AUCTORES
Globalize your Research
Research Article | DOI: https://doi.org/10.31579/2639-4162/166
1Obstetrics Gynecological Nursing, Faculty of Nursing Benha University
2Maternal and Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt
*Corresponding Author: Hanan Elzeblawy Hassan, Maternal and Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt.
Citation: Hanan E. Hassan, Elham A. Ramadan, Hassan Omran AA, Abdelazim Mohamed SS, (2024), Urinary Incontinence among Northern Upper Egyptian Menopausal Elderly Women, J. General Medicine and Clinical Practice, 7(8); DOI:10.31579/2639-4162/166
Copyright: © 2024, Hanan Elzeblawy Hassan. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 28 March 2024 | Accepted: 09 April 2024 | Published: 16 April 2024
Keywords: urinary incontinence; menopausal elderly women; obesity
Background: Urinary incontinence occurs when there is dysfunction in either the storage function or occasionally, in the emptying function of the lower urinary tract. Types of urinary incontinence, based on etiology and pathophysiology, urinary incontinence is classified into three types: Stress Urinary Incontinence, Urge Urinary Incontinence, and Mixed Urinary Incontinence.
Aim of the study: The study was conducted to assess urinary incontinence related factors among elderly women.
Design: A descriptive study design was utilized in this study.
Sample: A purposive sample was selected and this study was performed on 100 Menopausal women diagnosed with stress urinary incontinence. Setting: gynecological and urological outpatient clinics Beni-Suef university hospital. Tools: Data was collected using a structure interviewing questionnaire schedule.
Results: It reveals that 72% of the study sample was obese, 70% got pregnant and delivered more than three times while 56% of them aborted from 1-3 times, about 66% of them delivered spontaneous vaginally, while about 29% delivered by cesarean section. It indicates that 56% of the study sample has no regular frequency of urination; 53% of them experienced stress urinary incontinence during day and night, 38% lost splashes amount of urine, while 27% lost large amount of urine per once.
Conclusion: Statistically significant association between BMI, number of gravid, and number of parity and frequency of urinary incontinence among the studied sample were found.
Recommendations: Application of health education program for measurement of management of urinary incontinence among elderly women
Urinary incontinence occurs when there is dysfunction in either the storage function or occasionally, in the emptying function of the lower urinary tract. Urethral sphincter dysfunction and bladder dysfunction can co-exist and various components of the continence mechanism may compensate one another. For example, women may experience anatomical or neuromuscular injury during childbirth but remain asymptomatic until there is a loss of urethral sphincter function due to aging. [1-5].
Urinary incontinence is a significant health problem with serious physical, psychological, and social consequence, particularly among elderly women. Approximately 13 million people in United State suffer from urinary incontinence, with prevalence of stress urinary incontinence (SUI) varying between 10% and 30% in women between the age 15 and 64 years, as well as the prevalence of urinary incontinence in Egypt was 54.8% for all cases, and 14.8% of them suffer from stress urinary incontinence (SUI) [6-11].
The international Continence Society (ICS) has classified nomenclature types of urinary incontinence (UI), Based on etiology and pathophysiology, urinary incontinence is classified into three types: Stress Urinary Incontinence (SUI), Urge Urinary Incontinence (UUI), and Mixed Urinary Incontinence (MUI) [1,12-16].
Stress Urinary Incontinence: According to the International Continence Society, Stress Urinary Incontinence is defined as the involuntary leakage of urine with exertion such as coughing, sneezing, and laughing. An increase in abdominal pressure due to physical exertion places stress on the bladder, causing urine to leak. The basic mechanisms of failure of the urethra to maintain a water-tight seal are poor urethral support by the pelvic floor muscles and intrinsic sphincter deficiency, accounts for about 50–70% of all types of UI [12].
Urge Urinary Incontinence may be triggered by simple everyday occurrences such as the sound of running water, exposure to cold temperatures, or drinking cold beverages. A classic example of a trigger is the notorious “Key in the lock” syndrome. Women are able to hold their urine until they get home, but when they insert the key in their door the urine just pours out beyond their control, occurs in about 14% of all cases [17].
Mixed Urinary Incontinence is the involuntary leakage of urine associated with exertion and urgency. It is a mixture of Stress and Urge Urinary Incontinence. Basically, the bladder is overactive and the urethra and urethral sphincter muscles are underactive or deficient. In some cases, the Stress symptoms are more defined than the Urge symptoms, and the patients are categorized as Stress Predominant-Mixed Urinary Incontinence sufferers. If it is the other way around and Urge symptoms are the primary complaint, then they are categorized as Urge Predominant-Mixed Urinary Incontinence sufferers [18-20].
Aim of the study
The study was conducted to assess urinary incontinence related factors among elderly women through:
Research questions
Subject and methods
Study design:
The study followed a descriptive study design.
Study Setting and Sampling:
The study was conducted at gynecological and urological outpatient clinics at Beni-Suef University Hospital. A Purposive sample was used from the above-mentioned setting. Total sample was 100 women who attended to the previous mentioned setting.
Tools of data collection:
Tool that was used for data collection is a structured interviewing questionnaire sheet was developed by the researcher in the Arabic language based on a review of recent literatures, under guidance of supervisors. It was consisting of three parts:
The first part: included personal characteristics data of the study women such as (age, height, weight, body mass index "BMI" education level, occupation, residence, marital status).
Second part: Obstetrics history such as (number of gravidities, parity, and abortion, mode of deliveries, any complications during pregnancy, labor and post-partum, mode of delivery, weight of baby at birth and duration between pregnancy).
Third part: urinary incontinence history included duration of illness, frequency, amount of leakage of urine, timing (day and night), and predisposing factors as coughing, sneezing, laughing, using sanitary towels for urine leakage, frequency of change the towels.
Validity of the tools:
Tools of data collection were investigated for their content validity by three experts in the field of Obstetric and Gynecological Nursing from Faculty of Nursing and Benha University.
Administrative Design:
An official written approval letter for data collection to conduct this study clarifying the purpose of the study was obtained from dean of faculty of nursing, Benha University to the director of Beni-Suef university hospital.
Pilot study:
A pilot study was conducted on 10% (10 women) to evaluate the applicability, efficiency, clarity of tools, assessment of feasibility of field work and identification of suitable place for interviewing women, beside to detect any possible obstacles that might face the researcher and interfere with data collection. Necessary modifications were done based on the pilot study findings such as (omission of some questions from tool, editing on paraphrasing of some questions, adding some questions) in order to strengthen their contents or for more simplicity and clarity. The pilot sample was excluded from the main study sample.
Statistical Design:
The collected data was revised, coded, tabulated and introduced to a computer using statistical package for social sciences (IBM SPSS .25.0). Data was presented and suitable analysis was done according to the type of data obtained for each parameter. Descriptive Statistics used Mean and Standard deviation (X2±SD) and range for parametric numerical data, and Frequency and percentage of non-numerical data
| Personal Characteristics | No | % |
| Age (in years) | ||
| 50-55 years | 49 | 49.0 |
| > 55-60 years | 38 | 38.0 |
| >60 years | 13 | 13.0 |
| Residence | ||
| Rural | 71 | 71. 0 |
| Urban | 29 | 29.0 |
| Education | ||
| Illiterate | 49 | 49.0 |
| Primary education | 30 | 30.0 |
| Secondary education | 18 | 18.0 |
| University education | 3 | 3.0 |
| Marital status | ||
| Married | 87 | 87.0 |
| widower | 13 | 13.0 |
| Occupation | ||
| House wife | 48 | 48.0 |
| Working | 52 | 52.0 |
Table 1: Distribution of studied sample according to personal characteristics (n=100).
Figure 1: Distribution of studied sample according to their obesity level (n=100
Figure (1): Portrays the distribution of studied sample according to their obesity level. It reveals that most of the studied sample (72%) was obese.
Table (2): Illustrates that 70% of the studied sample got pregnant and delivered more than three times while 56% of them aborted from 1-3 times. Regarding type of delivery, about 66% of them delivered spontaneous vaginally, while about 29
| Obstetrics history | No | % |
| Number of gravidity | ||
| 1-3 pregnancies | 30 | 30.0 |
| More than 3pregnancies | 70 | 70.0 |
| Number of parity | ||
| 1-3 deliveries | 30 | 30.0 |
| More than 3 deliveries | 70 | 70.0 |
| *Type of delivery | ||
| Spontaneous vaginal deliveries | 66 | 66.0 |
| Vaginal deliveries with episiotomy | 25 | 25.0 |
| Caesarean section | 29 | 29.0 |
| Instrumental deliveries | 1 | 1.0 |
| Duration between pregnancy | ||
| Usually between 1 - 2 year | 4 | 4.0 |
| Usually between 2- 3 years | 51 | 51.0 |
| More than 3 years | 16 | 16.0 |
| Not regular intervals | 29 | 29.0 |
| *Complication during pregnancy | ||
| No complications | 40 | 40.0 |
| Antepartum hemorrhage | 15 | 15.0 |
| Gestational Diabetes | 19 | 19.0 |
| Pregnancy Induced Hypertension | 7 | 7.0 |
| Untreated urinary tract infection | 30 | 30.0 |
| Anemia | 7 | 7.0 |
| *Complication during labor | ||
| No complications | 46 | 46.0 |
| Antenatal hemorrhage | 9 | 9.0 |
| Prolonged Labor | 36 | 36.0 |
| Obstructed labor | 14 | 14.0 |
| *Complication during postpartum | ||
| No complications | 51 | 51.0 |
| Postpartum hemorrhage | 18 | 18.0 |
| Chronic constipation | 32 | 32.0 |
| Puerperal sepsis | 14 | 14.0 |
*Results not mutually exclusive
Figure (2): Present the distribution of studied sample according to urinary incontinence history. It indicates that 56% of the study sample has no regular frequency of urination. Moreover, 60% of them began to suffer from stress urinary incontinence from 5 years and more; 53% of them experienced stress urinary incontinence during day and night. Regarding the amount of urine leakage per once, (38%) lost splashes amount of urine, while (27%) lost large amount of urine per once.
Figure 2: Distribution of studied sample according to urinary incontinence history (n=100)
Table (3): Demonstrates the relationship between body mass index and frequency of urinary incontinence among studied sample. It demonstrates that there was statistically significant association between BMI and frequency of urinary incontinence among the studied sample (p≤0.05).
| Frequency of urinary incontinence | Body mass index | |||||||
| Normal | Overweight | Obese | X2 | p-value | ||||
| No | % | No | % | No | % | |||
| About once a week or less often | 4 | 100.0 | 6 | 25.0 | 10 | 13.8 | 19.75 | 0.003* |
| Two or three times a week | 0 | 0.0 | 8 | 33.3 | 22 | 30.6 | ||
| About once a day | 0 | 0.0 | 2 | 8.4 | 3 | 4.2 | ||
| Several times a day | 0 | 0.0 | 8 | 33.3 | 37 | 51.4 | ||
*Significant at p≤ 0.05 **highly significant at p≤0.01
Table 3: Relationship between body mass index and frequency of urinary incontinence (n=100)
Figure (3): Present the distribution of studied sample according to using sanitary towel for urine leakage. It reveals from both figures that 63% of the studied sample used sanitary towel for urine leakage.
Figure 3: Distribution of studied sample according to using sanitary towel for urine leakage (n=100)
Table (4): Illustrates the statistical relation between number of gravid and frequency of urinary incontinence; it reveals that there were statistical differences in the frequency of urinary incontinence in relation to number of gravidities among the studied sample (p≤0.05).
| Frequency of Urinary Incontinence | Number of gravidity | |||||
| 1-3 pregnancies (n=30) | More than three pregnancies (n=70) | X2 | p-value | |||
| No | % | No | % | 14.233 | 0.003* | |
| About once a week or less often | 10 | 33.3 | 10 | 14.3 | ||
| Two or three times a week | 13 | 43.3 | 17 | 24.3 | ||
| About once a day | 2 | 6.7 | 3 | 4.3 | ||
| Several times a day | 5 | 16.7 | 40 | 57.1 | ||
*Significant at p≤ 0.05 **highly significant at p≤0.01
Table 4: Statistical relation between number of gravid and frequency of urinary incontinence (N=100)
Figure (4): Present the distribution of studied sample according to using sanitary towel for urine leakage. It reveals from figure 94% of the studied sample began to suffer from stress urinary incontinence after frequent child birth and 68% of the studied sample stress urinary incontinence disturbed them a lot.
Figure 4: Distribution of studied sample according to using sanitary towel for urine leakage (n=63)
*Results not mutually exclusive
Table (5) shows the statistical relation between number of parity and frequency of urinary incontinence. It reveals that there were highly statistical differences in the frequency of urinary incontinence in relation to number of parities among the studied sample (p≤0.05).
| Frequency of Urinary Incontinence | number of parity | X2 | p-value | |||||
| 1 | 2 | 3 | ||||||
| No | % | No | % | No | % |
22.141 |
0.001* | |
| About once a week or less often | 1 | 50.0 | 9 | 31.0 | 10 | 14.5 | ||
| Two or three times a week | 0 | 0.0 | 13 | 44.8 | 17 | 24.6 | ||
| About once a day | 1 | 50.0 | 1 | 3.4 | 3 | 4.3 | ||
| Several times a day | 0 | 0.0 | 6 | 20.7 | 39 | 56.5 | ||
*Significant at p≤ 0.05 **highly significant at p≤0.01
Table 5: Statistical relation between number of parity and frequency of urinary incontinence (N=100)
Stress urinary incontinence results from failure of the sphincter mechanism to maintain outlet closure during bladder filling and increased intra-abdominal pressure during sneezing, coughing, running, laughing or exertion of greater physical effort [21].
The current study aimed to assess urinary incontinence related factors among elderly women. As regard to age of the studied women as a part of socio
demographic characteristics of the studied women, the present study indicated that slightly less than half of the studied women were in the menopausal stage (50-55yrs) and slightly more than half were in the post-menopausal stage (>55yrs), the same results reported by El-Sayied H.A (2020), who studied Self-care model management of urinary incontinence for elderly women attending Ain Shams hospital and mentioned that near half of the studied sample their age was 50yrs and above [22].
From the researcher pint of view the aging process is associated with many changes in the body include the urinary tract system especially in women due to pregnancy and delivery that weakens the pelvic floor muscles this is the physiological explanation of increasing incidence of urinary incontinence among elderly women. In relation to Body Mass index, the present study showed that slightly less than three quarters of the studied women were obese, while one quarter was overweight. This result similar to Deshmane, S & Memchoubi, K (2018) who studied an experimental study to assess the effectiveness of pelvic floor exercise for the management of urinary incontinence among women in selected areas of Pune city and mentioned that the most dominant group was obese followed by overweight then normal weight [23].
These results were not consistent with Khalifa, M., et al (2019) who assessed the urinary Incontinence in Healthy Saudi Women and reported that the most dominant group was the obsess group followed by normal weight females and finally overweight females [24].
Concerning correlation between number of parity and frequency of urinary incontinence, the current study revealed that there was positive correlation between number of parity and frequency of urinary incontinence pre and post intervention with highly statistically significant difference (p value=0.000), this was similar to Khalifa, M et al (2019) who studied the Urinary Incontinence in Healthy Saudi Women and revealed that multi-parity was related to the urinary incontinence prevalence [24].
Also, Rizk DE et al (2019) who studied the Urinary Incontinence in The United States Women and reported that urinary incontinence prevalence was more common in females who had three or more births [25].
Regarding correlation between number of gravidity and frequency of urinary incontinence, the present study reported that there was positive correlation with statistically significant (p value = 0.003), this result was in accordance with Cotillo (2019) who studied Hospital extra: urinary incontinence and depression [26].
Political, A (2019) who studied Pelvic muscle training may relieve SUI long term: study reports some patients experience extended relief after 8 weeks' training both of them documented that women suffer from urinary incontinence four times more than men due to multiple traumata from child birth that affects urethral sphincter function [27].
on the other hand, Wyman et al (2018) & Sharaf A-Y et al (2020) who studied The Impact of Nursing Interventions on the Control of Urinary Incontinence among Women and mentioned that there was no significant relationship between gravidity and frequency of urinary incontinence [28-29].
Statistical significant association between BMI, number of gravid, and number of parity and frequency of urinary incontinence among the studied sample were found.
Recommendations:
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.
