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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
Images in Medicine
Full Version
Spontaneous Subcapsular Haematoma as a Complication of Acute Pyelonephritis: Imaging Findings
Correspondence Address :
Senthil Kumar Aiyappan,
Professor and Head, Department of Radiodiagnosis, SRM Medical College Hospital and Research Centre, SRMIST, Kattankulathur, Chengalpattu-603203, Tamil Nadu, India.
E-mail: asenthilkumarpgi@gmail.com
A 70-year-old male patient presented with complaints of fever and burning micturition for the past five days associated with left loin pain and vomiting. There was no history of haematuria. The patient was a known case of diabetes and hypertension and had been on irregular treatment for the past five years. Upon examination, the patient was hemodynamically stable, and there was tenderness in the left flank region.
Routine blood and urine investigations showed a reduced haemoglobin value (10.8 g/dL), normal White Blood Cells (WBC) count (13,300 cells/μL), an elevated Glycated Haemoglobin (HbA1c) of 10.0, normal urea (94 mg/dL), and creatinine (1.1 mg/dL).
Plain and Contrast-Enhanced Computed Tomography (CECT) was done which showed an enlarged left kidney with peri-nephric inflammatory fat stranding and a subcapsular hyperdense collection. The enlarged left kidney showed multiple small irregular hypodense areas suggestive of abscesses (Table/Fig 1)a. A few of the small renal abscesses were communicating with the subcapsular haematoma in the left kidney, which measured approximately 2.7 cm in thickness (Table/Fig 1)b,c. There was mild hydroureteronephrosis due to a small 4 mm upper ureteric calculus (Table/Fig 1)d. The overall imaging findings suggested spontaneous subcapsular haematoma as a complication of acute pyelonephritis due to renal abscess rupture with an associated upper ureteric calculus.
The patient was treated with 12 units of subcutaneous insulin and intravenous injection of piperacillin and tazobactam 4.5 g four times a day for five days. The patient then underwent percutaneous drainage of the subcapsular haematoma followed by ureteroscopic retrieval of the left upper ureteric stone and Double J (DJ) stenting. A follow-up Computed Tomography (CT) was taken one month later, showing near complete resolution of the subcapsular haematoma with the DJ stent noted in situ (Table/Fig 2)a,b.
Pyelonephritis with a renal abscess that ruptures into the subcapsular space, forming a subcapsular haematoma, is a rare, life-threatening complication when left untreated. Lenk’s triad by Wunderlich, which includes tenderness, acute flank pain, and symptoms of internal bleeding, were common symptoms in spontaneous sub-capsular renal haematoma (1). The present case had acute flank pain and tenderness; however, there were no signs of internal bleeding. Complications of acute pyelonephritis include perinephric abscess, emphysematous pyelonephritis, pyonephrosis, and papillary necrosis (1),(2). However, spontaneous subcapsular haematoma is very rare. A meta-analysis showed that the most common causes of spontaneous subcapsular haematoma are tumours, which is 61.5%, followed by vascular disease at 17% and infection at 2.4%. In 6.7% of cases, it is of idiopathic aetiology (1).
The clinical presentation of these patients may vary greatly depending on the degree and duration of renal bleeding. Sudden onset of flank or upper abdominal pain, nausea and vomiting, low-grade temperature, and decreasing haemoglobin are common findings (3). In this case, although there was flank pain, there was no significant drop in haemoglobin drop. Although ultrasound can be used for diagnosis, the specificity and sensitivity depend upon the operator. CT scan has high sensitivity and specificity and can help identify the cause of the haematoma; hence it should always be done. Magnetic resonance imaging can be an alternative to CT and can be done to differentiate haematomas from tumours. Digital subtraction angiography can be used to identify vascular causes and for embolisation (3).
Bajaj T et al., reported a case of spontaneous bilateral subcapsular renal haematoma in a diabetic patient with clinical features of pyelonephritis (3). In that case, CT angiography of the abdomen and pelvis showed evidence of active arterial extravasation from the left renal artery. However, in the present case, there was no active arterial extravasation. Jankovic I et al., reported a case of spontaneous subcapsular renal haematoma as a complication of acute pyelonephritis (4). In that case, ultrasound showed globular swelling of the left kidney with a hypoechoic ovoid area involving its posterior upper pole compatible with acute focal bacterial nephritis. CT showed abnormal subcapsular soft-tissue density in the posterior pole of the left kidney, which corresponded with the density of the haematoma, similar to the present case. Kim HJ et al., reported a case of subcapsular haematoma as a complication of acute pyelonephritis in a diabetic patient with a renal abscess and upper ureteric calculus, like the present case (5).
Regarding the therapeutic approach, several authors suggest that the best method of management is non-surgical treatment, which involves percutaneous drainage of the haematoma with antibiotic coverage to treat the cause (3),(4),(5). In this case, since the patient had an upper ureteric calculus, DJ stenting with the retrieval of the calculus was done and the subcapsular haematoma was evacuated percutaneously.
In conclusion, spontaneous subcapsular haematoma is an uncommon complication of acute pyelonephritis. Clinical diagnosis is difficult unless a high index of suspicion is maintained. Therefore, once suspected, appropriate imaging studies like Ultrasound (US) or CT, or renal angiography, should be performed for early diagnosis and appropriate treatment.
Aspiration, Diabetes, Renal abscess, Ureteric calculus
DOI: 10.7860/JCDR/2024/69525.19369
Date of Submission: Jan 11, 2024
Date of Peer Review: Feb 26, 2024
Date of Acceptance: Feb 29, 2024
Date of Publishing: May 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: Jan 12, 2024
• Manual Googling: Feb 24, 2024
• iThenticate Software: Feb 27, 2024 (16%)
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