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
Multiple Anomalies in the Morphology and the Blood Supply of the Thyroid Gland: A Case Report
Correspondence Address :
Rimpi Gupta
H. No. 73/1, Azad chowk,
Ferozepur cantt. Punjab, India.
Phone: 09463872734.
E-mail: dr.rimpigupta15@gmail.com
During the routine undergraduate dissection of the thyroid gland of a 50 year old male cadaver, multiple anomalies in the morphology and the blood supply of the thyroid gland were encountered. These were in the form of the absence of the thyroid isthmus, the presence of the pyramidal lobe and levator glandulae thyroidae on the right side and the bilateral absence of the superior thyroid artery, the gland being supplied solely by the inferior thyroid arteries which came out as the branches of the thyrocervical trunk. Agenesis of the isthmus can be associated with other types of dysorganogenesis, such as the absence of a lobe or the presence of ectopic thyroid tissue and hence, in clinical practice, when such a condition is diagnosed, it is necessary to perform a differential diagnosis against other pathologies such as autonomous thyroid nodule, thyroiditis, etc. The knowledge of various developmental anomalies of the gland and the variations in the neurovascular relations helps the surgeon in the better planning of a safe and effective surgery.
Anatomy, Isthmus, Pyramidal lobe, Levator glandulae thyroidae, Superior thyroid artery
Introduction
The thyroid gland is the first endocrine gland to start developing in the embryo. It is well known for its developmental anomalies which include persistence of the pyramidal lobe, thyroglossal cysts, agenesis of the thyroid gland, agenesis of the isthmus alone or of the aberrant thyroid gland, etc (1),(2). It is a highly vascular endocrine gland which is placed anteriorly in the neck, extending from the fifth cervical to the first thoracic vertebrae. The gland is composed of two lateral lobes which are connected by a narrow median isthmus. The isthmus measures about 1.25 cm transversely as well as vertically and it is usually placed anterior to the second and the third Tracheal rings (3). The anomalies of the development of the thyroid gland distort the morphology of the gland and they may cause clinical functional disorders and various thyroid illnesses (4). The knowledge of the various developmental anomalies of the gland and the variations in the neurovascular relations will help the surgeons in the better planning of a safe and effective surgery (5).
During the routine undergraduate dissection of the thyroid gland of a 50 year old male cadaver in the Department of Anatomy, Govt. Medical college, Amritsar, India, the following anomalies were found:
• Absence of the thyroid isthmus • Presence of the right pyramidal lobe • Presence of levator glandulae thyroidae on the right side. • Bilateral absence of the superior thyroid artery, the gland being supplied solely by the inferior thyroid artery.
The right and the left lobes were lying independently on either side of the trachea. The right lobe measured 3.5cms along its anterior border and 2.2cms transversely, its apex being at the level of the lower border of the thyroid cartilage and its base being at the level of the third tracheal ring. The left lobe measured 3.0cms along its anterior border and 2.0cms transversely, its apex being at the level of the middle of the cricoid cartilage and its base being at the level of the fourth tracheal ring. The pyramidal lobe was 2.3cms long and 1.5cms wide. The length and breadth of the levator glandulae thyroidae were 3.5cms and 0.3-0.4cms respectively. It extended from the pyramidal lobe to the hyoid bone. The superior thyroid arteries were absent on both the sides. Instead, the two lobes were supplied by the inferior thyroid arteries which came out as the branches of the thyrocervical trunk on both the sides. There was no anastomosis between the two inferior thyroid arteries (See (Table/Fig 1)). There was no scar on the neck which suggested that the subject had not undergone any surgery. There was no ectopic thyroid tissue between the root of the tongue and the gland’s position.
Pastor et al (2006) (6) defined the agenesis of the thyroid isthmus as the complete and congenital absence of the thyroid isthmus. Its incidence varies between 3%–33%, as has been reported by various authors (See (Table/Fig 2).
The levator glandulae thyroidae was encountered in 49.5% of the dissections which were performed by Ranade et al, 2008 (11). According to Gregory and Guse (2007) (13), Soemmerring’s levator glandulae thyroidae is an accessory muscle which runs from the hyoid bone to insert partly on the thyroid cartilage and partly on the isthmus of the thyroid gland. Merkel (1913) (14) thought that the levator glandulae was constant and glandular, though it was usually surrounded by muscle fibres. Huschke (1845) (15) spoke of the structure only as glandular, while he mentioned nothing about the muscle (7),(8),(9),(10). Bourgery (1831) (16) described and illustrated a muscle which he called as “hyo-thyroïdien”, which occupied theplace of the pyramidal lobe. Finally, Godart (1847) (17) (12),(13) reported a case in which the structure was indeed muscular, on the basis of the nitric acid test for the muscle. Soemmerring’s muscle is the same as the hyo-thyro-glandulaire of Pointe, the levator glandulae thyroideae superficialis medius et longus of Krause (1879) (18) and the musculus thyroideus of Merkel (1913) (14); its usual full name in the literature being ‘levator glandulae thyroideae of Soemmerring’ (Table/Fig 3)(16),(17),(18),(19),(20),(21),(22).
Morrigyl and Sturm (1996) (19) reported a rare case in which both the inferior thyroid arteries and the left superior thyroid artery were absent.
All the previous researchers mentioned the individual incidence of these anomalies, but all were silent about all the variations which occurred in the same cadaver. Probably none had encountered a case with so many anomalies as was found in the present cadaver.
Ontogeny
The agenesis of the isthmus can be explained as an anomaly of the embryological development. The adult thyroid gland has two types of endocrine cells, the follicular and the parafollicular cells, which are derived from two different embryological cell families. The follicular cells come from the endodermic cells of the primitive pharynx and the parafollicular cells come from the neural crest (20). The thyroid gland begins to develop as a median thickening of the endoderm on the floor of the pharynx, between the first and the second pharyngeal pouches. This area later invaginates to form the median diverticulum, which appears in the latter half of the fourth week. This thyroid diverticulum grows in allometric proliferation, becoming a solid cellular cord which is called the thyroglossal duct. The duct grows caudally and bifurcates to give rise to the thyroid lobes and the isthmus . At the same time when its caudal growth is taking place, the cephalic end of the thyroglossal duct degenerates (21). A high division of the thyroglossal duct can generate two independent thyroid lobes with the absence of the isthmus. The absence of the isthmus can be associated with other types of dysorganogenesis, such as the absence of either lobe or the presence of ectopic thyroid tissue (22).
Phylogeny
When we trace the phylogeny, it is seen that the isthmus may be missing in amphibians, birds and among mammals- monotremes, certain marsupials, cetaceans, carnivores and rodents. In rhesus monkeys (Macacus rhesus) also, there is no isthmus (6).
Clinical significance
Clinically, the diagnosis of the agenesis of the isthmus can be made with scintigraphy, which can also be performed with an overload of TSH. The diagnosis can also be made with the aid of ultrasonography, computerized tomography (C.T.) and magnetic resonance imaging (M.R.I.) or during a surgical procedure. In asymptomatic patients with nodular goitres, fine-needle aspiration biopsies and eventually, immunohistochemistry tests are useful in supporting the medical decision, but when agenesis is present, the importance of the pre-operative differentiation between the benign and the malignant lesions is critical, considering the surgical procedure and the possibility of the impairment of the thyroid function (23). When an image of the absence of the isthmus is observed, a differential diagnosis against autonomous thyroid nodule, thyroiditis, primary carcinoma, neoplastic metastasis and infiltrative diseases such as amyloidosis should be considered (6).
The agenesis of the isthmus can be associated with other types of dysorganogenesis, such as the absence of a lobe or the presence of ectopic thyroid tissue and hence, in clinical practice, when such a condition is diagnosed, it is necessary to perform a differential diagnosis against other pathologies such as autonomous thyroid nodule, thyroiditis, etc. The surgeon who plans a thyroidectomy must be prepared to find variations like ectopic thyroid nodules around the normally-located thyroid gland. Proper identification of the vessels is very important in order to avoid major complications. Hence, a thorough knowledge of the thyroid anatomy and its associated anatomical variations is very much essential, so that these anomalies may not be overlooked in the differential diagnosis.
The thyroid gland is a highly vascular gland which is composed of two lateral lobes which are connected by a narrow median isthmus. The anomalies of the development of the thyroid gland distort the morphology of the gland and they may cause clinical functional disorders and various thyroid illnesses.
- 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