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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
Research Protocol
Full Version
Incidence of Metastasis of Oral Squamous Cell Carcinoma in Submandibular Gland among N+ Cases of Neck Dissection: A Research Protocol
Correspondence Address :
Dr. Amjad Munir Shaikh,
Near Karbala Bes, Raviwar Peth, A/P, T/Q-Ambajogai, Dist-Beed, Ambajogai-431517, Maharashtra, India.
E-mail: drshaikhamjad@gmail.com
Introduction: Oral Squamous Cell Carcinoma (OSCC) is one of the most common malignant diseases of head and neck region. Management of OSCC involves removal of the Submandibular Gland (SMG) along with lymph nodes. The submandibular salivary gland is routinely removed, considering metastatic involvement from OSCC. Many studies showed there is no or rare involvement of the submandibular gland.
Aim: To find the incidence of metastasis of oral squamous cell carcinoma in the submandibular salivary gland during neck dissection.
Materials and Methods: This cross-sectional, observational, descriptive study will be conducted in the Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Sawangi, Maharashtra, India. The research started from November 2018. Data will be compilated in tabular form in term of descriptive statistics with frequency and proportion of submandibular gland involvement. It will be conducted on 90 operated cases of OSCC in whom one or both the submandibular glands will be removed during neck dissection. The outcome parameters will be the nature and site of lesion, clinical nodal status, clinical stage of disease, preoperative and postoperative histopathological examination of lesion, histopathological examination of resected lymph nodes and proportion of involvement of submandibular gland.
Lymph nodes, Neck dissection, Xerostomia
Squamous cell carcinoma of the oral cavity is one of the most common tumours of the head and neck region (1). Worldwide oral squamous cell carcinoma is the sixth most common malignant disease, and the number of new oropharyngeal cancer cases is 3,00,000 annually, which is attributed to 3% of total cancer cases (2). In India, OSCC ranks among the top three types of cancers (3). Oral cancer in India is high, that is, 20 per 100,000 population and accounts for over 30% of all cancers in the country (4). The involvement of cervical lymph nodes is the most important factor impacting the survival of the patient (5),(6),(7). True status of preoperative neck nodes cannot be assessed by Ultrasound (USG), Computed Tomography (CT) or Magnetic Resonance Imaging (MRI). Even a single metastatic neck node may reduce a patient’s survival chances (8),(9).
Current surgical treatment includes surgical excision of the primary lesion with wide margins and appropriate neck dissection. Neck metastasis is most frequently observed in levels I, II, and III but
rarely in level IV. According to Rouviere H and Tobies MJ, five lymph node groups are present in this region: preglandular, prevascular, retrovascular, retroglandular and intracapsular (10). The Submandibular Glands (SMG) are located in level-Ib, where rich lymphatic tissues surround them. It was demonstrated that the submandibular gland does not have any intraparenchymal lymph nodes (11) and that the tumour involvement in the SMG must be through extension from a locally involved lymph node or the primary tumour (12). Among these, the prevascular and retrovascular nodes are the most important because they are the primary afferent draining nodes of the oral cavity. In about 5-7% of floor of the mouth and tongue cancers perivascular node involvement is seen (13). True infiltration of the SMG by Oral Squamous Cell Carcinoma (OSCC) is quite uncommon (14). Still, SMGs are frequently excised as a part of neck dissection because of their proximity to the primary lesion and afferent lymph nodes.
The SMGs are responsible for approximately 70% to 90% of unstimulated salivary volume, especially at night, removal of one SMG as part of the neck dissection causes significantly decreased unstimulated salivary flow and an increased incidence of subjective xerostomia, even though the patient does not receive postoperative radiotherapy (15),(16),(17). Preservation of atleast one gland will prevent these complications (18). Since the 1950s, more conservative approaches in neck dissection have been proposed that spare non lymphatic structures (19),(20). The study will aim to evaluate the incidence of metastasis of OSCC in submandibular gland for deriving guidelines pertaining to preservation or excision of the gland during neck dissection.
This cross-sectional, observational, descriptive study will be conducted in the Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Sawangi, Maharashtra, India. The research started from November 2018. The Institutional Ethical Committee had approved the study [DMIMS(DU)/IEC/2018-2019/7274].
The patient selected for the study will be requested to sign a consent form. The patients will be examined clinically, findings will be recorded on the case sheet, and then will undergo required investigations. In all operated cases, the excised gland will be processed for grossing of the gland and histopathogical examination. This data will be collected and recorded in a case sheet.
Inclusion criteria: Histopathological proven cases of OSCC with surgery as the primary treatment modality, and resection of primary lesion with clinically N+ neck and atleast one submandibular gland are required to be removed, will be included in the study.
Exclusion criteria: Patient with inoperable tumour, history of Chemotherapy (CT) or Radiotherapy (RT), proven distant metastasis, direct involvement of submandibular gland by OSCC of floor of mouth will be excluded from the study.
Study Procedure
All patients will undergo excision of primary lesion with wide margins and neck dissection at different levels depending upon the individual case, followed by primary closure or reconstruction with local, locoregional, or microvascular free tissue transfer depending upon respective defects and feasibility of surgery. The unilateral or bilateral SMG will be excised in all the cases. The SMG, excised nodes, and the primary lesion will be preserved in 10% formalin and ten times volume solution. It will be sent for histopathological examination, and the findings will be analysed.
STATISTICAL ANALYSIS
Data will be entered in Microsoft Excel sheet version 2016 and presented in descriptive statistics (percentage and proportion).
The study conducted by Chen TC et al., showed Floor of the mouth and buccal mucosa are the most common primary sites for OSCC in which submandibular gland involvement is seen. But, OSCC arising on the tongue, gingivobuccal sulcus, gingiva, and the mandibular region also have shown infiltration of the submandibular gland. also, further they showed that that SMG infiltration occurs mostly in higher stages of OSCC and hence, is associated with a larger size of the primary tumour and higher nodal stage (21). In a study by Basaran B et al., six cases of tongue OSCC had SMG involvement, of which three showed direct invasion, two showed invasion through metastatic lymph nodes, and one showed direct metastasis. Also, five cases with OSCC of the floor of mouth had SMG involvement, of which, four showed direct invasion and one invasion through metastatic lymph nodes. One case with OSCC in buccal mucosa had SMG involvement by invasion through metastatic lymph nodes, and one case of lip OSCC showed direct invasion. Most of these patients were of stage III and stage IV (22).
Ashfaq K et al., studied data of the 110 consecutive patients, operated for oral cavity tumours showed 2% frequency of SMG involvement in early oral cavity tumours and concluded that SMG metastasis from early oral cavity tumours is rare; any neoplastic involvement of the gland usually occurs via direct spread (23). Fives C et al., retrospectively reviewed data of 177 patients with oral cancer undergoing neck dissection and showed 1% frequency of SMG involvement, as well as the incidence and mechanism of SMG involvement in floor of mouth cancer. They concluded that there are no intraglandular lymph nodes, and possibility of lymphatic metastasis to the SMG are less (24).
Agarwal G et al., studied the records of 112 individuals who had their necks dissected for OSCC. They had 115 neck dissections, both therapeutic and preventive (three patients had bilateral neck dissections). In none of the cases, there was histologic evidence of metastasis to the SMG. It was found that preserving the SMG may be safe (25).
This study in future expected to help the clinicians in decisionmaking, whether to remove the SMG or not. The unnecessary removal of the gland will be averted and in turn will help in a better quality of life of the patients.
DOI: 10.7860/JCDR/2022/58458.17170
Date of Submission: Jun 16, 2022
Date of Peer Review: Aug 02, 2022
Date of Acceptance: Oct 18, 2022
Date of Publishing: Nov 01, 2022
Author declaration:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jun 22, 2022
• Manual Googling: Oct 03, 2022
• iThenticate Software: Oct 17, 2022 (13%)
Etymology: Author Origin
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