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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
Case report
Full Version
An Isolated Splenic Metastasis of Melanoma which Masqueraded as a Pancreatic Pseudocyst
Correspondence Address :
Dr. Kande Srinivasulu Associate Professor, Department of Pathology NRI Medical College, Chinakakani,Guntur, India. Phone: +919959835575 E-mail: vasulukande@gmail.com
A 60-year old man presented with left hypochondrial pain. Magnetic resonance imaging showed a large cystic lesion in the left hypochondrium, in close relation to the tail of the pancreas and an infiltrating splenic parenchyma, which were suggestive of a pseudocyst. The lesion was excised and it was sent for a histopathological examination. The histopathological examination revealed secondary deposits from the melanoma and this was confirmed by a immunohistochemical analysis. We are reporting this interesting case of an isolated splenic metastasis of melanoma which masqueraded as a pancreatic pseudocyst on an imaging study.
Splenic metastasis, Melanoma, Pancreatic pseudocyst
INTRODUCTION
Metastasis to the spleen is considered as a rare event in the late course of malignant solid tumours. In life, they are commonly a part of a wide spread end stage disease and an isolated splenic metastasis is rare. Most of the splenic metastases are asymptomatic. The symptomatic cases account for only 8% of all the cases and they are seen commonly in women and in the younger age groups. The main metastatic pathway to the spleen is haematogenous (1).
CASE HISTORY
A 60-year old man presented with pain in the left hypochondrium and in the epigastrium. He had a history of amputation of the right lateral three toes for melanoma three years back and he had received inadequate chemotherapy. An ultrasound examination of the abdomen suggested a pancreatic pseudocyst. MRI of the abdomen showed a 19x17x18 cm hyperintense, cystic lesion in the left hypochondrium in close relation to the tail of the pancreas and an infiltrating splenic parenchyma, which were suggestive of a pancreatic pseudocyst (Table/Fig 1). The cyst fluid amylase level was within normal limits. The patient underwent splenectomy and pancreatic pseudocyst excision.
Gross appearance: We received a dark brown, splenic mass which was 19x13x10 cm in size. The cut section showed a cyst of 14 cm diameter, which exhibited shaggy, dark brown walls with adherent organizing blood clots and compressed surrounding splenic parenchyma (Table/Fig 2).
Microscopic examination: Multiple sections from the cyst wall which were studied, showed organizing blood clots, dense, hyalinized fibrous connective tissue and a dark brown pigment. Entrapped in the blood clots, malignant epithelial tumour cells were seen, which were arranged in a pseudo papillary configuration around the blood vessels. The cells showed nuclear pleomorphism, abundant eosinophilic cytoplasm and prominent eosinophilic nucleoli (a dark brown pigment was noted in the occasional cells). The pigment in the tumour was lost with bleaching, thus indicating its nature as melanin. The tumour cells parenchymashowed a positive immunohistochemical staining for HMB-45 (Table/Fig 3) (Table/Fig 4). The rest of the spleen showed the evidence of a chronic congestion with Gamma - Gandy bodies. No pancreatic tissue was identified in the multiple sections which were studied. Based on the above findings, a diagnosis of secondary deposits from a malignant melanoma was made.
The spleen is an infrequent site for metastases, though it is a vascular organ of the body (2). The incidence of splenic metastasis varies from 2.3 to 7.1% (3). The explanations that were proposed were:
1) The sharp angle which is made by the splenic artery makes it difficult for the tumour emboli to enter the spleen.
2) The rhythmic contractile nature of the spleen squeezes out the tumour or the embolus and prevents its lodging in the spleen.
3) The absence of afferent lymphatics to the spleen, the phagocytic
activity of the splenic cells and humoral anti-cancer substances in the spleen are considered to be other reasons for the low incidence of splenic metastasis (3),(4).
An isolated splenic metastasis is rarely reported. A recent review found only 93 reported cases of isolated splenic metastases (5).
The more commonly reported primary tumours which develop splenic metastases are breast, lung and colorectal carcinomas, ovarian and gastric carcinomas and skin cancers. Skin cancers account for only 5% of all such tumours (6). The involvement of the spleen was observed in 30% of the melanoma patients at autopsy (6). The time between the diagnosis of the primary lesion and the appearance of the metastases is very long (7). Klaase et al., in 1990, found an average time of three years between the diagnosis of the melanoma and the development of the metastases, which was in accordance with our findings (8).
The splenic metastases are more often incidentally detected by ultrasonography and computerized tomography (CT) scanning during the regular follow up of the patients with cancer or in the work up which is performed at the time of any event which is related to cancer.
The splenic metastases are symptomatic in only 08% of the patients (2) and they can also be revealed by fatigue, weight loss, fever, abdominal pain, splenomegaly, anaemia or thrombocytopaenia due to hypersplenism and more rarely by splenic rupture (5).
In the present case, the patient presented with the symptom of acute abdominal pain, which masqueraded as a pancreatic pseudocyst radiologically. Histopathology revealed secondary deposits of malignant melanoma. A careful search did not reveal any other site of metastasis. Thus, this is a case of an isolated splenic metastasis of a malignant melanoma of the skin that was excised three years back.
The spleen is an infrequent site for tumour metastasis. It is often asymptomatic and it is detected as a part of multi organ metastases. The symptomatic cases, though they are rare, do occur as in our patient. The splenic metastasis should be considered as a differential diagnosis in cystic lesions of the spleen and in pancreatic pseudocysts. A thorough clinical history and a histopathological documentation is a must in making a final diagnosis in these cases.
Date of Submission: Dec 27, 2011
Date of Peer Review: Feb 25, 2012
Date of Acceptance: Mar 29, 2012
Date of Publishing: Jun 22, 2012
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