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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
Comparative Evaluation of the Rapid Slide Culture and Microscopy with the Conventional Culture Method in the Diagnosis of Pulmonary Tuberculosis
Correspondence Address :
Hemavathi
No. 12 Mount View Enclave, Bettahalasur cross
Bangalore North – 562157, Karnataka, India.
Phone: 9886218454
E-mail: hemasathyanarayana@yahoo.com
Introduction: Tuberculosis (TB) is a global health problem. An early diagnosis and an effective treatment are essential to prevent the spread of infection and to reduce the disease burden. Though the causative bacterium for this disease was discovered in the eighteenth century, its diagnosis in the twenty-first century is still a dogma.
Objectives: To compare of the rapid slide culture (RSC) method with the growth on Lowenstein Jensen (LJ) media and to know the sensitivity and specificity of the rapid slide culture method and the acid fast smear examination in comparison with the growth on the L J media.
Materials and Methods: One early morning sputum sample was collected from 220 clinically suspected pulmonary tuberculosis cases. All the samples were subjected to three tests: 1. Zeihl Neelsen Staining 2. Rapid slide culture and 3. Culture on Lowenstein Jensen media and the results were compared.
Results: Of the total 220 sputum samples which were tested by all the three methods, 51 samples (23.18 %) were found to be smear positive, 75 (34.09%) were found to be positive by the RSC method, 81 (36.81%) were found to be positive by the LJ culture method and 38(17.27%) samples were found to be positive by all the three methods and 93 (42.27%) samples were found to be positive by any one method. 127 (57.72%) samples were negative by all the three tests The sensitivity of RSC in comparison with the LJ culture was 88.88% with a specificity of 97.8%, whereas the smear showed a sensitivity of 49.4 % and a specificity of 92.1%.
Discussion: The RSC method is rapid, sensitive and more specific than microscopy. Hence, this method can be adopted by any simple laboratory for the diagnosis of tuberculosis.
RSC, Microscopy, LJ Media, Pulmonary Tuberculosis
Introduction
Tuberculosis is of great concern worldwide. The WHO has estimated 9.4 million incident cases and 11.1 million prevalent cases of TB globally (1). India accounts for nearly one-third of the TB cases worldwide and every year, around two million persons develop TB, of which 0.8 million are new-smear, highly infectious cases, with an incidence rate of 185 per one lakh population and a prevalence rate of 256 per one lakh population. About 3.5 to 4 lakh people die of TB every year, which amounts to the death of more than one thousand persons every day. The death rate is 26 per one lakh population. The case detection rate is 59% [2,3]. The situation has become worse because of HIV and drug resistance. For the diagnosis of tuberculosis, different modalities are being adopted but the confirmation is usually done by microscopy and culture or molecular methods. An early diagnosis and an effective treatment are essential to prevent the spread of infection and to reduce the disease burden. Different combinations of tests are being tried to reach an early diagnosis. Robert Koch, in 1882, observed under microscope, that a growing culture of Mycobacterium tuberculosis formed serpentine cords at a very early stage (4). Dickinson and Mitchison described a new slide method that was rapid, simple and safe, but it needed a fluorescent microscope (5). P.R Gupta et al. modified the method and got similar results by using a bright field microscope (5). Purohit et al compared human blood media and egg enriched sheep blood media which provided a low contamination rate and growth after seven days, as compared to the growth after six weeks on the Lowenstein Jensen (L J) media. They found this to be an advantage in the primary isolation and evaluation of drug sensitivity tests for tuberculosis (6).Articlemedia which provided a low contamination rate and growth after seven days, as compared to the growth after six weeks on the Lowenstein Jensen (L J) media. They found this to be an advantage in the primary isolation and evaluation of drug sensitivity tests for tuberculosis (6).
OBJECTIVES
1. Comparison of the Rapid Slide Culture (RSC) method with growth on the L J media. 2. To know the sensitivity and the specificity of the rapid slide culture method and acid fast smear examination in comparison with the growth on the L J media.
This study was done in 2007, at a medical college hospital in Bangalore, India. 220 morning sputum samples from clinically suspected cases (one sample from each patient) were collected; smears were made and they were stained by the Ziehl Neelsen (ZN) staining method and were reported. All the samples were decontaminated and concentrated by the modified Petroff’s method (7). One smear was made at the centre of the slide (Slide-1), it was fixed and Z N staining was done. The reading was taken and it was recorded. Two smears were made at the lower 1/3rd of the glass slides which were split longitudinally. The smears were air dried dipped into the McCartney’s bottlewhich contained Human Blood Medium (HBM), so that the smears remained dipped in the medium. The inoculated HBM were incubated at 370C. The slides were taken out on the seventh day and were dipped in sterile distilled water to remove the excess media which were present on the slide surfaces. The slides were then placed in an oven at 800C for 30 minutes and were later stained by ZN staining. The growth was recorded as has been mentioned below: The readings of the 0 grades was taken as negative and those of the grades 1-4 were taken as positive Grade 0- No division of AFB as compared to slide 1 Grade 1+ Small clumps –up to 4 bacilli were present but absent in the control Grade 2+ large clumps of bacilli Grade 3+ large clumps with some cord formation Grade 4+ Micro colonies with good cord formation
Human Blood Media for the Slide Culture Method
Citrated human blood from the blood bank, which was not more than four weeks old, was mixed with an equal volume of sterile distilled water. The mixture was mixed well till the blood got haemolyzed. The medium was made selective by the addition of chemotherapeutic agents like-polymixin B-200000 units/liter, carbenicillin-100mg/liter, trimethoprim-10mg/liter and amphotericin B-10 mg/liter. The pH of the medium was adjusted to 6.5-7.5. Ten ml of the medium was transferred to each of the Mc Cartney’s bottles and these were stored at 2-80c. After the decontamination of the sputum, the deposit was inoculated on the LJ media slants and these were incubated at 37oC. The readings were taken weekly and the growth was identified by assessing the colony morphology, rapidity of the growth and the ZN staining.
Of the total 220 sputum samples which were tested by all the three methods, 51 samples (23.18 %) were smear positive, 75 (34.09%) were found to be positive by the RSC method, 81 (36.81%) were found to be positive by the LJ culture, 38 (17.27%) were found to be positive by all the three methods and 93 (42.27%) were found to be positive by any one method. 127 (57.72%) samples were negative in all the three tests [Table/Fig-1]. When we compared the growth of two culture methods, the results were as follows: The total 72 (32.72 %) samples were found to begrowthculture positive by both the culture methods, whereas 75 (34.09%) samples were found to be positive by the RSC method and 81(36.81%) samples were found to be positive by the LJ media [Table/Fig-2]. The sensitivity of RSC in comparison with the LJ culture was 88.88%, and the specificity was 97.8%. The comparison of the smear positivity with the growth on the LJ media showed a sensitivity of (40*100/81) 49.4 % and a specificity of (128*100/139) 92.1% [Table/Fig-3]. Out of 169 smear negative samples, 35(20.71%) samples were RSC positive and 41(24.26%) were LJ culture positive. A total of 127(75.14%) samples were found to be negative by both the methods [Table/Fig-4].
This study included a total of 220 clinically suspected pulmonary tuberculosis cases. The sputum samples were studied by all the three methods, of which 51 samples (23.18 %) were found to be positive by the AFB staining, 75(34.09%) showed growth by the slide culture method and 81(36.81%) showed growth on the LJ media. A total of 72(32.72%) samples were found to be positive by both the culture methods, whereas 51 (23.18 %) samples were found to be positive by AFB staining. Both the culture techniques were found to be more sensitive as compared to the smear examination. Concentration of the sputum samples before the inoculation also would have added to the sensitivity, but it is a concern, as theNational Programme incorporates only smear examination for the screening of the TB cases without concentration. Out of the 169 smear negative samples, 35(20.71%) samples were RSC positive and 41(24.26%) were LJ culture positive. The RSC showed a sensitivity of 92.59%, and a specificity of 97.8%, whereas the smears showed a sensitivity of (40*100/81) 49.4%, (62.96) and a specificity of (128*100/139) 92.1% as compared to the growth on the LJ media. This difference indicated that the culture of the TB bacteria was very important for a definite diagnosis in the paucibacillary pulmonary tuberculosis cases. Though the LJ media showed more positivity, the growth appeared on the LJ media only after four weeks, which hindered the early start of the medication,leading to the spread of infection among the patients’ contacts and the patients had to bear the brunt of the nonspecific treatment. The RSC showed less positivity because of the following reasons- (1) Wet smear inoculation, leading to the washing off of the smear into the HBM. (2) Over drying of the smear, leading to death of the bacteria and (3) Use of very cold media (8).
A similar study which was done by Jena et al (8) showed that among 336 patients of pulmonary tuberculosis, the smear was positive only in 91(27.08%) patients, that the RSC showed positivity in 105 patients (31.25%), that the LJ culture showed positivity in137(40.77%) patients and that 161(52.08%) cases showed positivity by any method. An early availability of growth was possible in 27 smear negative cases by the RSC method. The RSC can be used for the routine cultivation of MTB in the laboratory, excluding the above said faults. The growth on RSC took only one week, which helped in initiating the treatment early. The RSC is cheap, it does not need special ingredients or equipment and it can be used for antibiotic susceptibility testing.
Dr Jayashree, Associate Professor, Department of Community Medicine, Sapthagiri Institute Of Medical Sciences, Bangalore- 90, for statistical analysis.
DOI: JCDR/2012/3910:1996
Financial OR OTHER COMPETING INTERESTS:
None.
Date Of Submission: Jan 04, 2012
Date Of Peer Review: Jan 14, 2012
Date Of Acceptance: Jan 20, 2012
Date Of Publishing: Apr 15, 2012
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