rankedfirst on total publicationnumber with 280 documents followed by the UK, Germany, France,Table 1Types of publications, top research areas, authors, institutions and journals in hirudotherapy literature.aNumber% of 834 articlesaDocument typesOriginal article74989.8Case report17520.98Review15618. R111.32Siddall ME333.95InstitutionsLomonosov Moscow State University (Russia)273.24University of Lille (France)263.12Russian Academy of Sciences (Russia)222.64University of California System161.92Commonwealth System of Higher Education (USA)121.44University of Pennsylvania (USA)121.44University of Texas System (USA)121.44National Centre for Scientific Research (France)111.32Harvard University (USA)111..2Thrombosis Research101.2Total834100aTotal percentage may exceed 100%; certain items were included in more than one category.E. S ̧ enel et al. / Journal of Ayurveda and Integrative Medicine 11 China, Russia, Canada, Turkey, India and Italy (n¼128, 101, 41, 38,35, 34, 31, 30 and 28 items, respectively). The USA dominated thehirudotherapy literature and covered 33.57% of all the world hir-udotherapy literature (Fig. 1).3.2. Productivity of the countriesA productivity score was given for each country publishing inhirudotherapyfield, where the formula: production numbers/population x 1,000,000 was used to measure productivity scores asreported in the literature[10]. The current population data of thecountries was retrieved from the United Nations Database[11]. TheUK was the most productive country (productivity score¼1.93)followed by Slovenia, Israel, Switzerland, Germany, Bulgaria, Can-ada, the USA, Sweden and Belgium (s¼1.44, 1.32, 1.3, 1.23, 0.99,0.93, 0.86, 0.71 and 0.7, respectively). The USA, the country thatdominated the hirudotherapy literature with the total publicationnumber (33.57) was eighth in this ranking (s¼0.86).3.3. Authors, journals and institutionsZoology, pharmacology, biochemistry, cardiology and surgerywere the most studied research areas (438, 402, 334, 330 and 285items, respectively) (Table 1). English was the major language of theliterature (93.28%). Russian, German and French were the mostdocumented non-English languages (3.23, 2.52 and 1.68%, respec-tively). Baskova IP from the Lomonosov Moscow State University(Russia) was the most productive author in thisfield with 33 re-cords. Lomonosov Moscow State University produced the highestnumber of hirudotherapy publications with 27 articles (Table 1).The highest number of publications on hirudotherapy were inthe journals Microsurgery, Annals of Plastic Surgery, Plastic andReconstructive Surgery and Blood Coagulation&Fibrinolysis (22,21, 16 and 16 items, respectively) (Table 1). The publications onhirudotherapy were cited 13,485 times (10,165 times without self-citations). Average citation per item was 16.17 and calculated H-index for the literature was 54. A review titled“The Genus Aero-monas:Taxonomy,Pathogenicity,and Infection”by Janda JM andAbbott SL published in 2010 in Clinical Microbiology Reviews wasthe most cited article in thisfield with 527 citations (Table 2).3.4. Progression of the publications and citationsThe peak publication year for hirudotherapy literature was 2011with 41 items and no correlation was found between publicationnumber and the year of publication. The increase in the number ofpublications in this area was quite irregular (Fig. 2). A significantcorrelation