AUCTORES
Globalize your Research
Research Article | DOI: https://doi.org/10.31579/2690-8808/231
*Corresponding Author: Ali Osman. Internal Medicine Department of Lokman Hekim University Ankara TURKEY.
Citation: Ali Osman Avcı, (2024), Title, Journal of Clinical Case Reports and Studies, 5(10); DOI:10.31579/2690-8808/231
Copyright: © 2024, Ali Osman Avcı. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 11 November 2024 | Accepted: 18 November 2024 | Published: 26 November 2024
Keywords: Type 2 Diabetes Mellitus; serum uric acid; Hb A1c, eGFR
Objective: The aim of this study was to investigate the relationship between serum uric acid (SUA) level and hemoglobin A1c (Hb A1c) and estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes mellitus (T2DM).
Materials and Methods: The study was conducted retrospectively by reviewing the files of patients diagnosed with T2DM aged 18 years and older. Patients were divided into two groups according to Hb A1c values: those with Hb A1c ≥7 and those with Hb A1c <7. Age, gender, uric acid, creatinine and HbA1c values and their correlations were analyzed.
Results: A total of 510 patients were included in the study. Of the patients, 162 were female (31.76%) and 348 were male (68.24%). The mean age was 69.68±12.29 years in female patients and 66.14±12.34 years in male patients. Mean duration of DM was 10.22±9.64 years in female patients and 11.42±10.12 years in male patients. The mean Hb A1c value of 263 patients with Hb A1c <7 was 6.05±0.55 and the mean Hb A1c value of 247 patients with Hb A1c ≥7 was 9.08±1.91. When serum uric acid, creatinine and eGFR values (calculated according to the Modification of Diet in Renal Disease (MDRD) formula) were compared between the groups with high and low Hb A1c, a statistically significant difference was found between serum uric acid levels (p=0.002). When the correlation between uric acid, and eGFR in the groups with high and low HbA1c was analyzed, a statistically significant, strong negative correlation was found (p<0.001 r= -0.640).
Conclusion: In T2DM patients, eGFR decreases as serum creatinine level increases, and eGFR decreases at approximately the same rate as serum uric acid level increases. This is independent of HbA1c. In other words, eGFR decreases as uric acid increases even if diabetes control is not impaired. This result reveals the importance of diet in T2DM patients.
Type 2 diabetes mellitus (T2DM) is one of the most common metabolic disorders worldwide, accounting for approximately 95% of diabetes mellitus (DM). There are two main mechanisms in the pathophysiology of T2DM: impaired insulin secretion from pancreatic β-cells and failure of insulin-sensitive tissues to respond to insulin. As a result, glucose cannot be utilized by cells and its level in the blood increases [1].
Glycolization, the combination of glucose with proteins, occurs in proportion to the increasing glucose level in the blood and the duration of high glucose levels [2]. The best example of glycolization is glycosylated hemoglobin, hemoglobin A1c (HbA1c) [3]. HbA1c, one of the markers showing the degree of glycolization, is used to monitor blood glucose control. An increase in HbA1c, which indicates poor diabetes control in DM patients, has been shown to be associated with many complications in DM patients [4-6].
It has been suggested that uric acid, the end product of purine metabolism, is associated with many diseases. Studies have reported that serum uric acid levels >5.5 mm/dL in women and >6 mg/dL in men are associated with metabolic syndrome, hypertension, cardiovascular diseases and DM [7-10].
One of the most important causes of elevated uric acid is increased fructose intake. Unlike other sugars, fructose intake has been directly associated with increased uric acid. Increased fructose intake also causes elevated blood glucose and increased HbA1c. Fructose intake can cause serious complications due to both increased blood glucose and increased uric acid levels [11-13].
The aim of this study was to investigate the relationship between SUA level and Hb A1c level and eGFR in T2DM patients.
This study was conducted retrospectively by scanning the hospital data recording system. Among the patients who applied to Lokman Hekim University Ankara Hospital Health Practice and Research Center, the files of patients aged 18 years and over with a diagnosis of T2DM were reviewed.
Inclusion criteria:
- Patients who met the American Diabetes Association (ADA) criteria [14] for the diagnosis of T2DM; fasting blood glucose ≥126 mg/dl or random blood glucose ≥200 mg/dl in patients with typical diabetes symptoms or blood glucose ≥200 mg/dl at the 2nd hour of 75 g oral glucose loading test or HbAc 6.5 and above.
- Eighteen years of age or older
- Patients whose clinical and laboratory records can be accessed
Exclusion criteria:
- Those under the age of eighteen
- Those with diagnosed gout
- Patients on dialysis treatment for chronic renal failure
- Patients with diagnosed malignancy and patients receiving chemotherapy.
Age, gender, duration of DM, Hb A1c, creatinine and uric acid levels were obtained from patient files. Normal ranges were considered as creatinine 0.6-1.2 mg/dL, uric acid <6>90 ml/min/1.73.m2 and HbA1c <5>= 186 * Serum Creatinine-1.154 * Age-0.203 * Gender * Race ) [15].
Patients were divided into two groups according to Hb A1c values: those with Hb A1c <7>
Statistical analysis
All analyses were performed using Statistical Package for Social Sciences (SPSS) software (version 27, Armonk, NY, USA). Variables were defined as minimum, maximum, mean and standard deviation. Data were analyzed for normal distribution using Kolmogorov Smirnov. Student t-test was used for normally distributed variables and Mann-Whitney U test was used for non-normally distributed variables. Correlation between parameters was determined using Spearman or Pearson correlation coefficient. A P value < 0>
This study was approved by the decision of Lokman Hekim University Scientific Research Ethics Committee dated 16.05.2024 and numbered 2024/59. The study was conducted in accordance with the Declaration of Helsinki and Research and Publication Ethics. Since it was a retrospective study, consent was not obtained from the patients included in the study. Artificial intelligence was not used for this study.
A total of 510 patients were included in the study. Of the patients, 162 were female (31.76%) and 348 were male (68.24%). The mean age was 69.68±12.29 years in female patients and 66.14±12.34 years in male patients. The mean duration of DM was 10.22±9.64 years in female patients and 11.42±10.12 years in male patients (Table 1).
Age (Year) DM Duration (Year)
| N | % | Mean±SD | Mean±SD | |
| DM Patients | 510 | 100 | ||
| Female | 162 | 31.76 | 69.68±12.29 | 10.22±9.64 |
| Male | 348 | 68.24 | 66.14±12.34 | 11.42±10.12 |
| DM Treatment | ||||
| OAD | 310 | 60.9 | 65.13±12.84 | 9.54±9.52 |
| OAD+Insulin | 126 | 24.9 | 67.32±12.47 | 10.20±10.26 |
| Insulin | 74 | 14.2 | 68.32±12.47 | 12.20±10.26 |
DM: Diabetes mellitus, OAD: Oral antidiabetic drugs, SD: Standard deviation
Table 1. Demographic characteristics of patients.
The mean Hb A1c value of 263 patients with Hb A1c <7 p=0.002)>
Hb A1c <7> Min Max Mean SD Min Max Mean SD P Uric acid 2.20 13.80 5.49 1.81 2.00 17.90 6.47 2.10 0.002 Creatinine 0.55 8.68 1.15 0.88 0.42 10.30 1.12 0.82 0.534 eGFR 5.98 151.60 71.38 24.77 5.18 158.44 75.20 29.22 0.170
eGFR: Estimated Gloeruler Filtration Rate, HbA1c: Hemoglobin A1c
Table 2. Comparison of serum uric acid, creatinine and eGFR according to HbA1c value
When the correlation between uric acid, and eGFR in the groups with high and low HbA1c was analyzed, a statistically significant, strong negative correlation was found (p<0 xss=removed> r p r p r p eGFR -0.505 <0> -0.556 <0> -0.640 <0> Creatinine 0.302 <0> 0.369 <0> 0.348 <0> HbA1c 0.320 0.608 -0.323 <0> -0.229 <0>
eGFR: Estimated Gloeruler Filtration Rate, HbA1c: Hemoglobin A1c
Hb A1c <7>
Table 3. Correlation of serum uric acid with eGFR
Figure 1. Correlation of serum uric acid with eGFR
T2DM is one of the most common metabolic disorders in the world. In T2DM, glucose cannot be utilized by cells and its level in the blood increases. HbA1c increases due to glycolization caused by the increased glucose level in the blood. It has been shown that the increase in HbA1c, which means poor diabetes control in DM patients, is associated with many complications in DM patients. Uric acid, the end product of purine metabolism, has also been suggested to be associated with many diseases (such as metabolic syndrome, hypertension, cardiovascular diseases, DM).
One of the most important causes of elevated uric acid is increased fructose intake. Unlike other sugars, fructose intake has been directly associated with increased uric acid. Increased fructose intake also causes elevated blood glucose and increased HbA1c. It is inevitable that fructose intake may cause serious complications in DM patients due to both increased blood glucose and increased uric acid levels.
There are many different recommendations for the nutrition of DM patients. Some of these recommendations include snacks and eating fruit at these meals. In addition, eating fruit is constantly encouraged for the body's need for vitamins. However, it is understood that fruits, which are very rich in fructose, will do more harm than good because they increase both blood sugar and uric acid. The most important issue in the treatment of DM patients is to pay attention to fructose intake in the diet of patients.
It was observed that eGFR decreased as serum uric acid level increased and this decrease was independent of HbA1c. Therefore, it shows that reducing fructose intake in DM patients is very important in terms of both blood glucose control and uric acid reduction.
Financial Support
The author reports no financial support regarding content of this article.
Ethical Declaration
This study was decided by Lokman Hekim University Scientific Research Ethics Committee at the meeting dated 16.05.2024 and approved with the number 2024/59.
This study was carried out in accordance with the ethical principles defined in the Declaration of Helsinki.
Patient Consent Statement
Since the study was retrospective, informed consent was not obtained from the patients.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
