|Year : 2022 | Volume
| Issue : 4 | Page : 140-144
Managing “Journal of Ayurveda Case Reports”: An introspection
Anu Ruhila1, Vijay Kumar2, R Galib3
1 Journal of Ayurveda Case Reports, AIIA, New Delhi, India
2 Department of Pharmacology, AIIA, New Delhi, India
3 Department of Rasashastra and Bhaishajya Kalpana, AIIA, New Delhi, India
|Date of Submission||15-Nov-2022|
|Date of Acceptance||01-Dec-2022|
|Date of Web Publication||29-Dec-2022|
Dr. Anu Ruhila
Journal of Ayurveda Case Reports, AIIA, New Delhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ruhila A, Kumar V, Galib R. Managing “Journal of Ayurveda Case Reports”: An introspection. J Ayurveda Case Rep 2022;5:140-4
| Background|| |
The role of generating evidences in practice is becoming very crucial with advancement in medical science. The necessity to bring evidence especially in Ayurveda healthcare practices is very much desired as the Prime Minister of the nation himself has urged the nation towards the practice of documentation and generation of data-based evidences. During the valedictory speech at the 9th World Ayurveda Congress in Goa, he said “It took so long for global consensus and acceptance regarding Ayurveda because the evidence is considered as the basis in modern science. We had results as well as effects as far as Ayurveda is concerned, but we were lagging behind in terms of evidence. And therefore, today it is imperative for us to do documentation of 'data-based evidence'. We have to work continuously for a long time in this regard. We have to bring our medical data, research and journals together and verify each and every claim on modern scientific parameters.”
Shri Narendra Modi,
Hon'ble Prime Minister of India
Case reports have always been crucial in generating evidences and played a role in the development of medical knowledge and clinical practice. The clinical case report and case series are indispensable parts of medical literature. A case report reveals what is unknown, yet not recognized, the possible sector to progress and the new to learn in medical science. However, according to tenets of evidence-based medicine, the case report and the case series are considered the lowest kinds of evidence-based medicine teaching. But, the peculiar role of case reports in the advancement of medical science, can be very well understood with the publication of the first observation of severe infant anomalies associated with sedative anti-nauseatic thalidomide in The Lancet on December 16, 1961, following which, additional case reports and series were published. The publication of case studies dated back to 1995 with the addition of a peer-reviewed “Case reports” section in “The Lancet.” This was followed by the release of an International PubMed-listed medical journal (Journal of Medical Case Reports) that only published case reports in 2007.
Case reports and series have great potential to encourage new learning. All medical innovation would halt without fresh concepts or learnings. The evidence-based medicine progress hierarchy should include new issues or theories. They are essential for newer observations, formulating hypotheses through the meticulous accumulation of scientific data about rare manifestations or diseases, and also serving as a significant educational tool. Any concept must first be discovered before it can be verified or quantified. The case report and case series can be put at the top due to this hierarchy with their strength in providing subtle observations of newer cases, the course of the cases, and etiological or therapeutic revelations, and paving the way for new hypotheses and research.
The ancient science of medicine, Ayurveda, is gaining popularity and necessitates strong scientific evidence-based studies and research with a robust pragmatic design for its globalization. Ayurveda, with its epistemological peculiarities such as Prakriti- (~state of normalcy) and Vikṛiti (~abnormal)-based treatment, and its approaches from person to person, ascertain the importance of case reports. These approaches not only bring evidence to the practices but would also give enough room for the epistemological differences and personalization of medical encounters which would give way to a more comprehensive “evidence.”
| Ayucare: The Journey so Far|| |
The All India Institute of Ayurveda (AIIA), an autonomous organization under the Ministry of Ayush, is releasing a peer-reviewed quarterly Journal of Ayurveda Case Reports (AyuCaRe) for the past 5 years. This journal is unique and is the first of its kind in Ayurveda stream that exclusively invites case reports from clinical specialties. It provides opportunities for students, researchers, and faculty of Ayurveda and allied medical sciences to be part of it. This initiative is expected to play a pivotal role in research, further generating evidence for the claims and principles of Ayurveda and allied sciences systematically. It is an open-access journal and is appreciated worldwide. To facilitate an easy understanding of the Sanskrit terminologies and to maintain uniformity, the journal emphasized the author to provide the English equivalent terminologies for all the Sanskrit terms mentioned in the manuscripts referring to the “Namaste Portal” developed by the Ministry of Ayush.
The institute has entered into an Memorandum of Understanding (MOU) with Medknow – Wolters Kluwer India Private Limited in February 2020, for the online management of this journal. Detailed information about the journal along with archives is available on the official website of the journal (ayucare.org). The submission portal is available at https://review.jow.medknow.com/JACR. Since then articles are being received through this online platform and issues are being released regularly. Subsequently, in July 2022, the journal has been enlisted into the University Grants Commission-Consortium for Academic and Research Ethics (UGC-CARE) list under the name of Journal of Ayurveda Case Reports.
The journal was founded in 2018, and the first issue of the first volume was published in September 2018. Within this short span, AyuCaRe has released five volumes holding 108 case reports of a wide range of diseases and morbidities [Table 1]. As the journal is growing, the number of case reports being received at the journal office is increasing day by day. This trend of increased submission is noticed exclusively after its inclusion in the UGC-CARE list. The status of the journal depicting the total number of articles including the case reports, editorials, guest editorials, invited articles, perspectives, and letters to editors processed till November 2022 is shown in [Graph 1]. During 5 years, the overall acceptance rate of articles for the journal is noticed to be 31.14% and the rate of rejection is 51.52%.
Till November 2022, cases related to nonhealing wounds (5), diabetes mellitus (5), fistula-in-ano (4) followed by COVID-19 specific related (4), and other disorders as depicted in [Table 2] were published. It is observed that the case reports published constituted mostly of the endocrine and metabolic disorders (21) followed by disorders of the integumentary system (16), gastrointestinal system (14), musculoskeletal system (12), eye and adnexa (10), central nervous system (10), circulatory system (7), respiratory system (7), ENT (5), genitourinary system (4), and neurodevelopmental disorders (2) [Graph 2].
|Table 2: System-wise disease-specific case reports published during 2018–2022|
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The diseases reported in the case reports are managed mainly with Shamana chikitsa (~palliative procedure) using a variety of formulations ranging from herbal, herbomineral, and metallo-mineral formulations. In the treatment protocol, the maximum number of drugs used was of herbal category and the use of the herbometallic, herbomineral, and metallo-mineral formulations are comparatively lesser. Formulations such as Lakshmi vilas rasa, Kamadudha rasa, Sutasekhara rasa, Vatagajankusha rasa, Arogyavardhini vati, Sameergaja kesari rasa, and Abhraka bhasma were used in few cases. Apart from internal administration of drugs, many Panchakarma therapies (~five biopurification therapies) such as Abhyanga (~therapeutic massage), Swedana (~sudation), Snehapana (~internal oleation), Vamana (~therapeutic emesis), Virechana (~therapeutic purgation), Anuvasana basti (~a form of unctuous enema), Takra dhara (~therapeutic butter milk - streaming over body), Niruha basti (~decoction enema), Patra pottali swedana (~sudation with bolus of leaves), and Udwartana (~therapeutic powder massage) were adopted as the management protocol. Various parasurgical and Kriya-kalpa (~ocular therapeutic procedures) procedures such as Siravedha (~venipuncture), Agnikarma (~therapeutic cauterization), Jalauka avacharana (~bloodletting using leech), Kshara karma (~therapeutic application of caustic material), Nasya (~medication through nasal route), Shiro-pichu (~therapeutic procedure of placing tampon with oil over the head region), Bidalaka (~application of medicated paste on the outer part of the eye), Tarpana (~therapeutic retention of medicated liquids over the eyes), etc., have been adopted.
These case reports provide the extent of possibilities of personalization-based treatment. These case reports ensure the safety and efficacy of the drugs and management protocols adopted along with the flexibility of personalized care, as no complications, nor adverse drug reactions were reported by the authors.
| Errors and Misconduct: Retraction of Case Reports|| |
Breaches and infringements are seen in all spheres of knowledge and all walks of life. AyuCaRe is wholly committed to upholding better standards and validity of the published case reports. In the five years of AyuCaRe, there have been two occasions of inadvertent ethical violations that required the journal to retract those published articles.
| Lessons Learned and the Way Ahead|| |
The purpose of publishing case reports is to describe and highlight the most unique and striking clinical situations covering a wide range of clinical issues. Case reports are being recognized as valuable contributors to the corpus of medical knowledge. From the editorial office perspective, the efficient functioning of any journal depends on various factors as depicted in [Figure 1].
The role of editors and reviewers can be thought of as the filter between submitted and published material. Editorial offices work hard to keep the accuracy and integrity of what is being published. Although conflicts of interest and potential prejudice will always exist in the realm of scientific publishing, it is the responsibility and duty of journal editors, authors, and reviewers to limit them to a minimum. The lack of skills for writing good case reports, lack of awareness, and knowledge about case reporting standard guidelines among the researchers, graduates, and scholars along with insufficient desire and competency toward implementation of ethical standards of the journals is presumed as the reasons for the massive rejection of case reports received. These demand proper training and encouragement to students, scholars, and researchers to indulge in clinical report writing. At the same time, it is also a legitimate concern about ethical lapses should be brought to the journal editors' notice by reviewers and readers. It is advised to the teachers, mentors, and guides to make efforts to guide about ethical standards of case report writing and promote a sincere sense of ethics while writing them.
Reviewing is a time-consuming process that helps to preserve the journal's quality and ensure the integrity of the publication by pointing out flawed research. Spotting plagiarism, research fraud, and other issues due to their expertise in the field can assist in preventing ethical lapses. AyuCaRe has a panel of distinguished, knowledgeable, and highly qualified reviewers from across the country. The reviewers are contributing to the journal voluntarily, devoting quality time, and providing each submitted work insightful feedback. However, the number of quality reviewers who can involve voluntarily and assist with the increasing workload is insufficient. Due to some professional obligations, it is also observed that reviewers sometimes find it difficult to meet the deadlines set for examining manuscripts, which causes delays in processing manuscripts on time. Due to the lack of volunteer reviewers as well as the lack of skilled reviewers for reviewing case reports, it is imperative to develop provisions for upskilling the professionals through conducting various training, workshops, and development of e-learning platforms on various topics related to publication ethics, such as standards publishing guidelines, identification of research misconduct, etc., in the sector of Ayurveda.
With this, the team AyuCaRe pays their heartiest gratitude to all the reviewers for their volunteer efforts to protect the integrity of scientific records. We value the reviewers' time and effort in reading the submitted manuscript. We sincerely thank for the insightful comments and recommendations, which allowed us to increase the manuscript's quality and raise the standards of the work published in AyuCaRe.
We, the team AyuCaRe, express our profound appreciation and respect to the Ministry of Ayush for always supporting and nurturing AIIA's initiatives. We sincerely thank all the Ministry's officials for their enthusiastic acceptance and appreciation for AyuCaRe publications at AIIA. Ministry of Ayush has consistently demonstrated unwavering faith and trust in every concrete action that AIIA has taken to advance, promote, and propagate Ayurveda both here in the nation and internationally.
We would also like to acknowledge and thank all the authors who have shared their clinical learnings and experiences through their case reports, which have certainly contributed in providing a scientific rationale to Ayurveda science, reinforcing the efficacy of Ayurveda as evidence-based practices. We genuinely hope to get more support from the esteemed Ayurveda fraternity and other professionals, mentors, and well-wishers. We also hope to receive assistance and support from numerous, self-driven reviewers so that AyuCaRe can continue to produce high-quality publications in the future. Anticipating more and more case reports by experienced professionals in coming days.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Vandenbroucke JP. Observational research and evidence-based medicine: What should we teach young physicians? J Clin Epidemiol 1998;51:467-72.
Ward SP. Thalidomide and congenital abnormalities. Br Med J 1962;2:646-7.
Nissen T, Wynn R. The clinical case report: A review of its merits and limitations. BMC Res Notes 2014;7:264.
Vandenbroucke JP. Case reports in an evidence-based world. J R Soc Med 1999;92:159-63.
Eranezhath SS. Practice-based evidence in Ayurveda. Anc Sci Life 2018;38:1.
[Table 1], [Table 2]