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
Ovarian Carcinoma Presenting as Meigs’ Syndrome- A Rare Case Report
Correspondence Address :
Dr. Francis Ankita,
Room No. G3, Ladies PG Hostel, F-Block, Shankar Nagar, Chromepet, Near Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India.
E-mail: francisankita27@gmail.com
Presence of fluid and air within pleural space is known as hydropneumothorax. A large proportion of patients present with shortness of breath, dry cough and pricking type of pleuritic chest pain as a result of pleural involvement. However, fever and constitutional symptoms like loss of appetite and loss of weight is most likely associated with tuberculosis. Meigs’ syndrome is a triad of ascites, hydrothorax and benign ovarian tumours (ovarian fibromas and fibrothecomas). Pseudo-Meigs’ syndrome shows accumulation of ascites, pleural effusion and associated with a pelvic or abdominal tumours. Here, is a case report of a 62-year-old postmenopausal female, who presented with right pleuritic chest pain and breathlessness, since one week. Chest radiograph showed right-sided hydropneumothorax which required an intercostal drainage tube insertion. Upon further evaluation, the primary unknown cancer was found to be of ovarian origin.
Benign ovarian tumours, Hydropneumothorax, Pseudo-Meigs’ syndrome
A 62-year-old, postmenopausal female came to the hospital with chief complaints of right-sided pleuritic chest pain, shortness of breath mMRC (Modified Medical Research Council) (grade III), since one week. Patient had history of significant loss of weight and loss of appetite for the past three months. There was no history of fever, cough, wheezing and haemoptysis. There was no history of similar illness, no co-morbidities and no significant family history.
The patient was conscious, oriented, afebrile and dyspnoeic. Patient had no evidence of pallor, icterus, clubbing, pedal oedema or cyanosis. Vitals showed SpO2- 94% in room air, pulse rate- 116/min, respiratory rate- 24 cycles/min, Blood Pressure (BP)- 100/80 mm of Hg, Basal Metabolic Index (BMI)- 18 kg/m2. Examination of respiratory system showed normal vesicular breath sounds with decreased intensity in right infra-scapular and infra-axillary areas. Examination of all other systems were normal. Routine blood parameters were normal. Chest radiograph showed air-fluid level, most likely of hydropneumothorax. Computed Tomography (CT) scan of chest showed right-sided moderate hydropneumothorax with collapse of right lower lobe (Table/Fig 1).
An intercostal drainage tube was inserted in right 5th intercostal space in anterior axillary line and pleural fluid was collected and sent for analysis showed an exudative type of pleural effusion and cytology confirmed presence of malignant cells. A chest radiograph, Post chest tube insertion, showed adequate lung expansion and indwelling pleural catheter in right pleural space (Table/Fig 2)a,b. Contrast-Enhanced Computed Tomography (CECT) scan showed right lung expansion and mild pleural effusion on the right-side (Table/Fig 3). On suspicion of a carcinoma of unknown origin, a whole-body Positron Emission Tomography (PET) scan was performed which revealed an ovarian malignancy as the primary with metastasis to the pleura. Chemical pleurodesis using a sclerosing agent was performed and patient was referred to a Cancer Institute for further evaluation and management.
Malignant Pleural Effusion (MPE) is a type of exudative pleural effusion, characterised by malignant cells in pleural cavity (1). In patients with metastatic carcinoma, pleural effusion is seen in 15% of them (2),(3). MPE is most commonly associated with neoplasm of the lung. Other malignancies associated with MPE include breast cancer, ovary cancer, and lymphoma (4). Pleural cavity is the most likely extra-abdominal site for metastatic ovarian carcinoma (5).
Breathlessness, dry cough and pleuritic type of chest pain are most likely in MPE (2). Malignancies presenting with pleural effusion as the initial symptom have a good prognosis (6). The MPE is universally a bad prognostic sign, regardless of the time of formation of the pleural effusion (6). Out of all the malignancy cases in females, 2.5% are cases of ovarian carcinoma and have a poor prognosis (7).
Pleural effusion associated with positive cytology is considered as stage FIGO IVA (International Federation of Gynaecology and Obstetrics) (8). The five year overall survival for patients with localised disease is 92%, whereas patients with a FIGO stage IV disease have an overall survival of less than 20% (8). The most common peritoneal manifestation of epithelial ovarian carcinoma is MPE (8). Spread of neoplastic cells from ovarian carcinoma to the interpleural space occurs along the diaphragmatic, pleuroperitoneal or haematogenous route (9). A 70% of all ovarian carcinoma is diagnosed at a late stage (FIGO III or IV) (10). In 15% of newly diagnosed patients, MPE is the first clinical sign of disease and therefore, clinicians must pay attention to typical symptoms of MPE in all ovarian carcinoma patients (9). MPE in ovarian carcinoma presents in 77% of cases ipsilaterally and in 23% bilaterally (9). Common for ovarian carcinoma in comparison with other cancers are elevated values of CA-125 and CA-15-3 (Cancer Antigen) markers (9).
Meigs’ syndrome is characterised by the presence of ascites, pleural effusion along with a benign ovarian tumour and excision of the mass helps in resolution of symptoms (11). Benign ovarian cysts and metastatic tumours with ovarian spread associated with hydrothorax and ascites is called Pseudo-Meigs’ syndrome (12). In females, ovarian malignancy can be a diagnosis when associated with increased CA-125 levels and ascites. Ultrasonography of abdomen and pelvis reveals the presence of a well circumscribed tumour along with fluid in pleural cavity and peritoneal cavity. Histological confirmation along with resolution of symptoms after surgical intervention confirms the diagnosis.
Hysterectomy with salpingo-oophorectomy is the procedure of choice in such cases (13). The index patient had ovarian carcinoma which manifested as unilateral hydropneumothorax and significant weight loss without ascites. The present case places an emphasis on the early recognition of Meigs’ syndrome, even with a rare presentation.
During dissemination of tumour foci from the ovary, right-sided MPE is more likely (14). Thus, the present case shows a unique presentation of ovarian cancer with hydropneumothorax involving the right hemithorax. The tumour origin in the present case was detected by PET-CT scan (15). In patients with ascites, a detectable pelvic mass and pleural effusion, rule out Meigs’ syndrome, which mostly cause benign gynaecological tumours. Rarely, ovarian metastases can occur from primaries of gastric, colorectal or breast (Krukenberg tumours) and can produce Pseudo-Meigs’ syndrome, in which the symptoms resolve after surgical resection of the ovarian masses (16).
The malignant cells from the ovary may have metastasised to pleura directly through the blood stream, leading to pleural effusion without ascites, making our diagnosis difficult. Thoracoscopic visualisation of pleura might have helped in early detection. Therefore, in cases of carcinoma of unknown origin with MPE, thoracoscopic evaluation should be done if patients are willing and if the facility is available.
The present case emphasises the need for suspicion of ovarian malignancy in an unexplained exudative pleural effusion associated with pneumothorax with no associated ascites. Thus, prompt diagnosis in MPE to prevent further complications and metastasis. Investigations like PET-CT should be done at initial stages to confirm primary malignancy.
DOI: 10.7860/JCDR/2023/59184.17686
Date of Submission: Aug 12, 2022
Date of Peer Review: Oct 01, 2022
Date of Acceptance: Dec 02, 2022
Date of Publishing: Mar 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: Aug 13, 2022
• Manual Googling: Oct 25, 2022
• iThenticate Software: Nov 11, 2022 (13%)
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