AUCTORES
Globalize your Research
Research Article | DOI: https://doi.org/10.31579/2690-1919/095
Department of Biotechnology, Faculty of Science, Indira Gandhi National Tribal University, Amarkantak, Madhya Pradesh (484886), India.
*Corresponding Author: Parikipandla Sridevi, Department of Biotechnology, Faculty of Science, Indira Gandhi National Tribal University, Amarkantak, Madhya Pradesh (484886), India.
Citation: Kshitij RB Singh, Sree Lekshmi KK, Diptimayee Manasingh, Srusti Badajena, Parikipandla Sridevi. Polycystic Ovarian Syndrome Burden In Central India: A Cross-Sectional Study!. J Clinical Research and Reports, 4(3); DOI:10.31579/2690-1919/095
Copyright: © 2020 Parikipandla Sridevi. 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: 27 April 2020 | Accepted: 17 May 2020 | Published: 05 June 2020
Keywords: polycystic ovarian syndrome; PCOS; infertility; hirsutism; hyperandrogenism
Background: Polycystic Ovarian Syndrome (PCOS) is a common endocrine syndrome with the disproportionate activity of androgen. This study is intended to determine attitudes with respect to the present names for the syndrome and acuities held by women regarding the main clinical features of PCOS. The study compares the status of PCOS patients and reproductive-aged tribal women prone to PCOS in the population of Central India at Amarkantak.
Methods: A cross-sectional study was performed in which a sample size of 500 females by random sampling was considered for the study and a well-validated questionnaire following the Rotterdam criteria for the diagnosis of PCOS was administered. Data collected relating to PCOS risk factors and the status of disease burden in society were analyzed using SPSS v 25.
Results: The prevalence of the PCOS was around 6.6% owing to wretched lifestyle practices. Midst them, the risk factors were depression/anxiety in 32.2%, obesity in 28.4%, diabetes in 7.6% and infertility in 1.8%. 86.6% of people were unaware of the disorder and 41.8% of them were prone to PCOS.
Conclusion: Early detection and tracking of risk factors can help in the management of PCOS symptoms. A population-based program of screening and awareness including treatment modalities may be beneficial for the management of the disease.
Polycystic Ovarian Disease (PCOD) stands for triad of 'Amenorrhea', 'Obesity' and 'Hirsutism’, relating to reproductive disorders [1]. Henceforth, it is also known as the hyper androgenic disorder, affecting nearly 6-10% of reproductive-aged women and is the most common endocrine metabolic disorder as it can be associated with metabolic concerns like obesity, insulin resistance, hyper-insulinemia and type 2 diabetes mellitus (TD2M) [2]. The disorder can be depicted by hyperandrogenemia (biochemical primarily) and polycystic ovaries (morphological) and PCOD can be associated to risk factors like cardiovascular problems, neuro-psychological effects, endometrial and breast cancers secondarily [3].
Over the last 15 years, the outline of disease status in India in general and mainly in rural India has endured a significant shift. Government of India report in 2001-2003 presented an early suspicion of this change on the causes of death in the country. Deaths in rural India due to communicable diseases (41%), according to the report, correspond to those due to non-communicable diseases (NCDs) (40%). It is evident from the data of WHO that, the total NCD mortality was approximately 40% whereas the premature NCD mortality was 48% [4]. PCOD is now considered as a lifestyle disorder and till date there has been no cause identified for this disorder. Thus, genetic and environmental aspect play a major role in etiology.
Clinical aspects in case of PCOS show a very broad-spectrum criteria for diagnosis. Ovulatory dysfunction cannot be confined by the presence of oligomenorrhea only, as diagnosis shall be appropriate also when progesterone levels are <3-4ng/mL in 20-24 days of menstrual cycle. In contrast hyperprogesteronemia can also result in anovulation in at least 2 cycles which can also make the patient anovulatory. Presence of acanthosis nigricans with symptoms of hyperandrogenism also shows to be criteria for diagnosis for PCOS [5]. According to the 2003 Rotterdam PCOS census, women with anovulation can be evaluated with early failure of ovarian considered for low E2 (estradiol test) and high FSH (Follicle stimulating hormone) concentrations and also serum FSH and E2 levels to exclude hypogonadotropic hypogonadism characterized according to the World Health Organization (WHO) classification [6]. Women with PCOS were observed with elevated levels of circulating LH (Lieutinizing hormone) as well as it relates to FSH levels [7]. PCOS affected women with frequent risk of developing type 2 diabetes at an occurrence of 3-7 times [8, 9]. There is also a clear evidence of women with PCOS in high risk for developing cardiovascular diseases [10]. Abnormal vascular function (11) and the high chances of incidence to dyslipidemia (12) also risk women affected with PCOS. PCOS patients when assessed show an inverse correlation to metabolic risk factors that are; insulin resistance, BMI, triglycerides, waist-to-hip ratio and total testosterone to Vitamin D and positively correlates to insulin sensitivity (13-15).
Reasons of threat-
Cardiovascular problems
According to the global action plan for the precaution and control of NCDs 2013-2020, that includes 25% relative reduction in premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 2025 (16). In January 1997, a study held at New-Zealand reported that women who had heart diseases also with 8/>% ovarian cysts, was 42% when compared to women without heart diseases were 22% (17). Henceforth, the conditions in which they live and work should be recognized and also the lifestyle that influences their health and quality of life should be monitored.
Obesity
It is observed that, 50% of PCOS women are affected by obesity. As per the WHO data till 2016, 39 % of women aged 18 and above are overweight (18). Typically, present in patients who get affected with upper body obesity are found to be linked with menstrual instabilities (19). Earlier the condition of obesity was found to be a cause of PCOS, but now it has been observed to be a modifier of the disorder (20).
Infertility
PCOS has another ambiguous difficulty of infertility as it affects the ovulation and fertility with 75 %< anovulation infertility in women (21). American Society for Reproductive medicine reports that after six months of pregnancy attempt failure once the couple had sexual intercourse more than two times deprived of any contraceptive measures, then infertility in women with PCOS should be examined (22).
This survey depicts the assessment and analysis of PCOS burden in the middle aged-women in Central India. Furthermore, the risk factors related to the disease was evaluated based on the comparative study and the burden of the disease was summarized among the population.
The cross-sectional study was performed in the tribal population of Amarkantak region, district Anuppur, Madhya Pradesh, India. Survey material was developed by strictly following the 2003 Rotterdam consensus in this consensus group of scientists and medical practitioner decided that PCOS is a syndrome of ovarian dysfunction, and also shows some key features like polycystic ovary (PCO) morphology and hyperandrogenism. For PCOS single clinical diagnosis criteria is not sufficient such as hyperandrogenism or PCO. Menstrual irregularities, signs of androgen excess, and obesity are some of its clinical manifestations. Insulin resistance and elevated serum LH levels along with risk of having type 2 diabetes and cardiovascular problems are also common features in PCOS (23). After the development of questionnaire, it was tested by presurvey analysis before going for the final administration. A total of 22 questions were asked to 500 female subjects from age group between 15-45 years. This is a survey-based study for the assessment, analysis and awareness program of PCOS in the tribal population. The participants who were included in the survey are students of higher secondary school, colleges/university and women working to earn their living. The reason to select this age group for study is that adolescent girls, and middle-aged women have developed reproductive abilities so chance of getting diagnosed or having PCOS are more in this age group. Children’s and women’s after menopause, are excluded from the study as they are not having menstrual disturbances or any symptoms of PCOS. The questionnaire prepared was utilized to take interview for data collection by random sampling method and for the study, the local tribal population of Pondki and Lalpur village of Amarkantak region was selected. The study was steered from February to June of 2019. In the first month the questionnaire was framed and validated. Subsequent four months were for the data collection and data analysis. Before going for the survey few hypotheses were framed as follows
After hypothesis was framed data was collected by conducting personal interviews and spreading awareness among the population was also carried out simultaneously to the respondents regarding PCOS risk factors after interview. For this study the ethical approval was taken from the institutional ethics committee as ethics are the prime concern, as the data collected regarding the personal aspect of an individual is very confidential and in this project the data was utilized only for analysis and assessment of PCOS, the surveyor obtained consent from the subjects prior to the data collection by assuring confidentiality, to the subject to get their cooperation and explained the purpose of the study and the results were kept confidential. Data regarding socio-demographic profile (sex, date of birth, weight, and height), lifestyle status, nutritional habits, menstrual cycle status (oligomenorrhea), chronic anovulation, diabetes, anxiety/depression, obesity, hirsutism, hyperandrogenism and awareness of PCOS among the population was collected.
While collecting the data medical history was recorded, with clinical, anthropometric, and biochemical (LH, FSH, triglycerides ≥150 mg/dL, HDL-C <50 mg/dL, etc.) parameters and subjects already diagnosed with PCOS on these parameters were assessed to get prevalence of this syndrome in tribal society. As there is no validated tool available for making clinical diagnosis of PCOS in the study, Rotterdam criteria of PCOS was considered and by seeing the clinical report of already suffering patients from PCOS and the symptoms of PCOS in population, we have come to conclusion for prevalence of PCOS and Prone to PCOS among the population. After the analysis the participant likely to have PCOS were asked to go for further clinical and ovarian ultrasound examination under the supervision of gynecologist for detailed diagnosis of the disease and the girls with BMI more than 23 kg/m2 were asked for dietary interventions along with counselling for PCOS The data of weight and height was analyzed to get BMI (Body Mass Index) of the population using the formula of BMI preferred by CDC (Centers for Disease Control & Prevention) (24) as given below:
Formula: weight (kg) / [height (m)]2
Calculation: [weight (kg) / height (cm) / height (cm)] x 10,000
After the BMI calculation using the formula given by CDC, it was analysed according to CDC criteria for Adult BMI range the BMI Less than 18.5 kg/m2 was considered as underweight; 18.5 kg/m2 to 24.9 kg/m2, it falls within the normal or Healthy Weight range; 25.0 kg/m2 to 29.9 kg/m2, falls within the overweight range; 30.0 kg/m2 or higher is within the obese range (25). The data was entered in MS Excel spreadsheet as well as in SPSS spreadsheet and analyzed based on comparison of age with hirsutism, menstrual cycle, and disease status; comparison of risk factors with disease status; and finally validation of the framed hypothesis using mean and proportion, Chi square test, ANOVA (One way ANOVA), and Student t-test (Independent sample t-test) analysis was performed with the help of statistical software SPSS v.25 and p-value of <0.05 was examined as significant.
The study shows a socio-demographic profile of 500 women, from which the mean age and mean BMI of the participants were 23.6 (±1.4) years and 22.5 (±4.6) kg/m2 respectively. A total of 10 patients claim to have PCOS with an average BMI of 30.85 kg/m2 (±2.8). With respect to further investigation 28.4% (±0.4%) were reported to be obese. Depression and anxiety were present in 32.2% (±0.4%), diabetes existed in 7.6% (±0.2%) and 1.8% (±0.1%) was reported with infertility (Table 1).
From the study, it was estimated that 14.8% (±0.5%) were adolescent girls in the age group of 15-20 years whereas 24.4% (±0.5%) of young girls were in the group of 21-25 years who were prone to PCOS. It was also evident from the study that the frequencies of subjects having PCOS were 1.8% (±0.9%) in the group of 15-20 years of age and 3.2% (±0.9%) in the age group of 21-25 years which was comparatively higher to other sets of age (Table 2).
From our analysis 12.6% (±0.8%) of girls in the age group of 15-20 years and 23.8% (±0.8%) of girls in the age group of 21-25 years suffer from menstrual disturbances. It is also evident that a very less proportion do suffer from menstrual problems in the age group of 26-30 years, that is just 5.8% (±0.8%%) and much less in case of 31-35 and 36-45 years of age group, 1.6% (±0.8%) and 1.2% (±0.8%) respectively (Table 3).
It was stated that girls had the occurrence of hirsutism in 10.32% (±0.8%) and 27.74% (±0.8%) in the age of 15-20 years and 21-25 years respectively. Comparatively a lesser section has hirsutism with 6.45% (±1.08%) and 1.93% (±1.08%) in the set of 26-30 and 31-35 years of age respectively. The lowest fraction was for the age group of 36-45 years which had only 0.64% for the occurrence of hirsutism (Table 4).
Finally, our study results show that burden of PCOS status in this particular region is projected quite seriously as 6.6% (±0.6%) of the total population, and just 13.4% (±0.3%) of the total population has the proper awareness about the PCOS when the majority of 86.6% (±0.3%), yet unaware about the pros and cons of this disorder, 41.8% (±0.6%) of the population is shown to be prone to PCOS (Table 5).
In the comparative analysis of lifestyle factor with PCOS it can be stated that the subjects with pathetic lifestyle practices are prevalent to PCOS (Figure 1).
India has witnessed about 30% rise in PCOS cases in the last couple of years. Lack of knowledge and lifestyle changes are considered to be the major factor leading to this phenomenon (26). Hence, PCOS have startled more than half number of the adolescent and young aged girls who are becoming susceptible. Girls of adolescent age group (15-20 years) are likely to get affected with PCOS (27). The prevalence of PCOS was found generally in young and reproductive aged women was assessed (28).
From the current study the risk factors are found to be more prevalent in reproductive aged women comparatively in a higher proportion, especially in the case of overweight and obesity, have a higher negative impact on the quality of their life (29). This concern was indeed raised to be more fatal than other problems like the menstrual instabilities (30). In the present study, 28.4% girls of from the total count reported to be obese and 10.4% and 27.6% in the age of 15-20 years and 21-25 years respectively were hirsute which are linked to raise levels of testosterone and presence of PCO on ultrasound (31). In case of overweight earlier studies prove that minimal loss of 5% of weight has shown to stabilize the menstrual disturbances and also accordingly alleviates the metal well-being. Hence, medical conditions of patients of PCOS can be enhanced by controlling the weight of individuals (32).
In the current study the problem of high incidence of hirsutism in most of the reproductive aged-women have shown to concern with greater emotional issues like mood swings, low esteem, worried and depressed feeling (33). Even though menstrual concerns (34, 35) and hirsutism (36) were risk factors for PCOS, but infertility too contributed to be a more cautious feature to the weakened quality of life (37).
The primary stage is proper awareness and diagnosis to improve the life of patients. Accurate alertness regarding the PCOS is much less as is only prevalent in 6.6% of the total population. Morbid lifestyle practices can be controlled to an extent by screening and inducing early interventions and endorsing a healthy lifestyle approach to halt the rise of PCOS as an emerging disorder in adolescent and young girls (38).
PCOS is a common hyper androgenic disorder that are found in a large number of the Indian population with exact etiology unfamiliar but pathophysiology rooted in insulin resistance, hyperandrogenism, and chronic anovulation. From this study it can be concluded that young woman of the population is having higher prevalence of PCOS. Though the major part of population is not suffering from PCOS, but higher percent is prone to this disease just because they have bad lifestyle, the main reason of bad lifestyle is their socio-economic condition as demonstrated in other study conducted to access the lifestyle parameters in this same locality by Singh et al. in 2019 (39). Current study has spread awareness among the female population about PCOS and their risk factors. We have also tried to guide the women having the risk of developing PCOS for proper diagnosis and treatment under consultation of a gynecologist. To treat PCOS, consume healthy diet, stay physically active, and it’s accompanied by added medications to treat the symptoms.
Periodic screening of the candidates with positive family history of PCOS and precise initial diagnosis at early age will help the girls to live healthy life and prevent them from further health hazard.
Hence emphasis should be given on spreading awareness among the girls for lifestyle modification intended for weight loss if BMI is more than 23, dietary interventions along with counselling of village women’s for visiting government hospitals for regular checkups if they feel these symptoms of the disease. Further there are many biological materials (peptide nucleic acids (PNA), xeno-nucleic acids (XNA), threose nucleic acid, locked nucleic acid (LNA), morpholino, etc.) which can be used for making diagnostic devices for point of care diagnosis and treatment of this type of disorders (40, 41).
Observatory study to identify menstrual intervals were not performed. The patients were not screened using clinical tools on biochemical parameters for PCOS such as LH, FSH, triglycerides, HDL-C, etc. This study is based on only questionnaire which is well validated and is strictly based on parameters to assess PCOS burden in society. Study has an issue relating to socio-cultural aspect as this problem is related with steroidal disturbance, infertility in women’s, menstrual disturbances, etc. and these things in tribal societies are considered as taboo in the area, so collecting data was a very difficult task for the investigator along with this problem, language was also a barrier but both the problems were overcome by convincing the tribal women’s of this region by talking to them in the language they are comfortable in, about this issue of PCOS by giving them knowledge about the world and Indian scenario of this syndrome, its unknown etiology, and it’s pathophysiology. They were convinced to adopt a healthy lifestyle by consuming nutritious food and becoming physically active to overcome the symptoms which can later result into this syndrome.
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.
