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
Morganella Morganii- A case of an Emerging Hurdle in the Journey of Septic Wound Healing
Correspondence Address :
Dr. Bhavna Pate,
Junior Resident, Department of Microbiology, Jawaharlal Nehru Medical College, DMIHER, Sawangi, Meghe, Wardha-442107, Maharashtra, India.
E-mail: bhavnaspate@gmail.com
Morganella morganii is a facultative gram-negative anaerobe present in the human gastrointestinal system as normal flora. Clinically, the organism is significant when it manifests as an opportunistic pathogenic infection elsewhere in the body. Morganella morganii (M. morganii) is a gram-negative bacillus found in the environment and among normal human intestinal flora. It is a well-known cause of urinary tract infections, wound infections, sepsis and other extraintestinal infections. It is also considered an opportunistic pathogen and has been known to occur in both community-acquired and nosocomial infections. The present case report depicts the outcome of wound healing in a 65-year-old, non diabetic, non hypertension male who had a history of a life-threatening necrotising soft-tissue infection in the right lower limb, which resulted in an infected ulcer due to M. morganii as the responsible pathogen. After proper diagnosis of the aetiologic pathogen as M. morganii, following pus and tissue culture and sensitivity tests from the infected wound, and after appropriate management with local wound care and antibiotics, there was early recovery, less morbidity, and an improved quality of life.
Anaerobic infection, Cellulitis, Debridement, Drug resistance
A 65-year-old male presented to the Outpatient Department with a chief complaint of a non healing ulcer on the right foot, extending over the ankle for a period of one year. The patient had been treated by a local practitioner with local wound care, along with intermittent and irregular oral medications for a necrotising soft-tissue infection. The patient was non diabetic, non hypertension, and had no other co-morbid conditions. There was no significant history suggestive of arterial or venous insufficiency. The patient had a surgical history of cellulitis debridement of the same foot three years ago, with no other associated co-morbidities. There was no significant family history.
Local examination revealed an irregular ulcer with approximate dimensions of 25 cm by 10 cm, located on the dorsum of the foot and extending over the ankle region (Table/Fig 1)a,b.
The ulcer floor was covered with slough and had a foul-smelling purulent discharge. Upon examination, the patient’s vitals were stable. Biochemical parameters indicated a hemoglobin level of 9.6 g/dL and elevated C-reactive Protein (CRP). The rest of the parameters were within normal limits (Table/Fig 2).
Radiological imaging of the right foot suggested no bony abnormality. The arterial and venous Doppler of the right lower limb was normal. The patient was hemodynamically stable, with no other systemic manifestations. The final diagnosis concluded a traumatic ulcer over the right lower limb. A wound swab from the patient was sent for a culture report, which suspected M. morganii (Table/Fig 3).
The final causative agent was reported as M. morganii infection by the VITEK® system. The antibiotic sensitivity profile indicated that the sample isolate was sensitive to ceftazidime, imipenem and amikacin, as determined by the Kirby-Bauer disk diffusion method. The drug sensitivity pattern of the sample was confirmed via the VITEK® machine before the initiation of medical management. The patient was started on injection ceftazidime (1 gm intravenous, three times a day for seven days) and injection amikacin (750 mg once daily for seven days). Along with the systemic therapy, local care of the wound was carried out by debridement at regular intervals, along with supportive care. After seven days, tablet cefpodoxime proxetil was started at a dose of 200 mg orally (twice daily) for 14 days. The patient responded well to the management regime and was found to be recovering well. After local infection control of the wound, the patient was subjected to negative pressure wound therapy, which further aided in recovery (Table/Fig 4).
Morganella morganii (M. morganii), also known as Proteus morganii, is a part of the common human microbiota. It is a rod-shaped, gram-negative facultative anaerobe. It has been reported as a cause of nosocomial infections, especially in postoperative recovery, where patients are vulnerable. M. morganii has been noted as a potentially fatal systemic infection in patients with compromised immune systems and in children (1).
Morganella morganii has been reported to have developed resistance against antibiotics such as penicillin and cephalosporin, which is attributed to the blaAmpC gene (2),(3). It is usually isolated from urinary tracts and wounds of patients with nosocomial infections. In recent times, infections caused by M. morganii have been on the rise in the skin and soft-tissues, making it a common infectious agent for bloodstream infections. Skin and soft-tissues have been observed as the most common infection foci (3),(4),(5).
M. morganii infections of the bloodstream have also included polymicrobial infections, which are mainly associated with Klebsiella pneumoniae, Proteus mirabilis, Escherichia coli, and Pseudomonas aeruginosa (3).
Antibiotic resistance has been observed to increase, and it has been termed the next ‘superbug’ (6). M. morganii has been studied extensively for antibiotic resistance and some genetic elements such as mcr, MMG1-4, dfrA15, dfrA24, Tn7376, tetA, bla variants, and others (3),(7),(8),(9). M. morganii has also been reported as the main causative agent of wound infections and necrosis. It has been reported in patients with snake bites, as well (2),(3),(10). A similar observation was noted in the present case, where the wound swab reported the presence of M. morganii and Pseudomonas species. It is identified by various methods, including the study of colony morphology, VITEK® systems, biochemical tests and molecular characterisation (2).
Although different treatment modalities are available, multidrug resistance has been observed in M. morganii. This is concerning, as despite therapy, mortality is reported in 15% of the patients (2),(5). M. morganii is also observed as a major contributor to neonatal sepsis in newborns (1). Infections caused by M. morganii have been reported to be associated with severe complications such as septic arthritis (11) and have been noted to cause rapid progression of inflammation (6),(9),(12). A research study involving 75 patients showed complete resistance to cefazolin, cefuroxime and nitrofurantoin, with a majority (95%) resistant to amoxicillin/clavulanic acid. Higher sensitivity was observed for drugs such as amikacin, gentamycin, ceftazidime and ceftriaxone (12). A similar management approach using amikacin and ceftazidime was employed for this patient, which was found to be effective.
Drug-resistant M. morganii infections are common in diabetic patients, with foot ulcers being a frequent observation; however, such infections are reported rarely in non diabetic patients. Various novel approaches have been reported for the treatment of non healing ulcers in diabetic patients (13), but there is a scarcity of published data on the same in non diabetic patients. The prognosis for these types of individual or polymicrobial infections is poor in diabetic patients compared to non diabetic patients. The present case report serves as an example of that. M. morganii infections, if treated timely and adequately, leads to favourable prognostic outcomes.
Morganella morganii infections have been on the rise, and there is a crucial need to monitor the incidence and resistance profile in non diabetic patients, which can aid clinicians in terms of incidence and management approaches. Timely diagnosis and drug sensitivity/resistance profiles can be helpful in the initiation of treatment and benefit the patient with a faster recovery. Future research and additional aetiological data are needed to combat this issue in a timely manner to prevent irreversible loss to the patient.
DOI: 10.7860/JCDR/2025/73742.20570
Date of Submission: Jun 22, 2024
Date of Peer Review: Aug 10, 2024
Date of Acceptance: Dec 02, 2024
Date of Publishing: Feb 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 26, 2024
• Manual Googling: Nov 28, 2024
• iThenticate Software: Dec 30, 2024 (8%)
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