Article in PDF
How to Cite
Citation Manager
Readers' Comments (0)
Audio Visual Article Statistics
Link
to PUBMED
Print this Article
Send to a Friend
Advertisers
Access Statistics Resources
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
Ileal Neuroendocrine Tumour Causing Carcinoid Syndrome in Absence of Hepatic Metastasis
Correspondence Address :
Ameet Kumar,
Professor, Department of Surgery, AFMC, Pune, Maharashtra, India.
E-mail: ameetsurg@gmail.com
Carcinoid syndrome consists of the classic symptom triad of flushing, diarrhoea, and valvular heart disease. It occurs in the majority of patients with liver metastases. This report presents a 68-year-old female who suffered from chronic diarrhoea with a history of multiple admissions for the same. On evaluation, a Computed Tomography (CT) scan showed a terminal ileal lesion and bulky ovaries. Suspecting Neuroendocrine Tumour (NET) with carcinoid syndrome, a Gallium 68 DOTANOC (DOTA-1-Nal3-octreotide) scan was done which revealed somatostatin receptor expression in enhancing soft tissue lesion in terminal ileum as well as in bilateral adnexa. This confirmed the diagnosis of NET of the ileum and bilateral ovarian metastases. The patient underwent laparoscopic curative resection of the primary tumour along with bilateral oophorectomy. The patient was diagnosed with ileal NET and presented with clinical symptoms of carcinoid syndrome, yet did not have evidence of hepatic metastasis, but instead had bilateral ovarian metastasis which itself is a rare entity.
Diarrhoea, Ileal carcinoid, Laparoscopic resection, Ovarian metastasis
A 68-year-old postmenopausal female presented with recurrent episodes of watery diarrhoea for the last 18 months. There was no history of fever, blood in stools, weight loss, flushing, breathlessness, or wheezing. She had multiple Outpatient Department (OPD) consultations and admissions where she received symptomatic treatment without definite relief. Her physical examination and routine haematological and biochemical parameters were unremarkable. The stool examination was normal. CT scan of the abdomen revealed a focal non obstructive submucosal lesion in the terminal ileum showing homogenous enhancement and measuring 17 mm in maximum thickness and 2.8 cm in length. It also showed bulky ovaries (left>right) (Table/Fig 1).
With suspicion of NET, a Ga-68 DOTANOC scan was done, which revealed somatostatin receptor expression in enhancing soft tissue lesion in the terminal ileum as well as in bilateral adnexa, which confirmed the diagnosis of NET of the ileum with bilateral ovarian metastases. Furthermore, serum chromogranin A levels and 24 hours urinary 5-Hydroxyindoleacetic Acid (5-HIAA) levels were elevated- 2580 ng/mL (normal <108 ng/mL) and 12 mg (normal 2-9 mg), respectively. Echocardiography was normal.
The patient underwent laparoscopic segmental resection with primary anastomosis of the distal ileum and bilateral oophorectomy (Table/Fig 2). To prevent carcinoid crisis intraoperatively, the surgery was performed under octreotide infusion cover at 50 μg/hr started 12 hours before surgery, and continued for 24 hours postoperatively.
Histopathological examination showed a well-differentiated NET (World Health Organisation (WHO) Grade-2) (1) in the ileum and bilateral ovaries. On Immunohistochemistry, tumour cells were positive for synaptophysin and chromogranin (Table/Fig 3). On the four week follow-up, the patient was completely asymptomatic.
Gastrointestinal NETs (GI-NETS), frequently called carcinoid tumours, are tumours derived from diffuse amine and acid-producing cells of the GI tract with different hormonal profiles, depending on the site of origin. Small Intestinal (SI) NETS comprise >50% of all SI tumours with an annual incidence of approximately, 0.8/100,000 (2). The ileum is the most common site of origin. Patients with GI-NETs must have liver metastasis before they develop carcinoid syndrome unlike ovarian or bronchial tumours, which may have carcinoid syndrome even in absence of liver metastasis (3).
Among the NET ectopic hormonal syndromes, carcinoid syndrome is the second oldest to be described, after insulinoma, with the earliest publication in 1954 (4). Approximately, 30-40% of patients with well-differentiated NETs present with carcinoid syndrome (5).
The occurrence of Carcinoid syndrome associated diarrhoea among NET patients is as high as 60-80%. One of the main secretory products of GI-NETS is serotonin. It acts on 5-HT3 receptors, stimulating intestinal motility and secretion and inhibiting absorption. High levels of serotonin cause increased frequency of bowel movements and decrease stool consistency, clinically seen as diarrhoea (6).
Two plausible explanations have been given to explain why carcinoid syndrome in such a case cannot occur in absence of liver metastasis (7):
• The liver contains a huge amount of monoamine oxidase activity, which inactivates most of the serotonin produced by the tumour (7).
• Primary GI-NETs are usually small and secrete a lesser amount of hormones than a metastatic liver lesion, which is much larger in size and secretory function (7).
Primary ovarian carcinoid tumours or ovarian metastasis as in this case, release serotonin or other vasoactive substances directly into the systemic circulation bypassing the liver and thus, can produce carcinoid syndrome. To the best of our knowledge, there have been only a limited number of such cases in the literature so far. A review of the literature yielded 19 cases of GI-NET with features of carcinoid syndrome in the absence of liver metastasis (Table/Fig 4) (7),(8),(9),(10),(11),(12),(13),(14),(15),(16),(17),(18). As mentioned in the table, the site of primary tumours in these patients was the middle and distal ileum, jejunum, caecum, appendix and mesentery. All the patients had evidence of carcinoid syndrome in the absence of hepatic metastasis. Only eight patients had metastatic deposits in the ovaries (Case 2,3,4,5,6,8,9,10), while in others the most common site of tumour spread was lymph nodes (Case 1,11,12,13,14,15,17). Most of the patients received surgical management and five patients (Case 5,10,12,14,17) showed complete remission without any postoperative complications or recurrence.
Management of chronic diarrhoea can challenge clinicians and the possibility of a carcinoid syndrome should be entertained in them. Further, carcinoid syndrome in absence of liver metastasis, though rare, can occur when vasoactive substances are released directly into systemic circulation as in this case with ovarian metastasis.
DOI: 10.7860/JCDR/2023/58953.17414
Date of Submission: Jul 12, 2022
Date of Peer Review: Aug 28, 2022
Date of Acceptance: Oct 26, 2022
Date of Publishing: Jan 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 13, 2022
• Manual Googling: Oct 10, 2022
• iThenticate Software: Oct 24, 2022 (7%)
ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com