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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 Series
Full Version
Elective Splenectomy for Haemolytic Anaemia: A Case Series
Correspondence Address :
A Ajay Raja,
SRM Nagar, Potheri, Kattankulathur, Chengalpattu, Tamil Nadu, India.
E-mail: drajayraja005@gmail.com
The spleen plays an important role in immune surveillance and haematopoiesis. Elective splenectomy is sometimes indicated for excessive cellular destruction (hypersplenism) or sequestration, lymphomatous or myeloid disease, or tumours. Hereditary haemolytic anaemias are disorders with a variety of causes, including red cell membrane defects, red blood cell enzyme disorders, congenital dyserythropoietic anaemias, thalassaemia syndromes, and haemoglobinopathies. Splenectomy is one of the therapeutic approaches in the management of haematological conditions. This is case series of 12 cases who underwent elective splenectomies for haemolytic anaemias in a tertiary care centre, over a period of one year. Out of the 12 patients, 10 patients were diagnosed to have Hereditary Spherocytosis (HS) and two patients were diagnosed with sickle cell anaemia. For all patients, preoperative blood transfusion was done to bring the Haemoglobin (Hb) above 9 g/dL for elective splenectomy. Among the 10 patients with HS, six patients had concomitant cholelithiasis for which cholecystectomy was done in the same sitting and three patients developed postoperative complication which was managed appropriately with no mortality and minimum morbidity. However, more detailed studies on this subset of patients are needed for the establishment of guidelines and optimal outcomes.
Blood transfusion, Cholelithiasis, Massive splenomegaly, Spleen
The spleen plays a significant part in immune surveillance and haematopoiesis. It also removes intracellular inclusions (pitting) and screens aged blood cellular elements from motion. Although the spleen has significant immune functions, elective splenectomy is occasionally indicated for hypersplenism or sequestration, or tumours. Hereditary haemolytic anaemias are disorders with a variety of causes, including red cell membrane defects, red blood cell enzyme disorders, congenital dyserythropoietic anaemias, thalassaemia syndromes, and haemoglobinopathies (1). One of the most important indications for therapeutic management in haematological conditions is splenectomy (2).
A case series of 12 patients with haemolytic anaemia was presented who were referred to the tertiary care centre for elective splenectomy over a period of one year from June 2019 to June 2020.
Preoperative preparation
1) All patients were properly vaccinated with Pentavalent vaccine (Diphtheria, Pertussis, Tetanus, Hepatitis B and Haemophilus influenzae type B), pneumococcal vaccine and meningococcal vaccine 72 hours before surgery.
2) Full preoperative blood work-up was done along with the cardiac status of all patients and anaesthetic fitness was obtained.
3) Preoperative Haemoglobin (Hb) of more than or equal to 9 g/dL was maintained; if found to be low, adequate blood transfusion was done before surgery.
4) Two pints of the packed cell was reserved for all patients before surgery, according to their blood groups.
Out of 12 patients with haemolytic anaemias 10 patients were diagnosed to have HS (83%) and 2 patients with sickle cell disease (17%). For all patient elective splenectomy (Table/Fig 1),(Table/Fig 2),(Table/Fig 3),(Table/Fig 4) was done without mortality and with minimal morbidity. Out of 12 patients, six patients had concomitant cholelithiasis (50%) for which cholecystectomy was done along with splenectomy. Results have been summarised in (Table/Fig 5).
Postoperative management
1) Postoperative intensive care unit care was given for 3-5 days.
2) All patients were well hydrated with i.v. fluids @ 125 mL/hr.
3) Oxygen supplement was given via face mask @2-4 L for 2-3 days.
4) Deep vein thrombosis prophylaxis with inj. Fondaparinux 5 mg for 5 days.
5) Adequate postoperative i.v. antibiotics and i.v. analgesics were given.
6) Daily complete blood count monitoring for Hb and platelets was done for 3-4 days.
Hereditary haemolytic anaemias are a collection of ailments with a diversity of causes, including red cell membrane defects, enzyme disorders, congenital dyserythropoietic anaemias, and haemoglobinopathies. The definitive management has yet to be determined. Splenectomy has been recommended as a likely method to manage severely affected patients (1).
The HS is the most common form of congenital haemolytic anaemia with an incidence of approximately 1:2000 and a dominant transmission in about 70-80% of cases (3). The risk of Overwhelming Postsplenectomy Infection (OPSI) is highest with encapsulated microorganisms though the incidence of OPSI is only 0.23% per year with a lifetime risk of 5% (4). Strategies to reduce the development of OPSI include: (i) patient education, including advice to take urgent action in response to febrile episodes; (ii) vaccination and the advent of new protein conjugate vaccines; (iii) prophylactic antimicrobial therapy; (iv) intraoperative normothermia; (v) early catheter removal; (vi) increased vigilance (5),(6). Though these measures are thought to reduce the risk of OPSI greatly, studies reported inconsistency in implementation (7).
In this case series, a total of 12 patients were operated for elective splenectomy for a duration of one year from June 2019 to June 2020, out of which 10 patients were females and 2 patients were males. Female preponderance was seen in HS in the present series, but in studies done by other authors, it had a male preponderance (2),(8),(9),(10). The mean age of presentation was 25-28 years of age which was in concordance with the study done by other authors (Table/Fig 6). In this series, the most common indication for elective splenectomy was HS. But in studies done by Lakhsmi BK et al., and Machado N et al., sickle cell anaemia is common, and in studies done by Rajan SP et al., and Ahmad J et al., immune thrombocytopenic purpura is the most common indication for doing elective splenectomy (2),(8),(9),(10).
It was found that 6 patients (50%) had cholelithiasis. In studies done by Lakhsmi BK et al., 13 patients underwent concomitant cholecystectomy during elective splenectomy (2). It has been reported that, following splenectomy, there is an increased risk of early and late venous and arterial thrombosis, including acute splenic and portal vein thrombosis, and delayed severe life-long complications (11).
It is remarkable that the rate of death from elective splenectomy in a large study is 1.6%, making it a procedure of comparable risk compared to 1-2% mortality in pancreatectomy or hepatectomy series in high-volume centres (11). However, there was no mortality in the present study. The lesser number of patients included in the study might be the reason for this.
There is a need for the conduction of more studies on this topic with a specific focus on decision-making for surgery and perioperative protocols. In the present study, all the signs have shown improvement in the early postoperative period.
Elective splenectomy is done mainly for all haemolytic anaemias with unconjugated hyperbilirubinaemia. HS is the most common cause of haemolytic anaemia.
DOI: 10.7860/JCDR/2023/59179.17442
Date of Submission: Jul 20, 2022
Date of Peer Review: Sep 09, 2022
Date of Acceptance: Nov 06, 2022
Date of Publishing: Feb 01, 2023
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 21, 2022
• Manual Googling: Nov 01, 2022
• iThenticate Software: Nov 04, 2022 (19%)
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