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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
Unusual Presentation Of Pediatric Myelodysplastic Syndrome: A Case Report
Correspondence Address :
Dr. Rashmi Tondon MD, PDCC Department of Transfusion Medicine, SGPGIMS, Lucknow
SGPGIMS, Lucknow Tel.: 91 522 2668700,
e-mail: rashmit@sgpgi.ac.in
Myelodysplastic syndrome (MDS) is a clonal hematological disorder characterized by dysplastic hematopoiesis and progression to leukemia. MDS is a rare childhood disorder presenting with nonspecific symptoms and has extremely variable prognosis. It should be considered in the differential diagnosis of all cytopenic disorders in children. The preleukemic phase is usually short and the disease rapidly evolves into overt leukemia. Marrow cellularity is normal or increased in MDS with hypocellular marrow being a rare feature. We report a case of MDS in a child with the rare finding of hypocellular bone marrow for that age.
Myelodysplastic syndrome; cellularity; children
Myelodysplastic syndrome (MDS) is a clonal hematopoietic stem cell disorder characterized by peripheral cytopenia(s), bone marrow dysplasia and susceptibility to acute leukemia (1). MDS is rare in childhood (2),(3). The disease seems to be more frequent in patients who previously received radiotherapy and chemotherapy for a first malignancy (4),(5). Bone Marrow cellularity is normal or increased in MDS with hypocellular marrow being a rare feature(7). This case highlights a rare feature of MDS with hypocellular bone marrow in a child.
A 7 year old boy presented with low grade fever, easy fatigability, and pallor of three months duration which was treated symptomatically considering the diagnosis to be nutritional anemia. General physical examination was unremarkable except for marked pallor with no hepatosplenomegaly or lymphadenopathy. Past history was non contributory with no prior exposure to cytotoxic drugs, radiation or other mutagens.
Laboratory picture showed pancytopenia, with hemoglobin 4.7g/dl, hematocrit 14.3%, mean corpuscular volume (MCV) 63 fl, total leukocyte count (TLC) 3.8 X 109 /l, with neutrophils 0.8 X109 /l, platelet count 75 X 109 /l and the proportional circulating blasts were 1%. Morphological diagnosis was based on analysis of peripheral blood smear (PBS), bone marrow aspirate (BMA) and bone marrow biopsy (BMB) with cytochemical staining with periodic acid Schiff (PAS) and Perl’s stains. PBS and BMA showed trilineage dysplasia. Dyserythropoiesis was evident principally by macrovalocytes, multinuclearity and nuclear hyperlobation (Table/Fig 1). Dysgranulopoiesis was characterized by Pseudo-Pelger-Huët anomaly and hypogranularity (Table/Fig 2). Megakaryocytic dysplasia was characterized by hypolobated megakaryocytes of all sizes and hyperlobated widely separated nuclei. (Table/Fig 3),[ Table/Fig 4]. Perl’s reaction on aspirated marrow showed erythrocytes at all stages of maturity loaded with siderotic granules. BMB indicated a hypocellular bone marrow for that age with characteristic trilineage dysplasia. There was no abnormal localization of immature precursors (ALIP) nor was the topography of the bone marrow distorted. However cytogenetic analysis could not be done because of financial constraints. The case was diagnosed as MDS with refractory cytopenia [MDS RC] in accordance with the WHO criteria modified for pediatric age group. The patient received supportive treatment consisting of folate and B12 and blood transfusions. The patient could be followed up to a period of approximately 2 months with routine blood tests to evaluate the hematological outcome of the disease. The patient did not transform to a more aggressive form of MDS or leukemia and was lost to follow up in a satisfactory clinical condition.
MDS is a rare hematological disorder in children. The symptoms are non specific and the diagnosis may be difficult to make. Prognosis is extremely variable depending on the type of MDS. The pre leukemic phase is usually short in children [12 – 18 months] and the disease rapidly evolves into overt leukemia. This case highlights two uncommon features: First, being the patient’s age as the term pediatric MDS is used for < 17 years age considering the latest proposed WHO classification. Second unusual finding is the hypocellularity of the bone marrow for the age of the patient. Bone marrow hypocellularity is a rare feature in MDS (6),[ 7]. Hypocellularity on BMB is defined when it is below the normal range value adjusted for the age on a semi-quantitative evaluation (8). Bone marrow cellularity is the critical determinant for the recognition of hypocellular MDS (9). According to the pediatric modification of the WHO classification (10), MDS patients are classified into three groups: refractory cytopenia (RC), refractory anemia with excess of blasts (RAEB) and RAEB in transformation (RAEB-T). Applying the recently proposed iagnostic criteria for detecting MDS in children, this patient fulfilled at least two of the minimal diagnostic criteria for pediatric MDS as suggested by Hasley et al (10): sustained unexplained cytopenia and/or at least bilineage morphological myelodysplasia and/or acquired clonal cytogenetic abnormality in hematopoietic cells and/or increased blasts > 5%. The differential diagnosis considered in this case was hypocellular acute myeloid leukemia (AML) with low blast count, aplastic anemia and several congenital bone marrow failure syndromes. The diagnosis was established by a combination of clinical and laboratory parameters along with BMA and BMB pictures which showed trilineage dysplasia.The diagnosis of hypocellular MDS without excess blasts is to be made with caution especially in the absence of cytogenetics.The sparse number of cells available for evaluation and the subjective grading of qualitative abnormalities account for the diagnostic difficulties. It would have been difficult to diagnose if a monolineage dysplasia was present.
MDS should be considered in the differential diagnosis of all cytopenic disorders in children. It is important to diagnose MDS at an early stage by critical evaluation of dysplasia particularly in pediatric patients as preleukemic phase is usually short in children and the disease rapidly evolves into overt leukemia.
Conflict of Interest: None declared
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