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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
Variational Anatomy of the Segmental Branches of the Splenic Artery
Correspondence Address :
Prashant Nashiket Chaware
Assistant Professor, Anatomy Department,
Shri Vasantrao Naik Government Medical College,
Yavatmal, Maharashtra, India, pin-445001
Phone: 09822928591
E-mail: prashantnchaware@gmail.com
Background: The human spleen is highly vascular and friable and so it cannot be sutured. Total splenectomy is commonly done after a splenic injury, but it leads to a decrease in the immunity and thus it creates an altered haematological picture. To avoid this, partial splenectomy can be done by ligating a particular segmental branch of the splenic artery. So, the aim of this study was to accurately identify the segmental branches of the splenic artery.
Materials and Methods: 111 human spleens were studied. Each spleen was dissected carefully by piece-meal dissection. The splenic artery and its branches were cleaned and traced. Any variation in the form of the number of the segmental branches and intersegmental anastomosis, if present, was noted. Other branches of the splenic artery which were not supplying the spleen were not taken into consideration.
Results: The number of branches of the splenic artery which divided the spleen into arterial segments, varied between two to five. Two segmental branches were found in 13.51% specimens, three were found in 60.66% specimens, four were found in 17.11% specimens and five segmental branches were present in 2.7% of the total spleens. The parts of the spleen which were supplied by these segmental branches were separated by an a vascular zone, except in 1.80% spleens in which an inter-arterial anastomosis was found between the arteries of the adjacent segments.
Conclusion: The findings of this study are useful for surgeons, especially in partial splenectomy.
Spleen, Polar branches of splenic artery, Splenic segments, Partial splenectomy
Introduction
In humans, the spleen is the largest lymphatic organ. It is connected to the blood vascular system. It consists of a large encapsulated mass of lymphoid and vascular tissues. The blood supply to the spleen is made by a splenic artery which is a branch of the coeliac trunk (1). The human spleen is highly vascular and friable and so it cannot be sutured (2). Total splenectomy is commonly done after a splenic injury. As the spleen performs important immunological and haematological functions, total splenectomy leads to a decrease in the immunity and altered haematological features (2). To avoid this, partial splenectomy can be done (2). Kehila and Abderrahim (3) reported the practice of partial splenectomy in cases of major trauma, to perform a subtotal splenectomy after the splenic vessel ligation. The application of the conservative splenic surgery requires a detailed knowledge of the avascular plane of the spleen and its segmental pattern (4).
According to Michel (5), the splenic artery terminates by dividing into 2 or 3 terminal branches which are named as the superior, middle and the inferior primary branches. The primary branches enter the spleen through its hilum. In some spleens, the splenic artery itself or its primary branch gives an artery which does not pierce the hilum, but goes to one of the poles of the spleen. It can be named as the superior or the inferior polar branch. These branches supply a particular part of the spleen which is separated by an avascular area. Thus, these branches divide the spleen into definite arterial segments.
The aim of this study was to accurately identify the segmental branches of the splenic artery, to find the variations in the numberArticleof the segmental branches and to find out any inter-segmental anastomosis, if they were present.
This study was conducted in the Anatomy Departments of Shri Vasantrao Naik Government Medical College, Yavatmal, India and the Indira Gandhi Government Medical College, Nagpur, India. For this study, 111 human spleens of both the sexes were used. Out of the 111 spleens, only 15 spleen specimens belonged to female cadavers. As only a very less number of spleens of female cadavers were available, it was difficult to do a comparative study between the males and females. So, the spleens from both the sexes were added together and a statistical analysis was done, without considering the sexual dimorphism.
To remove the spleens from the abdominal cavity, they were detached from their various attachments and the splenic vessels were cut, a minimum of 5 cm away from the hilum of the spleen. Then, they were washed with tap water to clean the debris and the fatty tissue. In each spleen, the splenic artery and its branches were identified and cleaned. Each spleen was dissected carefully along the course of the branches of the splenic artery by a piece meal dissection. The branches of the splenic artery which did not supply the spleen were not taken into consideration. The total number of the primary and the polar branches of the splenic artery was noted. Any variations in the form of the number of segmental branches of the splenic artery and intersegmental anastomosis, if they were present between the branches of the splenic artery, were noted.
The splenic artery terminated near the hilum by dividing into two or three primary branches. Of the 111 spleens, 95[85.58%] had two primary branches (Table/Fig 1) and 16 [14.42 %] showed three primary branches (Table/Fig 2). Polar branches were seen in 92 specimens. The superior polar branch was present in 32[28.82 %] specimens (Table/Fig 3), the inferior polar branch was present in 47[42.34 %] specimens (Table/Fig 4), both the superior and inferior branches were present in 13[11.71%] specimens (Table/Fig 5), (Table/Fig 6) and no polar branch was observed in 19[17.11%] (Table/Fig 1) (Table/Fig 2) of the total spleens. Then we found out an association between the polar and the primary branches (Table/Fig 7). From this, the numbers of the segmental branches of the splenic artery were counted. From (Table/Fig 7), it becomes clear that the number of segmental branches which were present in this study were two in 15 [13.51%] cases, three in [26+44+4=74 i.e.(66.66%)], four in [6+3+10 i.e. (17.11%)] and five branches in 3(2.70%) of the total spleens. These segmental branches of the splenic artery divided the spleen into arterial segments. These segments were separated from each other by an avascular plane in all but two specimens (Table/Fig 8). In those two specimens [1.80%], an inter-arterial anastomosis was found between the arteries of the adjacent segments.
The anatomy of the segmental branches of the splenic artery is revealed better by dissection than by investigative procedures, since the complete exposure of the organ during dissection provides a ready accessibility for its detailed study.
In the present study, the primary and the polar branches of the splenic artery were observed, which divided the spleen into definite segments. Two primary branches were found in 85.58% and three primary branches were found in 14.42% specimens. Earlier, Katritsis et al (6) had found two and three primary branches in 85.70% and 14.30% specimens respectively, Gupta et al (7) found them in 84% and 16% specimens, while Michels (5) observed them in 80% and 20% specimens respectively. In other studies which were done by Mikhail et al (8) and Garcia- Lemes (9), the incidence of the primary branches was in accordance with that of the above mentioned studies. In our study, the superior polar branch was observed in 45 [32+13] i.e. in 40.53% specimens, while the inferior polar branch was observed in 60 [47+13] i.e. in 54.06% specimens. These were found in 39.77% specimens and in 55.24% specimens respectively, in the studies which were done by Garcia-Lemes (9). Thus, their findings were in accordance with those of the present study. The incidence of the superior and the inferior polar branches was 65% and 82% respectively in the study which was done by Michel (5). It was 60% and 80% respectively.
in the study which was done by Katritsis et al (6), while they were found in 24% and 62% cases respectively in the study which was done by Mikhail et al (8). Thus, the incidence of the polar branches varied in the previous studies which were done by different authors, but in all of them, the number of the segmental branches of the splenic artery ranged between two to five, which was the finding in our study also. In most of the previous studies (5),(6),(7),(8), the splenic segments were separated from each other by an avascular plane, except in the studies which were done by Garcia-Lemes (9), Manderim et al(10) and Ignjatovic et al (11), who found an arterial anastomosis between the adjacent segmental branches in 16.7%, 19.8% and in 25% of the splenic specimens respectively. Such an inter-segmental anastomosis was observed in 1.80% of the total specimens in the present study.
Though the spleen is the centre where both the B and T lymphocytes multiply and play an important role in the immune responses (12) and as it filters the unwanted elements from blood by phagocytosis (13), the importance of the spleen in protection from infection was found to be neglected and it was thought that the other lymphatic organs of the body could take over its functions. But a series of animal experiments and follow up studies of patients revealed its actual importance in protection from blood born sepsis, where its role as a blood filter was found to be very significant (14),(15). Hence, now-a-days, despite the overwhelming indications for splenectomy, the tendency of the surgeons is to conserve as much splenic tissue as possible, by removing only the affected segment of the spleen. For this, a detailed knowledge of the segmental branches of the splenic artery is very important. Thus, from the above findings, we have concluded that the splenic artery gives primary and polar branches to the spleen. These branches divide the spleen into definite arterial segments which are separated by an avascular plane. So, they are called as segmental arteries. The number of such segmental arteries varies between2 to 5. These findings of our study will be helpful to the surgeons while they perform segmental resection of the spleen.
DOI: JCDR/2012/4146:2061
Financial OR OTHER COMPETING INTERESTS:
None.
Date of Submission: Feb 15, 2012
Date of Peer Review: Mar 04, 2012
Date of Acceptance: Mar 29, 2012
Date of Publishing: May 01, 2012
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