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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
Cytodiagnosis of Visceral Leishmaniasis in Lymph Node Aspirate: A Rare Case Report
Correspondence Address :
Prachi Garg,
Flat No. 476, First Floor, Omaxe City, Sector 28, Rohtak, Haryana, India.
E-mail: dr.prachi2008@gmail.com
Leishmaniasis is a parasitic disease caused by leishmania species. There are three main forms of the disease: Cutaneous, Mucocutaneous and Visceral Leishmaniasis (VL). VL with lymphadenitis is an uncommon presentation. Visceral leishmaniasis is usually diagnosed by identification of parasite Leishman Donovan (LD) bodies in bone marrow aspirates but cytological diagnosis of VL on lymph node aspirates has rarely been reported. This is a case report of a 37-year-old male presenting with multiple isolated cervical lymphadenopathy for three months. The lymphadenopathy was initially suspected to be tubercular in nature which is highly prevalent in India and lymphadenopathy is its common presenting feature, but on Fine Needle Aspiration Cytology (FNAC) of the node, multiple leishmania parasites were identified. Lymphadenopathy due to leishmaniasis is rare in India and most of the previous cases reported have association of leishmaniasis with Human Immunodeficiency Virus (HIV) infection. But this case is unusual as it is not associated with HIV infection. Thus, leishmaniasis should be included in the differential diagnosis of lymphadenopathy, especially in patients coming from endemic region. Cytology can be very helpful in such cases for early diagnosis and further management.
Cytology, Leishman donovan bodies, Leishmanial lymphadenitis, Parasite, Visceral leishmaniasis
A 37-year-old male from Bihar came to Medicine Outpatient Department (OPD), presenting with painless, swelling in left cervical region for past three months duration which gradually increased in size. He also had history of low-grade intermittent fever, mild pain in abdomen on and off, anorexia and weakness for past three months. He had a past history of pulmonary Tuberculosis (TB) with completed treatment five years back. General physical examination revealed enlarged bilateral cervical lymph nodes measuring 0.5-2 cm in size, non tender and non matted.
On palpation, moderate hepatomegaly and massive splenomegaly was also noted (Table/Fig 1). Investigations revealed few abnormal parameters like haemoglobin 6.4 g/dL (normal range 13-16 g/dL), total leucocyte count 1700/μL (normal range 4000-11000/μL) with P26L65M08E01 and platelets 1 lac/μL. (normal range 1.5-4 lac/μL). Routine biochemical investigations were within normal limits. Serology for HIV and Hepatitis B Virus (HBV) by Enzyme-linked Immunosorbent Assay (ELISA) was non reactive. Mantoux test was negative. Sputum was negative for acid-fast bacilli. Computed Tomography (CT) of the chest and abdomen examination revealed cavitatory consolidated lesion in right upper lobe of lung, hepatomegaly and splenomegaly suggestive of disseminated tuberculosis (Table/Fig 2). Based on these findings he was started again on antitubercular drugs. However, there was no improvement in the patient’s overall symptoms. Then he was recommended for FNAC of cervical lymph nodes. FNAC was performed and Giemsa stained smears revealed a polymorphic population of cells composed of lymphocytes, histiocytes, and macrophages filled with leishmania amastigotes LD bodies (Table/Fig 3). Zeil-Neil staining for acid fast bacilli was negative A final diagnosis of leishmania lymphadenitis was made. Patient refused treatment and went back to his native state and was lost to follow-up.
Leishmaniasis also called as Kala Azar is a protozoan disease caused by different species of leishmania which is an obligate intracellular parasite and transmitted by bite of infected female sand fly. The amastigote forms of leishmania species spread through haematogenous route in the human body and affect the macrophages of mononuclear phagocyte system (1). It’s annual incidence rate is 0.5 million in the world but the infection is endemic in eastern India mainly Bihar, West Bengal and Uttar Pradesh (2). It is characterised into three main types-visceral, cutaneous, and mucosal (1). Visceral Leishmaniasis (VL) is usually diagnosed by identification of parasite Leishman Donovan (LD) bodies in bone marrow, spleen and liver aspirates. Other methods such as tissue biopsy, immunohistochemistry and molecular methods are also used. However, lymph nodes involvement in Kala azar with demonstration of Leishman-Donovan (LD) bodies by Fine Needle Aspiration Cytology (FNAC) has rarely been reported in VL (3). Early accurate diagnosis and treatment are important otherwise it can be life threatening. This is a rare case report of Visceral leishmaniasis involving cervical lymph node and diagnosed on cytology. Life cycle of leishmaniasis has two forms: the promastigote form which replicates in sandfly and is extra cellular and the intracellular amastigote form which multiplies in mamallian host (4). The different clinical manifestations depend upon infection by different species of the parasite and the host immune response (1),(3). Cutaneous leishmaniasis is characterised by papular, nodular, and ulcerative skin lesion, whereas in mucocutaneous/mucosal leishmaniasis there is involvement of mucosa of the nose and throat (5). Visceral leishmaniasis is the most severe type caused by L. infantum and L. donovani presents with fever, anaemia, weight loss, darkening of skin and hepatosplenomegaly (6). The diagnosis of leishmaniasis is mainly based on detection of characteristic amastigote forms also known as Leishman-Donovan (LD) bodies in microscopic examination of bone marrow, spleen and lymph node aspirates (1). Microscopically, LD bodies appear as small round/ovoid structures of 2-5 μm (diameter) with fine membrane and central round nucleus and rod shaped kinetoplast (7). Although it is an endemic disease in eastern India but peripheral lymphadenopathy in Indian Visceral Leishmaniasis (VL) or Kala azar is a rare finding. It is an incidental finding on cytology with only a few cases reported till date where leishmaniasis has been mainly diagnosed on FNAC.
Most of the previous cases reported have association of leishmaniasis coexistent with HIV infection (an immuno-compromised state) (Table/Fig 4) (7),(8),(9),(10),(11),(12),(13),(14),(15),(16). But this case is rare as it is not associated with HIV infection. The cases of leishmaniasis reported in non endemic regions could be due to migrant population from endemic regions (13). The diagnosis of leishmaniasis is often difficult due to lack of awareness, non specific symptoms similar to other commonly occurring diseases, such as malaria, typhoid, and tuberculosis; and microscopically difficult identification of amastigotes in bone marrow smears (7). Cervical lymph adenopathy includes a variety of diseases in the differential diagnosis out of which tuberculosis, fungal infections, bacterial lymphadenitis and lymphomas are most common. Our patient had cervical lymphadenopathy with and hepatosplenomegaly as the predominant presentation. So diseases like disseminated tuberculosis and lymph oproliferative disorders were included in the differential diagnosis. Leishmaniasis was not included in the differentials because lymphadenopathy is a rare finding in Indian VL, and can closely mimic tuberculosis which is highly prevalent in India and lymphadenopathy is its common presenting feature. A clinical diagnosis of TB was made based on clinical and radiological findings and ATT was started, but due to non improvement of symptoms, patient was sent for FNAC to rule out lymphoproliferative disorders. However, the cytology smears revealed multiple macrophages filled with LD bodies and diagnosis of leishmanial lymphadenitis was made. So FNA cytology is a quick, reliable and a definitive diagnostic method and should always be considered as a method of choice in lymph node enlargement.
The index case was clinically challenging with past history of TB and ATT twice and presenting with intermittent fever, lung cavity and peripheral lymph adenopathy. Although leishmaniasis is a rare cause of lymph node enlargement, it should be considered as a differential diagnosis of all patients from endemic areas. FNAC is an excellent tool for the early diagnosis of leishmanial lymphadenitis.
DOI: 10.7860/JCDR/2022/57847.016969
Date of Submission: May 18, 2022
Date of Peer Review: Jun 25, 2022
Date of Acceptance: Aug 25, 2022
Date of Publishing: Sep 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: May 26, 2022
• Manual Googling: Aug 10, 2022
• iThenticate Software: Aug 26, 2022 (6%)
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