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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
Case report
Full Version
A Variant Dorsalis Pedis Artery and Its Relationship with the Deep Fibular Nerve
Correspondence Address :
Dr. Sulochana Sakthivel,
Additional Professor, Department of Anatomy, Jawaharlal Institute of Medical Education and Research, Puducherry-605006, India.
E-mail: sulo.ss@gmail.com
During a cadaveric dissection session, a distinctive neurovascular pattern was identified in the left leg of a 66-year-old female cadaver. The Anterior Tibial Artery (ATA), while maintaining a normal origin and luminal diameter, exhibited a shortened course, terminating in the upper third of the leg. In the lower third of the leg, the Fibular Artery (FA), known as the peroneal artery, traversed through the interosseous membrane to the anterior compartment, persisting as the Dorsalis Pedis Artery (DPA). The Deep Fibular Nerve (DFN), displaying a usual course in the upper two-thirds of the leg, crossed the variant DPA posteriorly and divided into two terminal branches on its posterolateral side. The medial terminal branch proceeded to cross the artery anteriorly within the anterior tarsal tunnel. This distinctive relationship between the DFN and the variant DPA renders the nerve susceptible to compression and may result in “anterior tarsal tunnel syndrome”.
Anterior tarsal tunnel, Anterior tibial artery, Compression, Fibular artery, Retinaculum
During the dissection of a 66-year-old female cadaver, a unilateral variation in the origin of the Dorsalis Pedis Artery (DPA) and its relation to the Deep Fibular Nerve (DFN), also known as the deep peroneal nerve, was observed in the left leg (Table/Fig 1). In the popliteal fossa, the popliteal artery is divided into the ATA and Posterior Tibial (PTA) arteries, with a normal arterial pattern detected in the posterior compartment of the leg. The PTA gave off the FA, also known as the peroneal artery, supplying the lateral compartment of the leg and measuring 3.86 mm in external diameter. The ATA had a short course in the anterior compartment, terminating after giving off a few muscular branches in the upper one-third of the leg. Despite its short course, the ATA showed no signs of hypoplasia, measuring 3.3 mm in external diameter (Table/Fig 1)a. Vascular supply to the middle one-third of the leg was provided by a few perforating branches originating from the FA.
In the lower part of the leg, at 66.39 mm above the lateral malleolus, the FA passed through the interosseous membrane into the anterior compartment, replacing the ATA for a distance of 54.33 mm before continuing as the DPA (Table/Fig 1)b. The external diameter of FA in the anterior compartment was 3.4 mm. In the upper two-thirds of the leg, the DFN followed a typical course, descending beneath the extensor digitorum longus muscle. In the lower one-third of the leg, the DFN passed posterior to a small perforating branch from the FA, continued downwards, and contrary to its name, “nervus hesitans,” crossed the FA posteriorly, from the medial to the lateral side. As the DFN wound around the artery, it divided into medial and lateral terminal branches on the posterolateral aspect, just above the malleoli. In the anterior tarsal tunnel of the dorsum of the foot, the medial terminal branch of the DFN (mtDFN) crossed the DPA anteriorly, positioning itself on its medial aspect and continued towards the first interosseous space where it terminated by dividing into two branches (Table/Fig 1)b. A normal neurovascular pattern was observed on the right-side, and the external diameters of the ATA, PTA, and FA were 3.5 mm, 3.62 mm, and 3.5 mm, respectively.
The popliteal artery and its branches provide the principal blood supply for the leg and foot. The ATA serves the extensor compartment, while the DFN runs along its lateral side in the proximal part of the leg. The DFN assumes an anterior position relative to the ATA in the middle third of the leg. Termed the “nervus hesitans,” the nerve intriguingly hesitates to cross over the artery. This distinctive behaviour persists into the distal third of the leg, with the DFN consistently maintaining its lateral position in relation to the ATA (1).
In the dorsum of the foot, the ATA transforms into the DPA and is accompanied by the mtDFN on its lateral side. The DPA courses toward the first intermetatarsal space and, by passing between the two heads of the first dorsal interosseous muscle, completes the plantar arch in the sole. Simultaneously, the PTA and FA supply the posterior and lateral compartments of the leg, respectively (1).
Variations in the anatomical vascular pattern significantly impact the success of vascular surgeries and interventional procedures. The branches emerging from the popliteal artery play a pivotal role in femorotibial arterial reconstructions and the creation of fasciocutaneous flaps (2),(3). The luminal diameter of the ATA is a crucial determinant in the patency rate of femorotibial arterial reconstructions (4). In cases of a hypoplastic ATA or PTA, the anterior perforating branch of the FA tends to undergo enlargement to compensate and supply the respective areas. In such situations, harvesting the fibula along with the FA poses a risk to the blood supply to the foot (5).
Kim D et al., categorised the branching pattern of the popliteal artery into three types. The normal anatomical pattern with the popliteal artery dividing at the lower end of the popliteus muscle is type I, and the high branching of the popliteal artery is type II. The type III pattern, where one of the vessels is hypoplastic or aplastic, is further divided into three subtypes: Type III-A - the PTA is hypoplastic and replaced by the FA; Type III-B - the ATA is hypoplastic and the DPA is replaced by the FA; Type III-C - both the ATA and PTA are hypoplastic with the dominant FA (6). The dominant FA in type III-C variation is also known as the “Peronea Arteria Magna” due to its sole supply to the leg and foot. As the prevalence of the latter anomaly varies between 0.2 and 8.3%, it is important to recognise this variation while harvesting the FA for free flaps, or it may result in limb ischaemia (7).
Among the type III variations, the most common occurrence is type III-A, observed with a prevalence ranging between 1.5% and 11%, and involves a hypoplastic or aplastic PTA with a dominant FA (8). The type III-B pattern exhibits a varying incidence ranging from 1.6% to 7.1%, wherein the FA substitutes for the DPA in the presence of a hypoplastic ATA (9). In such instances, the anterior perforating branches of the FA also contribute to the blood supply in those areas (10),(11). The current report aligns with a type III-B variation, even though the ATA was not hypoplastic despite its shortened course. In addition, the blood supply to the extensor compartment was facilitated by the anterior perforating branches of the FA.
During development, the arterial pattern of the lower limb originates from the axial sciatic artery (Table/Fig 2)a-c. In humans, the sciatic artery undergoes regression, with the middle and distal segments persisting to give rise to the popliteal and fibular arteries. During this developmental process, the emerging femoral artery establishes connections with the sciatic artery, ultimately giving rise to the ATA and PTA. The perforating arteries are formed between the ATA and fibular arteries. Thus, the variations in the branching pattern of the popliteal artery can be attributed to the regression or persistence of the axial sciatic artery and its communication with the developing femoral artery (12).
Due to variations in its course, the DFN is prone to compression underneath the extensor retinaculum. This compression may lead to motor weakness and sensory impairment in the lower part of the leg and foot (6). Compression neuropathy of the DFN in the tarsal tunnel was called the “Anterior tarsal tunnel syndrome” by Marinacci AA in 1968 (13). The relationship between the DPA and DFN in the anterior tarsal tunnel was classified into four types by I?kiz ZAA et al., as follows: Type I - DPA was medial to DFN in the tunnel, and mtDFN in the dorsum; Type II - DPA was medial to DFN in the tunnel but lateral to mtDFN; Type III- DPA and DFN cross each other multiple times; Type IV- mtDFN was absent, and DPA was medial to the lateral terminal branch of DFN (14). Conversely, Ranade AV et al., provided a different classification, designating the looping pattern of the DFN around the DPA in the tarsal tunnel as type IV. While these studies did not specifically address variations in the relationship between the DFN and ATA in the distal part of the leg, the present case shares similarities with the looping pattern described by Ranade AV et al., in the tarsal tunnel (15). This type IV variant of DFN is susceptible to compression beneath the tendon of the extensor hallucis brevis in the tunnel, leading to motor weakness and impaired sensation in the first interdigital area due to its sensorimotor components (2),(15). In addition, DPA thrombosis could lead to anterior tarsal tunnel syndrome (2).
Compression of the nerve can result from various other factors, such as direct trauma, arterial aneurysms, and persistent mechanical irritations. Decompression of the tarsal tunnel by releasing the inferior extensor retinaculum is the treatment of choice (2). Similarly, the present report identifies two vulnerable locations for DFN compression. Firstly, in the distal part of the leg, where the nerve crosses the artery posteriorly, and secondly, in the proximal tarsal tunnel; where mtDFN traverses anteriorly across the DPA from the lateral to the medial side.
Awareness of these neurovascular variations in the leg and foot is significant for vascular surgeons performing fasciocutaneous flap surgeries or arterial reconstructions in femorotibial bypass graft procedures, as well as for orthopaedic surgeons during surgical clubfoot release. Compression of the DFN in the lower leg may result in “anterior tarsal tunnel syndrome,” and any deviations in its course further heighten the risk of compression.
DOI: 10.7860/JCDR/2024/69831.19376
Date of Submission: Jan 29, 2024
Date of Peer Review: Feb 28, 2024
Date of Acceptance: Mar 15, 2024
Date of Publishing: May 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jan 29, 2024
• Manual Googling: Mar 11, 2024
• iThenticate Software: Mar 13, 2024 (16%)
ETYMOLOGY: Author Origin
EMENDATIONS: 6
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