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

Users Online : 17802

AbstractCase ReportDiscussionReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"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."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
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.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
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
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
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.


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

Important Notice

Case report
Year : 2011 | Month : November | Volume : 5 | Issue : 6 | Page : 1275 - 1277

Inverted Sinonasal Schneiderian Papilloma With Malignant Transformation

Sunil Vitthalrao Jagtap, Dhiraj B Nikumbh, Swati H Chavan, Gaurav Jain, Abhay D Havale

Corresponding Author Dept. of Pathology, Kims University, Karad, Maharastra Dept. of Physiology, Kims University, Karad, Maharastra Dept. of Pathology, Kims University, Karad, Maharastra Dept. of Ent, Kims University, Karad, Maharastra

Correspondence Address :
Dhiraj B. Nikumbh,
MD, Assistant Professor
Department of Pathology,
Kims University, Karad, Maharastra, INDIA.
Mobile : 9028522413
Email : drdhirajnikumbh@rediffmail.com

Abstract

Inverted papilloma is a lesion of the mucosal membrane of the nasal cavity and the paranasal sinuses. It is a unique tumour which is characterized by its tendency to recur after incomplete removal, to destroy the bone and rarely transform to malignancy. It is a rare tumour which comprises approximately 0.5 - 4 % of all the primary nasal tumours. Different names which are used for this papilloma include villiform cancer, fungiform papilloma, cylindrical / transitional papilloma, schneiderian papilloma, transformation of papilloma and many more. We hereby report a very unusual and challenging case which elicited a range from sinonasal papilloma, with invasion , atypia and foci of transitional cell carcinoma.

Keywords

Inverted sinonasal papilloma, Malignant transformation in papilloma, Sinonasal tumours

Introduction
Inverted papilloma is a locally aggressive sinonasal tumour that arises from the outlining schneiderian respiratory membrane. It is a benign epithelial tumour that arises within the nasal wall and less commonly in the paranasal sinuses. It is a rare tumour, incidence having 0.5-4 % of all the primary nasal tumours(1). It has a peak incidence in the 5th and 6th decades of life. It is a controversial topic due to its infrequent occurrence and confused nomenclature. Ward was the first one who described inverted papilloma in 1854. Billroth (1855) was credited for describing the first case of true papilloma of the nasal cavity and he called it ‘villiform cancer’(2). Ringertz, in 1938, was the first one to describe the microscopic appearance and the tendency of the tumuor to invert into the connective tissue stroma(3). He also marked the metaplastic transformation from columnar to squamous epithelium and emphasised its similarity with papilloma and cylindrical cell carcinoma(3). The ages of the patients vary from 10 - 87 years, with a majority of the patients in the age group of 50 – 70 years, with a male preponderance (M : F is 3.3 : 1). It is a relatively rare neoplasm with a typical presentation like unilateral nasal polyp. This neoplasm is characterized by its capacity to destroy, its tendency to recur after its removal and its association with malignancy(4). Synder et al noted a marked atypia and a significant increase in the mucous droplets within the epithelium of recurrent tumours(5). The aetiology of the tumour still remains unknown. Sulphur, tobacco, infection and other occupational exposures have been considered as the significant aetiological factors. Investigations like fluorescence in situ hybridization ( FISH ) and polymerase chain reaction (PCR) have been used to determine its link with the human papilloma virus types 6 and 11(6).

Case Report

A 50 - year old male presented with complaints of recurrent nasal discharge,epistaxis and watering of the left eye since 10 months months duration. On local examination, purulent rhinorrhoea and a pink polypoid mass in left nasal cavity were seen, which occluded the left nasal cavity. Radiological evaluation of the paranasal sinuses revealed a soft tissue mass which involved the left sinonasalsystem. Computed tomography of the nasopharynx and the paranasal sinuses showed an enhancing mass lesion in the left maxillary sinus, which eroded the superior and the medial wall, and extended into the orbital plate and the ethmoids – which was suggestive of a neoplastic lesion. The systemic examination was within normal limits. Left intranasal polypoidectomy under general anaesthesia was done and the curettage material was sent for histopathological examination.

PATHOLOGICAL FINDINGS
Gross : Received multiple, friable, irregular grey brown to pink, gelatinous tissue bits, totally weighing 20 grams.

Histopathology :
Revealed polypoid tissue which was partially covered with columnar ciliated epithelium and areas with neoplastic squamous epithelium which showed inversion into the underlying stroma to form large clefts, ribbons and islands (Table/Fig 1). The neoplastic epithelium was immature and showed hyperplasia, papillomatosis, extensive cellular and architectural atypia and minimal mitosis (Table/Fig 2). Foci of transitional cell carcinoma (i.e. nuclear pleomorphism, increased mitotic figures and focal tumour necrosis) were noted in the stroma, with mild mononuclear cell infiltration (Table/Fig 3)Histopathological diagnosis was given as inverted sinonasal papilloma with malignant transformation. The post.

The post operative recovery was uneventful and the patient is on regular follow up with a further plan for radiotherapy.

Discussion

Inverted papillomas which arise from the nose and the paranasal sinuses are distinctive lesions that have been discussed in the literature for over a century. However, because of their infrequent occurrence and confusing nomenclature, they remain a topic of controversy(7). These have been reported in the literature under a variety of titles. The designation, “inverted schneiderian papilloma” has been recommended as an appropriate title to best convey the tumour qualities of inversion, location and distinctiveness of character(4). Ward was credited for reporting the first case of inverted papilloma in 1864. However, Ringertz was the first to describe the tendency of the tumour to invert into connectivetissue stroma and its metaplastic transformation from columnar to squamous epithelium and he emphasized on the similarity between papilloma and cylindrical cell carcinoma(3). The neoplasm is characterized by its capacity to invade, its tendency to recur after incomplete removal and its association with malignancy. So, otolaryngologists have given a great deal of attention to this lesion. The association between inverted papilloma and squamous cell carcinoma is well known. The reported incidence of papillomas varies from 1.7 – 7 % (8). Many reports have documented malignant transformation in recurrent inverted papilloma, as well as inverted papilloma and squamous cell carcinoma co - existing in the initial specimen (9),(10).

We report here, an unusual and rare case of inverted, transitional, sinonasal papilloma with architectural and cellular atypia, with the foci of Transitional Cell Carcinoma (TCC) - i.e. nuclear pleomorphism, increased mitotic figures and focal necrosis within the large tumour islands.

Inverted papilloma should be distinguished from TCC – a variant of squamous cell carcinoma. The islands of TCC are larger and more confluent than the discrete island of inverted papilloma (11). This finding was very well appreciated in our case (Table/Fig 3).

The surgical treatment depends upon the location of the tumour. Due to the high recurrence rate, the surgical treatment for this tumour is intranasal polypectomy with medial maxillectomy, or ethmoidectomy with follow up is preferred. The practice of sending the complete tissue which was removed at the time of surgery for histopathological studies, results in an earlier and more accurate diagnosis.

To conclude, inverted papillomas of the nose and the paranasal sinuses with invasion, atypia and malignant transformation is relatively rare. These lesions are given a great deal of attention by otolaryngologists because of their characteristic attributes of high incidence of recurrence and the propensity to be associated with malignant changes.

References

1.
Woodruff WW, Varbae DP . Inverted papilloma of the nasal vault and the paranasal sinuses. Am J Roentgenolo. 1994;162(2):419-23.
2.
Brown B. The papillomatous tumours of the nose. J Laryngol Otol. 1964;58:889-96.
3.
Ringertz N. The pathology of the malignant tumours which arise in the nasal and the paranasal cavities and the maxilla. Acta Otolaryngol. 1938;27:31-42.
4.
Vrabec PD. The Inverted Schneiderian Papilloma: A 25-Year Study. Laryngoscope. 1994;104:582-604.
5.
Synder RN, Perzin KH. Papillomatosis of the nasal cavity and the paranasal sinuses. A clinicopathologic study. Cancer. 1972;30(3):668- 90.
6.
Buchwald C, Franzmann MB, Jacobson GK, Lindeberg H. The Human Papilloma Virus (HPV) in Sino-nasal Papillomas: A Study of 78 cases by using In-Situ Hybridization and Polymerase Chain Reaction. Laryngoscope. 1995;105:66-71.
7.
Lyngdoh NC, Ibohal TH, Marak IC. A study on the clinical profile and the management of inverted papilloma. Indian Jr of Otolaryngology and Head and Neck Surgery.2006;58(1) :41-6
8.
Benninger MS, Robert JK, Sibek BA, et al. Inverted papilloma and associated squamous cell carcinoma . Otolaryngol Head Neck Surgery.1990 ;103 :457-61.
9.
Keshma HK, Kessis T , Hruban RH. Human papilloma virus in sinonasal papilloma and squamous cell carcinoma. Laryngoscope.1992;102:973-6.
10.
Futuma Y, Shinohara T, Sano K, et al. Molecular study of the human papilloma virus infection in inverted papilloma and squamous cell carcinoma of the nasal cavities and the paranasal sinuses. Laryngoscope. 1991;101:79-85.
11.
Brandwain-Gasler M. Sinonasal and nasopharyngeal surgical pathology. In Silverberg’s Principles and Practice of Surgical Pathology and Cytopathology.4th ed. Elsevier pub. 2006;788-9.

DOI and Others

JCDR/2011/1629

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com