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
A Case of Persistent Headache Leading to Diagnosis of Lung Adenocarcinoma: An Atypical Presentation
Correspondence Address :
Arun Biju,
C2 704, Mahindra Antheia, Pimpri, Pune-411018, Maharashtra, India.
E-mail: arunbiju3010@gmail.com
Lung adenocarcinoma is a primary type of lung cancer and is classified as a non small cell lung carcinoma. Headache is a rare presentation of lung carcinoma. This case report found that early diagnosis and proper treatment can improve disease outcomes. The case describes a 36-year-old woman presenting with a persistent left-sided headache and non radiating pain. Despite normal vital signs and laboratory results, an Magnetic Resonance Imaging (MRI) revealed multifocal abnormalities in the brain, suggesting neoplastic metastasis. Further investigations, including Computed Tomography (CT) scans and Positron Emission Tomography-Computed Tomography PET-CT scans, confirmed lung adenocarcinoma with metastases to the brain, bone, and liver. Histopathology revealed an invasive, moderately-differentiated adenocarcinoma. The patient was recommended palliative radiation therapy, and after compliance with treatment, she was discharged. The present case underscores the importance of thorough diagnostic evaluation in unexplained symptoms, leading to the identification of advanced-stage lung adenocarcinoma with multiple metastases.
Early diagnosis, Magnetic resonance imaging, Metastasis
A 36-year-old woman presented with a one-month history of left-sided headache, non radiating pain, and vomiting unrelated to meals. She denied chest pain, dyspnoea, or breathlessness. Vital signs were within normal limits: temperature 98°F, blood pressure 110/70 mmHg, oxygen saturation 97% on room air, respiratory rate 20 cycles per minute, and pulse rate 80 beats per minute. Serology for Hepatitis B, C, and Human Immunodeficiency Virus (HIV), as well as lipid profile, were unremarkable (Table/Fig 1). Abdominal and pelvic ultrasonography revealed no abnormalities. Neurological examination demonstrated intact higher functions and cranial nerves, normal muscle tone and strength (5/5 in all extremities), and normal reflexes. No bladder or bowel involvement was noted, and respiratory and cardiovascular examinations were unremarkable.
Given the lack of response to Non Steroidal Anti-inflammatory Drugs (NSAIDs), MRI of the brain was performed, revealing multifocal abnormalities in subcortical and cortical white matter. Contrast-enhanced MRI spectroscopy suggested metastatic neoplasia (Table/Fig 2). Chest X-ray revealed consolidation with poorly defined margins in the right upper lobe, confirmed by plain CT thorax, which also identified a lobulated soft tissue density mass with bronchial cut-off (Table/Fig 3). Pleural tags and thickening favoured a neoplastic aetiology over infection.
Whole-body PET-CT (Table/Fig 4) demonstrated lesions in the brain, lungs, liver, and left iliac bone. CT-guided biopsy of the lung lesion revealed moderately-differentiated invasive adenocarcinoma of the acinar type (Table/Fig 5).
The final diagnosis was lung adenocarcinoma with metastases to bone, brain, and liver. The patient was recommended palliative radiation therapy, initially once weekly for twelve weeks, then three times weekly for four weeks. After two weeks of treatment, she was discharged with outpatient follow-up.
The present case underscores the importance of considering atypical presentations of lung adenocarcinoma and the necessity for a comprehensive diagnostic evaluation to guide appropriate management.
Lung cancer, particularly lung adenocarcinoma, stands as the most common type of primary lung malignancy and a significant cause of cancer-related morbidity and mortality worldwide (1). Falling under Non small Cell Lung Cancer (NSCLC), lung adenocarcinoma is strongly associated with smoking habits and typically arises from mucosal glands, constituting approximately 40% of all lung cancers (2). It is noteworthy that adenocarcinoma is also the most prevalent subtype in individuals with no history of smoking. Genetic mutations within the p53 gene are the primary drivers of tumourigenesis within NSCLC, detected in nearly 52% of cases (3). Treatment options vary depending on operability, with surgical resection recommended when feasible and structured radiotherapy with adjuvant chemotherapy considered otherwise. Radiotherapy is particularly indicated in cases with a high-risk of positive lymph nodes, and neoadjuvant chemoradiation may be employed in certain cases of definitive invasive tumours before resection (1).
A notable complication of lung adenocarcinoma is its potential to metastasise to the brain, leading to neurological symptoms such as headaches. These metastatic brain lesions can present with symptoms like those of primary neurological disorders, including severe, persistent headaches that may not necessarily be associated with other common symptoms like vomiting (4),(5). This sets the stage for a discussion on the mechanism by which lung adenocarcinoma metastasises to the brain, contributing to the presentation of headaches and other neurological manifestations, and highlighting the intricate relationship between primary lung tumours and secondary brain involvement (6).
The patient’s presentation with a left-sided headache, non radiating and devoid of vomiting symptoms, is a common clinical complaint. In a previous review of similar cases, facial pain rather than headache is almost always unilateral and most commonly localised to the ear, jaw, and temporal region. The pain is frequently described as severe and aching and may be continuous or intermittent. This type of pain is often associated with metastatic spread from lung cancer (7). It is crucial to consider possible causes and tailor treatment accordingly. Despite normal laboratory values and vital signs, differential diagnosis such as cluster headaches, primary headache disorder, tension headaches, and sinusitis warrant consideration based on her test results. Tension headaches and migraines are prevalent conditions characterised by unilateral, non radiating pain. Unlike some other headache disorders, they do not always accompany additional symptoms, such as vomiting (2),(8),(9). Similar cases from the literature showing unusual initial manifestations of lung malignancy have been tabulated in (Table/Fig 6) (10),(11),(12),(13),(14),(15),(16).
If headaches persist or remain unresponsive to analgesic treatment, it is imperative to maintain a heightened level of suspicion for underlying conditions. In such cases, neuroimaging, such as MRI or CT scans, should be promptly considered to identify any potential intracranial abnormalities or other serious issues contributing to the patient’s symptoms. This approach ensures early detection and appropriate management of any underlying pathologies.
It is critical for healthcare providers to regularly monitor the patient’s situation and initiate thorough clinical tests to gather more data and make a proper diagnosis. Detailed medical reports, along with any recent changes or stressors in her life, can offer significant insights into the possible causes of the intense headache. The comprehensive approach to diagnosis and management is essential in optimising patient outcomes and improving overall quality of life.
The present case report of a patient with persistent headaches, unresponsive to NSAIDs, culminates in the diagnosis of lung adenocarcinoma with metastases to the bone, brain, and liver, following extensive investigations including MRI, chest X-ray, CT thorax, and PET-CT, complemented by a confirmatory CTguided biopsy. The case emphasises the critical importance of a thorough diagnostic process in the presence of non specific symptoms, showcasing the necessity of advanced imaging and histopathological confirmation in identifying underlying malignant aetiologies. It highlights the value of a multidisciplinary approach to management, focusing on tailored palliative care to enhance the patient’s quality of life in advanced disease stages. The present case serves as a poignant reminder of the need for vigilance and comprehensive evaluation in patients with atypical presentations.
DOI: 10.7860/JCDR/2024/70905.19702
Date of Submission: Apr 06, 2024
Date of Peer Review: May 07, 2024
Date of Acceptance: Jun 03, 2024
Date of Publishing: Aug 01, 2024
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: Apr 07, 2024
• Manual Googling: May 06, 2024
• iThenticate Software: Jun 01, 2024 (5%)
ETYMOLOGY: Author Origin
EMENDATIONS: 5
- 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