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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
Original article / research
Full Version
Whole Brain CT Perfusion Evaluation in Transient Ischaemic Attack: A Cross-sectional Study from a Tertiary Care Centre, New Delhi, India
Correspondence Address :
Dr. Rohini Gupta Ghasi,
Room No. 6, Ground Floor, OPD Building, Department of Radiology,
VMMC and Safdarjung Hospital, New Delhi-110029, India.
E-mail: rohini1912@gmail.com
Introduction: Few studies exist in current literature regarding imaging features in Transient Ischaemic Attack (TIA) and most of the previous studies on Computed Tomography Perfusion (CTP) have used old generation scanners with limited brain coverage.
Aim: To study the spectrum of whole brain CTP parameters in patients presenting with TIA using a 256 slice CT scanner.
Materials and Methods: This cross-sectional observational study was conducted on 15 patients, tertiary care centre in New Delhi, India over a period of 18 months from October 2017 till March 2019. All patients presenting with the first episode of TIA were evaluated with Non Contrast Computed Tomography (NCCT), Whole brain CTP, and Colour doppler of carotid vessels. Quantitative assessment and statistical analysis of the alteration of CT perfusion parameters was done in areas of visualised Focal Perfusion Abnormalities (FPA) and seven predefined locations in bilateral hemispheres on perfusion maps.
Results: Five out of 15 patients had FPAs in the colour maps and there was a significant elevation of Cerebral Blood Flow (CBF) and Cerebral Blood Volume (CBV) in the FPA region (p-value=0.018) suggestive of postischaemic hyperperfusion. The mean hemispheric CBF was increased in the abnormal hemisphere compared to the normal hemisphere (p-value=0.04).
Conclusion: CTP parameters are significantly altered in the patients with TIA with predominant increase in CBF and CBV in the patients who have FPA on CTP. CTP shows postischaemic hyperperfusion changes in the form of increased CBF in the hemisphere corresponding to the symptoms.
Cerebrovascular accident, Computed tomography perfusion, Postischaemic hyperperfusion, Stroke
The PTC is a malignant epithelial tumour. Follicular cell differentiation is shown by the tumour with characteristic nuclear features (1). The mean age of occurrence is 43 years (2). The authors noted mean age of 47 years (20 to 75 years) with PTC known to have female preponderance (1).Several variants have been described like classic, follicular, tall cell, diffuse sclerosing, encapsulated, microfollicular, oncocytic, columnar cell and papillary microcarcinoma. Most common variant is classic variant which exhibits classic nuclear features like ground glass nuclei, nuclear grooves and psammoma bodies. The second common variant was follicular variant. Follicular variant is also known as Lindsay tumour (2) and it is composed of follicles with PTC type nuclei. Tall cell variant is composed of papillae lined by cells where height is two or three times the width size. Diffuse sclerosing variant is characterised by sclerosis, psammoma bodies, extensive lymphocytic infiltration and squamous metaplasia. Most of the time papillary microcarcinoma is diagnosed incidentally. Here, the size is 1 cm or less than that. The Encapsulated variant is completely surrounded by capsule and has better prognosis (2). PTC is studied exclusively for precursor lesion and researchers have found association between Hashimoto’s thyroiditis and PTC (3),(4),(6). Patients with Hashimoto’s thyroiditis have an increase risk of developing thyroid carcinoma most commonly PTC (5). Hashimoto’s thyroiditis is associated with a small but real risk of developing PTC by providing a biological link between the two that is RET/PTC rearrangement (1).
Meta-analysis by Lee JH et al., showed that PTC has significant association with Hashimoto’s thyroiditis and suggested careful monitoring of these patients with HT for the development of carcinoma. Thyroid cancer is predominantly of papillary type (3). Molnar C et al., showed that thyroid gland affected by Hashimoto’s thyroiditis have increased likelihood of developing PTC. They also confirmed that Hashimoto’s thyroiditis can be considered as a precondition for PTC. In their study, classical variant of PTC was the most common variant associated than the follicular and other variants (4). Zhang Y et al., in their study evidenced that PTC with Hashimoto’s thyroiditis has a greater incidence and 29.4% is accounted by it (5). They concluded that Hashimoto’s thyroiditis is associated with PTC in a significant risk manner.
Konturek A et al., in their study showed that PTC is associated with Hashimoto’s thyroiditis which has increased by three fold. They have concluded that association between Hashimoto’s thyroiditis and PTC is more than what is previously believed (6). The present study was conducted with the aim to analyse the variants of PTC and to evaluate the presence of associated lesions.
This was a retrospective study conducted on 41 cases of PTC from January 2016 to December 2018 in the Department of Pathology, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India. The demographic data and clinical findings were retrieved from the case files. The study was approved by Institutional Ethical Committee (KIMS/IEC/A42-2019).
All the cases reported to KIMS hospital during January 2016 to December 2018 were included in the study. There were 41 cases of PTC during the study period.
Inclusion criteria: All thyroid carcinoma diagnosed as PTC were included in the study.
Exclusion criteria: Thyroid carcinomas other than PTC were excluded from the study.
Specimens of thyroidectomies were received with request forms containing relevant clinical details and preoperative diagnosis. The specimens were examined, grossed and processed as per routine histopathology processing. Slides were stained with Haematoxylin and Eosin stain (H&E). The slides were studied under light microscope.
Statistical Analysis
The results were analysed by calculating frequency (n) and percentages (%). The Fischer’s-exact test using R Statistical Software v 4.0.0 was used for association between PTC and disorders.
The present study included 41 cases of PTC. The patient’s age ranged from 20-70 years with a mean age of 47 years. Majority of the patients were females (30/41).
Gross features in the thyroidectomy specimens varied from tiny grey white lesions (Table/Fig 1)a to large irregular mass (Table/Fig 1)b. Some of them appeared granular. Multiple nodules and cystic areas noted in few. The most common type of PTC was classic variant (31/41, 75.6%) (Table/Fig 2). Classic variant showed papillary structures lined by cells having ground glass nuclei, nuclear crowding, nuclear grooves and pseudoinclusions (Table/Fig 3). Psammoma bodies were seen in eight cases (Table/Fig 4). The second common type was follicular variant which showed follicular arrangement of cells with characteristics PTC nuclear features as described above (Table/Fig 5). There were three cases of papillary microcarcinomas. All of them measured 1 cm or less in diameter and showed characteristic nuclear features.
One case of diffuse sclerosing variant was noted where there was diffuse fibrosis throughout the tumour and the cells showed characteristic nuclear features. The slides of thyroidectomy specimens were studied to identify the associated diseases with PTC. Of 41 cases of PTC, 13 cases had associated disorders in thyroid (Table/Fig 6).
In these 13 cases, preoperative diagnosis of PTC was available in six cases and in the remaining seven cases PTC was diagnosed on histopathological examination. Multinodular goitre was noted in eight cases (Table/Fig 7), seven cases of them were associated with classic variant and one case was a papillary microcarcinoma. Among these eight cases, only two cases had preoperative diagnosis of PTC. In the remaining six cases, PTC was discovered on histopathological examination of thyroidectomy specimen for multinodular goitre. Association between PTC and multinodular goitre is not statistically significant (p-value=0.45). Hashimoto’s thyroiditis was associated in five cases of PTC (Table/Fig 8). Of these three cases were classic variant, one was follicular variant and other was papillary microcarcinoma.
In these five cases of Hashimoto’s thyroiditis, four cases had preoperative diagnosis of PTC and only one case was incidental which was a papillary microcarcinoma. Association between PTC and Hashimoto’s thyroiditis is not statistically significant (p-value 0.45).
In total data of 41 thyroidectomies of the present study, 30 were female patients. In the present study, of 41 cases we found 31 were classic variant, 6 were follicular variant, 3 were papillary microcarcinoma and single case of diffuse sclerosing variant.
Anand A et al., study showed that PTC with Hashimoto’s thyroiditis cases are less aggressive, presents earlier and less incidence of lymph node metastasis and extra thyroidal extension (7). They also showed PTC with Hashimoto’s thyroiditis patients have better prognosis, low recurrence and reduced mortality. They concluded that it is prudent to exclude malignancy in Hashimoto’s thyroiditis.
We have found Hashimoto’s thyroiditis associated with five cases of PTC of which three were classic variant, one was follicular variant and one was papillary microcarcinoma. (Table/Fig 9) depicts this in comparision to other studies (4),(6). The papillary microcarcinoma was diagnosed incidentally on histopathological examination of thyroidectomy specimen. Study by Resende de Paiva C et al., showed that an association was found between Hashimoto’s thyroiditis and thyroid lymphoma (8).
Moon S et al., in their meta-analysis showed that prognosis of patients is improved when Hashimoto’s thyroiditis is co-existed with PTC. And also noted that lymph node metastasis, extrathyroidal extension is reduced and recurrence free survival duration is increased in comparision to other patients who did not have associated Hashimoto’s thyroiditis. They concluded that association of Hashimoto’s thyroiditis with PTC could be used to assess the prognosis of PTC (9). Loh KC et al., and Yoon YH et al., had similar findings (10),(11).
Graceffa G et al., showed that there is decreased tumour aggressiveness and recurrence of pathology is diminished with association of Hashimoto’s thyroiditis and papillary thyrioid carcinoma (12). Rajkumar B et al., showed in their study that incidence of PTC with multinodular goitre was 25% when surgery was undertaken in the absence of any aetiological or risk factors (13). Nadeem k et al., showed incidence of 14.9% and Hanumanthappa MB et al., found 10% incidence of PTC with multinodular goitre (14),(15).
Fama F et al., showed a 12% risk of harbouring preoperatively unsuspected PTC, some even with capsular invasion in multinodular goitres (16). Botrugna I et al., found in their study of 462 thyroidectomies for MNG, around 10% showing incidental thyroid carcinomas, most of which were PTC (17). We have found eight cases of PTC associated with multinodular goitre, out of which seven were with classic variant and one was papillary microcarcinoma. Of the 8 cases 6 were incidental, unsuspected preoperatively.
Limitation(s)
It is a retrospective study, probably a prospective study would allow more detailed gross examination. Smaller sample size is a limitation.
Classic variant is the most common type of PTC. All thyroidectomies done for multinodular goitre and Hashimoto’s thyroiditis should be screened thoroughly for PTC especially microcarcinoma. Clinical importance between PTC and associated disorders has been found which has different line of management and follow-up. The present study did not show statistical significance between these disorders although. Further larger and multicentre study is required.
DOI: 10.7860/JCDR/2022/50889.15994
Date of Submission: Jun 15, 2021
Date of Peer Review: Sep 09, 2021
Date of Acceptance: Dec 11, 2021
Date of Publishing: Feb 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? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Dec 17, 2020
• Manual Googling: Feb 27, 2021
• iThenticate Software: Dec 10, 2021 (3%)
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