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Research Article | DOI: https://doi.org/10.31579/2768-2757/203
Department of Oral and Maxillofacial Surgery, Kantipur Dental College Teaching Hospital and Research Center, Kathmandu University, Nepal.
*Corresponding Author: Desar Bikash., Department of Oral and Maxillofacial Surgery, Kantipur Dental College Teaching Hospital and Research Center, Kathmandu University, Nepal.
Citation: Desar Bikash., (2026), Leprosy Patients and Its Dental Problems Management-A Cross Sectional Study, Journal of Clinical Surgery and Research, 7(2); DOI:10.31579/2768-2757/203
Copyright: © 2026, Desar Bikash. 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: 17 March 2026 | Accepted: 30 March 2026 | Published: 10 April 2026
Keywords: leprosy; mycobacterium leprae; oral health; orofacial
Objectives:
Leprosy is a chronic, non-fatal disease caused by Mycobacterium leprae. It can cause cutaneous lesions, peripheral nerve lesions and orofacial manifestations, including destruction of the alveolar premaxillary process associated with loss of the maxillary incisors. The aims of this study were to assess orofacial manifestations of disease in patients attending Anandaban Hospital Lele, and develop clinical guidelines for dentists.
Materials and Methods:
A cross-sectional questionnaire-based study was administered to 43 diagnosed leprosy patients. This included questions on perceived oral health status and oral hygiene habits. An extra-oral and intra-oral examination was also performed.
Results: Eighty-four per cent of patients were male with a mean age of 35.9 years. Forty-nine per cent had extra-oral cutaneous lesions. Twenty-eight per cent had intra-oral lesions including hyperpigmented patches. Twenty-one per cent had cranial nerve involvement and the trigeminal nerve was most commonly affected.
Conclusions:
From this data a clinical dental pathway protocol for managing patients with leprosy was developed. It highlights dental issues when managing leprosy patients. Nerve involvement may mean patients are unable to give an accurate account of their symptoms. Special tests should include cranial nerve examination and swabs of intra-oral ulcers. Low rates of infectivity means that normal infection control measures can be taken when treating these patients.
Although viewed by many as a disease of antiquity which died out in Europe centuries ago, leprosy continues to present a worldwide health challenge. In 2010, 228,474 new cases were reported globally by 130 countries. With 126,800 new cases reported in 2010, India has the highest incidence of leprosy in the world1. Leprosy is a chronic, non-fatal disease caused by the acid-fast bacillus Mycobacterium leprae. The route of transmission is thought to be person-to-person via nasal droplets. The mycobacterium causes chronic granulomatous inflammation affecting the skin, eyes and peripheral nerves leading to anaesthetic skin lesions and peripheral neuropathies 2 The clinical presentation and classification of leprosy depends on the level of cell-mediated immunity (CMI) expressed by that individual towards the mycobacterium. The different types of leprosy are categorised according to the Ridley–Jopling classification: Tuberculoid (TT), Borderline Tuberculoid (BT), Borderline (BB), Borderline Lepromatous (BL) and Lepromatous (LL). Patients with high levels of CMI tend to develop the tuberculoid form with few lesions and undetectable mycobacteria. Patients with absent CMI develop lepromatous leprosy with multiple lesions and detectable mycobacteria. The borderline leprosy types lie between these two and develop in patients who have a degree of CMI, but they can develop multiple lesions because of unstable immunity. The World Health Organization (WHO) also recommends a further classification into Paucibacillary (PB) and Multibacillary (MB) types of leprosy to simplify multidrug therapy. Paucibacillary leprosy is defined as having one to five skin patches with definite sensory loss or any one nerve trunk affected by leprosy and MB leprosy is defined as having six or more skin patches with definite sensory loss, or two or more nerve trunks affected by leprosy or the presence of five skin patches and one nerve trunk (i.e. six lesions; see Table 1)3., 4.
| Host’s resistance Clinical manifestations of leprosy |
| Excellent None (no infection) |
| Good None (subclinical infection showing spontaneous regression) |
| Fair Tuberculoid leprosy (TT) Paucibacillary leprosy (PB) |
| Borderline tuberculoid leprosy (BT) |
| Poor Mid-borderline leprosy (BB) Multibacillary leprosy (MB) |
| Borderline-lepromatous leprosy (BL) |
| Very poor/none Lepromatous leprosy (LL) Multibacillary leprosy (MB) |
Table 1: The level of host resistance to infection leads to a range of clinical manifestations.
Adapted from Leprosy for Medical Practitioners and Paramedical Workers S.J. Yawalkar (2002)5. Nerve damage is a serious complication of leprosy as it can lead to dryness, weakness of muscles and anaesthesia. This combination can lead to misuse of limbs and subsequent deformity and disability. The risk of disability is higher in patients with borderline leprosy. Leprosy is currently the leading infectious cause of disability4. The WHO has graded disability in leprosy into three categories; Grade 0 (no disability), Grade 1 (sensory impairment in the hands and feet or visual impairment in the eyes) and Grade 2 (visible deformity in the hands and feet, including ulcers, contractures and bone absorption or very reduced visual acuity, lagophthalmos or iritis in the eyes 6 . Leprosy may have relevance to dentistry because it often has orofacial manifestations. Of the different types of leprosy, LL is most commonly associated with orofacial disorders. These include intra-oral nodules on the palate, dorsum of tongue, lips and pharynx and skeletal changes which can cause destruction of the alveolar premaxillary process associated with loss or loosening of the maxillary incisors7. These nasal and orofacial changes are likely to be a result of the preference of M. leprae for cooler sites. However, it is not entirely clear whether these changes are related to the disease or poor oral health compounded by the lifestyle of a leprosy patient8., 9. A study in Fontilles, Spain, compared the presence of oral disease in a group of 76 patients with leprosy with matched control subjects and found that although the decayed, missing and filled (DMF) index was not significantly higher in the leprosy group, the number of missing teeth and filled teeth was significantly lower and higher, respectively10. This may suggest inequalities in access to the quality of dental care received. Another study done in Serra, Brazil, also examined oral disease in a cohort of 99 leprosy patients. Again, a high DMF index was noted, indicating a lack of oral health prevention, treatment and poor access to dental care11. In the UK, leprosy is a notifiable disease. Between 1999 and 2008, 36 cases of leprosy were reported in England and Wales. Seventy-five per cent of these cases were male, 70% were aged 15–44 years and 50% were from the Indian subcontinent12. Undernotification of the disease is likely because of its rare nature and low levels of awareness among health-care professional regarding its clinical presentation and diagnosis. Low levels of awareness mean that patients with leprosy in England and Wales still suffer considerable morbidity because of delays in diagnosis. There is often a very long lag time between infection and onset of symptoms, which means that cases from endemic areas may continue to present for several years. Therefore, it is important that all health-care professionals remain vigilant for the disease and consider leprosy in the event of undiagnosed orofacial lesions or unexplained cranial nerve impairments in patients who have lived in endemic areas. Based in Sion-Chunnabhatti, a slum area in Mumbai, India, the Bombay Leprosy project is a voluntary not-for-profit organisation where patients are diagnosed and treated for leprosy. It covers a population of two million in Mumbai and is also one of the main leprosy referral centres in India. Therefore, the aim of this project was to assess orofacial manifestations of disease in leprosy patients attending the Bombay Leprosy Project clinics and to develop a clinical pathway protocol for dental professionals in the UK.
A questionnaire was distributed to a random group of 43 patients attending the Anandaban Hospital Lele. This included questions regarding perceived oral health status, utilisation of dental services and barriers to care and oral hygiene habits. An extra-oral and intra-oral examination was also done to record a DMF index, the need and use of prosthesis, periodontal disease and the presence of mucous membrane oral lesions. Dental charting was used to record the presence of decayed, missing or filled teeth and the James index was used to classify periodontal disease as good, fair or poor, depending on the amount of debris and calculus present. A cranial nerve examination was also performed and documented for each patient. To confirm intra-examiner reliability, 10% of patients were recalled for a later repeat examination. Demographic data regarding age, gender, type of leprosy, treatment, disability grading and habits including chewing of paan were also collected from the medical notes. Interns from the Bombay Leprosy Project Clinic were assigned to help with translation and transcription from the medical notes. All patients were consented for treatment at BLP and a copy of the questionnaire and examination for each patient was left at BLP for inclusion in their medical notes, so as to form part of their care plan. The study was conducted in full accordance with the World Medical Association Declaration of Helsinki. All data were entered into Excel for analysis.
Forty three patients were recruited into the study, 36 male (84%) and 7 female (16%) and the age ranged from 8–70 years (mean age 35.9 years). Five patients (12%) had PB leprosy and 38 patients (88%) had MB leprosy. Most patients (93%) were currently receiving treatment for leprosy or had received treatment in the past. Only five patients (12%) smoked but 20 patients (47%) chewed either paan, or tobacco or both. With regard to disability of the hands, 11 patients (26%) had a Grade 2 visible deformity, five (12%) of which exhibited deformity in both hands and nine (21%) had a Grade 1 sensory impairment. With regard to the feet, three patients (7%) had a Grade 2 disability and eight patients (19%) had Grade 1 disability. Three patients (7%) had Grade 2 eye disability and no patients had a grade 1 eye disability.
Questionnaire results
Of the 43 patients, 30 (70%) reported satisfaction with their current oral health. One patient (2%) reported the condition of their mouth to be ‘excellent’, 24 (56%) reported it to be ‘good’, 15 (35%) reported it as fair and three (7%) reported it as ‘poor’. Although 29 patients (67%) reported current problems with their teeth, including pain, bleeding or swollen gingivae, pus, cavities and loose teeth, none of them were currently seeing a dentist. Thirty patients (70%) had never visited a dentist and the 13 patients (30%) only attended for a specific problem such as pain. None of the patients interviewed attended the dentist regularly. For those who had been to see a dentist, eight patients out of the 13 received a tooth extraction and two were advised to have a tooth extraction, making it the most common treatment. Seven of the 13 patients were satisfied with the treatment they received and would be happy to return. However the other six reported reluctance in returning for various reasons, which included not wanting to have more teeth extracted or having too many appointments to attend. Of those who never visited a dentist the main reason for not attending was that they did not perceive a need to attend, even if they had current problems with their teeth. Out of the 30 patients, 18 (60%) would tell the dentist about their diagnosis with leprosy, often because they felt that the dentist should know about their medication. Out of the other 12 patients, nine would only tell the dentist about their diagnosis if the dentist specifically asked about it. Only six patients (14%) thought that leprosy could affect the mouth and teeth. With regard to oral hygiene, a range of dentifrices were used. Most patients (28 patients, 65%) used a toothbrush and toothpaste, however other dentifrices such as ayurvedic powder or tobacco powder were used. Seven patients (16%) used fingers instead of a toothbrush, four of which had Grade 2 disability in the hands. One patient (2%) with Grade 2 disability in the hands used neem sticks to clean their teeth. Only two patients (4%) had ever received any oral hygiene advice from a health-care professional. The majority of patients (74%) would prefer to have a filling rather than having an extraction if they could.
Examination results
Nine patients (21%) were found to have cranial nerve impairment. Five patients (12%) were found to have involvement of the trigeminal nerve and four patients (9%) had involvement of the seventh cranial nerve. Twenty-one patients (49%) had extra-oral lesions which included nodules, erythema and hypopigmented patches of anaesthesia (Figures 1 and 2). Twelve patients (28%) had intra-oral lesions which included sinuses and diffuse areas of hyperpigmentation (Figures 3 and 4). Out of these 12 patients, nine (21%) also chewed either paan, or tobacco or both. Only one patient had intra-oral ulceration and this was in the gingivae above the upper left central the patients examined exhibited any bony or skeletal changes. Figure 1
Figure 1: Open in a new tab Hypopigmented lesions.
Figure 2: Open in a new tab Nodular lesions on the face.
Figure 3: Open in a new tab Hyperpigmented intra-oral lesions on the buccal mucosa and palate.
Figure 4: Hyperpigmented intra-oral lesions on the buccal mucosa and palate.
Figure 5: Gingival ulceration above the upper left central incisor.
Interestingly, the DMF index in this group ranged from 0 to 21 and the mean was 3.42. The mean number of decayed teeth was 2 and the mean number of missing teeth was 1.5. None of the 43 patients had any fillings. Regarding the periodontal status, using the James Index, 13 patients (30%) had good oral hygiene, 15 (35%) had fair oral hygiene and 15 (35%) had poor oral hygiene. Only one patient had a prosthesis, which was a fixed acrylic device on the lower anterior teeth (Figure 6).
Figure 6: Fixed acrylic prosthesis on lower anterior teeth.
The majority of patients reviewed in this study were male. This is probably because most migrant workers who come to Mumbai are male whereas females tend to stay at home and care for the family. This indicates gender inequalities in access to health care. Other studies from Ethiopia and Bangladesh have also reported that women with leprosy have longer delays in diagnosis and therefore higher levels of nerve damage and disability on presentation, which, in turn can have an impact on oral hygiene and oral health2. Not many women were included in this study, so although the majority of women (four out of seven) had poor periodontal health according to the James Index, it is difficult to make conclusions as to whether women had worse oral hygiene or DMF scores. The mean DMF was 3.42 and although comparable to other non-leprosy groups in India13, this is significantly lower than other studies done in Spain and Brazil where the mean score was reported as 19.06 and 14.4, respectively10., 11.. However, it is worth noting that the DMF for the general Brazilian population is also higher. Furthermore the study in Spain was done on leprosy patients resident in a sanatorium. The patients who attend BLP clinics are often those who have been diagnosed and treated early and therefore have less advanced disease. Patients residing in leprosy colonies tend to be older and have more advanced disease as multidrug therapy was less widely available in the past. Therefore they are very likely to have higher DMF indexes. There were no filled teeth in this study. The majority of patients in this study who had attended a dentist were treated with tooth extraction, which is characteristic of other disadvantaged groups. The patients in this study had a spectrum of oral hygiene levels, which was also seen in those with Grade 2 disability of the hands. In patients with deformity of the hands, the use of made-to-measure grip aids is advocated to improve handling of various implements such as pens and toothbrushes (Figure 7). Although the use of grip aids was not asked about in the questionnaire, one study has shown that they can improve oral hygiene14. However, it should also be noted that the two patients seen in this study with the most advanced disability and deformity of the hands (Figures 8 and 9) did not use toothbrushes with grip-aids, instead they used fingers or neem sticks. Figure 7.
Figure 7: Open in a new tab Grip-aids made of epoxy resin putty to assist eating and toothbrushing.
Figure 8: Advanced deformity causing disability of the hands.
Figure 9: Open in a new tab Advanced deformity causing disability of the hands.
Although relatively uncommon, for dentists, cranial nerve involvement is an important feature of leprosy. This study found the trigeminal nerve and the facial nerve were the most commonly affected nerves, which is similar to previous studies and reports15., 16.. This may have specific implications for the teeth. One patient who was found to have involvement of both the maxillary and mandibular branches of the trigeminal nerve reported anaesthesia on the affected side of the face and a feeling of ‘looseness’ within the teeth. Involvement of the buccal and mandibular branch of the facial nerve may also have implications for mastication and speech (see Figure 1). This emphasises the need for cranial nerve assessment in patients with leprosy. No bony or skeletal changes were seen as this sample of patients had received treatment in the early stages of the disease. This is consistent with other studies which have found that oral manifestations of leprosy are generally not present in patients undergoing treatment for leprosy17. As only one patient had any form of intra-oral ulceration, this was not a common feature. However the site may be significant as it was situated above the upper left central incisor. The characteristic triad of lesions in the mid-face, known as facies leprosa, consists of loss of the anterior nasal spine, alveolar inflammation and resorption of the anterior maxillary process16. An ulcer in this part of the mouth may be an early feature of infection with M. leprae and it may be worth doing swabs for microscopy from intra-oral ulcers to give an indication of infectivity. Although intra-oral soft tissue lesions were seen in 28% of patients, with the exception of oral ulceration, none were thought to be indicative of leprosy. This is because other confounding factors such as paan and tobacco chewing were often present.
Recommendations For Clinical Assessment by Dentists
From this data a clinical pathway protocol for managing patients with leprosy was developed (Figure 10). Management depends on whether the patient has a definitive diagnosis of leprosy or not. If they have then this should have been notified to the consultant in communicable diseases. In the patient history clinicians should be aware that a patient may or may not complain of pain caused by nerve involvement. The dental history may reveal problems accessing care and patients are more likely to have been treated for dental problems with extractions rather than restorations. Patients may not disclose their diagnosis of leprosy but their drug regimens should be recognisable. Habits such as chewing paan should also be noted. In the examination, extra-oral systemic features should be noted. This includes cutaneous features in the head and neck and disabilities in the hands and feet which may affect oral hygiene. Intra-orally, the soft tissues should be examined for ulcers. As with any routine examination, oral hygiene levels should be noted and charting should be done. Special tests such as cranial nerve testing and swabs should also be done. Liaison with a specialist physician should also be considered. Management of the patient should include adaption of oral hygiene procedures according to the patient’s level of disability and specialist referrals may also be required, for example to oral medicine for management of soft tissue lesions.
Figure 10.
Figure 10: Open in a new tab A clinical pathway protocol for dentists to manage leprosy patients.
If there is no definitive diagnosis, but leprosy is suspected, then, following routine history and examination, cranial nerve testing should be done with referral to a specialist unit. Liaison with the consultant in communicable diseases should also be considered. All patients should be given routine dental care using standard infection control as the disease has low rates of infectivity.
As the questionnaire was administered by a third party, translation was an issue. Language barriers made it difficult to assess stigma or perceptions of oral health. Limited resources and disposal facilities meant that only mirrors and no probes were used for oral examinations. Patients often did not know how to decide when asked certain questions, possibly as a result of low levels of education. During the 2-week period the Ganesh festival and Eid were taking place, which resulted in clinics being closed and fewer patients attending.
This study highlighted various issues that dentists should be aware of when managing leprosy patients. Nerve involvement may mean that patients are unable to give an accurate account of their symptoms such as pain. Systemic features should be noted as disabilities affecting the hands and feet can affect oral hygiene. Management of caries in this group is usually with extraction. Special tests should include cranial nerve testing and swabs of intra-oral ulcers should be taken as this may be an important early feature of leprosy. As the disease has low rates of infectivity, normal infection control measures can be used when managing these patients.
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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.
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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.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
Dear Grace Pierce, Editorial Coordinator of the journal IJCCR, I had a very positive experience with Auctores - Journal throughout the publication process. The Editorial Team was highly responsive, professional, and supportive at every stage. I would like to extend my sincere thanks to the Editor: Grace Pierce, for her guidance and assistance. The peer-review process was smooth and constructive, helping improve the quality of my work. I would gladly recommend Auctores Journal to fellow researchers and authors. Dr. SABITA SINHA, Medical Oncologist, MD (Electro Homeopathy).
Dear Maria Emerson, Editorial Coordinator of - Journal of Clinical Research and Reports. ''I am pleased to provide this testimonial following the publication of our recent case report in this journal. The peer review process was rigorous, constructive, thorough, and conducted in a timely manner. The reviewers’ comments were thoughtful, detailed, and highly constructive, contributing substantially to the refinement, clarity, and scientific robustness of our manuscript. The process was conducted with professionalism and academic integrity throughout. The support provided by the editorial office was exemplary. Communication was consistently prompt, clear, and courteous at all stages of the submission and publication process. The editorial team demonstrated a high level of organization and responsiveness, ensuring that all queries were addressed efficiently and that the process remained transparent and well-coordinated. The overall quality of the journal is reflected in its strong editorial standards, commitment to scientific excellence, and dedication to publishing clinically meaningful research. It has been a privilege to publish our work in this journal, and we would welcome the opportunity to contribute further in the future.'' Best wishes from, Dr. Efstratios Trogkanis, Cardiologist.
Dear Reader: We have published several articles in the Auctores Publishing, LLC, journal, Clinical Medical Reviews and Reports in recent years (CMRR). This is an ‘open access’ journal and the following are our observations. From the initial invitation to submit an article, to the final edits of galley proofs, we have found CMRR personnel to be professional, responsive, rapid and thorough. This entire process begins with Catherine Mitchell, Editorial Coordinator. She is simply outstanding, and, I believe, unparalleled in her capacity. I cannot imagine a more responsive and dedicated Editorial Coordinator. As I read the dates and timing of her correspondence with us, it seems that she never sleeps. I hope Auctores Publishing, LLC, appreciates her efforts as much as these authors do. Thank you to Auctores Publishing, LLC, to the Editorial Staff/Board, and to Catherine Mitchell from a grateful author(s).
