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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
Medullary Solitary Plasmacytoma of Maxilla- A Rare Case Report
Correspondence Address :
Dr. Jaya Dubey,
PG Girls Hostel, Civil Hospital Campus, Ahemdabad, Gujarat, India.
E-mail: jayadubey.dubey8.jd@gmail.com
Solitary Plasmacytoma (SP) is a rare disease characterised by a localised proliferation of neoplastic monoclonal plasma cells, without evidence of systemic disease. The aetiology of SP remains unknown, but chronic stimulation, overdose irradiation, viruses, and gene interactions in the reticuloendothelial system have been suggested as the aetiologic factor. While pain is the most common symptom of osseous mandible SP, it is usually painless in the maxilla and may manifest orally with paresthesia, swelling, soft tissue masses, mobility and migration of teeth, haemorrhage, or pathologic fracture due to cortical destruction of bone. Because the amount of haemopoitic bone marrow in the maxilla is decreased, oral involvement of the maxilla is less common than that of the mandible. Here, authors reported a case of 46-year-old male patient presented with the chief complaint of mobility of his upper left back teeth and swelling over his left-side palatal area. Clinical examination was suggestive of benign odontogenic tumors and salivary gland tumors, while two-Dimensional (2D) and three-Dimensional (3D) imaging were suggestive of malignant tumors arising from either alveolar bone or maxillary sinus. The laboratory investigations and biopsy revealed solitary plasmacytoma of maxilla. There were clinical symptoms of paresthesia and mobility, but no other signs of malignancy were observed. As the case report concludes, all necessary investigations need to be conducted to exclude all other pathologies, so that treatment can begin as soon as possible.
Extramedullary plasmacytomas, Hard palate, Multiple myeloma, Swelling
A 46-years-old male patient presented to the Department of Oral Medicine and Radiology with chief complaint of mobility of upper left-side of teeth and painless swelling extraorally over left-side of the face and intraorally over left palatal region for the past 3 months. Past history showed that patient first noticed mobility of teeth in upper left back tooth region. Then after one and half month he noticed paresthesia over left mid-face region and gradually increasing swelling in the same region. No history of any adverse oral habit, dental treatment or any systemic illness was present.
Extraoral examination, (Table/Fig 1)a showed facial asymmetry with diffuse swelling over left side of face with overlying skin was normal in colour, texture and afebrile temperature. Intraorally (Table/Fig 1)b, a well-defined swelling of approximately 3×4 cm extending mesiodistally 1 cm away from midpalatal raphe to alveolar ridge and anterio-posteriorly from mesial surface of 24 to distal surface of 28 over left-side of hard palate was present. Overlying mucosa was normal with obliteration of depth of upper left buccal vestibule. Swelling was firm in consistency, non pulsatile, non tender, non haemorrhagic, non fluctuant and not fixed to overlying mucosa. Grade II mobility were present in 26,27 while Grade I mobility in 24,25,28. On the basis of history and clinical findings, benign odontogenic tumors and salivary gland tumors were suspected, then salivary gland tumors were excluded by the fact of presence of facial asymmetry. Single segment tooth mobility (in absence of periodontitis) and paresthesia raise the suspect of malignant lesions of alveolar bone or maxillary sinus and was further investigated by radiological, histopathological and haematological tests.
Two-dimensional radiographs Intraoral Periapical (IOPA), lateral occlusal, Orthopantomogram (OPG) and Paranasal Sinus (PNS) (Table/Fig 2)A,B,C,D, showed ill-defined multilocular radiolucency with irregular destruction of alveolar bone and floor of maxillary sinus. Internal structure showed very thin and incomplete septa. There was resorption of root apex 23,24,25,26 and 27 at right angle at apical third region. Contrast Enhanced Computed Tomography (CECT) of facial bone showed an ill-defined, (Table/Fig 2)e heterogeneous enhancing soft expansile lytic lesion of size 4.5×3.8×4.7 cm involving left maxillary sinus, hard palate and alveolar process with multiple internal septations area of cortical break. There was erosion of all walls of left maxillary sinus and floor of orbit with extension in nasal cavity. Present case also showed an air space in upper portion of the sinus. Radiological findings were suggestive of malignant tumors arising from either alveolar bone or maxillary sinus.
Routine blood investigations showed normal range of Haemoglobin (Hb), Red Blood Cell (RBC), Differential Leukocytes Count (DLC). There were no abnormalities identified in the liver and renal function tests, as well as no Bence Jone protein or any other abnormalities found in the urine examination. An incisional biopsy showed (Table/Fig 3) sheets of mature and immature closely packed cells resembling plasma cells with eccentrically placed nuclei exhibiting chromatin clumping in a ‘cartwheel’ or ‘checkerboard’ pattern. Immunohistochemistry results were reactive for Mum-1 and CD-138 and non reactive for CD-20. Final diagnosis was made as Solitary Plasmacytoma (SP). On diagnosis of plasmacytoma, the patient was referred to the Oncology Department for treatment, where he was given thalidomide 100 mg once a day until now. During the past two and a half years, the swelling has regressed in size, and the patient has been receiving regular follow-ups. (Table/Fig 4)a,b.
Plasme Cell Neoplasms (PCN) are lymphoid neoplastic proliferations that have been grouped among B-cell peripheral lymphomas (1),(2).
PCN are rare and uncommon type of haematological disorders which are classically categorised into four groups: Multiple Myeloma (MM), Plasma cell leukaemia, Solitary Plasmacytoma of Bone (SPB) and Extramedullary Plasmacytomas (EMPs) (3),(4). The aetiology of SP remains unknown, but chronic stimulation, overdose irradiation, viruses, and gene interactions in the reticuloendothelial system have been suggested as the aetiologic factor (2). The male to female ratio of SP is approximately 2:1, with an average age of 55 years. Incidence rates varies from 8-15%. The most common site of occurrence is upper respiratory tract, especially the nasal cavity, oropharynx, nasopharynx, and sinuses (4). The oral manifestations may vary from tooth pain, swelling or soft tissue mass, migration of teeth, root resorption, haemorrhage, or pathologic fracture (5). The present case was reported in maxillary posterior region in a 46-years-old male patient having non ulcerated, painless firm palatal swelling and mobility of maxillary molars with paresthesia. Clinical differential diagnosis of palatal swelling includes odontogenic and non odontogenic, benign and malignant tumors of oral cavity.
SP exhibited a wide spectrum of radiographic findings, from illdefined destructive radiolucency with ragged borders and no periosteal reaction to well-defined, unilocular radiolucency. The mandible is more likely to develop osteolytic lesions than the maxilla (more haematopoietic activity) (4). The radiographic features in the present case were an ill-defined, multilocular radiolucency with straight septa that resembled an odontogenic myxoma. The 3D scan showed ill-defined lytic lesion with irregular destruction of the left upper alveolar bone, periodontium and the maxillary sinus suggestive of malignancy (6). In a middle-aged adult with an expansile multilocular radiolucent lesion, a number of differential diagnosis are possible. The most common lesions based on the clinical manifestation and radiographic feature included odontogenic myxoma, ameloblastoma, and odontogenic keratocyst (2).
The differentiation of the origin of tumor may be radiographically difficult when bone destruction is associated with soft tissue involvement. Radiographically, on basis of two point, it can be differentiated whether the mass was of bone origin rather than soft tissue. The first point was that the mass originated in the sinus mucosa would have had a central area of necrosis on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) and second point was that in maxillary sinus squamous cell carcinoma, the sinus would first be filled by the mass, then begin to destroy the sinus wall radiographically. Present case showed an air space in upper portion of the sinus, and at the same time bony destruction was also present which suggests that the mass had originated in bone, not sinus mucosa (5),(7).
The dense plasma cell infiltrate, commonly associated with inflammatory lesions, makes it difficult to diagnose SP. Therefore, Immunohistochemistry (IHC) is required to differentiate it with other lesions which shows plasma cell infiltration in bone (3). SP shows similar histological features to MM. Only IHC is useful for identifying lymphomas and MM as well as other tumors (4). In present case, histopathology showed classical features of SP but in some regions malignant spindle cells were present. IHC was used for confirmation of diagnosis. In IHC painting, CD-138, vimentin, Ki-67 and Epithelial Membrane Antigen (EMA) were positive. The results of the present case are in accordance with other studies (3),(4),(5),(6),(8),(9). SP, whether osseous or non osseous, is distinguished from MM by absence of hypercalcaemia, renal insufficiency and anaemia, normal skeletal survey. There was no evidence of these findings in the present case (9).
The ideal therapeutic approach is still controversial, however, radiotherapy seems to be the treatment that offers better clinical results since the SBP reveals itself as a radiosensitive lesion. The rates of local control of SBP with radiotherapy presented in the literature exceed the range of 80%. Surgical intervention should be carried out in situations where there is no prediction of functional or aesthetic damage. Chemotherapy is advocated only on the basis of reports in the literature that showed improvement of local control and delayed development of MM. Radiation therapy in conjunction with chemotherapy is accepted treatment (10),(11).
The present study reports a rare case of medullary SP of the maxilla presenting with tooth mobility and palatal swelling as the first signs and suggesting that dentists should thoroughly examine patients and perform all investigations, particularly when the maxilla is involved in order to rule out any other possibilities. Early detection of malignant tumors is very important as survival is highly dependent on the stage of the tumor.
DOI: 10.7860/JCDR/2022/58839.17045
Date of Submission: Jul 02, 2022
Date of Peer Review: Jul 29, 2022
Date of Acceptance: Sep 12, 2022
Date of Publishing: Oct 01, 2022
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: Jul 04, 2022
• Manual Googling: Sep 09, 2022
• iThenticate Software: Sep 10, 2022 (20%)
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