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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
Original article / research
Full Version
COVID-19 Infection in a Sickle Cell Anaemia Patient from Sudan
Correspondence Address :
Dr. Abdel Rahim Mahmoud Muddathir,
Associate Professor, Department of Medical Laboratory Technology,
Taibah University, Madina, Saudi Arabia.
E-mail: abdelrahimm@gmail.com
Sickle Cell Disease (SCD) is an inherited disorder with variable clinical presentation and low immunity. Coronavirus Disease-2019 (COVID-19) is a pandemic disease with a high-risk in chronic disease patients and older adults. SCD is widely distributed in Sudan; many SCD patients are infected with COVID-19. Despite this, no published data is available. This case report demonstrated the haematological and clinical course of a Sudanese sickle cell anaemia patient with COVID-19. A 20-year-old male patient was admitted to a hospital for 15 days. Demographic and clinical data were obtained from his medical records. A blood sample was taken at the time of admission and during hospitalisation. Tests were performed during admission, including Complete Blood Count (CBC), liver function test, renal function test, coagulation studies, viral screening, and urine general. The patient was diagnosed with COVID-19 using the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test based on the nasopharyngeal swab and COVID-19 IgG and IgM using Enzyme Linked Immunosorbent Assay (ELISA) for the previous infection. The patient received intravenous fluids, antibiotics, analgesia, oxygen supplementation, and blood transfusion two times during hospitalisation, and there was no need for Intensive Care Unit (ICU) admission. The patient’s prognosis was good; he was discharged on day 16 with no symptoms and a negative result of the COVID-19 PCR test. A severe illness was expected because he was infected twice by COVID-19, the patient showed mild clinical symptoms with a good prognosis, so further studies are required to understand COVID-19 among Sudanese SCD patients.
Coronavirus disease, Complete blood count, Haemoglobin S
A 20-year-old male reported with a chief complaint of fever, cough, and joint pain for two days. He was diagnosed with homozygous SCD two years back. He was regularly taking 5 mg of folic acid each day. He had a history of hospital admission due to painful Vaso-Occlusive Crisis (VOC) and Acute Chest Syndrome (ACS) for three-five days. He had auto-splenectomy and cholecystectomy at 13 and started taking hydroxyurea three times a week.
On day one, an investigation was performed at the hospital, including the following: Complete Blood Counts (CBC), liver function test, renal function test, and urine general. Laboratory test data included a white blood cell count of 12.99×109/μL, Hb 7.7 g/dL, HCT 18.5%, platelets 220×109 cells/mm3 with normal renal and liver function tests, and clear urine analysis. Screening tests for HBsAg, HCV, and HIV were negative.
On day two, no investigation was requested, and the patient suffered from high body temperature (37.8°C) and generalised pain. He was under treatment of ceftriaxone intravenously every 12 hours for five days. Also, he took a 500 mg paracetamol tab every six hours.
On day three, he presented a SpO2 of 86% and a temperature of 39°C. Supplemental oxygen was indicated, and he also lost both senses of smell and taste. Hence, the physician requested a nasopharyngeal swab for Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2). He also said he suffered from the same symptoms with cough and generalised pain six months ago. He did not make an investigation for COVID-19 at that time. He isolated himself at home for two weeks, took pain relievers, and did not required hospital, so COVID IgG and IgM were requested. Clinical examination showed mild hepatomegaly. The laboratory investigations asked on day three included CBC, liver profile, renal profile, C reactive protein, lactate dehydrogenase, ferritin level, and coagulation study, as shown in (Table/Fig 1), (Table/Fig 2). The laboratory investigation of the patients started to show signs of haemolysis. His haemoglobin was reduced to 2.45 g/dL, LDH level was increased from 345 to 726 U/L, and total bilirubin was raised from 2.7 to 4.3 g/dL. Also, signs of inflammation began, and his white blood cell count was 14000 cells/μL. CRP increased from 32.42 to 66.95 mg/dL, and serum ferritin was increased from 934 to 2730.4 mg/mL. Ceftriaxone and clarithromycin were given one tablet of 500 mg every 12 hours for five days.
On day 4 COVID-19 was confirmed and also there was a previous infection with COVID-19 (COVID IgG = 3.981 AU/mL [NR:0-1 AU/mL] and COVID IgM = 1.275 AU/mL [NR:0-1 AU/mL]). The coagulation study showed prolonged prothrombin time (22.9 seconds with INR 1.67), normal Activated Partial thromboplastin time, and normal TT (thrombin time). He was given heparin therapy and received two bags of whole blood transfusion, by which his haemoglobin was increased from 2.45 to 8.18 g/dL. After a blood transfusion, joint pain, dyspnoea, and haemolysis were improved. The radiographic findings showed mild cardiomegaly due to chronic anaemia; and hepatomegaly. Chest radiography was normal. He was given 500 mg vitamin C, 30 mg zinc, and 500 mg paracetamol tablets.
He stopped Oxygen supply after day seven, but the fever was continuous until day 14. He was treated with 500 mg of paracetamol twice every six hours and 500 mg of azithromycin for three days. His laboratory exams were stable, a nasopharyngeal swab for SARS-CoV-2 on day 15 was negative, and he was discharged on day 16. His haemoglobin level was 7.25 g/dL, and oxygen saturation 96% without any symptoms during discharge. One month after hospitalisation, the patient was cleared of COVID-19. His physical examination and laboratory tests were normal according to his health situation as a Sickler patient, and his haemoglobin was improved.
The patient gave written informed consent to participate in the study and to publish his clinical data.
COVID-19 (caused by SARS-CoV-2) is a pandemic viral infection disease discovered in Wuhan, China, and rapidly spread worldwide (1). Patients infected with COVID-19 suffer from various mild to severe clinical symptoms, including fever, cough, fatigue and gastrointestinal symptoms, pneumonia, acute respiratory syndrome, acute respiratory failures, sepsis, and septic shock (2). Patients with chronic diseases such as cardiovascular diseases, diabetes, respiratory diseases, chronic kidney disease, and obesity were at high-risk of developing severe COVID-19 with a bad prognosis (3).
Patients with SCD, on the other hand, are considered to be particularly at risk of COVID-19 complications by the Thalassaemia International Federation (TIF) due to a number of factors, including COVID pneumonia which can lead to acute chest syndrome, which is a significant cause of morbidity and mortality in SCD patients due to the low immunity of those patients. Medical care for sickle cell anaemia and COVID-19 infection is a difficult task (4).
SCD is widely distributed in Africa. In Sudan, SCD has a high prevalence in Western Sudan. In the Messeryia tribe, one out of every 123 children is at risk of developing SCD (5).
The outbreak of COVID-19 infected many people, including SCD patients. Many studies on sickle cell patients with COVID-19 showed mild to moderate clinical course. In the USA, four sickle cell patients with COVID-19 showed a mild clinical course with no deaths (6). In the UK, the authors reported only one death in 10 SCD patients infected with COVID-19. Five patients had mild symptoms without hospitalisation and the remaining recovered after a short period of hospitalisation (7). The French national consortium found that the clinical outcome of COVID-19 was mild in patients with SCD, especially those younger than 45 years (8).
Although Sudan had a high prevalence of SCD and COVID-19 was widespread, the haematological and clinical outcome of those patients with COVID-19 is unknown. On the other hand, there was no obvious treatment guideline for sickle cell patients with COVID-19 in Sudan. The SCD patients are treated like any patient affected with COVID-19. They are managed with painkillers such as acetaminophen and morphine in addition to intravenous antibiotics (ceftriaxone), and oral azithromycin with vitamin support like Vitamin D, C, and zinc. This case report aimed to illustrate the clinical outcome in Sudanese SCD patients with COVID-19 to put a protocol for managing and treating this condition.
The patient’s age was 20, the most affected age group, as shown in a previous study by Arlet JB et al., (8) and Ramachandran P et al., (9). The studied patient was affected by COVID-19 two times. He presented with cough and pain the first time, with loss of smell and taste. He did required hospitalisation and recovered after isolating himself at home for two weeks.
Previous literature shows that patients may have reinfection by COVID-19 due to low lymphopenia (10),(11). The patient was infected for the second time, but unfortunately, no investigation was recorded after the first infection to confirm the previous issue. He presented with joint pain, fever, cough, and loss of sensation, and he needed oxygen supplementation for the second time. This case was in accordance with Al-Ansari RY et al., who reported that all patients presented with bone pain, cough, and fever in 80%, 40%, and 40% of cases, respectively (12).
The patient received no support in the ICU, similar to that reported by Hejlbronner C et al., (13) and Beerkens F et al., (14). This indicates a milder clinical presentation of SCD with COVID-19 than previously predicted.
Arlet JB et al., reported that most sickle patients with COVID-19 infection required blood transfusion before or during admission to ICU (8). The studied patient received two whole blood bags, indicating that the blood was diluted because of the patient’s enormous intravenous fluid intake to lower his fever. The laboratory investigation of the patient had been improved with clinical enhancement; these findings were similar to Beerkens F et al., findings (14). Despite the deviation of the haematological findings from the normal range (High white blood cells, low red blood cells, Haemoglobin, and haematocrit) and also the biochemical lab tests (High total Bilirubin, Direct Bilirubin, Aspartate transaminase, C-reactive protein, and, lactate dehydrogenase level) the patient has been discharged from the hospital by the physician in charge. Because he was anaemic before as SCD patient, the Hb, RBCs, and HCT are usually low in these patients. Also, SCD patients develop haemolytic jaundice (High total Bilirubin, Direct Bilirubin) due to red cell destruction during the crisis. Also, because of infection, the inflammatory markers like C-reactive protein, LDH, and ferritin need time to get dropped down, as mentioned by his physician. According to that, patient health was not affected by the discharge.
The study patient gives good responses to medication with stable health status. The finding of this case study did not identify SCD as a risk factor for COVID 19, as shown by Abdulrahman A et al., (15). The reported case study did not differ from previous cases regarding hospitalisation time and clinical outcome. The patient presented with an excellent response to medication and stable health status.
In conclusion, the case report shows that SCD patients with COVID-19 have a favourable clinical outcome and a good prognosis. Sickle cell patients need special care, particularly among the pandemic COVID-19. Therefore, clinicians should pay attention to the SCD patients’, and a treatment protocol should be established for good prognosis and better patient management. Further studies with a large sample size will be needed to understand COVID-19 in SCD patients better.
Many thanks to Dr. Ream Elzain Abdelgadir for her valuable comments and assistance.
DOI: 10.7860/JCDR/2022/56403.16888
Date of Submission: Mar 16, 2022
Date of Peer Review: Apr 23, 2022
Date of Acceptance: Jul 25, 2022
Date of Publishing: Sep 01, 2022
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 25, 2022
• Manual Googling: Jul 21, 2022
• iThenticate Software: Aug 09, 2022 (5%)
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