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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
Haemophilus Influenzae, an Underdiagnosed Cause of Respiratory Tract Infections
Correspondence Address :
Rekha Rai, MBBS, MD
Associate professor, Department of microbiology,
K.S.Hegde Medical Academy,
Deralakatte, Mangalore - 575018.
Karnataka State, India
Phone:+91-0824-2204490-92; Fax: +91-0824-22014162
Mobile: 09480366683
Background: Haemophilus influenzae is an obligate human parasite that is transmitted from person to person by the respiratory route. This organism causes several diseases which range from chronic respiratory to serious invasive infections. Haemophilus influenzae is prevalent worldwide, and the morbidity and mortality of the associated disease increases with the complications and therefore a laboratory diagnosis is a vital necessity.
Aims and Objectives: The intention of the present study was to determine the prevalence of Haemophilus influenzae in patients who were suffering from respiratory tract infections and to study its antibiotic sensitivity pattern.
Methods: Samples were collected from144 patients with upper and lower respiratory tract infections, who were segregated by their age groups. All the samples were analyzed in a specific manner, which included gram staining, culture and biochemical reactions for the identification of the organism. Antibiotic sensitivity testing was performed for the isolated organism. Based on the findings, the results were analyzed.
Results: The results showed a prevalence of 18.05%, with the maximum numbers of isolates in patients of the age group of 0-10 years and the least number of isolates in patients of the age group of 21-30 years. The antibiotic sensitivity pattern showed a high susceptibility to the commonly used antibiotics.
Interpretation and Conclusion: An overall finding showed that the prevalence of Haemophilus influenzae in patients with respiratory tract infections was 18.05%, with a higher prevalence in the paediatric age group. Specific isolation of the organism and sensitivity testing are essential to enable the proper administration of antibiotics for early treatment and prevention.
Haemophilus influenzae, X and V factor, Levinthal agar, Haemophilus spp.culture, Satellitism
INTRODUCTION
Members of the genus, Haemophilus, form part of the indigenous flora of the mucous membrane of the human upper respiratory tract and the mouth. However, some species such as Haemophilus influenzae causes diseases which range from chronic respiratory infections to serious invasive infections. Haemophilus influenzae type b (Hib) was the single most important cause of meningitis in children in the US before the availability of vaccines (1). Haemophilus influenzae is an important cause of acute, recurrent and persistent infections of the human respiratory tract. This organism is found in 8% of the pneumonias. More than 95% of the invasive infections are associated with type b encapsulated H. influenzae. The non-encapsulated strains also play an important role in chronic bronchitis, and they are the most common cause of pneumonia in adults. These strains are also an important cause of lower respiratory tract infections in patients with cystic fibrosis (2).
Chronic obstructive pulmonary disease is frequently associated with exacerbations, owing to bacterial infection. Antibiotic therapy is effective in accelerating a recovery from the exacerbations and in preventing an early clinical deterioration. As a result, the antimicrobial agents which are used to treat exacerbations should be active against the strains of H. influenzae that are present in the lower airways (3). Children are frequent carriers of Haemophilus influenzae in the nasopharynx, and the rate of the carriage is high in infancy. Its colonization may subsequently lead to the development of infectious diseases which are caused by Haemophilus influenzae. It has also recently been reported that β-lactamase negativeSectionampicillin-resistant ( BLNAR) strains have increased in some countries, although the global prevalence still remains low (4).
From the diagnostic perspective, the reason for the lack of data on the burden of Haemophilus influenzae in developing countries was mainly the failure of the detection of this fastidious organism in the laboratory. The specimens which are collected are sputum, throat swab, ear and conjunctival scrapings, CSF, blood and other body fluids. Most of the laboratories speciate the genus, Haemophilus on the basis of haemolysis and the X and V factor requirements. Biochemical tests are useful for species identification and for the differentiation of the biotypes. The additional useful methods are the commercial identification system, immunoserologic and serological identification, identification by molecular methods and the epidemiologic typing systems (5). This study was undertaken to determine the prevalence of Haemophilus influenzae in patients who were suffering from respiratory tract infections and to study its antibiotic sensitivity pattern.
This study was carried out in the K.S. Hegde Medical Academy, Deralakatte, on 144 cases of respiratory tract infections. The patients were from different age groups.
Specimen collection: • Sputum was collected into a sterile container with proper aseptic precautions. • Throat swabs were collected aseptically. Sterile Dacron or Alginate cotton swabs were used.
• The samples were sent to the laboratory immediately for processing. I solation of bacilli and its identification: • The samples which were received in the Microbiology Laboratory were processed immediately. The sputum sample was homogenized by shaking it with sterile water and glass beads for 15-30 minutes for better results (6). • Gram staining showed pale, gram negative, small coccobacilli.
Culture: The homogenized sputum sample or the throat swabs were streaked onto blood agar, chocolate agar, Levinthal’s agar (selective media), chocolate agar containing 5.0 μg of Vancomycin per ml (CHOC-V), chocolate agar containing 5.0 μg of Vancomycin per ml, 300 μg of Bacitracin per ml, and 1.0 μg of Clindamycin per ml (CHOC-VBC) and Muller-Hinton agar with the X and V factor discs. The inoculated plates were kept in a candle jar and were incubated at 370C for 24-48 hrs (7). The plate of Levinthal’s agar, CHOC-V and CHOC-VBC showed small (0.5-1.0 mm), b haemolytic, smooth, translucent, greyish, convex colonies with an entire edge and a mousy odour.
Confirmatory methods: The isolated colonies were subcultured on Muller-Hinton agar with the X and V factor discs and they showed growth only around the discs. S atellitism: Staphylococcus aureus was streaked across a plate of blood agar on which Haemophilus influenzae was inoculated and kept for incubation. After overnight incubation, the colonies of Haemophilus influenzae were found to be large and well developed alongside the streak of Staphylococcus aureus and smaller farther away (5).
Biochemical reaction: The preliminary biochemical tests showed positive Oxidase and Catalase tests. Nitrates were reduced, phosphatase was positive and glucose was fermented. Antibiotic sensitivity testing: The sensitivity testing of Haemophilus influenzae was performed by using the following antibiotics, Ampicillin (10mcg), Amoxiclav (30mcg), Doxycycline (30mcg), Erythromycin (15mcg), Co-trimoxazole (25mcg), Chloramphenicol (30mcg) and Ceftriaxone (30mcg) on chocolate agar with a haeme supplement by using the Kirby Bauer disc diffusion method (8).
144 samples from clinically suspected cases of lower respiratory tract infections were analyzed over a period of 1 year, of which 26 (18.05%) samples showed the growth of Haemophilus influenzae, with an increased prevalence in the age group of 0-10 yrs (42.3%) and the least prevalence in the age group of 21-30 years (11.53%), as summarized in (Table/Fig 1). Haemophilus influenzae showed high susceptibility to most of the routinely used antibiotics, with Ceftriaxone (92.3%) being the most effective one and Cotrimoxazole (69.23%) being the least, as tabulated in (Table/Fig 2).
Haemophilus influenzae is a strict parasite of humans, which is found principally in the upper respiratory tract. Although the type of infectious diseases which are caused by Haemophilus influenzae has changed considerably in recent years because of the widespread and routine immunization of children against the type B organisms, Haemophilus influenzae remains to be a significant pathogen. Humans are the only natural hosts for Haemophilus influenzae. Therefore, the maintenance of this organism in thehuman population depends on a person-to-person transmission, which efficiently occurs via respiratory droplet spreads. Both the nontypeable strains and Hib spread easily via person to person transmission (6). In our study, the prevalence of Haemophilus influenzae and its antibiotic sensitivity pattern have been described. 144 samples from clinically suspected cases of lower respiratory tract infections were analyzed over a period of 1 year, of which 26 (18.05%) samples showed the growth of Haemophilus influenzae, with an increased prevalence in the age group of 0-10 yrs (42.3%) and the least prevalence in the age group of 21-30 years (11.53%). Among the 26 isolated samples, 18 (69.23%) gave identifiable growth on chocolate agar, and all the 26 isolates gave visible growth on special media (CHOC-V,CHOC-VBC). In a study which was done by Fang et al, it was observed that the isolation rate of Haemophilus influenzae could be improved by using selective media (9). A similar study which was conducted in another part of India by B. K. Das, et al, in the year 2000–2001, on school going children, found a prevalence rate of 27.16% (10). A related study which was carried out by Ayyagari et.al.showed a prevalence of 21.9% in patients with respiratory tract infections (11). The present study revealed that the highest prevalence was in the age group of 0-10 years (42.3%) and that the least prevalence was in the age group of 21-30 years (7.69%).
Klebsiella pneumoniae and Streptococcus pneumoniae were the most common pathogens, while Haemophilus influenzae was the third commonest pathogen which was responsible for lower respiratory tract infections in our study. This finding is almost similar to that of a study which was conducted by Karen C, Carroll, where Hameopholus influenzae was commonly isolated after Streptococcus pneumoniae (12).
The present study showed a high sensitivity of Hameopholus influenzae to the commonly used antibiotics, with a high sensitivity to ceftriaxone (92.30%) and the least to ampicillin, chloramphenicol (73.07%) and cotrimoxazole (69.23%). Similar results were observed in various other studies which were done by Nag V L et al (13),Marina Cerquetti et al (14), Mariana Castanheira et al (15) and Michael R Jacobs et al (16).
The study showed a high prevalence of Haemophilus influenzae in paediatric patients (0–10 years) with respiratory tract infections. Prompt diagnosis and proper antibiotic treatment is essential to prevent complications.
DOI: JCDR/2012/3637:2065
Financial OR OTHER COMPETING INTERESTS:
None.
Date of Submission: Sep 21, 2011
Date of Peer Review: Nov 03, 2011
Date of Acceptance: Dec 22, 2011
Date of Publishing: May 01, 2012
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