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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 report
Full Version
Lobular Capillary Haemangioma in the Anterior Maxillary Gingiva of a Six-year-old Patient: A Case Report
Correspondence Address :
Dr. Ganesh Jeevanandan,
Reader, Department of Saveetha Dental College and Hospitals, 162, Poonamallee High Road, Velappanchavadi, Chennai-600077, Tamil Nadu, India.
E-mail: helloganz@gmail.com
Haemangiomas are benign proliferative tumours with vascular tissue origin. These neoplasms are recognised as benign tumours commonly found in infancy, characterised by a period of rapid growth accompanied by proliferation of endothelial cells, followed by gradual involution. The male to female ratio is observed to be 3:1, with a predominant impact on the female population, particularly during the early stages of their second decade of life. The diameter of the lesion spans from a few millimeters to several centimeters, with rare instances exceeding 2.5 cm. The present case report details the occurrence of Lobular Capillary Haemangioma (LCH) in a young male patient of six years, who exhibited gingival overgrowth in the anterior maxillary region. The patient presented with symptoms of discomfort during mastication, occlusal interference, and excessive hemorrhage during oral hygiene practices. Due to the lesion’s extensive blood supply and the confirmation of the diagnosis in the histology report, it was surgically removed in a single session while the patient was under conscious anaesthesia. The patient underwent a thorough six-month follow-up examination, which demonstrated a favourable outcome with no evidence of lesion recurrence. Although haemangiomas are prevalent soft tissue tumours in the head and neck region, they are infrequently found in the oral cavity and rarely encountered by doctors. Intraoral haemangiomas most commonly occur in the lips, tongue, buccal mucosa, and palate. However, this case report describes a rare occurrence in the maxillary anterior site, which has limited documentation. The treatment involved the use of monopolar cautery, which effectively reduced bleeding at the surgical site after the use of a scalpel. The purpose of present case report is to report an unusual case of a benign tumour occurring in the anterior maxillary region, which was diagnosed as LCH.
Infancy, Paediatric surgery, Pyogenic granuloma, Rare tumour
A six-year-old male child with a reddish lesion near his upper front tooth for the past 20 days visited the Department of Pedodontics and Preventive Dentistry. After getting the patient’s history, the parent revealed that the patient had previously had damage around his upper front teeth one month ago when he was playing and fell down. His right central deciduous tooth (51) was avulsed upon the fall, and his left central deciduous tooth (61) was mobile and avulsed after three days. A lesion, large enough to obstruct his usual occlusion, had started as a little red spot in the same region and gradually grew until it reached its current size. The past medical history was non contributory.
On clinical evaluation, no significant extraoral findings were noticed. Intraoral examination revealed a solitary, pedunculated erythematous exophytic growth measuring 2 cm arising from the 21 region fully and 11 region partially (Table/Fig 1). The growth was above the level of occlusion, and the borders were distinct.
The lesion was soft in consistency, non tender with a pedunculated base, and slight bleeding on palpation. Based on the history and clinical appearance, a provisional diagnosis of Pyogenic Granuloma (PG) was made. The differential diagnosis included various types of haemangiomas, such as cavernous haemangioma or infantile haemangioma, although they differ in their histological and clinical appearance.
An Intraoral Periapical Radiograph (IOPAR) revealed an ill-defined radio-opaque shadow in the maxillary anterior region of 11,21 (Table/Fig 2). The radiograph showed no displacement of the tooth. None of the teeth showed root resorption. The Orthopantomogram (OPG) revealed developing roots in relation to 11 and 21 (Table/Fig 3)
Blood investigations: The blood reports were normal with a haemoglobin value of 13.2 gm/dL, platelet count of 3.72 lacs/uL, and bleeding time and clotting time of two minutes 35 seconds and nine minutes 10 seconds. The patient tested negative for Human Immunodeficiency Virus (HIV), and Hepatitis C Virus (HCV) and Hepatitis B surface Antigen (HBsAG).
Treatment: The treatment plan was to remove the lesion under conscious sedation using a scalpel and monopolar cautery. Treatment began with the parents’ informed permission after they were educated about the condition, possible side-effects, and benefits and drawbacks of the suggested course of therapy. The afflicted area was cleaned and irrigated, and oral prophylaxis was carried out to lessen the irritation surrounding the lesion. The patient was treated under conscious sedation, the lesion was surgically removed after an evaluation of the patient’s general health and suitability for the treatment. The erythematous growth was first cut with a surgical blade, bleeding was stopped with monopolar electrocautery, and a haemostatic agent (gel foam) was kept on hand because bleeding was anticipated due to the vascular lesion (Table/Fig 4),(Table/Fig 5). Without any suturing, the lesion was fully removed from the base (Table/Fig 6). The surgical site began to recover after a full day.
The excised lesion was stored in a 10% neutral buffered formalin solution (Table/Fig 7) and was sent for histopathological investigation. Multiple Haematoxylin and Eosin (H&E) stained sections showed fibrous connective tissue stroma with small to large endothelium-lined capillary spaces admixed with a few areas of proliferating bland spindle-shaped endothelial cells, some of which showed evidence of lumina formation. The intervening stroma is myxomatous in a few areas and shows a moderate inflammatory cell infiltrate. The overlying parakeratinised stratified squamous epithelium showed areas of ulceration replaced by a fibrinopurulent membrane. Clinically correlating, histopathology was suggestive of LCH (Table/Fig 8)a,b.
The patient was advised not to touch the surgical site, brush or gargle vigorously, or consume hot meals or liquids. The patient was followed-up every month for six months to check for recurrences, and after six months following surgery, no erythematous growth was visible (Table/Fig 9).
In 1943, PG was initially reported (1). Since then, it has been described as a red-coloured, smooth, or lobulated growth that protrudes outward from the surface, often attached to a stalk-like structure or occasionally without one, and has a tendency to easily bleed (1),(2). The lesion is neither “pyogenic” (meaning it forms pus) nor is it a “granuloma” (meaning it is an organised collection of inflammatory cells belonging to the monocyte family). Therefore, the name “PG” is an inaccurate description of the lesion. Furthermore, in 1980, the name “Lobular Capillary Haemangioma” (LCH) was developed as the underlying histological counterpart of the condition (3). LCH is a non cancerous vascular tumour that develops on the skin and mucous membranes. In some cases, it may also be detected beneath the skin or within blood vessels. It can develop on its own, in areas where there has been trauma, or within capillary abnormalities (4).
A variety of synonyms are used for PG, such as LCH, granuloma pyogenicum, granuloma telangiectaticum, angiogranuloma, epulis gravidarum, and pregnancy tumour (the latter two when occurring in the gingiva during pregnancy) (5). PG has two histological variations. The first form is distinguished by the rapid growth of blood vessels structured in lobular aggregates known as LCH PG, while the second type exhibits a highly vascular proliferation that mimics granulation tissue, referred to as non LCH PG (6). Haemangiomas are a broad category of vascular developmental malformations that often affect infants and children (7). According to reports, it affects 5-10% of one-year-old children. Although just a small percentage of instances are said to be congenital, the majority of haemangiomas are not apparent at birth and develop throughout the course of the first eight weeks of life (8). Vascular abnormalities, on the other hand, are evident from birth and last a lifetime (9). Infantile haemangiomas are often divided into three categories: superficial, deep, and mixed (10). PG develops over time in response to things like hormones, trauma, and localised irritation (11). Children’s oral cavities seldom experience it, with poor dental hygiene being the main contributing reason. Trauma, however, is the primary factor in present situation (12).
In a case report published by Tedjosasongko U et al., the 10-year-old patient had a red, smooth, flat-surface papule measuring approximately three millimeters on his right upper lip. During the monitoring period, the size of the lesion increased to 7 mm within a span of four weeks. The patient’s increased mass was determined to be caused by an intensified lip-biting habit, acting as a traumatic aetiological component. Subsequently, the nodule was surgically removed under general anaesthesia (13).
The patient’s increased mass was determined to be caused by their intensified lip-biting habit, which acted as a traumatic etiological component. Subsequently, the nodule was surgically removed under general anaesthesia (13).
Rachappa MM and Triveni MN conducted a case study on a seven-year-old male child who presented with a swelling on the posterolateral aspect of the hard palate. The development exhibited remarkable expansion within a span of one week, characterised by a solitary, pedunculated, spherical-shaped reddish swelling with a well-defined border. A tentative diagnosis of PG was obtained, and it was surgically removed under local anaesthesia (14).
Surgical intervention for haemangiomas is the most widely adopted therapeutic approach and can be performed with or without vascular ligation and embolisation (15),(16). Alternative treatments, including intralesional injections of sclerosing agents, steroid therapy, interferon alpha-2b, radiation, electrocoagulation, cryosurgery, and various laser therapies like Yattrium Aluminium Garnet (YAG) and Carbondioxide (CO2) lasers, as well as embolisation, are options for cases where surgery is not suitable (15).
The differential diagnosis includes various types of haemangiomas, such as cavernous haemangioma or infantile haemangioma, although they differ in their histological and clinical appearance (17). Kaposi’s sarcoma may bear a resemblance to LCH, particularly in individuals who have Acquired Immunodeficiency Syndrome (AIDS) or other conditions that weaken their immune system (17). Angiosarcoma is a cancerous tumour that affects blood vessels and can appear similar to LCH in terms of symptoms and characteristics (8),(17). Both PG and Peripheral Giant Cell Granuloma (PGCG) exhibit comparable clinical symptoms, and the presence of chronic poor oral hygiene can trigger their development. The key distinction lies in the prominent presence of many giant cells observed during histopathological examination in cases of PGCG (18).
In present case, the lesion was present on the maxillary anterior gingiva, which is a rare location for LCH to be present. After the initial diagnosis indicated a haemangioma, leading to the selection of surgical excision as the primary treatment method, along with the use of monopolar electrocautery to control bleeding, a final diagnosis of LCH was made. Efforts to eliminate them through basic excision can result in significant medical complications. Therefore, dental surgeons should be cognizant of these hazards while diagnosing and managing patients and should take essential precautions before attempting to remove seemingly harmless lesions.
DOI: 10.7860/JCDR/2024/69900.19383
Date of Submission: Feb 06, 2024
Date of Peer Review: Mar 13, 2024
Date of Acceptance: Apr 04, 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: Feb 06, 2024
• Manual Googling: Mar 29, 2024
• iThenticate Software: Apr 01, 2024 (7%)
ETYMOLOGY: Author Origin
EMENDATIONS: 6
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