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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
Alloplastic Reconstruction in Post-ablation Oral Squamous Cell Carcinoma Surgery: A Case Report
Correspondence Address :
Dr. Tikeshwari Kailas Gurav,
Assistant Resident, Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institue of Higher Education and Research, Wardha-442001, Maharashtra, India.
E-mail: tikeshtg99@gmail.com
Surgical management of Oral Squamous Cell Carcinoma (OSCC) leads to ablative defects. There are various reconstructive options for these defects, such as autogenous grafts from the patient, including local flaps, regional flaps and distant flaps. Harvesting these flaps to reconstruct the defects can cause a significant amount of morbidity. The use of alloplasts in the reconstruction of the head and neck can reduce this morbidity at the donor site and decrease the surgical time required for flap harvesting. The present case of a 45-year-old female patient presented a microinvasive squamous cell carcinoma in whom an alloplast was used to restore the ablative defect following excision. This case report demonstrates the innovative application of alloplastic materials in surgery, eliminating the need for harvesting autologous grafts and minimising pain, recovery time and complications for patients postsurgery. This method reduces operating time, enhances patient outcomes and is flexible enough to meet various clinical requirements. The present case study highlights the challenges of restoring shape and function while considering aesthetic concerns by examining a cutting-edge alloplastic reconstruction procedure used in a patient following OSCC ablation. The surgical technique, materials utilised and results obtained after surgery are described herein, illustrating how alloplastic techniques can successfully overcome the drawbacks of conventional reconstructive methods. The results suggest that, in the context of OSCC, alloplastic reconstruction can improve surgical outcomes and enhance the patient’s quality of life with proper planning and implementation. This instance emphasises the importance of customised treatment programs and the potential of advanced reconstructive methods to address the specific challenges posed by oral cavity abnormalities.
Collagen sheet, Oral cancer, Rehabilitation, Surgical treatment
A 45-year-old female patient reported to the Department of Oral and Maxillofacial Surgery. She had been experiencing swelling and pain in the lower left back area of her jaw for two months. The pain was throbbing and constant, aggravated by opening her mouth, chewing and cleaning her teeth. The patient also reported a history of a burning sensation, difficulty chewing and swallowing, difficulty opening her mouth for one month, decreased appetite, weight loss and increased salivation over the last 15 days. Additionally, the patient admitted to chewing tobacco for the past 15 years.
On general examination, the patient’s build was average. The clinical examination indicated a limited mouth opening of approximately 2.5 mm, as shown in (Table/Fig 1)a. Intraoral examination revealed a non tender lesion that was firm in consistency and indurated on palpation. It presented as a painful, whitish-coloured proliferative lesion in the left buccal mucosa in the posterior region, with a rough surface measuring approximately 2.5×2 cm, as shown in (Table/Fig 1)b. Widespread oedema was observed on the left side of the face. Lymph node examination revealed a palpable left submandibular lymph node that was non tender, approximately 1 cm in size, roughly oval and mobile. The differential diagnosis included leukoplakia, erythroplakia, leukoedema and oral lichen planus. The provisional diagnosis was squamous cell carcinoma.
The patient underwent Contrast Enhanced Computed Tomography (CECT) of the head and neck, as well as high-resolution Computed Tomography (CT) of the thorax for metastatic work-up. The CECT showed an area of increased density on the left side of the lingual aspect of the mandible (Table/Fig 2). Radiographic findings confirmed an area of increased density on the left side of the lingual aspect of the mandible. An incisional biopsy was performed, during which a small piece of tissue was removed from the suspicious area for examination. The removed tissue was then sent for histopathological examination. The histopathological examination of the biopsy sample indicated microinvasive squamous cell carcinoma with a Depth of Invasion (DOI) of 3 mm and negative lymphovascular, perineural and muscle invasion. The tumour grading was Tumour stage 1, Lymph node 0, Metastasis nil (pT1N0Mx). Clinical, radiographic and histopathological tests confirmed the diagnosis of microinvasive squamous cell carcinoma.
After assessing the extent of the lesion on the CT scan, the plan was to perform surgical excision of the defect followed by alloplastic reconstruction. After inducing general anaesthesia through nasoendotracheal intubation, a wide local excision of the lesion from the left buccal mucosa, with a 1 cm margin, was carried out. Selective radical neck dissection was performed, as shown in (Table/Fig 3), followed by reconstruction with a buccal fat pad and collagen sheet.
The defect reconstruction was accomplished with a sterile meshed wet collagen sheet (ColloSkin®), as shown in (Table/Fig 4). After surgery, the patient received intravenous antibiotics and analgesics for five days before being discharged. On the seventh day of follow-up, the patient had adequate mouth opening and the collagen sheet had adapted well to the defect area intraorally. According to the surgical margin report, which was discussed in the multidisciplinary tumour board panel-including an oral oncologist, medical oncologist, radiation oncologist, surgical oncologist and pathologist-the staging of the tumour was Stage 1 (pT1N0Mx), with a DOI of 3 mm. Therefore, the patient did not receive any adjuvant therapy and was advised to have regular follow-ups. After one year of follow-up, the patient had no other primary lesions and the collagen sheet was well integrated into the defect (Table/Fig 5). The patient is healthy, disease-free, has adequate mouth opening and can perform everyday activities comfortably.
Oral cancer ranks as the eleventh most common cancer globally (1). OSCC accounts for about 90% of all oral cancers (2). It generally develops from the mucosal lining of the oral cavity and is linked to tobacco use, alcohol intake and Human Papillomavirus (HPV) infection (3). Clinically, carcinomas of the oral cavity present with ulceration, swelling, loose teeth and other symptoms (3),(4). Common therapies for OSCC include surgical excision and radical neck dissection, especially in cases of lymph node metastases (5).
For the restoration of aesthetics and function, reconstruction is critical following surgical intervention (2). Reconstruction aims to restore function, cervicofacial symmetry and form, creating a barrier between cavities in the head and neck (3). The type of reconstruction is determined by tumour size and location, the extent of tissue removal and the patient’s overall health. Reconstruction is typically performed using autogenous grafts, which can include local flaps such as the buccal fat pad, tongue flap and palatal flap, as well as regional flaps like the pectoralis major myocutaneous flap and deltopectoral flap, or distant flaps such as the radial forearm free flap, free fibula flap and anterolateral free flap, depending on the defect’s requirements (5). However, autogenous grafts have disadvantages, such as the need for a second surgical procedure, procurement morbidity, donor site pain and limited availability (4),(5).
Allografts are tissue grafts harvested from donors of the same species but genetically different from the recipient. They are treated to minimise the risk of rejection while maintaining the structural integrity and properties of the tissue for reconstruction (6). Allografts come in different types based on the defect to be reconstructed, including cortical bone allografts, cancellous bone allografts, dermal allografts, fascia allografts, cartilage allografts and vascularised allografts (7). Allografts are osteoconductive and osteoinductive, which avoids the need for a second procedure and provides rapid structural support. However, there are some disadvantages to allografts, such as the potential to trigger an immunological response, although the risk of contracting a disease is limited (8).
For the reconstruction of ablative soft-tissue defects in excised areas of OSCC, dermal allografts, fascia allografts, amniotic membrane allografts, collagen membranes, tendon allografts and ligament allografts can be used as needed (8). The present paper presents a case of OSCC in which an allograft was used to reconstruct the ablative soft-tissue defect.
Allografts are easily obtained from tissue banks, avoiding the need for a second surgical site and shortening the surgery time. This reduces postoperative pain and complications. Colloskin is sterile collagen in sheet form derived from a bovine source. The use of Colloskin has been widely accepted for biological wound dressing, especially for burns. It is designed to imitate the qualities of real skin and is commonly utilised in various therapeutic applications, including burn therapy and surgical reconstruction (9). However, availability may vary depending on the region and specific medical supply providers. Complications such as infection, rejection and allergic reactions are reduced when autologous tissue is used. Revision surgery, wound care and reconstruction are just a few of the applications for collagen. By providing long-term stability and coverage, the graft can lessen the need for subsequent treatments (10).
Collagen sheets were utilised in the aforementioned instance, particularly for wound healing and tissue regeneration after surgical resection. Collagen sheets can be used in various medical applications, including creating scaffolds that provide temporary support while the body regenerates new cells during the healing process. Their use aids both bone regeneration and wound healing (11). Collagen sheets act as a barrier, shielding wounds from external contaminants, such as bacteria (12). They maintain a moist environment, which is essential for proper wound healing. Moist conditions promote cell migration, angiogenesis (the formation of new blood vessels) and collagen synthesis (13),(14).
Surgery is the primary treatment option for non metastatic OSCC and less invasive curative surgical approaches are preferred in the early stages of the disease to reduce surgical-related morbidity. Adjuvant radiation therapy or chemoradiation is frequently used for patients with a high risk of recurrence (14). Regular check-ups are required to monitor for recurrence or new tumours. Early detection is crucial for improving outcomes for patients with OSCC. In the present case, a selective radical neck dissection on the left side was performed under general anaesthesia, followed by reconstruction with a buccal fat pad and a collagen sheet.
Nataraj S et al., conducted a study in which collagen was used to cover surgical defects of Oral Submucous Fibrosis (OSMF) in 15 cases, while a buccal pad of fat was used in the remaining 15 cases (15). They discovered that, while not statistically significant, the use of a collagen membrane after fibrotic band excision in managing OSMF resulted in better postoperative mouth opening, as observed in a 6-month follow-up. In a similar study, Pradhan H et al., found that the surgical group had better mouth opening with an insignificant difference in postsurgical morbidity and higher grades of surgical convenience when using a collagen sheet as a wound dressing material compared to buccal pads of fat (16). Raghavendra Reddy Y et al., reported good results in OSMF cases when they impregnated dexamethasone into the collagen graft after fibrous band excision (17).
The OSCC is a life-threatening disease. Early diagnosis can aid in prompt patient care, extending the patient’s life. When it comes to head and neck cancers, surgery is still the standard of care. However, it causes significant morbidity for the patient; after resection of the lesion, reconstruction is done with flaps, which can damage the donor site. This morbidity can be reduced by using an alloplast, as it avoids considerable complications for the patient. Different alloplasts are available that are specific to the requirements of the defect. The present case report describes how a patient with OSCC was successfully treated surgically using a collagen sheet. Overall, the present case contributes to the current body of research on OSCC and enhances the authors understanding of its management and consequences.
DOI: 10.7860/JCDR/2025/73359.20673
Date of Submission: Jun 07, 2024
Date of Peer Review: Jul 11, 2024
Date of Acceptance: Dec 02, 2024
Date of Publishing: Mar 01, 2025
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: Jun 08, 2024
• Manual Googling: Aug 30, 2024
• iThenticate Software: Nov 30, 2024 (17%)
ETYMOLOGY: Author Origin
EMENDATIONS: 10
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
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