Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 45194

AbstractCase ReportDiscussionConclusionReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"

Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."

Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."

Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

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)
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.
On April 2011

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
On Jan 2020

Important Notice

Case report
Year : 2022 | Month : May | Volume : 16 | Issue : 5 | Page : VD03 - VD05 Full Version

Acute Confusional State in a Neuropsychiatric Systemic Lupus Erythematosus Patient: A Case Report

Published: May 1, 2022 | DOI:
Sambhu Prasad, Shikha Jha

1. Assistant Professor, Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India. 2. Senior Resident, Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India.

Correspondence Address :
Sambhu Prasad,
Assistant Professor, Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India.


Systemic Lupus Erythematosus (SLE) affects various systems in human including central and peripheral nervous systems. The Neuropsychiatric Systemic Lupus Erythematosus (NPSLE) is a severe complication of SLE which causes a formidable challenge in term of diagnosis and its management. Acute confusional state (delirium) is a rare entity of numerous symptoms of NPSLE which is being overlooked even though it is associated with increased mortality. The present case report describe about the presentation of SLE consisting of hyperpigmentation maculopapular rashes over face, neck regions, lower back and extremities in a 36-year-old female with abrupt onset and fluctuating course of psychotic symptoms, acute confusional state and oddities in behaviours. Treatment with low dose of antipsychotic (aripiprazole) resolve the symptom with due consideration taken to rule out steroid induced manifestation of above symptoms.


Antipsychotic treatment, Diagnostic challenge, Fluctuating thinking and behaviour oddities, Hyperpigmented maculopapular rashes

Case Report

A 36-year-old female presented in the Dermatology Department with 8 months history of pain in multiple joints and intermittent low-grade fever. The pain was localised to joints, non radiating, mild to moderate grade in intensity, without any aggravating or relieving factors. Around 4 months back, she developed lesions over the exposed areas of the face, neck, lower back, and extremities. Lesions were hyperpigmented, involved the nose, and extended to bilateral malar areas, both the eyebrows, forehead, and chin sparing the nasolabial folds. She also developed thinning of frontal hair margin, hyperpigmented macule, and patches over the bilateral palm, hyperkeratotic plaques over the bilateral sole, erythema over nail folds in hand and feet (Table/Fig 1). Patient did not report of any similar illness in past or in family members.

On examination, she had a temperature of 99°F, pulse rate of 86/min, no pallor, icterus, cyanosis, clubbing, lymphadenopathy, blood pressure was 136/90 mmHg, respiratory rate of 24 cycles/min, clear heart sounds per abdominal examinations reveal no abnormality and no focal neurological deficits. The laboratory investigations showed mild anemia (Haemoglobin was 7.6 gm/dL), Anti; Anti Nuclear Antibody (ANA) was positive (grade++++), urine analysis showed the presence of albumin 100 mg/dL (3+), 24 hour urinary protein showed 502.1 mg/day, Thyroid Stimulating Hormone (TSH) was 16.06 uIU/mL, serum electrolytes were within the normal range (Table/Fig 2).

She was diagnosed with Systemic Lupus Erythematosus (SLE) with lupus nephritis and admitted to the Dermatology Ward for initiating immunosuppressive therapy including three consecutive days of intravenous methylprednisolone pulses (1,000 mg/day for three days). Followed by oral prednisone 0.5 mg/kg/day for 4 weeks and the dose was further tapered by 5 mg every other day each week to a dose of 0.25 mg/kg every other day or the minimal dose required to control extrarenal disease (1). On the second day of admission, she developed a low-grade fever, pain during swallowing food with a sudden change in behaviour (shouting, running, restlessness, making odd hand and facial gestures) for which Psychiatric consultation was done. Pulse therapy was stopped due to the suspicion of steroid-induced psychosis and she was started on hydroxychloroquine 200 mg BD, Azathioprine 50 mg BD, Thyroxin 50 microgram/day, paracetamol 650 mg for control of pain.

On detailed evaluation by the Psychiatry team, she expressed suspicion of being mocked by villagers due to her skin lesions 10 days before getting admitted. For the last 2 days, she expressed her suspicion and fear of being killed by the people in the ward which was contrary to any evidence, had a fluctuating orientation to time, place, and person, showed hypervigilant behaviour, with worsening of symptoms in the evening. She had perplexed affect, incoherent speech and her thought content revealed persecutory delusion, fleeting in nature, and had a perceptual abnormality in the form of auditory hallucination commenting type with impaired recent and immediate memory. She was pre morbidly well-adjusted and had no significant past or contributory family history. She denied being treated for her psychiatric or medical conditions elsewhere. Diagnosis of delirium was made on basis of the above findings as per 10th revision of the International Classification of Mental and Behaviour Disorders (ICD-10) (2). Magnetic Resonance Imaging (MRI) of the brain was advised for identification of lesions associated with Neuropsychiatric Systemic Lupus Erythematosus (NPSLE) (like- infarcts or myelopathy) and other differential disorders (like- tumours or infections) which showed tiny diffusion bright foci in bilateral centrum semi ovale and parietal lobe gyri suggestive of vasculitis, reversible vasoconstrictive changes (Table/Fig 3).

Treatment was started with haloperidol 5 mg in divided doses which was gradually increased to 10 mg. There was an improvement in orientation and behavioural changes. After 1 week, her psychotic symptoms subsided. During treatment she developed tremors in tongue and hand, had decreased eye blinking, masked facies, rigidity and decreased arm swing during walking. On suspicion of Extra Pyramidal Symptoms (EPS) due to haloperidol, the dose was reduced to 5 mg/day and she was switched to aripiprazole 7.5 mg/day. After control of psychotic symptoms, she was given pulse therapy with dexamethasone 80 mg, and cyclophosphamide 500 mg for 3 consecutive days. When she did not have any active psychiatric symptoms, she was discharged on hydroxychloroquine 200 mg BD, azathioprine 50 mg OD, thyroxin 50 mcg/day and aripiprazole 7.5 mg/day which was tapered and stopped within 1 week. She was maintaining well during subsequent follow-up which were done initially weekly for a month then fortnightly and increased to monthly intervals.


The acute confusional state is one of the rare manifestations of NPSLE and it is associated with increased morbidity and mortality (3). The prevalence of acute confusional state in SLE reported to be round 4-7% (4),(5). It is a diffuse neurological dysfunction that is equivalent to delirium in the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) and varies widely from mild confusion and disturbed attention to profound disorganisation with agitation and hallucinations (6). It occurs due to Central Nervous System (CNS) infection, metabolic changes, alteration of drug treatment etc., especially corticosteroids (7). Here, authors reported a case of delirium with SLE and discuss the challenges in its diagnosis and management.

There are many similar care studies which found that identification of acute confusional state and differentiating it from psychosis in SLE remains a challenge and it also affects its management. Similarly, they also highlighted that the role of low doses of antipsychotic (risperidone, haloperidol, quetiapine) with steroids to tackle such entity as with our case (8),(9),(10),(11). If psychosis is identified, it is important to differentiate primary NPSLE from corticosteroid-induced psychosis. Corticosteroid-Induced Psychotic Disorder (CIDP) typically starts 5~14 days after initiation or after an increase in the dose of corticosteroid therapy, is dose-dependent, and regresses with steroid discontinuation (12). In the present case, as corticosteroid was given only for 1 day, it was likely that acute confusional state was not corticosteroid-induced. A strict differential diagnosis and individualisation of treatment depending on the neuropsychiatric presentation and severity of symptoms is crucial in the management of NPSLE. If NPSLE is severe (acute confusional state, seizures, encephalitis), it should be treated with immunosuppressive drugs. However, the challenge of using corticosteroid or pulse therapy is CIPD i.e., corticosteroid-induced psychiatric disorder (13).


A great degree of expertise and clinical skill is needed for identification of acute confusional state as an initial manifestation of NLSLE or its treatment so that it is not falsely attributed to a psychiatric symptoms and medical treatment will be foregone. Various symptoms of delirium as disorganised thinking may overlap the core symptoms of psychosis leading to bias in diagnosis and its management as in our case. Thus early recognition and timely treatment of such entities is important mortality and morbidity.


Visser K, Houssiau FA, da Silva JAP, Vollenhoven Rv. Systemic lupus erythematosus: treatment - Module 18; 2018, › 18_main_CH21.docx_1.pdf [accessed on 24th December 2021]
The ICD-10 International Classification of Mental and Behavioural Disorders › classifications › icd ›
Govoni1 M, Hanly JG. The management of neuropsychiatric lupus in the 21st century: still so many unmet needs? Rheumatology. 2020;59:v52-v62. [crossref] [PubMed]
Zirkzee EJ, Huizinga TW, Bollen EL, van Buchem MA, Middelkoop HA, van der Wee NJ et al. Mortality in neuropsychiatric systemic lupus erythematosus (NPSLE). Lupus. 2014;23:31-38. [crossref] [PubMed]
Postal M, Costallat LT, Appenzeller S. Neuropsychiatric manifestations in systemic lupus erythematosus: epidemiology, pathophysiology and management. CNS Drugs. 2011;25:721-36. [crossref] [PubMed]
Stojanovich L, Zandman-Goddard G, Pavlovich S, Sikanich N. Psychiatric manifestations in systemic lupus erythematosus. Autoimmun Rev. 2007;6:421-26. [crossref] [PubMed]
Hanly JG, Harrison MJ. Management of neuropsychiatric lupus. Best Pract Res Clin Rheumatol. 2005;19:799-821. [crossref] [PubMed]
Nayak RB, Bhogale GS, Patil NM, Chate SS. Psychosis in patients with systemic lupus erythematosus. Indian J Psychol Med. 2012;34:90-93. [crossref] [PubMed]
Lonergan E, Britton AM, Luxenberg J, Wyller T. Antipsychotics for delirium. Cochrane Database Syst Rev. 2007;(2):CD005594. Doi: 10.1002/14651858.CD005594.pub2. Update in: Cochrane Database Syst Rev. 2018 Jun 18;6:CD005594. [crossref]
Sarwar S, Mohamed AS, Rogers S, Sarmast ST, Kataria S, Mohamed KH, et al. Neuropsychiatric systemic lupus erythematosus: a 2021 update on diagnosis, management, and current challenges. Cureus. 2019;13(9):e17969. Doi 10.7759/cureus.17969 [crossref]
Yoon S, Kang DH, Choi TY. Psychiatric symptoms in systemic lupus erythematosus: diagnosis and treatment. Journal of Rheumatic Diseases. 2019;(26)pISSN:2093-940X, eISSN: 2233-4718 [crossref]
Govoni M, Bortoluzzi A, Padovan M, Silvagni E, Borrelli M, Donelli F, et al. The diagnosis and clinical management of the neuropsychiatric manifestations of lupus. J Autoimmun. 2016;74:41-72. [crossref] [PubMed]
Kivity S, Agmon-Levin N, Zandman-Goddard G, Chapman J, Shoenfeld Y. Neuropsychiatric lupus: a mosaic of clinical presentations. BMC Med. 2015;13:43. [crossref] [PubMed]

DOI and Others

DOI: 10.7860/JCDR/2022/52527.16334

Date of Submission: Sep 22, 2021
Date of Peer Review: Dec 16, 2021
Date of Acceptance: Jan 12, 2022
Date of Publishing: May 01, 2022

• 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 X-checker: Sep 23, 2021
• Manual Googling: Dec 15, 2021
• iThenticate Software: Mar 31, 2022 (11%)

ETYMOLOGY: Author Origin

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)