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
Diabetic Mastopathy Mimicking Malignancy: A Surgical Perspective on Diagnosis and Management
Correspondence Address :
Dr. Imran Thariq Ajmal,
Professor, Department of General Surgery, Chettinad Hospital and Research Institute, Kelambakkam, Tamil Nadu, India.
E-mail: drnandy97@gmail.com
Diabetic Mastopathy (DMP) is an uncommon benign fibroinflammatory condition of the breast, predominantly seen in individuals with long-standing diabetes mellitus. It often mimics malignancy on clinical and radiological examination, leading to diagnostic uncertainty. DMP accounts for 0.5-13.5% of all benign breast lesions. Here, authors present the case of a 48-year-old postmenopausal female who presented with complaints of serous, cheesy discharge of minimal quantity from the right nipple, intermittently for the past 10 years, along with pain over the right breast for the last four weeks. Clinical evaluation revealed a firm, tender subareolar mass with nipple-areola distortion and cheesy discharge. Imaging via sonomammography revealed a Breast Imaging Reporting and Data System 3 (BIRADS 3) hypoechoic lesion with cystic areas and ductal dilatation. A wide local excision, including the removal of the distorted nipple-areola complex, was performed. Gross and histopathological examination showed fibrocystic changes with dense fibrous stroma, lymphoplasmacytic infiltration and giant cells, consistent with DMP. Close clinical follow-up is essential. Heightened clinical awareness and individualised treatment strategies can help minimise unnecessary surgeries while ensuring patient safety and reassurance.
Benign breast disease, Case report, Lymphoplasmacytic infiltration, Recurrence, Wide local excision
A 48-year-old postmenopausal female presented with complaints of serous, cheesy discharge of minimal quantity from the right nipple, intermittently over the past 10 years and pain in the right breast for the last four weeks. She was diagnosed with type 2 diabetes mellitus three years prior and was being treated with insulin and Oral Hypoglycaemic Agents (OHAs). Her HbA1c level was 9.2%, indicating poor glycaemic control. Autoimmune markers, including anti-GAD (anti-glutamic acid decarboxylase), were positive. She also had a six-year history of hypertension and was on regular medications. Additionally, she had hypothyroidism and was on T. Thyroxine 25 μg once daily. She had a history of ischaemic heart disease and attained menopause five years ago. Her obstetric history included one pregnancy, one live birth, a full-term, Lower Segment Caesarean Section (LSCS), with the last childbirth occurring 26 years ago. There were no other significant symptoms besides the breast symptoms.
Her mother was known to have had carcinoma of the esophagus, but details were not available. There was no significant family history of breast carcinoma or other autoimmune diseases. The patient had not sought medical consultation for her breast symptoms in the past due to hesitance in going to the hospital.
On clinical examination, a firm, tender lump measuring 5×3 cm was palpable just below the right nipple, with distortion of the nipple-areola complex (Table/Fig 1). A thick, minimal, cheesy discharge was expressed upon gentle pressure. The skin was free and mobile, with no fixity and no axillary lymphadenopathy was noted. The left breast was unremarkable. Sonomammography showed a BIRADS 3 hypoechoic lesion with tiny cystic components in the outer quadrant of the right breast (Table/Fig 2), (Table/Fig 3). Dilated subareolar ducts with non mobile luminal material were noted, causing retraction of the nipple. Magnetic Resonance Imaging (MRI) was not performed due to the patient’s unwillingness.
The patient underwent wide local excision of the lump, including the distorted nipple-areola complex, under general anaesthesia. Intraoperatively, a firm, fibrotic mass was observed, adherent to surrounding ducts (Table/Fig 4), (Table/Fig 5). No axillary dissection was performed due to the absence of lymphadenopathy. The patient tolerated the procedure well. Postoperatively, she was treated with intravenous fluids, analgesics and proton pump inhibitors. She was discharged on postoperative day 5 with no complications. The patient was placed on a six-monthly ultrasound follow-up with no suspicious features of malignancy noted.
A wide local excision specimen was received, comprising a right breast lump along with an elliptical portion of overlying skin and nipple, measuring 8.0×6.0×2.5 cm. The skin and nipple appeared grossly unremarkable. Upon sectioning, a well-defined lump measuring 5.0×4.0 cm was identified. The cut surface revealed a grayish-white area interspersed with multiple unilocular, thick-walled cysts containing blood-stained purulent material. The remaining breast parenchyma and adjacent fatty tissue appeared grossly unremarkable.
Histological examination of multiple sections from the lump, including solid and cystic areas, revealed features of fibrocystic changes with apocrine metaplasia and many ducts contained eosinophilic secretions. Additionally, there were moderate to dense infiltrates of mature lymphocytes in periductal, perilobular and perivascular areas, accompanied by occasional plasma cells, keloid-like fibrosis and epithelioid myofibroblasts. The cyst wall was composed of fibro-collagenous tissue, densely infiltrated by polymorphonuclear cells, lymphocytes, plasma cells and a few multinucleated foreign body-type giant cells (Table/Fig 6). Sections from the surrounding adipose tissue were unremarkable and no pathological changes were identified in the skin or nipple; specifically, there was no evidence of Paget’s disease or epithelial atypia. Special stains for acid-fast bacilli and fungal organisms were negative. No evidence of malignancy was identified in the examined material.
DMP is a rare fibroinflammatory condition of the breast, a complication of diabetes mellitus that mimics malignant processes but is neither premalignant nor malignant in nature (1), accounting for 0.5-13.5% of benign breast lesions (2). It is most commonly observed in premenopausal or perimenopausal women with long-standing type 1 diabetes mellitus, although it has also been reported in type 2 diabetics and even in males. The pathogenesis of DMP remains unclear but is believed to involve chronic hyperglycaemia, insulin resistance, autoimmune responses and connective tissue remodeling (3). It might be due to biochemical alterations in the extracellular matrix resulting from prolonged hyperglycaemia, leading to dense fibrotic stroma (3).
Tomaszewski JE et al., identified specific microscopic features (4), such as epithelioid cells within the fibrous stroma, particularly associated with Insulin-dependent Diabetes Mellitus (IDDM). Seidman JD et al., later elaborated on diagnostic criteria, highlighting keloid-like fibrous stroma, increased stromal spindle cell density and clustered mature lymphocytes around small blood vessels, lobules and ducts (5). Clinically, patients present with a painless or tender breast mass, often raising concern for malignancy. Discharge, as seen in this case, though uncommon, may be present. Imaging findings are non specific. Mammography often shows dense breast tissue, while ultrasound may reveal hypoechoic masses with posterior shadowing (6). MRI may help delineate the extent of the lesion, but it is not pathognomonic (7). Definitive diagnosis requires histopathological confirmation. Fine Needle Aspiration Cytology (FNAC) is usually non diagnostic due to dense fibrosis (8). Core needle or excisional biopsy is preferred.
Management is typically conservative, with surgery reserved for diagnostic confirmation or symptomatic relief. The recurrence rate ranges from 40-75%, with potential for bilateral involvement (9). Therefore, close clinical follow-up is essential. A six-monthly sonomammogram for the first year postsurgical excision, followed by annual follow-up, is necessary. Differential diagnoses include breast carcinoma, fibrocystic changes, duct ectasia and chronic abscess (10). A summary of a few similar cases is presented in (Table/Fig 7) (11),(12),(13),(14),(15).
This case underscores the importance of considering DMP in the differential diagnosis of suspicious breast lesions in diabetic patients. Histopathological examination is essential for diagnosis. Although benign, its clinical and radiological overlap with malignancy may lead to overtreatment. Long-term surveillance is recommended due to the risk of recurrence.
DOI: 10.7860/JCDR/2025/79135.21450
Date of Submission: Mar 07, 2025
Date of Peer Review: Jun 24, 2025
Date of Acceptance: Aug 11, 2025
Date of Publishing: Sep 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: Mar 21, 2025
• Manual Googling: Aug 07, 2025
• iThenticate Software: Aug 09, 2025 (4%)
ETYMOLOGY: Author Origin
EMENDATIONS: 7
- 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