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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
Original article / research
Full Version
The Diagnostic And Prognostic Value Of Serum Adenosine Deaminase Levels In Head And Neck Cancer
Correspondence Address :
Ashok Kumar. J., Professor and Head, Department of Biochemistry, Father Muller Medical College Kankanady, Mangalore 575002, Karnataka, INDIA.
Ph: 9886727459, Email:
drashokkumarj@yahoomail.com
Serum adenosine deaminase (ADA) levels were estimated in 63 patients with histologically proven squamous cell carcinoma of the head and neck region of the body in different stages. Serum ADA levels were also estimated in 30 healthy controls. Serum ADA levels in cases (34.89 ± 6.80 IU/L) was significantly increased when compared to the control group (20.47 ± 3.33 I U/L). There was a highly significant correlation between the serum ADA level and the increasing disease stage (severity of the disease). The tumour status and metastasis of the tumour to the neck nodes has shown a correlation with serum ADA levels. After the treatment of head and neck cancers by different modalities, the serum ADA levels were found to be decreased (24.74 ± 3.91) when compared to the serum ADA activity before treatment (34.89 ± 6.80 IU/L).
Adenosine deaminase, Head and neck cancer
Introduction
Head and neck cancer is one of the most common cancers in the world, accounting for up to 30 to 40% of malignancies in India (1). Oral cancer has become the fourth reason for cancer death in males in Taiwan (2). Tobacco smoking (or chewing), alcohol consumption and betel quid chewing are shown to be independent risk factors for oral, pharyngeal and oesophageal cancers [3,4].
Adenosine deaminase (ADA: 3.5.4.4) is a cytosolic enzyme which catalyzes the hydrolytic deamination of adenosine to form inosine and 2’ deoxy adenosine to 2’ deoxy inosine, respectively. The physiological function of ADA is critical in controlling the effects of these metabolites on immunological, neurological and vascular systems. ADA is also involved in the development of B and T lymphocytes, as is evident from the fact that ADA deficient animals suffer from B and T lymphopaenia (5).
The levels of enzymes in T- lymphocytes vary according to cellular differentiation (6). The activity of the ADA enzyme is subjected to changes, depending upon the degree of activity of the cell (7). The evidence of high ADA activity during rapid and stimulated growth of normal tissues is of importance in making a fully functional purine salvage pathway possible (8). An increased serum ADA level is associated with oesophagus tumours (9), liver cancer (10), breast cancer (11) and colorectal cancer (12). In addition, ADA is the most sensitive marker for tuberculosis (13).
The present study was designed to evaluate the diagnostic and prognostic importance of ADA activity in head and neck cancer, and to evaluate its usefulness as a possible marker of head and neck cancer progression.
The present study was conducted in the department of otorhinolarygology and Department of Biochemistry, after obtaining clearance from the hospital ethics committee.
Cases
The study group consisted of 63 patients with histologically proven squamous cell carcinoma of the head and neck region of the body in different stages, who had not taken any prior treatment. Care was taken to exclude patients with head and neck cancer, who had already taken the treatment, and those patients with tuberculosis. Cancer staging had been done according to the TNM classification of head and neck cancer (14).
Controls
The control group consisted of 30 age and sex matched normal healthy individuals who came to the hospital for the health checkup.
Sample collection
Blood samples were collected from controls and patients by using aseptic precautions, after obtaining their consent. They were immediately processed to obtain serum for the estimation of serum ADA level. The ADA level in serum was assayed by the colorimetric method of Giusti (15), in which adenosine is used as substrate, and the ammonia liberated by the action of ADA on adenosine is measured as blue indophenol. Serum ADA activity was expressed as IU/L (1 IU/L is defined as one micromole of ammonia formed per minute per liter of serum).
Patients with head and neck cancer were treated with different modalities (Radiotherapy, Chemo-radiation, surgery). One week after the treatment of head and neck cancer, with the consent of the patient, once again, a venous blood sample was collected and the serum ADA level was estimated.
Statistical analysis
Serum ADA level between the controls and cases was compared by t-test. Serum ADA activity in different stages of cancer was compared by analysis of variance (ANOVA). Serum ADA activity was compared between different tumour status and nodal status by the Bonferrine test. Serum ADA activity in cases before and one week after the treatment was compared by t-test.
There was statistically significant increase in the ADA level in cases (34.89 ± 6.80 IU/L) when compared to control group (20.47 ± 3.33 I U/L) (Table/Fig 1).
Lal et al (16) reported that mean value of ADA was significantly higher in cases, compared to controls. Our findings were consistent with that of Lal’s study. Walia M, Mahajan M and Singh K (17) have reported that serum adenosine deaminase is a better parameter for the detection of breast cancer, and the assessment of the development of various stages of cancer.
According to the staging of the head and neck cancer done by considering the tumour status and nodal status, 18 of the patients were in stage IV, 16 in stage III, 17 in stage II, and 12 were in stage I. The majority of the patients studied, were in stage IV.
Serum ADA level was compared between the different stages of the disease by analysis of variance (ANOVA) (Table/Fig 2).
There was a statistically significant increase in the serum ADA level as the disease stage progressed from stage I to stage IV disease. Serum ADA level was more in cases with stage IV disease, when compared to patients with stage III disease. Significant increase was also found between stage II disease and stage III disease. Serum ADA level was more in cases with stage II disease, as compared to stage I. This was statistically analyzed by pair wise comparisons (Bonferrine test) (Table/Fig 3)
Serum ADA level was compared between different tumour status (Table/Fig 4). Serum ADA level appeared to be increased as the tumour status progressed from T1 through T3. There is a statistically significant correlation between the serum ADA level and the tumour status when pair wise comparison (Bonferroni test) was done (Table/Fig 5).
Several studies suggest that there is increase in the activity of purine salvage enzymes including ADA, as the adenocarcinoma of the colon becomes more invasive [18, 19]. ADA activity was highest at the mucosa adjacent to the carcinoma of the colon. The ADA synthesis is increased in tissues surrounding cancer, and it has got a role in progression and invasion of colon cancer (20) .
Serum ADA activity was compared between different nodal status (Table/Fig 6).
There was a statistically significant correlation between different nodal status and the serum ADA activity, as determined by the pair wise comparison (Bonferroni test) (Table/Fig 7). The main physiological activity of ADA is found in T-lymphocytes, and is related to lymphocytic proliferation. Cell mediated immune response particularly mediated by the lymphocytes have been shown to be important in patients with transitional cell carcinoma of the bladder. A fully functioning cell mediated immune response is partly dependant on the purine salvage enzyme, ADA (21).
Serum ADA is sensitive to stimulation by growth factors and cytokines during rapid tissue proliferation (22). The activity of ADA is increased in very rapidly growing malignancies, while slow growing, well differentiated tumours, do not express pronounced ADA activity [23, 24]. The treatment of colon carcinoma cells with deoxycoformine, an ADA inhibitor, resulted in inhibition of cell growth [25, 26]. This shows that ADA plays a metabolic role in supporting a rapid growth of tissues by reutilization of nucleotides which are required for the RNA and DN
Serum Adenosine deaminase levels are found to be increased in head and neck cancers. ADA levels can be used as an additional tool for diagnosis of head and neck cancer. It can also be used for the follow-up of the treated cases. There is a scope for further study of serum ADA levels and its usefulness in the diagnosis and follow-up of head and neck cancer in a larger population.
The authors wish to thank the management of Father Muller Charitable institution, Kankanady Mangalore, for providing facilities to carry out this work. They would also like to thank the statistician, Mrs Sucharetha Suresh, and the Research and Development cell coordinator, Prof. M.N. Madhyastha, for their valuable suggestions.
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