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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
Radiological evaluation of chest in Abdominal Tuberculosis
Correspondence Address :
Sujit Kumar Bhattacharyya
Vill-Aminpur, P.O.-Khamarchandi
P.S-Haripal, Hooghly(DISTRICT) ,West Bengal, India
PIN - 712405
E-mail: drsujit.haripal@yahoo.in
Phone: 9433151875.
Aim: To evaluate the chest x-ray in all non-HIV patients with abdominal tuberculosis.
Methods: Total 161 patients were studied who were retrospectively diagnosed as abdominal tuberculosis based on clinical examination and various biochemical, histopathological and radiological investigations . They were analyzed in the Department of Pulmonary Medicine of a tertiary medical centre during the period May 2005 to April 2010. All patients with abdominal tuberculosis were reviewed with x-ray chest both PA and Lateral view.
Results: Total 161 patients were studied with x-ray chest PA and lateral view. In 63 cases (39.13%) there were no radiological abnormalities and 98 cases (60.87%) showed radiological abnormalities of which 49 cases (30.43%) had features consistent with old lesion and 49 cases (30.43%) had features of active lesions. Commonest old lesion was pulmonary fibrosis found in 21cases (13.04%) of which majority (80.95%) were solitary. Pleural thickening was found in 9 cases (5.59%), calcification of pleura in 8 cases (4.97%) and mostly in the left side. Calcified hilar lymphnode found in 2 cases (1.24%) and combination group under old lesion seen in 9 cases (5.59%).Commonest active lesion was pulmonary infiltrate seen in 25 cases (15.52 %) and majority ( 80%) were solitary. Pleural effusion found in 8 patients (4.97%) and was more common in the right side. Miliary opacities were found in 2 cases (1.24%). Isolated hilar and paratracheal lymphadenopathy were found in 1case (0.62%) and 2 cases respectively. Mediastinal widening was found in 2 cases (1.24%), cavitary lesion seen in 3 cases (1.86%) and all were found in upper zone and combination group with active lesions observed in 6 cases(3.72%).
Conclusion: In our study ,more than 60% cases showed radiological abnormalities of chest. It was equal in number both for old lesion and active lesion. Pulmonary fibrosis was the commonest old lesion whereas pulmonary infiltrate was the commonest radiological abnormalities among active lesion .Diagnosis of abdominal tuberculosis often poses a challenge to the physicians. High degree of clinical suspicion is required and x-ray chest often helps to diagnose these cases.
Abdominal tuberculosis, Radiology of chest, Abdomen, Pulmonary fibrosis
Introduction
Tuberculosis of abdomen is not so uncommon in India. Even with improved medical services and easy availability of antitubercular drugs incidence and severity of abdominal tuberculosis is expected to increase with increasing incidence of HIV infection. Tuberculosis may affect any part of abdomen i.e, gastrointestinasl tract, peritoneum and pancreatobiliary system. Extrapulmonary tuberculosis accounts for about 10-12% of total number of cases of tuberculosis of which 11-16% affect the abdomen. Abdominal tuberculosis may be primary or secondary due to reactivation of abdominal foci. Abdominal tuberculosis may present as intestinal, peritoneal or mesenteric lymph node or combination of these. Diagnosis of abdominal tuberculosis is very difficult because of vague and non specific clinical presentation. Imaging like ultrasound, barium x-ray and CT scan of abdomen and Mantoux test have only supportive value. Many of these investigation facilities are not widely available in remote corners of India. Moreover high cost and facility for invasive procedures for obtaining tissue for histopathological examination and culture for mycobacterium are neither affordable nor available in such areas. In some cases trial with anti-tubercular drugs are given which may cause delay in the diagnosis of other diseases which mimic abdominal tuberculosis e,g crohn’s disease, lymphoma, malignancy of abdominal organs. Therefore diagnosis of abdominal tuberculosis is an on going challenge to the physicianespecially in countries with limited resource. A chest x-ray may help to give the clue to the diagnosis of abdominal tuberculosis.
This was a retrospective analysis over 161 patients who attended the out patient and in patient Department of Pulmonary Medicine of Nilratan Sircar Medical college, one of the tertiary medical colleges in West Bengal. Diagnosis of abdominal tuberculosis was based on high degree of clinical suspicion. Patients demographic, clinical presentation, family and past history of tuberculosis were evaluated. HIV screening was done. Routine sputum smear for acid fast bacilli (AFB), routine biochemical investigations were done, histopathological review to those patients who were referred from Department of Surgery of same medical college showing tubercular granuloma with or without caseation, radiological features compatible with tuberculosis in barium x-ray of gastrointestinal tract, ultrasonography, CT scan of abdomen, ascitic fluid study for cytological, microbiological, and biochemical examination in selected cases. X-ray chest PA view and Lateral view were evaluated amongst all patients with diagnosed abdominal tuberculosis.
Results: X-ray chest PA and lateral view were reviewed in all 161 patients with abdominal tuberculosis. About one-third of them showed normal chest x-ray. Radiological abnormalities were seen in two-third cases, of which old healed lesions and active lesionswere equally distributed. Commonest old lesion was pulmonary fibrosis. Solitary pulmonary fibrosis was more common in left side. These were predominantly situated in upper zone. Pleural involvement in the form of calcification and thickening was found in relatively small number of cases. Calcified hilar lymph nodes were also found in some cases (Table/Fig 1).
Commonest active lesion was pulmonary infiltrate. Most of which were solitary, upper zonal and right sided. Pleural effusion was seen in small number of cases. Cavities were found in cases allin right upper zone. The other active lesions were miliary shadow in 2 cases, Lymph node enlargement in 3 cases and mediastinal widening in 2 cases (Table/Fig 2).
Correlation of roengenography of chest with abdominal tuberculosis has not been documented widely. As in developing countries investigations like CT scan, routine invasive procedure for tissue diagnosis is not freely available at every corner and as most of the abdominal tuberculosis cases are secondary to pulmonary tuberculosis, chest x-ray findings often give clue to the diagnosis. (Table/Fig 3) shows a comparison of the findings between various studies including the present one, which shows wide variations of results (1),(2),(3),(4),(5),(6). Rita Sood stated radiography of chest may show evidence of active or healed pulmonary tuberculosis in some patients with abdominal tuberculosis while findings of tuberculous lesions on chest x-ray support the diagnosis of abdominal tuberculosis ,a normal chest x-ray does not rule it out (7).
Maniar et al found radiologic involvement in chest in 44.99% cases. pulmonary infiltrate was found in 62.5% and unilateral was more common than bilateral (71.8% v/s28.2%).Majority involved the mid zone followed by lower zone (8). In our study pulmonary infiltrate was found in 25 (15.52%)cases ,unilateral lesion was more common 80% v/s 20% than bilateral lesion.12 solitary lesion was presented on right side 8 cases was on the left .Majority of solitary lesion was situated in upper zone (12) followed by middle zone (6), lower zone (2).
In our study old lesion suspecting prior pulmonary fibrosis found in 13.04% and recent pulmonary infiltrate found in 15.33% cases. Sharma et al studied 70 cases of abdominal tuberculosis and found evidence of active or healed lesions on chest x-ray in 22 cases (46%) (9). In prakash series of 300 patients none had active pulmonary TB but 39% had evidence of healed TB (10). Kapoor et al studied 70 cases of abdominal TB and found evidence of active or healed lesions on chest radiograph in 32(46%) (11).
Abdominal tuberculosis is a diagnostic challenge. There are several investigations which are either costly or involve invasive procedures which precludes its practicability in remote areas of developing countries. High degree of clinical suspicion is required and x-ray chest is often supplementary for diagnosis of abdominal tuberculosis. While findings of tuberculous lesions on chest x-ray support the diagnosis of abdominal tuberculosis, a normal chest x-ray does not rule it out.
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