The present study examined 581 Indian acute pancreatitis research publications, as indexed in Scopus database during 2007-16, with a view to understand their growth rate, global share, citation impact, international collaborative papers share, distribution of publications by broad subjects, productivity and citation profile of top organizations and authors, preferred media of communication and characteristics of high cited papers. The Indian publications registered an annual average growth rate of 14.09%, global share of 4.28%, international collaborative publications share of 11.88% and its citation impact averaged to 9.21 citations per paper. Among broad subjects, medicine contributed the largest publications share of 92.94% in India’s acute pancreatitis research output, followed by biochemistry, genetics & molecular biology (19.45%), pharmacology, toxicology & pharmaceutics (8.61%) and immunology & microbiology (3.61%) during 2007-16. Among various organizations and authors contributing to India’s acute pancreatitis research, the top 15 organizations and authors together contributed 48.02% and 59.38% respectively as their share of India publication output and 44.26% and 58.13% respectively as their share of India citation output during 2007-16. Among 574 journal papers in Indian acute pancreatitis research, the top 14 journals registered 35.71% share during 2007-16, which showed increase from 26.70% to 40.21% from 2007-11 and 2012-16. Indian Journal of Gastroenterology and Journal of the Pancreas, contributed the largest number of papers (27 papers each), followed Pancreatology (21 papers), Journal of Gastroenterology & Hepatology Australia (20 papers), etc. during 2007-16. There were only top 7 highly cited publications, which registered citations from 105 to 611 during 2007-16 and they together received 1343 citations, which averaged to 191.86 citations per paper.

 Key words: Acute Pancreatitis; Pancreas; Indian publications; Scientometrics; Bibliometrics.

The pancreas is a large gland behind the stomach and next to the small intestine. The pancreas does two main things: (i) It releases powerful digestive enzymes into the

small intestine to aid the digestion of food and (ii) It releases the hormones insulin and glucagon into the bloodstream. These hormones help the body control how it uses food for energy. Pancreatitis is a disease in which the pancreas becomes inflamed. Pancreatic damage happens when the digestive enzymes are activated before they are released into the small intestine and begin attacking the pancreas. There are two forms of pancreatitis: acute and chronic [1].

The etiology and pathogenesis of acute pancreatitis have been intensively investigated for centuries worldwide. Many causes of acute pancreatitis have been discovered, but the pathogenetic theories are at present controversial. The most common cause of acute pancreatitis is gallstone impacting the distal common bile-pancreatic duct. The majority of investigators accept that the main factors for acute billiary pancreatitis are pancreatic hyperstimulation and bile-pancreatic duct obstruction which increase pancreatic duct pressure and active trypsin reflux. Acute pancreatitis occurs when intracellular protective mechanisms to prevent trypsinogen activation or reduce trypsin activity are overwhelmed [2].

The revised Atlanta classification of acute pancreatitis identified two phases of the disease: early and late. Severity is classified as mild, moderate or severe. Mild acute pancreatitis, the most common form, has no organ failure, local or systemic complications and usually resolves in the first week. Moderately severe acute pancreatitis is defined by the presence of transient organ failure, local complications or exacerbation of co-morbid disease. Severe acute pancreatitis is defined by persistent organ failure, that is, organ failure >48 h [3].

Treatment of mild disease is supportive, but severe episodes need management by a multidisciplinary team including gastroenterologists, interventional radiologists, intensivists, and surgeons. Improved understanding of pathophysiology and better assessments of disease severity should ameliorate the management and outcome of this complex disease [4].

Literature Review

No bibliometric study had been published so far focusing on pancreas research. However, few bibliometric studies have been carried in the area of gastro related research. Among such studies, Loomes [5] carried a comprehensive bibliometric analysis of clinical articles in digestive disease. The country, authorship of the top 100 most frequently cited articles published in the field of digestive disease. It also undertook an effort to identify and examine characteristics, such as citation ranking, year of publication; publishing journal, study design. Chou [6] analyzed the MEDLINE-indexed publications in gastroenterology specialty journals from 2001 to 2007. Special attention was paid to specific types of articles (randomized controlled trials). According to MEDLINE, 81 561 articles were published in 91 gastroenterology journals from 2001 to 2007. Only 12 journals had more than 2000 articles indexed in MEDLINE. The “World Journal of Gastroenterology” had the largest number of publications (5684 articles), followed by “Hepato-Gastroenterology” (3036) and “Gastrointestinal Endoscopy”. Among 141 741 author names appearing in the articles of gastroenterology journals, 92 429 had published only in one journal, 22 585 in two journals, 9996 in three journals, and 16 731 in more than three journals. Lewison [7] examined the volume and potential impact of gastroenterology research outputs from 1985 to 1998 from 14 developed countries; the overlap with research in cancer, infectious diseases, and genetics; and the funding sources for this research. It also determined if countries' research outputs correlated with their burden of corresponding diseases and inputs to their research.

The present manuscript aims to study the various dimensions of India’s acute pancreatitis research in terms of various bibliometric indicators based on publications and citation data, derived from Scopus database during 2007-16. In particular, the study analyzed overall annual and cumulative growth of Indian publications, its global share among top 10 most productive countries, its citation impact, its international collaborative papers share, publication output distribution by broad sub-fields, productivity and citation impact of most productive organizations and authors, leading media of communications and characteristics of top highly cited papers.

For the present study, the publication data was retrieved and downloaded from the Scopus database (http://www.scopus.com) on India’s acute pancreatitis research during 2007-16. A main search strategy for global output was formulated, where the keyword such as “acute pancreatitis’’ is searched in the “keyword tag” or ‘’Article Title Tag’’ or “Source Title tag” and further limited the search output to period ‘2007-16’ within “date range tag”. This search strategy generated 13568 global publications on acute pancreatitis from the Scopus database. This main search strategy was later refined by ‘’Country Name Tag’’ to get acute pancreatitis research output of individual top 10 most productive countries, including India one by one. Detailed analysis was carried out on 581 Indian publications data using the analytical provisions or tags existing in Scopus database such as “subject area tag”, “country tag”, “source title tag”, “journal title name” and “affiliation tag”, to get data distribution by subject, collaborating countries, author-wise, organization-wise and journal-wise, etc. For citation data, citations to publications were also collected from date of publication till 13 October 2017. A series of raw (such as number of papers and international collaborative papers, number of citations, citations per paper) and relative (activity index, relative citation index) bibliometric indicators were used by authors to understand the dynamics of India’s acute pancreatitis research from different perspective (KEY(acute pancreatitis* or pancreatitis, acute ) OR TITLE(acute pancreatitis* or pancreatitis, acute) OR SRCTITLE(''acute pancreatitis*'')) AND PUBYEAR > 2006 AND PUBYEAR < 2017 AND (LIMIT-TO( AFFILCOUNTRY,"India" )

The global and Indian research output in acute pancreatitis research cumulated to 13568 and 581 publications in 10 years during 2007-16 and they increased from 1186 and 33 in the year 2007 to 1407 and 80 publications in the year 2016, registering 2.02% and 14.09% growth per annum. Their five-year cumulative output increased from 6310 and 193 to 7258 and 388 publications from 2007-11 to 2012-16, registering 15.02% and 49.74% growth respectively. The share of Indian publications in global output was 4.28% during 2007-16, which increased from 3.06% to 5.35% from 2007-11 to 2012-16. Amongst Indian publications on acute pancreatitis, 70.74% (411) was published as articles, 11.19% (65) as reviews, 10. 33% (60) as letters, 4.13% (24) as notes, 1.38% (8) as editorials, 1.20% (7) as book chapters, 0.86% (5) conference papers and 0.17% (1) as short surveys. The research impact as measured by citations per paper registered by Indian publications in acute pancreatitis averaged to 9.21 citations per publication (CPP) during 2007-16; five-yearly impact averaged to 18.39 CPP for the period 2007-11 which declined to 4.65 CPP in the succeeding five-year 2012-16 (Table 1).

Table 2: Global Publication, Citation and International Collaboration Output of Top 10 Countries during 2007-16.

India’s International Collaboration

The share of India’s international collaborative publications (ICP) in its national output in acute pancreatitis research was 11.88% during 2007-16, which increased from 10.88% during 2007-11 to 12.37% during 2012-16. About 67 foreign countries collaborated with India in 69 acute pancreatitis research papers during 2007-16. These 69 papers together registered 1515 citations, with 22.61 citations per paper. USA, among foreign countries, contributed the largest share (50.72%) to India’s international collaborative papers in acute pancreatitis research, followed by Japan (13.04%), Australia, Germany and U.K. (11.59% each), Canada (10.14%), South Korea and Spain (8.70% each), Netherlands, Spain and Sweden (7.25%) during 2007-16. The share of ICP increased by 14.58% in Canada, followed by Netherlands, Spain and Sweden (10.42% each), U.K. (9.82%), South Korea and Taiwan (5.65% each), USA (4.46%) and Germany (2.98%), as against decrease by 10.71% in Australia and 8.63% in Japan from 2007-11 to 2012-16 (Table 3). 

581 Indian publications in acute pancreatitis research, as indexed in Scopus database, were published during 2007-16 and they increased from 33 to 80 in the year 2007 to the year 2016, registering 14.09% growth per annum. Their cumulative Indian output increased from 193 to 388, witnessing 49.74% growth from 2007-11 to 2012-16. India’s global publication share in acute pancreatitis research was only 4.28% during 2007-16, witnessing increase from 3.06% to 5.35% from 2007-11 to 2012-16. The citation impact per paper of Indian publications on acute pancreatitis research was averaged to 9.21 citations per paper, however, decreasing from 18.39 during 2006-11 to 4.65 during 2012-16. The share of India’s international collaborative publications in acute pancreatitis research was 11.88% during 2007-16, showing increase from 10.88% during 2007-11 to 12.37% during 2012-16. USA in India’s international collaborative papers, contributed the largest publications share of 50.72%, followed by Japan (13.04%), Australia, Germany and U.K. (11.59% each), Canada (10.14%), South Korea and Spain (8.70% each), Netherlands, Spain and Sweden (7.25%) during 2007-16.

Medicine, among sub-fields contributed the highest publications share (92.94%), followed by biochemistry, genetics & molecular biology (19.45%), pharmacology, toxicology & pharmaceutics (8.61%) and immunology & microbiology (3.61%) during 2007-16. The research activities, as reflected in activity index, showed increase in medicine and biochemistry, genetics & molecular biology, as against decrease in pharmacology, toxicology & pharmaceutics and immunology & microbiology from 2007-11 to 2012-16. -16.

Among leading organizations and authors participating in India’s acute pancreatitis research, the 15 most productive Indian organizations and 20 authors together contributed 48.02% and 59.38% respectively as their share of Indian publication output and 44.26% and 58.13% respectively as their share of Indian citation output during 2007-16. The leading organizations in research productivity were: Postgraduate Institute of Medical Education & Research, Chandigarh (94 papers), All India Institute of Medical Sciences, New Delhi (37 papers), Asian Institute of Gastroenterology, Hyderabad (29 papers), Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow (25 papers), étc during 2007-16.. The leading organizations registering comparatively higher citation impact were: G.B. Pant Hospital, Delhi (22.57), Asian Institute of Gastroenterology, Hyderabad (13.55), All India Institute of Medical Sciences, New Delhi (13.35) and SMS College, Jaipur (11.0) during 2007-16.

The leading authors in publication productivity were: D.K. Bhasin and S.S. Rana (45 papers each), R. Gupta (28 papers), V. Sharma (27 papers), K. Singh (23 papers) and R. Kochhar (19 papers) during 2007-16. The leading authors in terms of research impact were: M. Kang (16.5), T.D. Yadav (16.3), J.D. Wig (14.8), P.K. Garg (13.8), R. Kochhar (12.74), R. Gupta (12.5), U. Datta (12.44), S.K. Sinha (11.3), K. Singh(10.91) and B. Negi (10.78) during 2007-16.

Among the total journal output of 574 papers; the top 14 most productive journals contributed 35.71% share of total journal publication output during 2007-16, which increased from 26.70% to 40.21% from 2007-11 and 2012-16. Indian Journal of Gastroenterology and Journal of the Pancreas contributed the largest number of papers (27 each), followed by Pancreatology (21 papers), Journal of Gastroenterology & Hepatology Australia (20 papers), etc. during 2007-16.

The 7 highly cited publications individually received citations varying from 105 to 611 in acute pancreatitis research and together these papers received 1343 citations, with 191.86 citations per paper. Around 57 authors and 42 organizations (5 Indian) participated in these 7 high cited papers and were published in 6 journals, with 2 papers in Nature Reviews Microbiology, and one paper each in Critical Reviews in Biotechnology, Critical Reviews in Oncology/Hematology, Hepatology, International Journal of Environmental Research & Public Health and Pancreas,

Concludes that pancreas disorders research have been a neglected subspecialty in India, both in teaching and research. A staggering patient load, a severely inadequate number of trained pancreas specialists and limited advocacy are some of the critical challenges that confront pancreas care research. To address the many problems with pancreas care in India, curricular reforms, capacity building, patient education and political support and funding support from Indian government are badly needed.

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