AUCTORES
Research Article | DOI: https://doi.org/10.31579/jnmir/013
1 Consultant Professor in General Surgery, Auxiliary Researcher, General Teaching Hospital, Enrique Cabrera. Havana. Cuba.
2 Auxiliary Assistant in General Surgery, Auxiliary Researcher, General Teaching Hospital, Enrique Cabrera. Havana. Cuba.
3 Assistant Professor in General Surgery, Aggregate Investigator, General Teaching Hospital, Enrique Cabrera. Havana. Cuba.
4 Assistant Professor in General Surgery, General Teaching Hospital, Enrique Cabrera. Havana. Cuba.
5 Auxiliary Teacher in MGI, Associate Researcher, General Teaching Hospital, Enrique Cabrera. Havana. Cuba.
6 Resident third year in General Surgery, General Teaching Hospital, Enrique Cabrera. Havana. Cuba.
*Corresponding Author: Pedro Rolando Lòpez Rodrìguez. Consultant Professor in General Surgery, Auxiliary Researcher, General Teaching Hospital, Enrique Cabrera. Havana. Cuba.
Citation: Pedro Rolando Lòpez Rodrìguez, Olga Caridad Leòn Gonzalez, Jorge Satorre Rocha, Eduardo Castillo Garcia, Luis Marrero Quiala, M. Elisa Puentes Rizo, and Angelica Lais Ceruto Ortiz, Characterization of Patients with Inguinal Hernia Ambulatory Surgical Treatment, J. New Medical Innovations and Research, 2(3): DOI: 10.31579/jnmir/013
Copyright: © guez. This is an open-access article distributed under the terms of The Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 22 March 2021 | Accepted: 05 April 2021 | Published: 12 April 2021
Keywords: inguinal hernia; outpatient treatment; hospital costs; ambulatory surgical treatment; hospital infection; anxiety; local anesthesia; femoral hernia; prosthetic techniques
Introduction: the surgical treatment of inguinal hernia has increased in the last decade and its prevalence is not known.
Objective: Characterization of patients with inguinal hernia ambulatory surgical treatment.
Methods: an observational, descriptive and prospective study of 972 patients with the diagnosis of inguinal hernia was performed, which were operated on an outpatient basis in the General Teaching Hospital "Enrique Cabrera" since January.
From 2009 to December 2020. Emergency operated patients were excluded.
Results: the highest incidence of inguinal hernia was found between the ages of 60 and 80 years. Indirect right inguinal hernia appeared more frequently. Desarda's anatomic surgical technique was the most applied in 410 (42,1%) of the cases and Lichtenstein's hernioplasty with 224 (23.0%) followed in frequency. There was a total of 5 (0.5%) recurrences. Local anesthesia was applied in 828 (85.2%) of the patients, on an outpatient basis they were 100%. The total complications were 42 (4.3%).
Conclusions: surgical treatment of inguinal hernia on an outpatient basis is an appropriate process. It creates comfort in patients, decreases the risk of hospital infection, and reduces waiting lists and hospital costs.
The inguinal hernia is known since man adopted the erect position, so it is one of the most frequent conditions. Its history is as old as humanity itself. It is a topic of interest not only for historians, but for compulsory knowledge for anatomists and surgeons. The first description of hernia reduction dates from the time of Hammurabi in the Egyptian papyri [1].
According to the Papyrus of Ebers, dating from 1560 BC, the hernia is a tumor in the genitals in which the intestines move. It is the protrusion of an organ of the abdominal cavity through a natural or acquired orifice. Hesinten, in 1794, establishes a Differentiation between hernias treated by direct and indirect inguinal sacs. It is important to note that this had already been
Demonstrated by Cospar Stromary in 1599, who insisted on the uselessness of the sacrifice of the testicle in direct hernias [2].
In 1804, Cospar described the transverse fascia and pointed out that this layer and not the peritoneum and external oblique aponeurysis was the main barrier to avoid herniation. He also defined direct hernia as a defect that occurs through the Hesselbach triangle [3].
With the passing of time came the modern era of hernia surgery, which began with the discovery of antisepsis by Lister, studies on anesthesia, knowledge of the normal physiology of the inguinofemoral region, the introduction of antibiotics and the best understanding of the repair process
Tissue and scarring. Everything was linked to the emergence of better surgical methods as shown by the work of Henry and Marcy in the USA. UU by E. Bassini in Italy [4].
We must point out that from the second half of the eighties a new era began, characterized by the use of prosthetic meshes and patches with which better results are obtained in this surgery. Among the materials used is polypropylene, which is biocompatible with high tensile strength, flexible, impermeable to water and resistant to high temperatures, which makes it sterilizable [5].
The application of outpatient surgery has the following advantages: Altering only alters the patient's life, which receives more individual attention; the anxiety of the patient is attenuated; costs are reduced; decreases the risk of hospital infection and disability; it also facilitates the return to work. All this contributes to improve the quality of the services.
One of the most important aspects of this type of surgery is the application of local anesthesia that improves the cost-benefit ratio of the procedure, decreases the use of hospital beds and allows the patient's collaboration if necessary.
The objective of this study is to evaluate the results of outpatient surgical treatment of this entity, describe the population, techniques and complications from January 2009 to December 2020.
A cross-sectional, retrospective, descriptive observational study of patients operated out of inguinal hernia was performed in the surgery service of the "Enrique Cabrera" General Teaching Hospital in the period from January 2009 to December 2020.
The universe consisted of patients operated on inguinal hernia in the surgery service of the General Teaching Hospital "Enrique Cabrera" from January 2009 to December 2020. The sample consisted of patients operated on inguinal hernia on an outpatient basis by the Group. Basic Work (GBT) No. 1 in the surgery service of said hospital in the aforementioned period.
This study included all patients aged 18 years or older, ASA III or lower risk of anesthesia, obesity not over 50% overweight and carriers of the disease under study. Patients with associated, decompensated and overweight diseases greater than 50% of their body weight were excluded.
The hernia classification used was that of Lloyd M. Nuhys, American surgeon in 1991, who describes a publication based on anatomical criteria.
Type I. Indirect inguinal hernia with normal internal ring.
Type II Indirect inguinal hernia with enlargement of the inner ring.
Type III Contemplate in turn three possibilities:
Type IIIa: Direct inguinal hernia, Type IIIb: Mixed inguinal hernia or in trousers, Type III c: Femoral hernia.
Type IV: All recurrent hernias. Type IV: All recurrent hernias [6].
The principles related to the code of ethics were followed, according to the Helsinki declaration. The security and confidentiality of the information was guaranteed.
It is observed that the most frequent location of the inguinal hernia was the right side with 484 patients for the (49.8%) of the total, of which 62.2%, were indirect. The average age of the patients included in the study was 57.4 years. There were five recurrent hernias (0.5%). According to the Nyhus classification, there were a total of 972 patients with hernias belonging to types II and III b, which were the most frequent (Table 1).
Sex | No | % |
Female | 104 | 10,7 |
Male | 868 | 89,3 |
Location | ||
Right | 484 | 49,8 |
Left | 386 | 39,7 |
Bilateral | 102 | 10,5 |
Variety | ||
Indirect | 605 | 62,2 |
Direct | 325 | 33,4 |
Mixed | 42 | 4,4 |
Classification of Nyhus | ||
Type I | 0 | - |
Type II | 438 | 40,8 |
Type IIIa | 296 | 27,4 |
Type IIIb | 256 | 24,0 |
Type IIIc | 0 | - |
Type IV | 84 | 7,8 |
Table No 1: Sex, location, and classification of hernias.
The operative techniques most used in inguinal hernias are shown in Table 2. Non-prosthetic techniques were applied and of these the most performed was the Mohan P. Desarda technique in 410 patients 42.1%). Within the prosthetic techniques, the most applied was that of Lichtenstein, in 224 patients (23.0%).
Techniques | No | % | Recurrence | % |
Shouldice | 6 | 0,6 |
|
|
Zimmerman I | 10 | 1,0 |
|
|
Madden | 8 | 0,8 | 1 | 12,5 |
Mc Vay | 20 | 2,0 |
|
|
Goderiche | 8 | 0,8 | 1 | 12,5 |
Bassini | 10 | 1,0 |
|
|
Camayd | 2 | 0,2 |
|
|
Lotheissen Mc Vay | 6 | 0,6 |
|
|
Halsted | 6 | 0,6 |
|
|
Desarda | 410 | 42,1 | 2 | 0,4 |
Plug de Rutkow | 2 | 0,2 |
|
|
Marcy | 12 | 1,2 |
|
|
Rives | 22 | 2,2 |
|
|
Lichtenstein | 224 | 23,0 | 1 | 0,4 |
Rutkow-Robbins | 8 | 0,8 |
|
|
Desarda Modificada | 212 | 22,0 |
|
|
Zimmerman II | 6 | 0,6 |
|
|
Total | 972 | 100,0 | 5 | 0,5 |
Table No 2: Relationship between relied techniques and recurrence.
Table 3 shows the most used anesthetic procedures. Local anesthesia was applied in 828 patients (85.2%) of the total, followed by spinal anesthesia or spinal anesthesia in 66 patients (8.8%).
Procedures | No | % |
Local Anesthesia | 828 | 85,2 |
Spinal Anesthesia | 130 | 13,4 |
General and Endotracheal Anesthesia | 7 | 0,7 |
Acupuncture Anesthesia | 0 | - |
Peridural Anesthesia | 3 | 0,3 |
General Endovenous Anesthesia | 4 | 0,4 |
Total | 972 | 100,0 |
Table No 3: Analgesic Procedures.
The associated diseases are shown in Table 4, with the prevalence of arterial hypertension 155 patients (16.0%) and the conditions associated with umbilical hernia with 13 patients (1.3%).
Associated Diseases and Associated Conditions | No | % |
Ischemic Cardiopathy | 30 | 3,5 |
Arterial Hypertension | 155 | 19,0 |
Diabetes Mellitus | 38 | 4,0 |
Umbilical Herniorraphy | 13 | 1,3 |
Femoral Herniorraphy | 6 | 0, 6 |
Incisional Herniorraphy | 3 | 0,3 |
Eversiòn of Vaginal | 3 | 0,3 |
Total | 248 | 25,5 |
Table No 4: Diseases and Associated Conditions.
Table 5 shows the distribution of complications in patients undergoing local anesthesia in the period from January 2009 to December 2020, at the "Enrique Cabrera" General Teaching Hospital.
Complications | No | % |
Seromas | 13 | 1,3 |
Recurrences | 5 | 0,5 |
Hematomas | 6 | 0,6 |
Orchitis | 5 | 0,5 |
Bladder Piercing | 2 | 0,2 |
Infection of the surgical site | 11 | 1,1 |
Total | 42 | 4,3 |
Table No 5: Complications.
It is observed that the seroma was the complication that most frequently presented 13 patients (1,3), followed by infection of the surgical site 11 patients (1,1) and in total 42 complicated patients (4,3).
The results obtained in this series are consistent with those obtained by different authors and differ from others who point out the primacy of inguinal hernia in younger patients. There was predominance of males, results similar to those referred in several studies on the subject [7,8].
According to experts in the field, up to 25% of males and only 2% of females will develop inguinal hernia at some point in their life. This fact has been related to the descent of the testicle, with a greater thickness of the spermatic cord and with a lower obliquity of the inguinal canal in man.
In the opinion of the authors, who share the Goderich criterion, 8 when other conditions are concomitant, patients should be treated before having herniorrhaphy to avoid postoperative discomfort and the increase in the recurrence rate. There are also criteria that the McBurney incision during appendectomy is related to the appearance of inguinal hernia. In the present work the ages ranged between 60 and 80 years, which is similar to the literature reviewed. The right inguinal hernia was the most frequent, as well as the indirect variety on both sides. It was also observed that the highest number of hernias corresponded to variety II, from the Nyhus classification, (144 patients) and variety III b (103 patients) [6,9]. Every surgeon who frequently intervenes in patients with a hernia of the inguinal region knows that there are innumerable surgical techniques, to which advantages and disadvantages are indicated. The purpose is to reduce complications and, above all, to avoid recurrences [10]. There are so-called classical (anatomical) techniques that repair the defect of the inguinal wall with the patient's own tissues and, the so-called prosthetic techniques, which use synthetic materials that have had a great development in recent decades and whose application always leads to the same purposes as anatomical.
It was observed that the most used anatomical technique was that of Mohan P. Desarda, followed by the Lichtenstein technique. For some years now, a basic working group of our surgical service has applied the anatomical technique of Professor Desarda and has obtained good results. This technique, as pointed out by its creator, has some advantages, among which are its easy learning and execution, available to residents and surgeons not specialized in the treatment of this disease [11,12]. The technique provides a posterior wall of the canal Strong inguinal, mobile and physiologically active. When not using the mesh (foreign body) the fibrosis is minimal or does not exist, there is no rejection to foreign body and the postoperative pain on the fifth day of the operation is less than with the techniques that use prosthesis. With the application of local anesthesia, to carry out the outpatient procedure in these patients, the complications were minimal [13,14].
By carefully analyzing the number of recurrences and the level of preparation of the acting surgeon, it was found that all patients operated by residents were helped by specialists, who correct the possible defects of the operative procedure, this contributes to the technical improvement and the increase of skills and skills during the surgical act. In Cuba, this has greater relevance, since the teaching care system guarantees the integral surgical training of the resident, an aspect not comparable with what is referred to in the international medical bibliography, where this centralization does not exist [15-17].
In this series there were no deaths. None of the operated patients had the need to change their occupation, or difficulty to get into their job before 60 days. It is important to highlight the late complications of this procedure, such as the rejection of the bioprosthesis and the appearance of fistulas and granulomas.
We must point out that in this center the various techniques of hernia repair, facial and aponeurotic are applied, with the use of prosthetic meshes or without these, with good results, especially in the repair of hernias with tension-free facial techniques, since anatomically it is more physiological, compared at the same time, with national and international studies [18].
Taking into account the large number of patients operated during the study period, the savings contributed to the hospital by the reduction of occupied beds, the decrease in the cost of materials and medicines, the faster recovery of patients and the incorporation into their social environment and labor. It is concluded that outpatient surgery with local anesthesia plus sedation is a beneficial method for patients and hospital institutions and this is shown in the results in this case [19-25].
The male sex, the right location of the hernia and the type II of Nuhys predominated the herniorrhaphy Desarda, the local nestesia and serona as a complication were more frequent, being the hernia recurrence in our work was 0.5%. As summary we can say that, The treatment of inguinal hernia on an outpatient basis results in satisfactory results.
Conflicts of interest
The authors do not declare having conflicts of interest.
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.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.