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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
First Branchial Cleft Sinus Mimicking an Epidermoid Inclusion Cyst: A Case Report
Correspondence Address :
Dr. Khushbu Prasad,
Junior Resident, Department of Ear, Nose and Throat, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha-442107, Maharashtra, India.
E-mail: khushbu1712prasad@gmail.com
First Branchial Cleft Anomaly (FBCA) is an uncommon congenital anomaly that may mimic other periauricular lesions. A two-year-old male child presented with a right infra-auricular pit present at birth and eight months of intermittent painful swelling with foul-smelling whitish discharge following spontaneous rupture. An examination showed a sinus tract scar. Computed Tomography (CT) sinogram demonstrated a tract extending toward the floor of the External Auditory Canal (EAC), consistent with a Type II first branchial cleft sinus. After the infection resolved, the cyst was completely resected while preserving the facial nerve. Histopathology revealed a cyst with a keratinising stratified squamous lining, lamellated keratin, and no adnexal or mesodermal structures, confirming an Epidermoid Inclusion Cyst (EIC).
Diagnostic dilemma, External auditory canal, Histopathology, Infra-auricular region, Paediatric neck mass
A two-year-old male child presented with a chief complaint of right infra-auricular swelling for the past eight months. The swelling was intermittent (on and off) in nature and associated with episodes of pain and discharge. The child had a congenital pit at the same site since birth, which remained asymptomatic initially. At around six months of age, it began discharging whitish, foul-smelling material and subsequently developed recurrent infections, each episode resolving temporarily with treatment, followed by recurrence of swelling.
The child was born full term through normal vaginal delivery without any complications. There was a small cutaneous puncture at the right infra-auricular region that was seen right after birth, but was asymptomatic in early infancy. The swelling at the same site became painful and, approximately eight months prior to presentation, ruptured spontaneously, discharging a sticky, whitish, foul-smelling, non bloody material, accompanied by local tenderness. The child was treated at a peripheral healthcare facility with antibiotics, incision and drainage, followed by serial wound dressings. The acute infection resolved following treatment; however, a chronic healed sinus tract persisted thereafter, noted from approximately one year of age.
The child was active on admission and appeared healthy, with normal growth parameters and consistent vital signs. On examination of the right infra-auricular region, there was a healed sinus opening measuring approximately 2-3 mm, with no active discharge, erythema, induration, tenderness, or local warmth (Table/Fig 1). The bilateral EACs and tympanic membranes were found to be normal and intact on otoscopic examination. Parotid gland swelling could not be palpated, and the functionality of the facial nerves was not impaired. General physical examination was unremarkable.
Laboratory investigations showed haemoglobin of 11.3 g/dL and a total leukocyte count of 6,400/cu mm; liver and kidney function tests, and urine analysis were within normal range.
The CT sinogram revealed a localised collection measuring approximately 1.9×1.4×2.8 cm in the right parotidomasseteric region, with a sinus tract extending toward the floor of the EAC over a length of approximately 2.5 cm, as shown in (Table/Fig 2)a,(Table/Fig 2)b.
The intraoperative photograph shows the exposure of the right infra-auricular and preauricular area using a preauricular incision.
The reflection of the skin and subcutaneous tissues has provided a view of the field of operation immediately adjacent to the external ear canal and ear lobe. There is a fibrous tract that is observed running parallel to the EAC, which is in line with the suspected sinus tract. There is no sign of cartilaginous attachment or middle ear communication in the surrounding soft-tissues. A close dissection was done very near the facial nerve that was detected and spared. Parotid ductal structures were not violated, and the tract was removed in totality as depicted in (Table/Fig 3).
Histopathological analysis of the resected tract showed that there was a cyst that was lined by keratinising stratified squamous epithelium that had a large amount of lamellated keratin debris (Table/Fig 4). The cyst wall was composed of fibrous stroma and a focal chronic inflammatory infiltrate. It is important to note that no adnexal structures of the skin, lymphoid tissue, or mesodermal/cartilaginous matter were detected. Such characteristics did not fit with a branchial cleft defect. The histopathology report specifically stated that no branchial cleft sinus was present, thereby favouring the diagnosis of an EIC.
The surgical wound was seen to be well approximated with existing sutures and no signs of wound gaping, active discharge, erythema, or oedema. The ear shape was maintained, and the facial nerve was not dysfunctional (Table/Fig 5).
On postoperative day 1: The patient was stable and had no complications. Postoperative day 15: Sutures were removed, and the wound had healed well. At 6-month follow-up: No recurrence, facial nerve palsy, or residual lesion.
Congenital periauricular lesions such as Preauricular Sinuses (PAS), EICs, and FBCAs present a diagnostic challenge due to their similar embryogenesis and anatomical proximity to the EAC, the parotid gland, and the facial nerve (1),(2). These lesions often present as recurrent infra-auricular or postauricular infection and discharge, which often results in late diagnosis and inappropriate recurring interventions (3).
Work WP (1972) first proposed a widely accepted diagnostic framework for FBCA, classifying them into two types based on embryological origin. Type I lesions are purely ectodermal and represent duplications of the membranous external auditory canal, typically presenting as superficial cysts or sinuses without cartilaginous components. In contrast, Type II lesions are of ectodermal and mesodermal origin and may have deeper extensions, often associated with the parotid gland, facial nerve, and cartilaginous structures, thereby posing greater surgical complexity and risk. Importantly, Work WP emphasised that these anomalies may follow variable anatomical courses, often running parallel to the external auditory canal and in close proximity to critical neurovascular structures. However, he also acknowledged that not all lesions conform strictly to this classification, highlighting inherent limitations in applying this model to atypical or overlapping presentations (4).
This diagnostic ambiguity has been further supported by subsequent studies. Choi SJ et al., (2007) described a variant type of PAS, termed the “postauricular sinus,” which accounted for approximately 10.9% of cases (5).
In a study by Dutta M et al., (2013), a total of 28 cases of epidermoid cysts were analysed. Five were female, with a male: female ratio of 4.6. The age range was two to 60 years (mean=30). Excision was the preferred treatment in 20 cases (71.4%). Various sites like the submandibular region (5), pinna (5), sublingual region (1), periorbital (6), suprasternal (6), along the anterior border of sternocleidomastoid (1) and glabella (3) were involved, along with an iatrogenic implantation epidermoid cyst in a tracheostomy scar (6).
Jain S et al., (2014) provided a vivid example of the clinical outcomes of this overlap, in which a rare Work Type II FBCA manifested as a postauricular salivary fistula. In their case, CT sialography revealed parotid duct communication, and this required superficial parotidectomy, including facial nerve dissection, and histopathology revealed ectodermal lining and salivary acini, making a true FBCA (7).
The present case shows that EICs, PAS variants, and first branchial clefts exhibit significant diagnostic overlap in children with an infraauricular sinus tract. Although clinicoradiological findings strongly suggested a Type II first-branchial cleft sinus, definitive diagnosis was established only by histopathologic analysis, which favoured an EIC.
Ethical considerations: The patient had the informed consent of his parents/guardians to be clinically evaluated, undergo surgery and have the present case report published, complete with accompanying images. The patients’ anonymity has been preserved, and no personally identifiable information has been revealed. The ethical principles that guided the research are those outlined in the Declaration of Helsinki.
The authors would like to acknowledge the Departments of Otorhinolaryngology and Pathology for assisting them with the diagnosis, surgical management, and histopathology of the case.
DOI: 10.7860/JCDR/2026/88096.24421
Date of Submission: Feb 08, 2025
Date of Peer Review: Apr 28, 2026
Date of Acceptance: Jun 17, 2026
Date of Publishing: Oct 01, 2026
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 04, 2026
• Manual Googling: Jun 13, 2026
• iThenticate Software: Jun 15, 2026 (5%)
ETYMOLOGY: Author Origin
EMENDATIONS: 6
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
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