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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 Series
Full Version
Tubeless Supine Percutaneous Nephrolithotomy in Calyceal Diverticular Stone
Correspondence Address :
Dr. Dilip Kumar Pal,
Professor and Head, Department of Urology, Institute of Post Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, 242- AJC Bose Road, Kolkata-700020, West Bengal, India.
E-mail: urologyipgmer@gmail.com
Percutaneous Nephrolithotomy (PCNL) has routinely been performed in prone position as a treatment for calyceal diverticular stone. PCNL is performed supine as an alternate modality for calyceal diverticular stones. The objective of the procedure is to reduce operative time and anaesthetic morbidity during supine tubeless PCNL in calyceal diverticular stone. The series is about three patients with calyceal diverticular stones. These patients underwent supine tubeless PCNL in Galdakao modified supine Valdivia position. There was no intraoperative, postoperative or on follow-up complications in any of the the patients. In all the patients stones were cleared completely in single sitting. Supine PCNL in calyceal diverticular stone could be an alternative with similar outcomes to the standard prone PCNL. It provides an additional benefit of performing the procedure in a single position, which is known to reduce total operating time and also reduces anaesthesia complications.
Anaesthesia, Complications, Galdakao modified supine valdivia position, Operative time, Urolithiasis
Calyceal diverticula are usually congenital, non secreting cavities. They are lined by urothelium and are located within the renal parenchyma which communicates with the calyceal fornix through a diverticular neck (1). Calyceal calculi usually occurs in 9.5-50% of cases and most of them are asymptomatic, but few can cause flank pain, urinary tract infections, haematuria or can even lead to damage of renal parenchyma that is surrounded locally (2).
In present era, minimally invasive treatments are usually preferred over traditional open techniques which include Shock Wave Lithotripsy (SWL) (3), flexible Ureteroscopy (URS) (4), laparoscopy (5) and PCNL (6). There are different treatment modalities for managing calyceal diverticuli and have their pros and cons for example SWL can provide symptomatic pain relief but have low stone free rates (7). On the other hand, percutaneous approach yields high stone-free rates and also leads to resolution of the diverticulum (8). Traditionally, prone position had been the dominant position for PCNL but use of supine PCNL is increasing over time globally (9).
This series reports three cases of Calyceal diverticular stone disease who were treated by supine PCNL and were found to have excellent results.
All the patients were evaluated for the size of calyceal diverticulum, its location, puncture site, operative time, stone clearance rate and its complications. All patients had undergone basic biochemical tests and urine routine and microscopic examination and culture. Preoperative Contrast Enhanced Computerized Tomography (CECT) Kidneys Ureter Bladder (KUB) was performed in all cases to evaluate the diverticulum and stone. Informed consent was obtained from all patients before procedure.
Galdakao modified supine valdivia position (Table/Fig 1) was used in all the cases (10). The ipsilateral arm was brought across the chest; the contralateral arm was abducted. A gentle break was placed in the table at the level of the flank. The patient was then tilted and, to raise the side to be operated on, an air filled 3l bag was placed under the ipsilateral flank. The airbag enhances the natural lordosis of the lumbar spine and increases the surface area available for access. Upper pole punctures, which are often tricky in the prone position, are made much more achievable in the supine position.
As shown in (Table/Fig 2), two patients were male and one was female. Average age was 41.3 years with the youngest being 36 years and eldest being 48 years of age. Average stone size was 18.3 mm with the largest being 20 mm and smallest being of 17 mm size. Average BMI was 28.8 kg/m2 with lowest being 26.4 and highest being 31.0. The cases were analysed for Guy’s Stone Score (GSS) which is a scoring system to grade the complexity of PCNL and is used to predict the stone-free rate after PCNL (11). All three patients had GSS three.
All the three patients underwent supine tubeless PCNL and calyceal puncture access was done taking into consideration location of stone (Table/Fig 3). Average time for surgery was 47.6 minutes, maximum being 50 minutes for patient with BMI 31.0 and lowest being 45 minutes for patient with BMI 26.4 kg/m2 (Table/Fig 4). Fulguration was done in one patient and in rest it was not done because of thin diverticular wall and sufficiently wide diverticular neck. There was no intraoperative complication in any of the patient. There was no significant difference in pre and postprocedure haemoglobin levels. Postoperative period was uneventful. Mean hospital stay was found to be 3.66 days. As described in (Table/Fig 3), all patients stones were cleared completely in single puncture and single sitting. Nephrostomy tube was not placed in any patient (Tubeless supine PCNL done in all cases). All patients had 21 days of stent in dwelling time, after that stents were removed.
Percutaneous treatment of calyceal diverticular calculi have excellent stone-free rates 87.5-100% with successful obliteration rate of the diverticular cavity in 76-100% cases. The PCNL for the treatment of diverticular stones has superior results along with long-term symptom relief that justify the use of PCNL over any other minimal invasive approach (12). It is now considered as the gold standard for treatment of large stones and over the time it has evolved and results in decreased invasiveness and morbidity and also improved ergonomics and outcomes (13). However, in some cases it may be difficult to negotiate through caliceal neck and in those cases sometimes trans-diverticular approach and creation of neo-infundibulum may be an alternative approach.
Originally, PCNL was performed in the prone position since it was postulated that other positions may lead to increased risk of colon injury during percutaneous puncture of the kidney in supine or other positions. Over the last few years different variations in positioning have been described, lateral (14), complete supine (15) and modified supine positions.
Supine PCNL offers advantages over prone PCNL in terms of anaesthesiological management including improved access to the patient for cardiovascular and pulmonary management, less risk of injury to central and peripheral nervous system (16). Supine PCNL also shortens the operative time since there is no need to reposition the patient after ureteral catheter placement as is the case for standard prone PCNL (17). Supine PCNL also facilitate antegrade as well as retrograde transurethral approaches to complex stone disease (18).
In a study, Jones MN et al., also concluded that modified supine PCNL has significantly lower operative time, shorter length of hospital stay, higher stone free rate and more safe when compared with prone PCNL (19). In another study Paksi S et al., suggested supine PCNL to be promising alternative to conventional prone PCNL due to less blood loss, shorter operative time in patients undergoing supine PCNL (20).
The PCNL is considered a safe and effective treatment option in patients with renal stones in a calyceal diverticular stone. Supine position is a viable and safe option for PCNL. It also reduces intraoperative complications and also advantageous over anaesthetic outcomes.
10.7860/JCDR/2021/49210.15233
Date of Submission: Mar 07, 2021
Date of Peer Review: Apr 27, 2021
Date of Acceptance: May 31, 2021
Date of Publishing: Aug 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Mar 09, 2021
• Manual Googling: May 28, 2021
• iThenticate Software: Jul 01, 2021 (5%)
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