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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 journalsNo manuscriptsNo 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
The Accessory Renal Arteries: A Comparative Study in Vertebrates with Its Clinical Implications
Correspondence Address :
Anupama Gupta
34, Krishna square II
Amritsar -143001.
Ph-09878449785
E-mail - anupmag@ymail.com
Anomalous blood vessels are always interesting from a purely scientific point of view, especially since they so often shed light on obscure problems of phylogeny and ontogeny. The evolutionary history of kidney & renal artery is recapitulated during embryonic development .Most of the variations of human renal vessels can be explained on the basis of phylogeny as many conditions which are anomalous in human are normally present in some animals. The most common variation of renal artery is the presence of an accessory renal artery, occurring in approximately 30% of cases.
Aims: The present study was undertaken with the aim to study the accessory renal artery in human as well as in some other vertebrates and to make an attempt to explain them on ontogenetic & phylogenetic basis.
Materials and Methods: Material of this study comprised of 30 adult human cadavers (60 sides) and 30 animals of specifiedvertebrate series. These were dissected to expose the kidneys and their arterial supply. The renal and accessory renal arteries were traced up to their origin from abdominal aorta.
Result and Discussion: In this study, in all experimental animals except mammals multiple renal arteries were found. In human beings the accessory renal arteries were found in 17(28.3%) kidneys. All of these were compared for understanding of the phylogeny and ontogeny of accessory renal arteries. Further an attempt has been made to discuss their clinical and surgical significance.
Conclusion: We as anatomist believe that knowledge and awareness of causes of these accessory renal arteries are necessary for better surgical management during urological procedures & angiographic interventions as well as to design newer technique for them.
Renal artery, Accessory. Vertebrate, Variation, Phylogeny, ontogeny
Introduction
With the advent of laparoscopic renal surgeries and donor nephrectomies, it becomes mandatory for the surgeons to understand the abnormality or variations in the renal vasculature (1), otherwise renal transplant may be jeopardized by the presence of aberrant or accessory vessels. Existence of the accessory arteries is accountable in cases of renal pathologies, radiological interventions, renal transplants, and other surgical approaches on them.
The renal arteries usually arise from the anterolateral or lateral aspect of the abdominal aorta just below the origin of the superior mesenteric artery (2). Usually one renal artery supplies each kidney which enters through its hilum (3). Variations in the pattern of renal arteries have been reported more frequently than other large vessels in the literature. The most common variation of renal artery is the presence of an accessory renal artery, which may enter through the hilum or through the surfaces of the kidney. Alternative nomenclatures have been used to describe the accessory renal artery as supernumerary, multiple, aberrant, additional etc. According to Graves (1956) (4), any artery arising from the aorta in addition to the main renal artery should be named ‘accessory’ and the renal arteries arising from sources other than the aorta should be called ‘aberrant’.
Different studies have given different incidences of accessory renal arteries ranging from about 11% to 61% (5), (6). Such high incidence certainly warrants proper understanding of this anomaly and its clinical implications. Almost all the studies of accessory renal arteryare conducted on humans whether living or cadavers but none have incorporated its comparative anatomy. The present study was undertaken with the aim to study the prevalence of accessory renal artery in humans as well as in some other vertebrates and to make an attempt to explain them on ontogenetic & phylogenetic basis. The study also throws light on the clinical applicability of the same.
The possible aetiology of this variation has been explained by embryological development from the lateral mesonephric branches of the dorsal aorta. Again, from the standpoint of comparative anatomy there are conditions which anticipate the variations. The anatomical knowledge of such may be important for academic, surgical as well as radiological procedures and the present study is a humble effort to highlight the same.
Material of this study comprised of adult human cadavers and animals of specified vertebrate series. The well embalmed adult human cadavers of known sex were obtained from department of Anatomy. Experimental vertebrates were obtained from different departments of Govt. Medical College, Amritsar and from the slaughter house.
The human cadavers were serialized from 1-30 with suffix M for male & F for female. The abdominal cavity was opened by a cruciform incision passing through the whole thickness of anterior abdominal wall. Flaps were reflected and abdominal viscerawere systemically removed according to Cunningham Manual of Practical Anatomy (7)(9)(10).
The animals procured for the study were sacrificed after deep anaesthesia with ether by open method. The body cavities were opened up and then animals were fixed by dipping in 10% formalin for 48 hours. The dissection was carried out to expose the kidneys & their arterial supply and observations were made.
Human Beings
In the present study out of 60 kidneys (30 cadavers) accessory renal arteries were found in 17(28.3%). In one case, three accessory renal arteries were found on left side and two accessory renal arteries were present on right side, which is extremely rare anomaly (Table/Fig 1).
In Other Vertebrates
In the present study, in frog, lizard and domestic fowl, the kidney received multiple pairs of renal arteries from the aorta. In frog, dorsal aorta sends off 5-6 pairs of small renal arteries in a series, into both kidneys while in lizard, aorta sends off 3 or more pairs of renal arteries (Table/Fig 2) (Table/Fig 3).
In domestic fowl the kidneys were supplied by three pair of arteries but arrangement was different as the cranial pair was arising directly from the aorta and middle & caudal pairs from the left and right ischiatic arteries (Table/Fig 4).
However in mammals, only cranial pair of arteries from aorta was present. In guinea pig renal arteries gave rise to caudal phrenic, caudal abdominal and suprarenal arteries as well as tiny twigs to the ureter. In rabbits each renal artery sent a branch to suprarenal gland (Table/Fig 5).
(Table/Fig 6) compares the %age incidence of accessory renal arteries as observed by earlier workers in human beings. It shows a great disparity ranging 11% to 61% which may be owing to the social, ethnic and racial differences. It is more common in Africans (37%) and Caucasians (35%) when compared with other populations, and less common in Hindus (17%) (8). Our results are more in line with Merklin & Michel (1958) and Bregman et al (2000).
Opinions of earlier authors differ on the side of accessory renal arteries; some authors have reported a high frequency on the left side (14),(15) (16) while other (3), (5) reported it to be more frequent onright side. In the present study, these were more frequent on right side (11cases) as compared to left side (6 cases).
The high prevalence of accessory renal arteries confirms the statement of Anson & Kruth (1955) (11)(12),(13) that variation is the rule in renal vessel, not the exception. Presence of accessory renal arteries can be explained on the basis of phylogeny and the complex ontogeny.
Phylogeny
Development of the vertebrate urogenital system reviews the apparent evolutionary history of this system. Without knowledge of comparative anatomy, the development of urogenital system of higher vertebrate is puzzling (17).
Many conditions which are anomalous in human are normally present in some lower animals. In this study, in all experimental animals except mammals multiple renal arteries were found originating from aorta. Thus the occurrence of multiple renal arteries in human may be explained from point of view of phylogeny (6). In other words, it may be the persistence of these phylogenetic traits.
Ontogeny
Ontogenic basis of accessory renal artery has been convincingly explained by Keibel &Mall (1912) (18). As the kidneys ascend from the pelvis during the ontogeny, they receive their blood supply from the vascular structures close to them. Initially renal arteries are the branches of common iliac arteries. Later, while the kidneys ascend they receive new branches from the aorta, and the inferior branches disappear. In the ninth week of the intrauterine life the kidneys come in contact with the suprarenal glands and the ascent ceases. The kidneys receive their most cranial branches from the aorta. These are the permanent renal arteries. Failure of degeneration of initial branches leads to formation of accessory renal artery.
Clinical Implications
Accessory renal arteries originate from the abdominal aorta either above or below the main renal artery and reach the hilum. It is important to be aware that accessory renal arteries are end arteries; therefore, if an accessory artery is ligated or damaged, the part of kidney supplied by it is likely to become ischemic (3).
The unrecognized presence of accessory renal arteries is a hazard in surgery. Apart from the danger of damage to them during surgical procedure, the arteries have an additional interest. Lowerpolar arteries which typically pass in front of ureter are associated with a relatively higher incidence of hydronephrosis resulting from obstruction of ureter in the uretopelvic region (19).
Although it is very rare, fibro muscular dysplasia in an accessory renal artery can be responsible for renovascular hypertension. Selective renal angiography should be performed as the “gold standard” test when renovascular intervention is considered. Every accessory renal artery is related to segmental arteries, so the risk of bleeding during urological surgery or renal transplantation, segmental ischemia and postoperative hypertension increases (20). Lastly, the demand for kidney donation has rapidly increased, so it is essential to be aware of the possibility of donors with multiple renal arteries. Even though being considered as relative contradiction, allograft with multiple renal arteries can be implanted with short and long term results comparable to those with singe renal arteries by using surgical technique that best fits a particular situation.
To conclude the evolutionary history of kidney & renal artery is recapitulated during Ontogenic development .Most of the variations of human renal vessels can be explained on the basis of phylogeny.
We as anatomist believe that knowledge and awareness of causes of these anomalies of the renal arteries are necessary for sufficient surgical management during renal transplantation, repair of abdominal aorta aneurysm, urological procedures and angiographic interventions and to design newer technique for the same.
Authors are grateful to their respected teachers and staff of the department for helping them in this study.
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