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
Original article / research
Full Version
Assessment of Abdominal Aorta Diameter on Contrast-enhanced Computed Tomography: A MDCT-based Observational Study
Correspondence Address :
Ms. Rakhee Shashikant Naik,
H. No. M-88, Housing Board Colony, Alto Porvorim, Bardez-403501, Goa, India.
E-mail: rakheenaik510@gmail.com
Introduction: The average size of the abdominal aorta is less than 3 cm, which varies over time. An increase in abdominal aortic dimensions of more than 3 cm can result in the presence of ectasia, which can further convert into an aneurysm. The expansion rate can also lead to aortic dissection and rupture. Its increasing dimensions can influence to give rise to numerous other abdominal aortic conditions and be fatal due to the aortic wall stress. Monitoring the variation in the abdominal aorta is now possible with the various advancements in imaging techniques including Computed Tomography (CT).
Aim: To measure the Anteroposterior (AP) and Right-Left (RL) diameters of the abdominal aorta on Contrast-enhanced Computed Tomography (CECT) abdomen and to analyse its variation with age and gender.
Materials and Methods: A cross-sectional observational study was conducted in the Department of Radiodiagnosis at KS Hegde Charitable Hospital, Deralakatte, Mangaluru, Karnataka, India. The duration of the study was 11 months, from April 2020 to March 2021. A total of 81 patients referred for CECT abdomen divided into two age groups of 20-40 years and 41-80 years. The scan was performed using 16-slice Multidetector Computed Tomography (MDCT). On the reconstructed axial images, the abdominal aortic diameters were measured at the level of T12-L1. The non parametric Mann-Whitney U test was used to compare the RL and AP diameters with respect to age groups. Unpaired t-test was used to compare the RL and AP diameters with respect to gender. Paired t-test was used to compare AP diameter on contrast and non contrast scans.
Results: The mean age of study participants was 47±14.83 years and was divided into two age groups between 20-40 years and 41-80 years. Out of the 81 cases, 31 (38%) were in the age group of 20-40 and 50 (62%) were in the age group of 41-80 years. There was a significant increase in the AP and RL abdominal aortic diameter with age (p-value <0.001) and males were found to have significantly higher abdominal aorta diameter than females (p-value <0.001) in both the age groups of 20-40 and 41-80 years. Also, the abdominal aorta diameter measurements on Non Contrast Computed Tomography (NCCT) and CECT abdomen showed no notable difference.
Conclusion: The present study concluded that, there was a remarkable variation in the diameter of the abdominal aorta with age and gender. Besides, the abdominal aorta diameter measurements on NCCT and CECT abdomen showed no notable difference.
Anteroposterior, Contrast-enhanced computed tomography, Non contrast computed tomography
The abdominal aorta being the largest artery, supplies the abdomen and both lower limbs. Diameter of the abdominal aorta and the characteristics of its walls changes with time. The normal diameter of the abdominal aorta is foreseen to be less than 3 cm. The enlargement rate is around 2.6 mm per year (1). Several conditions can lead to changing dimensions of the abdominal aorta including atherosclerosis, aortic dissection, aortic rupture, and the most common being the Abdominal Aortic Aneurysm (AAA). More than 3 cm diameter of the abdominal aorta is regarded as an aneurysm and can be potentially lethal (2). Monitoring and visualisation of the abdominal aorta is now possible with the various advancements in imaging techniques. CT is the most reliable and widely available imaging modality for the evaluation of AAA. With the help of various reformation techniques, software, and measurement tools available in CT, diameters of the abdominal aorta can be measured accurately (3). NCCT can be used for the detection of vascular calcification (4). CECT is useful for evaluating luminal and aortic wall abnormalities. A study established that, the measured suprarenal and infrarenal abdominal aorta diameters increased in size with the increasing age of the subjects (5). Also, in another study, the authors concluded that, there is a high prevalence of AAA in men traced on CT abdomen (6).
In the present study, both AP and RL diameters of the abdominal aorta were measured. Also, the comparison was made between different age groups and gender on both, NCCT and CECT whereas, in another study, only transverse diameter was taken into consideration and measured only on NCCT (3).
A cross-sectional observational study was conducted in the Department of Radiodiagnosis Justice KS Hegde Charitable Hospital attached to KS Hegde Medical Academy, a unit of NITTE (Deemed to be University) Mangaluru, Karnataka, India. The duration of the study was 11 months, from April 2020 to March 2021. The study was approved by Institutional Ethics Committee (Approval no. INST.EC/EC/045/2020-21).
Inclusion criteria: All patients referred for CECT abdomen within the age group of 20-80 years were included.
Exclusion criteria: Patients with history of cardiac diseases, abdominal trauma, known cases of vasculitis, AAA and history of previous aortic interventions were excluded.
Study Procedure
The procedure was explained to the subjects and a written informed consent was obtained from each subject. The participants were divided into two age groups under 20-40 years and 41-80 years and gender. CECT abdomen scan was performed using GE Bright Speed Elite (16-slice MDCT machine) and pressure injector (Medrad Salient). The acquired images in the arterial phase were reconstructed into the three planes (sagittal, axial, and coronal) via the Multiplanar reformation (MPR) technique to 1.25 mm and with the distance measuring tools, the AP and RL abdominal aortic diameters were measured at the level of T12-L1 on both plain and contrast abdominal scans. The variation in the diameter of the abdominal aorta with age and gender was analysed.
Statistical Analysis
Data collected was analysed by the Statistical Package for Social Science (SPSS) version 20.0 (SPSS-IBM Corporation, New York 2014). The non parametric Mann-Whitney U test was used to compare the RL and AP diameters with respect to age groups. Unpaired t-test was used to compare the RL and AP diameters with respect to gender. Paired t-test was used to compare AP diameter on contrast and non contrast scans. The mean and standard deviation of abdominal aortic measurements were calculated to show the AP and RL diameter variation with age and gender. The p-value<0.001 was considered significant.
A total of 81 patients with a mean age of 47±14.83 years were divided into two age groups between 20-40 years and 41-80 years. Out of the 81 cases, 31 (38%) were in the age group of 20-40 and 50 (62%) were in the age group of 41-80 years. Also, 48 (59%) were males and 33 (41%) were females in the total. There was a significant difference in the AP and RL diameters measured on both NCCT and CECT between the age groups of 20-40 years and 41-80 years (p-value <0.001). This showed that, the diameter increases with age and was more in the age group of 41-80 years (Table/Fig 1),(Table/Fig 2)a,b.
There were 21 males and 10 females in the age group of 20-40 years while there were 27 males and 23 females in the 41-80 years age group. There was a significant difference in the AP and RL abdominal aorta diameter measurements performed on NCCT and CECT abdomen between males and females in the age category of 20-40 years and also, 41-80 years (p-value <0.001). This showed that, males had a larger abdominal diameter than the females of the same age group (Table/Fig 3),(Table/Fig 4)a,b. Comparing the AP and RL diameters of the abdominal aorta, the authors found that, there was no significant difference in the diameters between the NCCT and CECT measurements (p-value >0.05) (Table/Fig 5).
The CT is a medical imaging modality where digital geometry processing is utilised to create three-dimensional (3D) images testof the inner structures of an object. CECT offers radiologists valuable information about not only the abdominal aorta but, also the surrounding structures (3). Compared to another study, the authors have also measured the abdominal aorta diameters on NCCT, as these images do not have to get interfered with any gastrointestinal gas (7).
In the current study, the authors observed a significant difference in abdominal aorta diameters between the two age groups (p-value <0.001). Similar results were observed in a study by Kumar R et al., consisting of 603 cases in the Nepalese population within the age limit of 21-85 years, the abdominal aorta diameter was measured at three different levels suprarenal, infrarenal and bifurcation and the values were found to be 18.57±2.56, 16.48±2.44 and 15.82±2.29 mm, respectively. They too showed that age has a significant influence on the abdominal aortic diameters which increase with age (8). Another study by Sharma D et al., included 130 patients who underwent abdominal CT and were divided into two age groups of 20-40 years and 40-80 years. They perceived that, there was a significant difference in the AP and RL diameter between the two age groups (p-value <0.001) and hence, concluded that the size of the abdominal aorta differs with age (9). In a study by Hawn S et al., 300 patients were enrolled from the Korean population including 150 males and 150 females. They were divided into six age categories 21-30, 31-40, 41-50, 51-60, 61-70 and 71-80 years. Their abdominal aortic measurements were performed at the level of the celiac axis, suprarenal aorta, and aortic bisection, which were found to be 1.98±0.31, 1.84±0.39 and 1.47±0.22 cm in the females while it was 2.21±0.36, 2.04±0.31 and 1.68±0.22 cm in the males respectively (10). Hence, the abdominal aorta diameter in males was found to be more compared to females (p-value <0.05) which were similar to the present study.
Also, the authors have observed no significant difference in the diameters measured on NCCT and CECT (p>0.05). In a comparable literature by Nambi P et al., including 316 participants, the average abdominal aortic diameters were measured at the level of the lowest renal artery to the aortic bifurcation on both, NCCT and CECT which were 1.16 and 1.14 cm, respectively. They showed almost similar results to the present study with no significant difference (11). Hence, this shows that, the abdominal aorta diameter measurements are reproducible on both NCCT and CECT and NCCT can be an alternative to CECT. Espinosa G et al., carried out a study, to compare angiography with CT for evaluation of AAA prior to endograft implant. The study included 113 patients of which 104 were males and 9 were females with AAA. All the participants underwent abdominal spiral CT and catheter angiography. Infrarenal abdominal aorta diameters were measured in both investigations and mean diameters were compared. The authors observed that, there was a statistical difference in the infrarenal aneurysmal neck diameter of the abdominal aorta between the two examinations (p-value <0.05). Therefore, they concluded that, CT was a better method for the evaluation of diameters (12). Another similar study by Liisberg M et al., was performed to compare NCCT and Ultrasound for AAA screening. The study included 566 men who underwent NCCT and ultrasound examination. In the axis of the abdominal aorta, diameters were measured in anteroposterior and transverse planes. A total of 30 AAA were found using NCCT whereas, ultrasound could not detect nine of these. Also, five additional iliac artery aneurysms were identified by NCCT. They concluded that, NCCT was superior to ultrasound concerning sensitivity since the entire length of the vessel can be evaluated using CT (13).
Hence, the authors considered that, CT is the best modality for the measurement of the abdominal aorta and other large vessels. Also, assessment of variation in the abdominal aorta diameter using CECT abdomen might help in predicting further complications such as AAA and other aortic diseases. Further studies can be performed considering other variable factors for analysing the variation in abdominal aorta diameter like height, weight, patients with hypertension, and history of smoking.
Limitation(s)
The limitations of the present study include the small sample size.
There was a significant variation in the diameter of the abdominal aorta with age. Besides, the abdominal aorta diameter measurements on NCCT and CECT abdomen showed no notable difference. Hence, plain CT can undoubtedly be used for diameter measurements. Therefore, CT abdomen can help the radiologist to accurately measure the abdominal aortic diameter, and comparing the values with the standard values will help predict the possibility of progression to AAA.
The authors would like to thank the Department of Radiodiagnosis and Medical Imaging Technology at KS Hegde Medical Academy, Mangaluru, Karnataka, India, for their approval and permission for collecting the data and carrying out the present study without any interruption. The authors also acknowledge the Department of Statistics for its guidance in data analysis and interpretation.
DOI: 10.7860/JCDR/2023/58912.17853
Date of Submission: Jul 05, 2022
Date of Peer Review: Oct 30, 2022
Date of Acceptance: Feb 01, 2023
Date of Publishing: May 01, 2023
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• 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: Jul 06, 2022
• Manual Googling: Dec 08, 2022
• iThenticate Software: Jan 24, 2023 (9%)
ETYMOLOGY: Author Origin
- 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