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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
Images in Medicine
Chronic Polyarticular Gout at Unusual Sites: A Rare Case
TJ01-TJ02
Correspondence
Dr. Senthil Kumar Aiyappan,
Professor and Head, Department of Radiodiagnosis, SRM Medical College Hospital and Research Centre, SRMIST, Kattankulathur, Chengalpet-603203, Tamil Nadu, India.
E-mail: asenthilkumarpgi@gmail.com
A 59-year-old male presented to the orthopaedics department with complaints of pain and swelling in the right knee for one week. The pain was insidious in onset with gradual progression, dull aching, non-radiating, and aggravated on weight bearing and knee movements with no relieving factors. The patient also had a similar history of pain and swelling in both knee joints on and off for the past three years. The patient also gave a history of pain in the neck region radiating to both upper limbs for the past two months. The patient was not a known hypertensive, diabetic, not a smoker or alcoholic. The patient consumed a vegetarian diet. The medical history of the patient revealed chronic gout for four years, diagnosed elsewhere and the patient was on intermittent treatment with allopurinol. The general examination of the patient was unremarkable.
On local examination, the right knee showed diffuse swelling and tenderness on the medial aspect of the knee with no evidence of redness or warmth. Blood investigations revealed haemoglobin of 13.2 mg/dL (13-17 mg/dL), elevated blood urea of 49 mg/dL (17-43 mg/dL), uric acid of 9.3 mg/dL (3.5 to 7.2 mg/dL), reduced calcium of 8.1 mg/dL (8.8-10.6 mg/dL) and serum creatinine of 1.2 mg/dL (0.7 to 1.3 mg/dL). X-rays of both knees including both anteroposterior and lateral projections were taken which showed small marginal osteophytes involving medial femoral and tibial condyles on both sides with multiple subchondral cysts involving the lower end of the bilateral femur and upper end of the bilateral tibia. Subtle increased density was noted within the bilateral knee joint. The imaging findings on X-ray suggested chronic gout with associated osteoarthritis (Table/Fig 1)a-d. Computed Tomography (CT) of both knees was taken to confirm the X-ray findings and to demonstrate hyperdense soft-tissue which reaffirmed chronic tophaceous gout. CT showed small marginal osteophytes involving medial femoral, and tibial condyles and multiple large subchondral cysts. Hyperdense soft-tissue was demonstrated within the bilateral knee joint (Table/Fig 2)a-d which was suggestive of chronic tophaceous gout/gouty arthritis. The patient had also given a history of cervical radiculopathy for which an MRI and CT of the cervical spine were done. CT showed evidence of hyperdense soft-tissue along the atlantoaxial joint and bilateral Sternoclavicular Joint (SCJ) - suggestive of chronic gout involving the atlantoaxial joint and bilateral SCJ (Table/Fig 3)a-d. MRI of the right knee joint was done to evaluate synovial thickening and cartilage assessment. MRI showed T2 hypointense areas in the knee joint corresponding to hyperdense soft-tissue on CT predominantly involving Hoffa’s fat pad and suprapatellar bursa with mild synovial thickening. These features were suggestive of chronic gout (Table/Fig 4)a. MRI of the cervical spine showed evidence of cervical spondylosis with hypointense areas in the regions of the atlantoaxial joint corresponding to hyperdense soft-tissue on CT- suggestive of tophaceous gout (Table/Fig 4)b. Synovial fluid analysis of the knee joint was not done since there was no significant joint effusion. The overall laboratory and radiological findings were confirmatory for chronic tophaceous gout involving the bilateral knee joint (Right > Left), sternoclavicular, and atlantoaxial joint. The patient was managed conservatively with allopurinol 100 mg twice a day and discharged as he was not willing for further management.
Gout is a form of inflammatory arthritis characterised by elevated levels of uric acid in the blood, known as hyperuricaemia. This excess uric acid can lead to the formation of urate crystals in joints and surrounding tissues, causing pain (1). Risk factors for developing gout include increasing age, male sex, postmenopausal state, African American race, and certain comorbidities such as insulin resistance, obesity, hypertension, congestive heart failure, and organ transplantation (1). Impaired renal excretion of uric acid is one of the major contributing factors to hyperuricaemia which is defined as a serum uric acid level of more than 7 mg/dL in males and 6 mg/dL in females (2),(3). Gout typically presents as sudden and severe pain, swelling, redness, and tenderness in a single joint, most commonly the big toe (first metatarsophalangeal joint). However, in the present case, it was polyarticular involvement (3). Tophi are collections of Monosodium Urate (MSU) crystals that are deposited in soft-tissues or within the tendons and joints. Typical locations of the tophaceous deposits are the first metatarsophalangeal joint, the Achilles tendon, the olecranon bursa, and the ear and finger pulps (4). In this case, there was the involvement of the bilateral knee joints, atlantoaxial joint, and SCJ. These deposits can also occur in atypical locations which include second metacarpal, patellar tendon, spinal cord, and clavicle (4),(5). Tophi occurring in the SCJ and atlanto-axial joint is an extremely rare condition (6),(7), both of which were involved in the present case. In a case report described by Romero AB et al., there was the involvement of atlantoaxial joint by tophaceous gout in an 82-year-old male who had a 40-year history of proven gout (6). In the present case, the patient is a 59-year-old male with a 4-year history of gout. According to the case report described by Romero AB et al., there were only seven described cases of atlantoaxial joint involvement including his case till 2021(6). To the best of our knowledge after 2021, there were no case reports of gout involving the atlantoaxial joint. Sahdev N et al., described a case of tophaceous gout involving the left SCJ. In that case, the SCJ involvement mimicked a bony tumour (7), however, in this case, there was no swelling and only joint involvement was noted on CT imaging with characteristic high-density soft-tissue deposits. According to the case report described by Sahdev N et al., there were only three reported cases of true gout involving the SCJ including his case till 2021(7). Patients with gout need to manage their condition through lifestyle modifications, such as dietary changes to reduce purine intake (which can contribute to uric acid formation), weight management, and avoiding triggers like alcohol consumption (8). To conclude, this case is unique in the form that tophaeous deposits in the atlantoaxial joint and SCJ are rarely reported in the literature and should be looked for, in cases of chronic gout.
