Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

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Dr. Arundhathi. S
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Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
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Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
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Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

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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.
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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.
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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)
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.
On April 2011

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
On Jan 2020

Important Notice

Case report
Year : 2010 | Month : April | Volume : 4 | Issue : 2 | Page : 2308 - 2310 Full Version

Salmonella Typhi Septic Arthritis Of The Hip - A Case Report

Published: April 1, 2010 | DOI:

*( MSc) (Medical Microbiology), ,**(MSc) (Medical Microbiology), ***(MD) (Microbiology), ****(MSc) (Medical Microbiology), *****(MD) (Microbiology), Department of Microbiology, AJ Institute of Medical Sciences, Mangalore,(INDIA).

Correspondence Address :
Faseela T.S, 708, Plama Residency, Kuntikana, Mangalore,Karnataka, (India) -575004,Ph- +91 9481140834,+91 9945354173e-mail,


Salmonella infection is endemic in developing countries. Although the commonest manifestation of Salmonella infection is acute gastroenteritis, the infection may spread through the blood stream and the illness can present with focal lesion in almost any organ with or without septicaemia. Isolation of Salmonella species from aberrant sites with a variety of clinical syndromes where they are hardly expected has been reported. We describe here, a case of rarely encountered Salmonella typhi septic arthritis of hip in a 16 years old female. She was treated with ciprofloxacin therapy to which she responded favourably.


Septic arthritis of hip, Arthritis due to Salmonella typhi

Salmonella consists of a large heterogeneous group of gram negative bacilli that affect animals and humans. As a group, they are enteroinvasive and enteropathogenic organisms. Human beings are infected with Salmonella, mainly by ingestion of contaminated food or drink (1). Salmonellosis can result in four types of clinical syndromes: enteric fever, septicaemia with or without suppurative lesions, gastroenteritis and the carrier state (3). Bacteraemia is a constant feature of enteric fever (8). Its dissemination may lead to localised foci of infection even in the bones and joints (3),(10). Organisms which are commonly responsible for septic arthritis are Staphylococcus aureus, Haemophilus influenzae type b and streptococci (4),(6),(7),(14). Salmonella arthritis occurs very infrequently, accounting for only approximately 1% of all cases. It usually presents as one of the metastatic infections in children with non-typhoidal Salmonella bacteraemia following earlier episodes of gastroenteritis. Salmonella that causes septic arthritis is almost invariably a non-typhoidal species. Septic arthritis is an extremely rare complication of S. typhi infection (6).

Case Report

A 16 year old female was admitted to the orthopaedic ward of AJ Hospital and Research centre, Mangalore, with complaints of pain in the right hip joint since two months. The patient had a past history of viral encephalitis two months prior to the episode and also a history of typhoid fever one month ago, for which she was treated. There was no history of any trauma. On examination, the patient had a temperature of 990F, a pulse rate of 80/min and blood pressure -130/60 mm Hg. On systemic examination, there was no abnormal finding. Chest X-ray was normal. Whole body scan showed increased uptake over the head and at the proximal neck of the right femur. The right acetabulum suggested bony inflammation. The total blood count was10,400/, with normal differential count. ESR was 16mm/hour.Haemoglobin was 9. 82 mg/dl. The peripheral smear showed normocytic normochromic anaemia. PCR for tuberculosis was negative. Widal test was positive, with a titre of 320 for both Salmonella typhi O and H antigens.

Aspiration of pus was done. Gram stain of pus showed plenty of pus cells and a few gram negative bacilli. Culture of the pus sample was done, which grew gram negative, non-fermenting bacteria. The isolate was identified as S.typhi by standard biochemical tests and it was confirmed by the slide agglutination test by using polyvalent and monovalent antisera(11), (12), (13). Antibiotic susceptibility testing was done and was interpreted as per Clinical Laboratory Standards Institute Guidelines (11) .The isolate was sensitive to Amoxycillin, Chloramphenicol, Cotrimaxazole, Ciprofloxacin, Cefixime, Ceftriaxone, Cefotaxime and Ofloxacin. The patient was treated with ciprofloxacin with which she recovered completely.


Enteric fever is the most common presentation of Salmonella typhi. In enteric fever, there is bacteremia and seeding of bacteria to all the parts of the body including the bones and joints. The other presentations like neuropsychiatric, cardiovascular, hepatobiliary and genitourinary manifestations have also been seen. Occasionally, focal lesions such as osteomyelitis, sacroiliitis, brain abscess, and spleen and liver abscess have also been reported (1). Although any skeletal site can become infected, Salmonella infections of the bone typically involve the long bones, the chondrosternal junctions, the knee, the shoulder, the hip, the sacroiliac joints and the spine(1).Septic arthritis of the hip caused by S.typhi is very rare(3). More than 100 cases of salmonella arthritis were reviewed, which revealed a disease primarily of children and young adults, with a favourable response (2).All the cases reported were culture positive. Some of the cases showed a high widal titre as in this case. The correlation between the widal test and culture positive cases are shown in the (Table/Fig 1).

In the present case, there was a history of typhoid fever one month before the joint involvement and also a history of viral meningitis, approximately two months prior to this. The continuous ill health and the debilitated state may be the underlying cause for this focal sepsis. Correct diagnosis and treatment at the right time saved the affected hip joint in this case.


To conclude, in areas where enteric infections with salmonella are endemic, bacteremia can occur in immunosuppressed individuals and in children, with congenital diseases in whom infection has a tendency to spread haematogenously to larger joints (2), (5), .So, physicians should be aware of this rare manifestation of S.typhi infection. All cases of pyrexia of unknown origin with or without bone involvement should be properly investigated and treated.

Widal test should be done along with the culture, which will help reinforce the diagnosis. Early diagnosis, surgical intervention and administration of appropriate systemic antibiotics play a pivotal role in successful treatment.

Key Message

Septic arthritis, arthritis of hip, Salmonella typhi


Mehmet Ulug1, Mustafa Kemal Celen2, Mehmet Faruk Geyik2, Salih Hosoglu2, Celal Ayaz2. Sacroiliitis caused by Salmonella typhi The Journal of Infection in Developing Countries, Aug 2009;3(7):564-8.
Naithani, Rahul MD; Rai, Sanjay MD; Choudhry, Ved P. MD. Septic Arthritis of Hip in a Neutropenic Child Caused by Salmonella typhi. Journal of Pediatric Hematology /Oncology.Issue: Volume 30(2), February 2008, pp 182-184
Agnihotri N, Dhingra MS, Gautam V, et al. Salmonella typhi septic arthritis of hip—a case report. Jpn J Infect Dis. 2005; 58:29–30.
W. Yang, Y. Huang, M. Tsai, C. Chiu, T. Jaing. Salmonella Septic Arthritis Involving Multiple Joints in a Girl with Acute Lymphoblastic Leukemia at Diagnosis, Pediatrics & Neonatology 2009, Volume 50, Issue 1, Pages 33-35
P Sarguna, V Lakshmi. Neonatal septic arthritis due to Salmonella typhimurium Indian Journal of Medical Microbiology. Year : 2005 | Volume : 23 | Issue : 1 | Page : 66-67
Chiu S, Chiu CH, Lin TY, et al. Septic arthritis of the hip caused by Salmonella typhi. Ann Trop Pediatr. 2001;21:88–90.
Akakpo-Numado GK, Gnassingbe K, Sakiye KA, Boume MA, Amadou A, Tekou H.Hip septic arthritis in young children with sickle-cell disease. Rev Chir Orthop Reparatrice Appar Mot. 2008 Feb; 94(1):58-63. Epub 2008 Feb
Dr. J. Y. Chen; S. F. Luo; Y. J. J. Wu; C. M. Wang; H. H. Ho. Salmonella Septic Arthritis in Systemic Lupus Erythematosus and other Systemic Diseases Clinical Rheumatology.Volume 17,Issue 4,1998,Pages 282-287
John Ebenezeer.Text book of orthopaedics 3rd ed,521
Gordon C Cook and Alimuddin Zumla,Manson’s Tropical diseases, ed,940
Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Winn WC. Color atlas and textbook of diagnostic microbiology, 6th ed.,251-258,968-987.
J.G.Collee,A.G.Fraser,B.P.Marmion,A.Simmons,Mackieand McCartney Practical Microbiology 14th ed,393-402
Betty A,Forbes,Daniel F Sahm,Alis SWeissfeld ,Bailey and Scott’s Diagnostic Microbiology,12th ed, 324-30
.Mandell GL, Bennett JE, Dolin RD. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases. 6th ed.vol.1;1312.

Tables and Figures
[Table / Fig - 1]
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