Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
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Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018

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Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

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Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
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Professor and Head
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Saraswati Dental College
On Sep 2018

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Best regards,
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Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

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Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

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)
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.
On April 2011

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
On Jan 2020

Important Notice

Case report
Year : 2012 | Month : April | Volume : 6 | Issue : 2 | Page : 296 - 298

Anomaly of Coeliaco-Mesenteric Axis: A Rare Arterial Variation

Arindom Banerjee, Anirban Das Gupta, I. Anil Kumar, M. Pranay Kumar, P. Jhansi Laxmi

1. MD Anatomy, Assistant professor 2. MD Anatomy, Assistant professor 3. MD Anatomy, Assistant professor 4. M.Sc. Anatomy, Tutor 5. M.Sc. Anatomy, Tutor Konaseema Institute of Medical Sciences & Research Foundation (KIMS), Amalapuram, Andhra-pradesh

Correspondence Address :
Dr. Arindom Banerjee (MD Anatomy)
Assistant professor, Department of Anatomy,
Konasemma Institute of Medical Sciences & Research
Foundation (KIMS),
Amalapuram, Andhra Pradesh - 533201
Phone: 09966275513


While doing a routine dissection in an 85 years old cadaver, it was observed that instead of a single coeliac trunk, two trunks originated separately from the ventral aspect of the aorta, which were situated approximately 17 mm apart from each other. The proximal one which was known as the gastro splenic trunk, divided into the left gastric and the splenic arteries, whereas the distal trunk which was known as the hepato mesenteric trunk divided into the common hepatic artery and the superior mesenteric artery. The common hepatic artery ran anterior to the portal vein. This anomalous pattern conformed to the Adachi type V, which is a very rare anomaly and it could be attributed to the developmental changes which occurred in the primitive ventral splanchnic arteries. This rare anomaly could cause a catastrophe during surgical procedures, especially laparoscopic ones, if the same was not kept in mind before contemplating pre -operative investigations. So, the reporting of such a rare case is significant.


Hepato mesenteric trunk, Coeliac artery, Gastro splenic trunk, Vascular anomaly

The knowledge of the anomalous arterial branching patterns is essential from the view point of surgical anatomy, especially while contemplating hepatic and pancreatic surgeries. The coeliac trunk, the chief arterial supply for the foregut derivatives and one of the ventral branches of the abdominal aorta, usually gives origin to three branches, namely the splenic artery, the common hepatic artery and the left gastric artery. In antithesis, the superior mesenteric artery, yet another ventral branch of the abdominal aorta, supplies the midgut derivatives. Adachi (1), depending upon the patterns of ramification of the coeliac trunk, classified them into six types. According to Adachi’s classification, when the hepatic artery and the superior mesenteric artery arise from a common stump which is named as the hepato-mesenteric artery and pass anterior to the portal vein, it is referred to the type V anomaly. In his study on 252 Japanese specimens, this anomaly was reported only in 0.4% of the cases. Hence, it is a rare anomaly and its reporting becomes very significant.

Case Report

In a routine dissection of an 28-years old south Indian male, it was observed that (Table/Fig 1) two trunks arose separately from the ventral aspect of the abdominal aorta; the proximal trunk divided into the splenic artery and the left gastric artery and another trunk, approximately 17 mm distal to the previous trunk, divided into the hepatic artery and the superior mesenteric artery, namely the gastro-splenic trunk and the hepato-mesenteric trunk respectively. In our case, the gastro-splenic trunk’s diameter was measured as approximately 7 mm at its origin. The splenic artery which was recognized by its tortuous and meandering course, served as a continuation of this trunk and it arose approximately 20 mm distal to the origin of the trunk. The splenic artery, as usual, gave off several branches (Table/Fig 2) to the pancreas and divided into five terminal branches before entering the hilum of the spleen.

The left gastric artery ended by supplying the lesser curvature of the stomach. The diameter of the hepato-mesenteric trunk was approximately 9 mm and it divided into two branches at a length of approximately 20 mm distal to its origin. The common hepatic artery, after taking a supero-lateral direction, passed anterior to the portal vein and after ascending for roughly 30 mm, gave off the gastro duodenal artery and itself continued as the hepatic artery proper. The rest of the course and the branches of the hepatic artery proper were normal.


These coeliac trunk and the mesenteric artery anomalies were embryologically explained by Tandler (2), Morita (3), Sato (4) and Wustinger (5). Morita and Sato did their study on human adults, whereas Tandler did it on human embryos and Wustinger did it on sheep. While Morita cited the disappearance of the roots of the primitive ventral splanchnic arteries and their anastomoses as the reasons for this type of anomaly, Sato cited mid gut rotation with a consequential disappearance and the persistence of various anastomoses between the arteries of the right, middle and left liver rudiments as an explanation towards these type of coeliac-mesenteric variations. Our case fitted well into Morita’s hypothesis (Table/Fig 3). Disappearance of the proximal part of the 2nd and 3rd roots and the longitudinal anastomosis between them led to the formation of the gastro-splenic trunk and its branches (formed by the entire 1st root, the distal part of the 2nd root and the anastomosis between them) and the hepato-mesenteric trunk and its branches (formed by the entire 4th root, the distal part of the 3rd root and the anastomosis between them). Subsequently, the distal part of the 1st root formed the left gastric artery, the distal part of the 2nd root formed the splenic artery, the distal part of the 3rd root formed the common hepatic artery and the distal part of the 4th root formed the superior mesenteric artery. The proximal part of the 1st root and the 4th root formed the gastro-splenic trunk and the hepato-mesenteric trunk respectively.

Many previous studies have been done, based on Adachi’s classification. According to those reports, Adachi type V was found in 0.4% of 252 specimens by Adachi, in 1.9% of 107 specimens by Imakoshi (6), in 2.0% of 450 specimens by Shoumura (7) and in 0.7% of 275 specimens by Sato. A study on the coeliac artery and the superior mesenteric artery has also been done by Morita, Katsume (8), Saga (9), Kitamura (10), Kajiwara (11), Yamaki (12), Higasi (13), Tamura (14), Akira Iimura (15) and Horiguchi (16) and Yoichi Nkamura (17).

With the advances in the surgical techniques, increased concern for the post-operative cosmetic appearance and the advent of still newer horizons of treatment like laparoscopic operations, surgeons may not have the opportunity of seeing the entire surgical operative area, which necessitates well planned pre-operative investigations and an appropriate knowledge of the possible anomalies of that particular region. This will avoid or at least reduce the risk of inadvertently damaging the blood vessels, thereby preventing the conversion of a life saving operation to a life threatening one. Moreover, the knowledge on the hepatic arterial vascularization and its variations has a significant relevance in the daily practice because the classical arterial anatomy is seen only in 55-77% of the population (18),(19). Keeping these facts in view, the reporting of such a rare anomaly stands very significant.


Adachi B. A Coeliaca Arteriensystem der Japaner. Bd. II Verlag Der Kaiserlich-Japanischen. Universitant zu Kyoto 1928; 18-71.
Tandler J. Uber dieVarietaten der Arteia coeliaca and deren Entwicklung. Anat Hefte 1094; 25:473-500.
Morita M. Reports and conception of three anomalous cases of the celiac and the superior mesenteric arteries. Igaku Kenkyu 1935; 9:1993-2006.
Sato Y, Takeuchi R, Kawashuma T, et al. On the branches of the celiac trunk. J Kyorin Med Soc 1993; 24:75-92.
Wustinger J. Developmental anomaly of the hepatic artery in sheep. Folia Morphol (Warsz) 1978; 37:99-102.
Imakoshi K. Study of the celiac artery. Studies from the Anatomical Department of the Kanazawa Medical College 1949; 37:1-14.
Shomura S, Emura S, et al. An anatomical study on the branches of the celiac trunk (IV); comparison of our findings with Adachi’s classification. Acta Anat Nippon 1988; 66:452-61.
Katsume Y, Kanamaru E, Sakai K, et al. The statistical report about thirteen anomalous cases on the branches of the celiac trunk. J Kur M A 1978; 41:266-73.
Saga T, Hirao T, Kitashima S, et al. An anomalous case of the left gastric artery, the splenic artery and the hepato-mesenteric trunk independently arising from the abdominal aorta. Kurme Medical Journal 2005; 52:49-52.
Kitamura S, Nakamura T, Yoshioka T, et al. A case of the common hepatic artery arising from the superior mesenteric artery. Acta Anat Nippon 1980; 55:280.
Kajiwara A, Kimura A, et al. A case of the hepatic artery arising from the superior mesenteric artery. J Showa Med Asso 2005; 65(3): 254-58.
Yamaki K, Kastume Y, Ohtsuka K, Momota K, Miyazaki M. An anomalous case of truncus coeliaco-mesentericus. Acta Anat Nippon 1984; 59:648.
Higashi N, Hirai K. On the hepatic artery arising from the superior mesenteric artery. Acta Anat Nippon 1995; 70:338-46.
Tamura K, Kitazawa M, Itonaga T, Oioshi H, et al. Four anomalous cases of the splenic artery with an abnormal origin. Acta Anat Nippon 1986; 61:130-37.
Iimura A, Oguchi T, Shibata M, Takahashi T. An anomalous case of the hepatic artery arising from the superior mesenteric artery. Okajimas Folia Anat. Jpn. 2007; 84(2):61-66.
Horiguchi M, Koizumi M, Isogai S. Two cases of absence of the common hepatic artery. Acta Anat Nippon 1988; 63:557-63.
Nkamura Y, Miyaki T Hayashi S, Iimura A, Itoh M. Three cases of the gastrosplenic and the hepatomesenteric trunks. Okajimas Folia Anatomica Japonica 2003; 80(4): 71-76.
Bertevello P, Chaib E. Hepatic artery system variations correlated to split liver surgery: anatomic study in cadavers. Arq Gastroenterol 2002; 39(2): 81-5.
Makisalo H, Chaib E, Krokos N, Calne RY. Hepatic arterial variations and liver related diseases of 100 consecutive donors. Transpl Int 1993; 6(6):325-9.

DOI and Others

DOI: JCDR/2012/3936:1942


Date Of Submission: Jan 07, 2012
Date Of Peer Review: Jan 19, 2012
Date Of Acceptance: Jan 20, 2012
Date Of Publishing: Apr 15, 2012

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