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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
Pathological Portrait of a Submandibular Gland Lymphoepithelial Cyst in a Non HIV Patient: A Case Report
Correspondence Address :
Dr. Suhit Pradeep Naseri,
T18, Raaghobaji PG Boys Hostel, AVBRH Campus, Sawangi (Meghe), Wardha, Maharashtra, India.
E-mail: drsuhitnaseri@gmail.com
Lymphoepithelial Cysts (LEC) manifest as benign, unilocular to multilocular lesions predominantly in the head and neck areas. LEC typically localise in the salivary glands, with the parotid gland being more common and the submandibular gland being a rare occurrence. Additionally, they may be observed in the oral cavity, with a particular affinity for the floor of the mouth. It manifests as a painless, solitary cystic mass situated close to or within the salivary gland. It predominantly occurs in individuals infected with Human Immunodeficiency Virus (HIV). It typically arises as a consequence of lymphocyte-induced dilation of the cystic duct, and in accordance with index case, the definitive diagnosis is consistently confirmed through postoperative histopathological examination. They are infrequently observed in immunocompetent individuals and may have a connection to Sjögren’s syndrome. Numerous contemporary investigative methods are at our disposal, with Fine Needle Aspiration Cytology (FNAC) emerging as a swift diagnostic tool for promptly confirming a LEC. Additional diagnostic modalities encompass Ultrasonography (USG) and Computed Tomography (CT). The primary treatment for an LEC continues to be surgical intervention. Understanding the characteristics and behaviour of such cysts in non HIV patients is critical for accurate diagnosis, appropriate therapy, and, perhaps, enhancing the understanding of the spectrum of conditions associated with these cyst formations. Investigating LEC occurring in the rare location of the submandibular salivary gland, this work is distinctive in that it involves an immunocompetent individual. The present case is of a 42-year-old woman who elucidates the diagnostic pathway, encompassing both FNAC and histopathology.
Painless swelling, Salivary gland, Submadibular cyst
A 42-year-old female of Asian origin presented to the Outpatient Department (OPD) seeking medical assistance for a painless swelling beneath her right-sided lower jaw (Table/Fig 1). The patient noted that the swelling had gradually increased in size over the past six months, accompanied by intermittent pain while swallowing. She denied experiencing significant weight loss, fever, or other systemic symptoms. Upon extraoral examination, a soft, non tender, compressible enlargement in the right submandibular area measuring 8×6×5 cm was observed. No abnormalities were detected during the intraoral examination.
The swelling was aspirated with a fine needle, yielding a straw-coloured fluid. Smears revealed numerous lymphocytes and squamous cells dispersed in a proteinaceous background. The cytology strongly suggested a LEC. The patient underwent testing for HIV using both Enzyme-Linked Immunosorbent Assay (ELISA) and Western blot, with results indicating a negative status. Subsequently, the patient underwent complete excision of the lesion (Table/Fig 2). The postoperative period was uneventful. The excised specimen was then sent for histological analysis. Grossly, it appeared as an irregular, brownish tissue piece measuring 5×3.5×2 cm (Table/Fig 3).
Microscopically, the section revealed a cyst lined by thin stratified squamous epithelium surrounded by a dense lymphocytic infiltrate and lymphoid follicles with germinal centres (Table/Fig 4),(Table/Fig 5). There was evidence of lymphocyte infiltration in the epithelium (Table/Fig 6). As a result, the final diagnosis of LEC was made.
Bernier JL and Bhaskar SN coined the term “Lymphoepithelial Cyst” (LEC) to emphasise that the lesion is not an embryologic remnant. It is described as single or multiple cysts within lymph nodes connected with salivary glands (1). LEC, also known as branchial cysts, are most commonly found in the lateral cervical region, just below the mandibular angle and anterior to the sternocleidomastoid muscle. LECs are frequently associated with salivary glands, particularly the parotid gland, with rare occurrences in the submandibular gland. These cysts have a strong affinity for the lateral neck and are less common in the oral cavity or the parotid gland. Branchial cysts that do not involve the salivary component often develop in the lateral cervical region, including the lymph node. LECs range in size from 0.5 to 5.0 cm and can lead to significant cosmetic deformities as well as physical discomfort (2).
The LEC has been associated with HIV infection, particularly as part of the diffuse infiltrative lymphocytosis syndrome. In HIV-positive individuals, HIV-associated salivary gland illness is characterised by lymphoid hyperplasia of the parotid and sometimes submandibular glands, as well as LEC and lymphoepithelial lesions. HIV-associated salivary illness affects roughly 3-10% of HIV-positive patients. It affects individuals of all ages and genders, including children and adults. Salivary gland disorders often precede Acquired Immunodeficiency Syndrome (AIDS), serving as an early indicator of HIV infection. It is common for the condition to manifest bilaterally and exhibit a correlation with cervical lymphadenopathy (3). The primary cause of concern associated with LEC in HIV-positive individuals is progression to lymphoma (4), which makes investigations for HIV imperative, similar to the case mentioned.
LECs may co-exist with Mikulicz’s disease. Additionally, these cysts may also be observed concurrently with myoepithelial sialadenitis. In contrast, Sjögren’s syndrome involves the minor salivary glands but lacks a lymphoepithelial component. Another close differential diagnosis is that of Brachial cleft cyst, which is infrequent in the parotid (5). When comparing an HIV-infected patient to a non HIV patient, CT and Magnetic Resonance Imaging (MRI) demonstrate evidence of bilateral and multicystic lymph nodes, which could potentially be regarded as a significant radiological diagnostic indicator (5).
The treatment of LEC incorporates both conservative and surgical methods. The conservative method involves decompressing the cyst through fluid aspiration, thereby reducing the pressure. This procedure is particularly recommended for immunodeficient patients, such as those with HIV, where the potential risks associated with surgical management outweigh the benefits. Additional conservative treatments may involve external radiotherapy. However, the most efficient and effective treatment is surgical management, which includes full enucleation of the cyst as well as excision of the involved gland. Excision typically results in a complete cure for the majority of patients, with no likelihood of recurrence (6). To date, LECs have shown no recurrence or metastasis. Consequently, it is crucial to distinguish them from more aggressive lesions such as extranodal marginal zone lymphoma, Warthin tumour, and mucoepidermoid carcinoma (7).
While LECs are primarily associated with HIV infection, they can also occur in non HIV patients, albeit much less frequently. Below are a few reported LEC cases in non HIV patients (Table/Fig 7) (8),(9),(10),(11),(12),(13),(14),(15),(16). As observed, LECs are predominantly situated in the parotid gland among non HIV patients. The scarcity of submandibular occurrences emphasises the importance of considering parotid LECs, particularly in non HIV individuals presenting with swellings in that area.
LEC is traditionally associated with the parotid gland, prevalent in HIV-infected individuals, often progressing to lymphoma. This case highlights its occurrence in an atypical site-the submandibular gland-and in a non HIV-infected individual. Diagnostic methods include both surgical and conservative approaches. LECs exhibit no recurrence or metastasis. This report challenges conventional patterns, emphasising the need for comprehensive diagnostic strategies and raising awareness about LEC’s diverse presentations beyond the expected scenario.
DOI: 10.7860/JCDR/2024/68941.19363
Date of Submission: Dec 08, 2023
Date of Peer Review: Jan 21, 2024
Date of Acceptance: Feb 10, 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: Dec 09, 2023
• Manual Googling: Jan 24, 2024
• iThenticate Software: Jan 27, 2024 (13%)
ETYMOLOGY: Author Origin
EMENDATIONS: 6
- 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