Review Article | DOI: https://doi.org/10.31579/2690-1919/628
1Professor Department of General Medicine Pacific Medical College & Hospital, Udaipur.
2Associate Professor, Department of General Medicine Pacific Medical College & Hospital, Udaipur.
3Senior Resident, Department of General Medicine Pacific Medical College & Hospital, Udaipur.
4Post Graduate Residents, Department of General Medicine Pacific Medical College & Hospital, Udaipur.
*Corresponding Author: Jayesh Trivedi, Professor Department of General Medicine Pacific Medical College & Hospital, Udaipur.
Citation: Jayesh Trivedi, Raja Joshi, Atul Gupta, Sanjay Gupta, Hiren Chaudhary, et al., (2026), Systemic Sclerosis and Severe Peripheral Ischaemia with Schild in a Young Woman: An Analytical Review and Case‑Integrated Pathway, J Clinical Research and Reports, 24(3); DOI:10.31579/2690-1919/628
Copyright: © 2026, Jayesh Trivedi. 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: 05 June 2026 | Accepted: 19 June 2026 | Published: 21 July 2026
Keywords: meanings; realities; truths
The beliefs, knowledge, and understanding that adolescents have regarding the function, purpose, and benefits of pursuing an undergraduate degree have always been shaped by the historical, social, political, economic, and even geographical context in which they live. Unfortunately, these constructs do not evolve quickly enough to keep pace with each rapidly changing environment, resulting in a disconnect between their understanding of the subject and their current reality in the workplace, society, and professions. This situation has led to a misconception, both socially and especially among adolescents, that the benefits will arise almost spontaneously or by decree. The truth, in this case, is an amorphous, complex, hidden, and even painful dimension for many adolescents who lack the necessary skills to understand it and act accordingly. Instead of success, this often leads to partial or total failure in their studies and training, ultimately resulting in underemployment or unemployment.
This paper reviews systemic sclerosis (SSc; scleroderma) with emphasis on vasculopathy (digital ischaemia/ulceration and macrovascular disease) and interstitial lung disease (SSc‑ILD), and applies evidence to a 34‑year‑old woman with: bilateral distal upper‑limb arterial thrombosis (radial/ulnar), distal lower‑limb arterial compromise, HRCT chest showing ILD with UIP features plus superadded pneumonitis, very high CRP, prior severe microcytic anaemia now improved, hyponatraemia, vitamin D deficiency, mild TSH elevation, and preserved renal function (case data as provided).
Key points for treating teams: - SSc can plausibly unify (a) severe peripheral ischaemia/digital tissue threat via SSc vasculopathy spanning micro‑ and macrovascular beds and (b) fibrotic ILD, including honeycombing/UIP‑like features in advanced disease; however, the extent of bilateral radial/ulnar thrombosis is atypical and mandates urgent evaluation for overlap/alternative drivers such as antiphospholipid syndrome (APS) or ANCA‑associated vasculitis [1].
- Superadded infection is strongly suggested by very high CRP and CT consolidation; this must be treated promptly before escalation of immunosuppression for ILD, with microbiology and oxygenation assessment [2].
- Evidence‑based therapies for SSc‑ILD centre on mycophenolate (strong recommendation), with options that include cyclophosphamide, rituximab, tocilizumab, nintedanib, and combinations in selected settings (ATS/EULAR/BSR guidance) [3].
- Digital critical ischaemia/tissue necrosis is an emergency; contemporary guidance supports prompt specialist assessment, fast vascular imaging (CTA), vasodilator escalation (PDE5 inhibitors/IV prostanoids), targeted wound/infection care, and a parallel prothrombotic work‑up (APS/ANCA) to decide on antithrombotic and immunomodulatory strategy [4].
Abstract. Systemic sclerosis is a multisystem autoimmune disease characterised by immune dysregulation, vasculopathy, and progressive fibrosis affecting skin and internal organs. Contemporary guidelines highlight a “vascular therapeutic continuum” linking Raynaud’s phenomenon, digital ulcers, and pulmonary arterial hypertension, with parallel antifibrotic/immunomodulatory strategies for SSc‑ILD. This paper synthesises key evidence (EULAR, ATS, ACR/CHEST, BSR, ESC/ERS) and applies it to a young woman with severe peripheral arterial thrombosis and UIP‑like ILD plus pneumonitis. We outline mechanistic plausibility for SSc, critical differentials (ANCA vasculitis, APS, thromboangiitis obliterans), and provide prioritised investigations and a stepwise management algorithm suitable for urgent multidisciplinary care [5].
Background, epidemiology, and risk factors
Introduction. Systemic sclerosis (SSc) is a chronic connective‑tissue disease in which vascular injury and immune activation lead to fibroblast activation and organ fibrosis; major morbidity and mortality arise from ILD and pulmonary hypertension, while peripheral vasculopathy causes Raynaud’s phenomenon, digital ulcers, and occasionally gangrene [6].
Epidemiology (global and Indian context). SSc is rare, shows a strong female predominance, and typically presents in early‑to‑mid adulthood [7]. In Indian cohorts, several series report younger age of onset and a high prevalence of anti‑topoisomerase I (Scl‑70) positivity, with high ILD burden and substantial functional restriction on spirometry—features highly relevant to the current case phenotype [8].
Risk factors. SSc arises from genetic susceptibility interacting with environmental and immunologic triggers. Major environmental associations include crystalline silica exposure and organic solvents, supported by observational evidence and meta‑analyses; these are particularly relevant to occupational histories and should be elicited in India where exposures may be under‑recognised [9].
Pathogenesis and pathology
SSc pathogenesis is best conceptualised as an interlinked triad of autoimmunity, vasculopathy, and fibrosis, beginning with endothelial injury and culminating in persistent myofibroblast activity and extracellular matrix accumulation [10].
Immunologic mechanisms. Innate and adaptive immune activation in SSc includes altered dendritic‑cell and macrophage polarisation, T‑cell dysregulation, and B‑cell activation with production of disease‑associated autoantibodies (e.g., anti‑topoisomerase I, anticentromere, anti‑RNA polymerase III) that correlate with organ phenotypes and prognosis. Cytokine pathways (including IL‑6) and interferon‑related signatures contribute to inflammatory amplification and fibrotic signalling [11].
Vascular mechanisms (micro‑ and macrovascular). Endothelial dysfunction drives vasospasm, impaired angiogenesis/vasculogenesis, capillary dropout, and luminal remodelling. Clinically, this manifests as Raynaud’s phenomenon and digital ulcers; pathobiologically, the same continuum is linked to pulmonary arterial hypertension. [12] Importantly for this patient, SSc is not confined to microvasculature: macrovascular involvement (e.g., ulnar/radial disease, palmar arch compromise, and lower‑extremity arterial disease) has been described, and can contribute to severe digital ischaemic loss [13].
Fibrotic mechanisms. Fibrosis results from sustained activation of fibroblasts/myofibroblasts via profibrotic mediators (classically including TGF‑β‑centred signalling), aberrant mechanotransduction, and persistent inflammatory cues. Organ‑specific modifying factors (e.g., microaspiration in lung, neuro‑motility changes in gut) shape phenotype and progression [14].
Clinical spectrum and systemic manifestations
SSc is clinically heterogeneous; typical phenotyping includes limited cutaneous and diffuse cutaneous disease, but visceral involvement can occur across subsets. Organ complications should be anticipated and actively screened, given that outcomes improve with earlier detection and treatment [15].
Digital ischaemia, ulcers, and macrovascular disease. Raynaud’s phenomenon is often earliest; progression includes recurrent digital ulcers, infection, osteomyelitis, and tissue
loss. Contemporary guidance frames these as a vascular continuum amenable to vasodilator escalation (CCB → PDE5 inhibitor → IV prostanoid) and—when recurrent ulcers occur—endothelin receptor antagonism (bosentan) to reduce new ulcer formation [16]. Macrovascular stenosis/occlusion can be present in severe cases and may coexist with additional thrombotic drivers (e.g., antiphospholipid antibodies, ANCA positivity, smoking) [17].
Interstitial lung disease. ILD is common in SSc; HRCT may show NSIP most frequently among CTD‑ILD, but UIP‑like fibrosis and honeycombing occur, particularly in advanced disease and specific cohorts [18]. ILD is a leading cause of SSc‑related morbidity/mortality and requires structured screening/monitoring with HRCT and pulmonary function tests (including DLCO) [19].
Pulmonary hypertension. SSc‑associated pulmonary arterial hypertension (SSc‑PAH) is a major determinant of prognosis. Annual screening strategies use symptoms/signs, echocardiography, natriuretic peptides, and pulmonary function metrics; high‑risk algorithms (e.g., DETECT) reduce missed diagnoses and can detect milder disease [20].
Renal involvement. Scleroderma renal crisis (SRC) is a feared complication; risk increases with diffuse disease, anti‑RNA polymerase III positivity, and glucocorticoid exposure. Management relies on immediate ACE inhibitor therapy and cautious steroid use [21]. The provided case has preserved renal function; this does not exclude SSc, but reduces the likelihood of current SRC [22].
Gastrointestinal and nutrition. GI involvement is frequent (reflux, dysmotility, malabsorption). Vascular GI lesions such as gastric antral vascular ectasia (GAVE) can cause chronic blood loss and iron‑deficiency anaemia—important in this case given prior severe microcytic anaemia [23].
Cardiac disease. Primary myocardial involvement (inflammation/fibrosis), arrhythmias, and right‑heart strain from PAH can occur; annual screening (ECG, echo, NT‑proBNP) is recommended in contemporary guidance [22].
Diagnosis and classification
Diagnosis relies on pattern recognition across clinical features, serology, and organ assessment, while classification criteria support standardisation for research and structured clinical thinking.
Core clinical evaluation. History should capture Raynaud’s phenomenon, digital ulceration/gangrene, skin thickening, puffy fingers, inflammatory arthritis/myositis symptoms, reflux/dysphagia, dyspnoea/cough, syncope/exertional limitation, and exposures (silica/solvents) and smoking [24]. Physical examination should assess skin score, sclerodactyly, telangiectasia, calcinosis, tendon friction rub, digital perfusion (capillary refill, temperature), and cardiopulmonary signs.
Serology. ANA by immunofluorescence is a sensitive entry test; ENA should include anti‑topoisomerase I (Scl‑70), anticentromere, and anti‑RNA polymerase III given phenotype correlations (ILD, PAH, SRC) [25]. In the present case, serology is crucial because the vascular phenotype (large‑artery thrombosis) may reflect SSc overlap with APS or vasculitis.
Nailfold capillaroscopy. Detection of a “scleroderma pattern” microangiopathy supports early diagnosis and is integrated into modern criteria/diagnostic algorithms; it is relatively low‑cost and can be implemented widely with training [26].
Imaging and organ testing. - HRCT chest + PFTs (spirometry, lung volumes, DLCO): recommended for screening and longitudinal monitoring of SSc‑ILD; surgical lung biopsy is strongly discouraged for screening/monitoring in SARD‑ILD guidance [19].
- Echocardiography + NT‑proBNP: annual screening for PAH is recommended; right‑heart catheterisation confirms diagnosis [27].
- Vascular imaging: Duplex and, when tissue is threatened or macrovascular disease is suspected, CT angiography guides urgent decisions (revascularisation, thrombolysis, medical escalation). Macrovascular occlusion of ulnar/radial arteries is recognised in severe SSc but remains uncommon enough that alternate causes must be excluded [28].
ACR/EULAR classification criteria. The 2013 ACR/EULAR criteria use a weighted score; a total score ≥9 classifies “definite SSc.” Items include skin thickening (high weight), fingertip lesions, telangiectasia, abnormal nailfold capillaries, PAH/ILD, Raynaud’s phenomenon, and SSc‑specific autoantibodies [29].
Treatment principles and evidence‑based therapies
Modern management is organ‑based, severity‑stratified, and multidisciplinary, balancing infection risk, vascular risk, and progression risk.
Digital ischaemia and ulcer disease (acute and chronic). The European Alliance of Associations for Rheumatology [30] (EULAR) recommends dihydropyridine calcium‑channel blockers (often nifedipine) first line for SSc‑Raynaud; PDE5 inhibitors should be considered; and IV iloprost should be considered for severe Raynaud refractory to oral therapy. For digital ulcers, PDE5 inhibitors and/or IV iloprost are recommended options, and bosentan should be considered to reduce new ulcers (prevention more than healing). [31] The British Society for Rheumatology [32] highlights that new tissue necrosis/critical digital ischaemia is an emergency and supports urgent assessment, PDE5 inhibitors as frontline for healing/secondary prevention, IV prostanoids when needed, and specialist wound care; it also supports antiplatelet therapy consideration in necrotic DU disease [22].
SSc‑ILD immunomodulation and antifibrotics. The American Thoracic Society [33] guideline for SSc‑ILD recommends mycophenolate (strong recommendation) and suggests cyclophosphamide, rituximab, tocilizumab, nintedanib, and nintedanib+mycophenolate in appropriate contexts [34]. EULAR similarly recommends MMF/cyclophosphamide/rituximab for SSc‑ILD, considers nintedanib alone or with MMF, and considers tocilizumab [35]. Landmark trials underpin these choices: cyclophosphamide showed modest benefit vs placebo (SLS‑I), MMF and cyclophosphamide improved outcomes with better tolerability for MMF (SLS‑II), and nintedanib reduced FVC decline (SENSCIS). [36] Tocilizumab preserved FVC in early inflammatory SSc with ILD signals in trial analyses, aligning with guideline positioning in select patients (especially with raised acute‑phase reactants) [37].
Anticoagulation and APS considerations. Routine anticoagulation is not a standard treatment for uncomplicated SSc vasculopathy and is explicitly discouraged in some SSc‑PAH contexts (e.g., warfarin not recommended for SSc‑PAH in EULAR/BSR guidance) [38]. However, this patient’s documented arterial thrombosis (radial/ulnar) justifies an APS work‑up and vascular‑team decisions on antithrombotic therapy as per acute arterial thrombosis protocols (separate from SSc vasodilator strategies). Evidence indicates antiphospholipid antibodies occur in a subset of SSc and may associate with macrovascular disease and outcomes, supporting combined evaluation rather than assuming “pure” SSc vasculopathy [39].
Infection and supportive care. In SSc‑ILD management frameworks, infection control and supportive therapies (pulmonary rehabilitation, nutrition, reflux management, oxygen when hypoxaemic, vaccination) are integral; guidance also advises reducing/stopping immunosuppression in severe fibrosis with recurrent infections and considering antifibrotic‑only approaches in selected high‑infection‑risk scenarios [2].
Managing anaemia, hyponatraemia, vitamin D, thyroid. - Severe microcytic anaemia warrants iron studies and GI evaluation (including consideration of GAVE in SSc), with correction and source control [40].
- Hyponatraemia should be approached systematically (confirm hypotonicity, assess volume status, consider SIADH with pneumonia, correct safely under protocol) [41].
- Vitamin D deficiency is common in India; Indian consensus guidance supports structured replacement strategies based on 25‑OH vitamin D thresholds and risk profile [42].
- Mild TSH elevation requires correlation with free T4 and symptoms; Indian consensus guidance outlines when to treat vs monitor in subclinical hypothyroidism [43].
Prognosis and outcomes (high‑level). Prognosis hinges on cardiopulmonary involvement (ILD/PAH), the rate of physiologic decline, and extent of fibrosis; guideline‑driven screening and earlier treatment are associated with better outcomes in contemporary cohorts [44].
Prevention strategies. Preventive care in SSc is primarily secondary prevention: early identification, regular organ screening (ILD/PAH/cardiac/renal), cold protection and smoking cessation to reduce vascular events, vaccination and infection prevention during immunosuppression, reflux management to reduce microaspiration‑related lung injury, and occupational risk mitigation (silica/solvents) when relevant [45].
Case discussion and recommended pathway for the provided patient
Case synthesis: how SSc could explain the pattern (and what is atypical)
What fits SSc well - ILD with UIP‑like features (honeycombing/traction bronchiectasis) is compatible with advanced fibrotic CTD‑ILD; SSc‑ILD is common and a leading driver of morbidity, and guidelines prioritise HRCT+PFT‑based pathways and early therapy for progressive disease [46].
- Severe peripheral ischaemia is part of the SSc vascular continuum; macrovascular disease (including ulnar/radial/palmar arch) has been described and can contribute to severe tissue loss [47].
What is atypical / red‑flag for overlap - Bilateral radial and ulnar arterial thrombosis (upper limbs) plus distal lower‑limb compromise suggests either unusually aggressive macrovascular SSc vasculopathy or an additional systemic prothrombotic/inflammatory vasculitic driver. In SSc, co‑positivity for aPL or ANCA and smoking can associate with digital gangrene and macrovascular stenosis; therefore, “SSc alone” should not be assumed [17].
- Very high CRP with CT consolidation suggests superadded infection, which may both worsen vascular events (inflammation‑thrombosis coupling) and contraindicate immediate immunosuppression escalation until controlled [2].
Other case elements that may connect - Prior severe microcytic anaemia could reflect iron deficiency from nutritional causes or chronic blood loss; in SSc specifically, GAVE is a recognised cause of iron‑deficiency anaemia and should be actively considered if GI symptoms/occult blood loss are present [48].
Differential diagnosis comparison table
| Condition | Clinical clues in this patient | Key tests to distinguish (high‑yield) | Immediate management priorities |
|---|---|---|---|
| Systemic sclerosis with severe vasculopathy ± macrovascular disease | ILD with fibrotic pattern; severe digital/limb ischaemia can occur via vascular continuum; macrovascular disease reported (ulnar/radial/palmar arch possible) | ANA (IFA), ENA (Scl‑70/ACA/RNA‑pol III), nailfold capillaroscopy; HRCT+PFTs; echo/NT‑proBNP; CTA limb arterial tree | Treat threatened limb as emergency; vasodilator escalation (CCB → PDE5i → IV prostanoid), wound/infection care; initiate SSc‑ILD strategy only after infection control; avoid high‑dose steroids |
| ANCA‑associated vasculitis (AAV) with ILD / vascular ischaemia | Digital ischaemia can reflect vasculitis; ILD can coexist (esp. MPO‑ANCA) and may mimic fibrotic CTD‑ILD; systemic inflammation can be prominent | ANCA (MPO/PR3), urinalysis + urine protein/active sediment, creatinine trend, inflammatory markers; consider CT angiography patterns; tissue diagnosis if safely feasible | If life/organ threatening vasculitis suspected: urgent rheumatology; infection exclusion; immunosuppression decisions per vasculitis protocols (balanced against infection) |
| Antiphospholipid syndrome (APS) ± SSc overlap | Arterial thrombosis pattern (bilateral radial/ulnar) is highly suggestive; APS can coexist with SSc and aPL may relate to macrovascular disease and outcomes | Lupus anticoagulant, anticardiolipin IgG/IgM, anti‑β2GP1 IgG/IgM (repeat at ≥12 weeks for classification); evaluate for other thrombosis risks | Acute arterial thrombosis pathway with vascular team; start/continue antithrombotic therapy as indicated; avoid attributing thrombosis solely to SSc vasospasm |
| Thromboangiitis obliterans (Buerger disease) | Young age and multi‑limb distal ischaemia could fit; requires strong tobacco history; ILD/UIP pattern not typical | Detailed tobacco/smokeless tobacco history; angiographic “segmental” distal disease; exclude diabetes/hyperlipidaemia/embolism; consider Shionoya/Olin criteria | Absolute tobacco cessation is definitive; manage ischaemia and wounds; avoid immunosuppression unless alternate diagnosis |
| Cardioembolic / infective endocarditis / sepsis‑related thrombosis | Multifocal arterial occlusion can be embolic; very high CRP and pneumonitis raise systemic infection possibility | Blood cultures, echocardiography, ECG; inflammatory and coagulation profile | Antibiotics per syndrome and cultures; embolic source evaluation; anticoagulation decisions case‑specific |
Recommended investigations with priority, rationale, and timing
| Priority & timing | Investigation | Rationale in this patient | Notes for interpretation |
|---|---|---|---|
| Immediate (hours to <24> | Urgent vascular assessment + limb staging (pain, colour/temp, capillary refill, motor/sensory, pulses) | Tissue threat assessment; guides need for emergent intervention | Critical ischaemia/new necrosis is a time‑sensitive emergency in SSc vasculopathy guidance |
| Immediate (hours to <24> | CT angiography (upper + lower limbs) | Define level/extent of occlusion; differentiate embolic vs in‑situ disease; plan revascularisation/thrombolysis vs medical | Particularly important given bilateral radial/ulnar thrombosis and distal leg flow compromise |
| Immediate (hours to <24> | Sepsis/infection work‑up: blood cultures, sputum (if productive), CBC, CRP trend; CXR if needed; procalcitonin per local protocol | Very high CRP + CT consolidation suggests pneumonitis; infection status determines timing of immunosuppression | Consider TB risk contextually in India when imaging/clinical features suggest |
| Immediate (hours to <24> | ABG / oxygenation assessment(SpO₂ trend; ABG if hypoxic) | Severity of respiratory compromise; supports oxygen/ICU decisions | Oxygen strategy and rehab are part of SSc‑ILD supportive care recommendations |
| Urgent (<24> | ANA (IFA) + ENA panel (Scl‑70, ACA, RNA‑pol III; consider Ro52, PM/Scl if overlap) | Establish SSc serologic phenotype and SRC/ILD/PAH risk correlation | Anti‑Scl‑70 correlates with ILD in Indian cohorts; RNA‑pol III flags SRC/malignancy risk |
| Urgent (<24> | ANCA (MPO/PR3) | Rule out AAV‑ILD/vasculitis contributor to ischaemia | Interpret with urinalysis and clinical context; not all ANCA positivity equals vasculitis |
| Urgent (<24> | APS panel (LA, aCL, anti‑β2GP1) | Arterial thrombosis mandates APS evaluation; overlap with SSc occurs | Repeat at ≥12 weeks for classification if initial positive |
| Urgent (<24> | Echocardiography + NT‑proBNP | Screen for PAH/cardiac involvement; informs peri‑procedural risk | Annual screening is recommended in SSc; DETECT helps in high‑risk groups |
| Urgent (<24> | PFTs (spirometry, DLCO) | Baseline severity and monitoring plan for ILD; supports prognostication | Anaemia affects DLCO; interpret with Hb correction |
| Soon (<72> | Urinalysis + urine protein/creatinine ratio; BP monitoring | Screen for renal involvement/SRC risk; establish baseline | SRC risk increases with steroids; routine BP monitoring is emphasised with glucocorticoids |
| Soon (<72> | Iron studies (ferritin, TSAT), stool occult blood; consider GI referral | Clarify microcytic anaemia mechanism; evaluate for GAVE/occult loss | GAVE is a vascular GI manifestation associated with iron‑deficiency anaemia in SSc |
| Soon (<72> | Coagulation profile + D‑dimer + fibrinogen | Characterise thrombo‑inflammation and guide anticoagulation strategy | Interpret in infection/inflammation contexts |
Treatment algorithm for digital ischaemia in suspected SSc (adaptable to local protocols)
| Step | Clinical trigger | Core interventions (parallel tracks) | Escalation cues |
|---|---|---|---|
| Stabilise | Any suspected critical ischaemia/tissue necrosis | Admit/urgent specialist review; analgesia; thermal protection; stop vasoconstrictors; assess for infection at ulcer sites | Pain out of proportion, sensory/motor deficit, spreading necrosis, systemic sepsis |
| Document anatomy | Absent pulses / severe symptoms / suspected macrovascular disease | CTA limb arterial tree; vascular surgery/interventional radiology input | Consider revascularisation/thrombolysis where anatomically feasible and clinically appropriate |
| First‑line vasodilator | Raynaud/digital ischaemia without immediate tissue loss | Dihydropyridine CCB (e.g., nifedipine class) | Inadequate control or evolving ulcers/ischaemia |
| Second‑line / add‑on | Persistent ischaemia / active digital ulcers | Add PDE5 inhibitor (sildenafil/tadalafil class); optimise hydration and pain control; specialist wound care | Ulcer progression, severe refractory vasospasm |
| Rescue therapy | Severe refractory ischaemia or threatened tissue | IV prostanoid (iloprost/related) in monitored setting; evaluate sympathectomy in focal refractory ulcers | Non‑healing ulcers, recurrent necrosis, intolerant to systemic vasodilators |
| Prevent recurrence | Recurrent ulcers despite above | Bosentan to reduce new ulcers (prevention); ongoing wound/infection surveillance | Repeat admissions, new ulcers, functional decline |
| Address thrombosis drivers (case‑specific) | Proven arterial thrombosis / APS suspicion | Antithrombotic strategy per vascular/haematology; APS panel; evaluate embolic source | High clot burden, recurrent thrombosis, systemic embolic source |
Stepwise management plan for this patient (pragmatic and team‑ready)
Immediate priorities (today) 1. Treat limb threat as a vascular emergency: urgent vascular consult, limb staging, pain control, and CTA upper/lower limbs to define occlusion anatomy and intervention options [49].
2. Treat likely superadded pneumonitis: obtain cultures and start empiric antibiotics per local policy, with oxygenation assessment (SpO₂ trend/ABG). Delay escalation of immunosuppression until infection is stabilised unless a competing life‑threatening immune process is proven [2].
3. Launch parallel aetiology work‑up: ANA/ENA, ANCA, APS panel, coagulation profile/D‑dimer, urinalysis/protein, echocardiography/NT‑proBNP, baseline PFTs when feasible [51].
Near‑term priorities (next 48–72 hours) - Start/optimise vasodilator strategy for severe peripheral ischaemia (CCB → PDE5 inhibitor; consider IV prostanoid in refractory/critical cases) with blood pressure monitoring and haemodynamic caution [50].
- Once infection is controlled and phenotype clarified, initiate an SSc‑ILD plan (often MMF as first‑line), with consideration of tocilizumab/rituximab/nintedanib depending on inflammatory profile, fibrosis extent, and infection risk [52].
- Evaluate anaemia: iron studies and occult blood loss; consider GI evaluation for GAVE if unexplained iron deficiency persists [48].
Supportive/metabolic corrections - Hyponatraemia: confirm type and correct safely under guideline‑based protocols, especially if pneumonia‑associated SIADH is suspected [41].
- Vitamin D deficiency: treat per Indian consensus recommendations (dose and schedule per local endocrinology/medicine protocol) [42].
- Mild TSH elevation: check free T4 and thyroid peroxidase antibodies; follow Indian consensus on when to treat vs observe in subclinical hypothyroidism [43].
Dear Editorial Team, Clinical Medical Reviews and Reports. My experience with the journal was highly positive. The peer-review process was rigorous, constructive, and completed in a timely manner. The reviewers provided valuable comments that helped improve the quality and clarity of our manuscript. The editorial office was professional, responsive, and supportive throughout all stages of the publication process. Communication was clear and efficient, and any questions were addressed promptly. Overall, I found the journal to maintain high scientific standards and an excellent publication workflow. I would be pleased to consider submitting future work to this journal. Best wishes from, Elena Popa.
It was my pleasure to submit my testimonial concerning the Reviewer Board of our Scientific Journal “Brain and Neurological Disorders”. The Reviewers focused on some modifications and their contribution was helpful. The ladies of our Editorial Office were also supported my efforts. It was my honor to have such a co-operation and I am looking forward for more collaboration.
Dear Grace Pierce, Editorial Coordinator of Journal of Clinical Research and Reports, Thank you for the speedy and efficient peer review process. I appreciate the fact that your peer reviewers do not take months to respond like with some other journals. I would also like to thank the editorial office for responding quickly to my questions. It is an excellent journal. I plan to submit more manuscripts in the future. Best wishes from, Robert W. McGee
Dear Grace Pierce, Editorial Coordinator of Journal of Clinical Research and Reports, Working with you and your team on our recent publication in JCRR has been a truly wonderful and enjoyable experience. The responses were prompt, and the reviewers were patient, constructive, and highly professional. One reviewer in particular gave me the feeling that a professor was carefully reading and commenting on my coursework, which was deeply touching. The entire process was straightforward and hassle‑free, with no tedious online forms to complete. I highly recommend this journal. Best wishes from, DR Aibing Rao, Head of R&D
I Appreciate the Opportunity to Share my Experience with the Journal of Clinical Research and Reports. The peer review process was timely and constructive, and the feedback provided helped improve the quality of our manuscript. The editorial office was professional, responsive, and supportive throughout the process, ensuring smooth communication and efficient handling of the submission. Overall, it was a positive experience collaborating with your team.
Dear Mercy Grace, Editorial Coordinator of Obstetrics Gynecology and Reproductive Sciences, We would like to express our gratitude for your help at all stages of publishing and editing the article. The editors of the magazine answer all the necessary questions and help at every stage. We will definitely continue to cooperate and publish other works in the Obstetrics Gynecology and Reproductive Sciences! Best wishes from, Alla Konstantinovna Politova,
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 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).
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 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 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.
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 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.
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 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 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 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 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 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
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 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.
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 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 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 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, 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 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 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 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.
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 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
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 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 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 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, 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.
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
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.
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.
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.
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.
"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".
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 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.
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 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.
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.
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 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.
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
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!”
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, 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.
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.
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, 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.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
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.
“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”.
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.
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.
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 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.
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 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 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 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!
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.
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.
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.
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.
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 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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 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.
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.
