximum overall total time for publication i.e. 12.61 months. The differences among the journals were found to be significant for all three time measures (P < 0.0001, ANOVA). On comparison of Indian and international journals, all three time measures were found to be higher in Indian journals (5.81 vs 4.96 months, 6.75 vs 3.59 months and 11.53 vs 7.51 months, respectively) with the differences being significant (P < 0.0001, independent samples t-test). LIMITATION: This data does not represent the performance status of rejected manuscripts, the information of which was not available in the public domain. CONCLUSION: An effective editorial screening, fast-tracked editorial and peer review process and regulation on turnover time of submissions by Indian dermatology journals are imperative in improving the impact of research publication.

Analysis of submissions, editorial and peer-review process, and outcome of manuscripts submitted to the Indian Journal of Dermatology Venereology and Leprology over a 6-month period.

BACKGROUND: Despite an interest in the editorial process at biomedical journals, not much information is available on this topic. AIMS: To study the characteristics of the submissions to the Indian Journal of Dermatology Venereology and Leprology (IJDVL) and analyze the editorial and peer-review process and factors influencing the final outcome. METHODS: Retrospective review of the manuscripts submitted to the IJDVL from January 1, 2016, to June 30, 2016. RESULTS: The IJDVL received 639 manuscripts during the study period, most being Case reports (35%), Research articles (30%), and Letters to editor (20%). The proportion of submissions from Indian (53%) and foreign (47%) authors was comparable. About 55% (n = 353/639) of the submissions were editorially rejected. Some of the common reasons for editorial rejection included "sub-optimal images," "no novelty," "incomplete information or results," and "incorrect diagnosis or interpretation of results." The acceptance rate during this period was 19%. The median number of days to reach the final decision was 14 days for editorial rejection, 146 days for acceptance, and 85 days for rejection after external peer-review. The acceptance rates were higher for submissions from Indian authors [odds ratio (OR) 1.96], those submitted as Letters (OR 2.06), or in the area of tropical infections (OR 2.17). Submissions as research articles (expB = 1.23), those from Indian authors (expB = 1.15), final decision being acceptance (expB = 1.56), and those requiring preliminary author revisions (expB = 3.34), external re-reviews (expB = 2.22), and repeated author re-revisions (expB = 2.34) were associated with longer times to reach final decision. LIMITATIONS: A relatively short study period of 6 months. CONCLUSION: The IJDVL attracts submissions both from India and abroad. Articles submitted in the Letters category or related to tropical infections were most likely to be accepted. There is scope for improving the time taken for editorial processing of manuscripts.

Proposed global drooping and wrinkles classification and scoring system for aging face with validation and experience on 54 Indian subjects.

BACKGROUND: Aging is an inevitable biological change, but understanding the process of aging of face is important to customize the treatment options for facial rejuvenation. Evidence-based estimation of global facial aging is necessary for the validation of various treatment modalities. AIMS: Classification and implementation of a scoring system for aging face based upon volume loss and surface changes as evident by drooping of different areas of the face and appearance of fine and deep wrinkles, respectively, and to apply this drooping-wrinkles classification on 54 participants to evaluate and understand the validity of scoring. METHODS: An observational study was conducted, and scores were calculated based on 13 parameters (7 areas of drooping and 6 areas of wrinkles on the face) at Aura Skin Institute, Chandigarh, India. Accordingly, age was divided in different age groups followed by clinical estimation of facial age and calculation of scores. RESULTS: According to our classification and scoring system, 61% (33 out of 54) of the participants were correlated with their chronological age group. Out of the remaining 21 (39%) participants who were aging faster, 13 (24%) were in the age group of 25-35 years. Approximately one-fourth of the patients in the age groups 36-45 and 46-55 years were aging faster. Only 1 patient had scores showing younger age in comparison to chronological age. Overall, there was a good correlation between the calculated score and the chronological age of patients. Moreover, a gradual increase in scores was noticed with increasing age groups. CONCLUSIONS: This is a new clinical classification and scoring system for facial age which is much easier to apply in daily clinical practice for easy calculation of baseline scores and customizing their antiaging treatment options. Moreover, it will also make it easier to compare the efficacy of treatment in their future follow-ups. The limitation of this study is that it has been proposed for all skin types but validation has been done only for Indian participants.

[Development of external medicine and dermatology of TCM in the Republican period].

The inheritance of the theory in external medicine in the Republican period was mainly derived from Wai ke zheng zong (Orthodox Manual of External Medicine) and Yi zong jin jian (Golden Mirror of Medicine) and the sorting out of medical plasters, pills, and powders from Wai ke shi san fang (Thirteen Recipes of External Medicine). Zhang Shanlei's Yang ke gang yao (Guidelines for Ulcerations), based on the five-year experience of Zhu's family, offers new experience and ideas for syndrome differentiation; Ding Ganren's diagnosis for external medicine is exquisite with many well known formulae prescribed by himself; Monographs on leprosy and syphilis were published by famous physicians. Departments of external medicine and anal diseases, and classes on external medicine and dermatology and venereal diseases were set up in TCM schools in Guangdong and Zhejiang provinces with teaching materials compiled. All these mark the development of external medicine in modern age.

A longitudinal study of consistency in diagnostic accuracy of teledermatology tools.

BACKGROUND: Diagnostic accuracy (DA) is an outcome measure to assess the feasibility of teledermatology tools. Despite ample data with variable DA values, no study has examined the aggregate DA value obtained from the available studies and observed its consistency over a period of time. This kind of a longitudinal study about teledermatology will be necessary to check its usefulness and plan for further implementation. AIMS: To observe the DA trend over a period of 15 years (1997-2011). METHODS: Only those studies (n = 59) using a single tool for general, tertiary, and subspecialty teledermatology practice were included to obtain the DA values. Studies were graded based on the number of subjects and gold standard comparison between teledermatologist and clinical dermatologist (face-to-face examination). RESULTS: This analysis sought to identify the DA trend was carried out by evaluating 17 store and forward teledermatology (SAFT) based and 8 Video conference (VC) tool-based studies with 2385 and 1305 patients respectively, in comparison with the gold-standard assessment. The average DA was 73.35% ± 14.87% for SAFT and 70.37% ± 7.01% for VC. One sample t-test analysis with 100% accuracy as standard value revealed 28% deficiency for SAFT (t = 7.925; P = 0.000) and 30% deficiency for VC (t = 11.955; P = 0.000). Kruskall-Wallis test confirmed the consistency of DA values in the SAFT (χ2 = 1.852, P = 0.763) tool. CONCLUSION: SAFT and VC were adequately validated on a large number of patients by various feasibility studies with the gold standard (face-to-face) comparison between teledermatologists and clinical dermatologists. The DA of SAFT was good, stable over the 15 years and comparable to VC. Health-care providers need to plan for appropriate utility of SAFT either alone or in combination with VC to implement and deliver teledermatology care in India.

Sparing phenomena in dermatology.

Despite considerable overlap, the confusion hovering over the four common sparing signs can be cleared as follows: Reverse Koebner relates to sparing by physical trauma; isotopic non-response/reverse isotopic response relates to sparing over an already healed dermatosis; Renbok Phenomenon relates to sparing among two concomitant active diseases often with autoimmune etiology; anatopic phenomenon relates to sparing caused by presence of certain infectious diseases of skin. In conclusion, sparing phenomenon of dermatology seems to command our attention by their sheer number, variety, and clinical implications. Therefore, it may be said that astute clinician is the one who will look, not only for the presence of lesions in the patient but also for the conspicuous absence thereof.

Morphea: evidence-based recommendations for treatment.

Morphea is a rare fibrosing disorder of the skin. Evidence-based treatment strategies in morphea are lacking. This review summarizes the available data on morphea treatment and provides therapeutic strategies based on morphea subtypes. The Cochrane Library, Medline and Embase from inception until May of 2011 were searched using the key words "morphea" and "morphea treatment." Reference lists of the resultant articles, as well as relevant reviews, were also searched. This review focuses on randomized controlled trials, prospective interventional trials without controls and retrospective reviews with greater than five subjects.

Standard guidelines for care: sclerotherapy in dermatology.

DEFINITION: Sclerotherapy is defined as the targeted elimination of small vessels, varicose veins and vascular anomalies by the injection of a sclerosant. The aim of sclerotherapy is to damage the vessel wall and transform it into a fibrous cord that cannot be recanalized. It is a simple, cost-effective, efficacious and esthetically acceptable modality for both therapeutic and esthetic purposes. INDICATIONS: Therapeutic indications include varicose veins and vascular malformations. Esthetic indications include telangiectasias and reticular veins. In the management of varicose veins, it may need to be combined with other surgical methods of treatment, such as ligation of the saphenofemoral junction, stab ligation of perforators and stripping. A surgical opinion may be necessary. METHODOLOGY: A thorough knowledge of the anatomy and physiology of the venous system of the legs, basic principles of venous insufficiency, methods of diagnosis and, in addition, uses, mechanisms of action and complications of sclerosing agents and proper compression techniques are important pre-requisites to successful sclerotherapy. Although various sclerosing agents are available, polidoconal and sodium tetradecyl sulfate are most commonly used. More recently, these sclerosants have been used in microfoam form for increased efficacy. The basic principle of a successful sclerotherapy technique is the use of an optimal volume and concentration of the sclerosant according to the size of the vessel. The sclerosant is injected carefully into the vessel and compression is applied. CONTRAINDICATIONS: Contraindications include superficial and deep venous thrombosis, sapheno-femoral junction incompetence, pregnancy, myocardial decompensation, migraine, hypercoagulable state, serious systemic illness, dependency edema, immobility, arterial disease, diabetes mellitus and allergic reactions to sclerosants. COMPLICATIONS: While sclerotherapy is usually a safe procedure, complications may occur due to inappropriate patient selection or improper injection techniques. The complications may be acute or delayed. Complications include hyperpigmentation, matting, local urticaria, cutaneous necrosis, microthrombi, accidental intra-arterial injection, phlebitis, deep vein thrombosis, thromboembolism, scintillating scotomas, nerve damage and allergic reactions. PHYSICIAN QUALIFICATION: Sclerotherapy may be administered by a surgeon or dermatologist who has acquired adequate training during post-graduation or through recognized fellowships and workshops dedicated to sclerotherapy. He should have an adequate knowledge of the anatomy of the venous system, be able to diagnose and manage venous disease and its associated consequences as well as possess the necessary skills to perform the procedures, understand the appropriate indications and limitations, technique modifications and management of the potential adverse sequelae associated with sclerotherapy and also understand the pharmacology of the sclerosing solutions. FACILITY: The procedure may be performed in the physician's procedure room.

Disinfection, sterilization and operation theater guidelines for dermatosurgical practitioners in India.

Modern day dermatologists conduct different esthetic and surgical procedures, with risk of infective complications. Hence, infection control practices need to be established in dermatological practice to minimize the risk of exogenous infections. These practices include hand washing, cleaning, sterilization, disinfection, operation theater sterilization and specifications. Proper hand washing after examination of each patient and prior to any surgery with a formulation containing alcohol alone or as a combination with other agents reduces the chances of transferring infections to and from patients. Sterilization and disinfection constitute the most important aspect of infection control. Disinfectants and disinfecting procedures vary according to the environment and equipment. Proper knowledge of different processes/agents for sterilization and disinfection is essential. Disinfectants for use in hospitals should always be freshly prepared and should be of adequate strength. Sterilization is carried out most commonly using steam sterilizers or ethylene dioxide sterilizers. The waste generated during practice is a potential source of nosocomial infections and should be treated as per the proper protocol and guidelines. Trained staff to carry out these practices is essential.