Value of Reticulocyte Count, Absolute Reticulocyte Count and Platelet Count for Bone Marrow Recovery Status on Remission Induction Phase

Research Article | DOI: https://doi.org/10.31579/2768-0487/108

Value of Reticulocyte Count, Absolute Reticulocyte Count and Platelet Count for Bone Marrow Recovery Status on Remission Induction Phase

  • Shaila Yesmin 1
  • Fatima Zohra 2
  • Debatosh Paul 3
  • Tuhin Sultana 4
  • Afiqul Islam 5
  • Mesbah Uddin Ahmed 6*
  • A.N. Nashimuddin Ahmed 4

1 Assistant Professor, Department of Laboratory Medicine, Bangabandhu Sheikh Mujib Medical University.

2 Assistant Professor, Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University.

3 Professor & Chairman, Department of Laboratory Medicine, Bangabandhu Sheikh Mujib Medical University.

4 Professor, Department of Laboratory Medicine, Bangabandhu Sheikh Mujib Medical University.

5 Professor, Department of Paediatric Haematology & Oncology, Bangabandhu Sheikh Mujib Medical University.

6 MS in Microbiology, Bangladesh University of Health Sciences.

*Corresponding Author: Mesbah Uddin Ahmed, MS in Microbiology, Bangladesh University of Health Sciences.

Citation: Yesmin S., Zohra F., Paul D., Sultana T., Mesbah U. Ahmed, et al., (2023), Value of Reticulocyte Count, Absolute Reticulocyte Count and Platelet Count for Bone Marrow Recovery Status on Remission Induction Phase, Journal of Clinical and Laboratory Research. 7(2); DOI:10.31579/2768-0487/108

Copyright: © 2024, Mesbah Uddin Ahmed. 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: 20 November 2023 | Accepted: 20 December 2023 | Published: 22 January 2024

Keywords: blood group in covid; covid–19; esr in covid; haematological parameters; sars–cov–2

Abstract

Reticulocyte count performed on a supravitally stained blood film is a initial and common laboratory method of determining early hematological recovery. This method is rapidly replaced by automated flow cytometry methods which have the advantage of much greater precision, before other test become positive after chemotherapy. A prospective observational study was carried out in the Department of Laboratory Medicine in collaboration with Paediatric Haematology and Oncology, Bangabandhu Sheikh Mujib Medical University during a period of one year to evaluate the bone marrow recovery in children with acute lymphoblastic leukemia by automated reticulocyte analysis over platelet count. Total fifty patients were enrolled in this study on remission induction phase. All patients were between 8 months to 15 years’ age range with a mean age of 5.5 ± 3.2. At the end of the study out of 50 cases, Ret% and Abs ret count showed early recovery in a median of 6 days before the platelet count recovery and concluded that reticulocyte parameter showed earlier haematopoietic recovery than the platelet count recovery. 

Introduction

Acute lymphoblastic leukaemia (ALL) is the most common malignancy diagnosed in the children aged 2-5 years, representing nearly one third of all pediatric cancers 1. Chemotherapy is the main stay of treatment in ALL. ALL is a highly curable disease due to chemotherapy responsiveness. The cure rate in western countries lies between 70-80percentage 2. Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy the leukaemic cells. In ALL patients, aplasia occurred after chemotherapy and leaves the patient with little or no red cell, white cell or platelet production. As a result, infection may occur which increases the time of aplasia and prolonged the period of hospital stay after chemotherapy3. After chemotherapy blood counts generally fall within a week of treatment and may take some time to recovery 4,5,6.  At this period, extensive monitoring of bone marrow recovery is needed. Among the hematological parameter’s reticulocyte parameter, platelet count can predict the bone marrow recovery over others. So, serial measurement of reticulocyte parameter & platelet count is useful to monitor the bone marrow recovery7. Reticulocytes are immature red blood cells. Reticulocytes typically composed about less than 1percentage of the red cells in the human body8. They are released in the peripheral blood after a period of maturation in the bone marrow and undergo further differentiation into mature RBC8. The number of reticulocytes in the peripheral blood is a fairly accurate reflection of erythropoeitic activity assuming that the reticulocytes are released normally from the bone marrow and they remain in circulation for the normal time period. An increase in the reticulocyte percent grater than1percentage is used as an indicator of erythroid regeneration. Spanish Multicentric Study Group for Haematopoietic recovery defined Absolute reticulocyte countgrater than50x109 /L as hematopoietic recovery 5,6. Platelet count grater than20x109/l defined as a predictor of BM recovery6. Platelet recovery acts as a conventional indicator of bone marrow regeneration. But it is delayed parameter over other haematological parameter9. Platelet count may be influenced by frequent platelet transfusions. For platelet recovery a minimum of 4 weeks’ time interval is needed10. So, Platelet counts are less frequently monitored as a useful predictor6. The aim of this study is to compare the earliest indicator of marrow recovery among the reticulocyte parameter and platelet count in children with ALL.

Materials and methods

This study was carried out in the Department of Laboratory Medicine and Department of Paediatric Haematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during the period of October’ 2009 to September’ 2010. 50 Children up to 18 years of age irrespective of sex with acute lymphoblastic leukaemia attended in Paediatric Hemato-Oncology outpatients and inpatients department were included in this study on the basis of inclusion and exclusion criteria. Blood sample (2 ml) was collected in an EDTA tube for complete blood count (CBC), total platelet count, reticulocyte profile (both manual and automated method) and peripheral blood film (PBF) examination. Count was done preferably within 2 hours of collection. Supravital staining of unfixed RBCs was done with new methylene blue (NMB) in 50 patients. Mixing of 100 µl whole blood with 100 µl of 1% NMB solution was done. After incubation at 37° for 15-20 minutes, the dilution was remixed and a wedge smear was performed19. The number of reticulocytes per 1000 RBCs determined microscopically on x100 objective. Then percentage of reticulocyte was done. A reticulocyte was defined as a RBC containing at least 2 granules of reticulum. Absolute reticulocyte count was calculated from RBC count obtained from automated hematology analyzer. Automated reticulocyte count was done in 50 patients in Sysmex xt-2000i haematology analyzer. The measuring principle of the system is based on flow cytometry combined with hydrodynamic focusing. Serial hemogram with reticulocyte count, Abs ret and platelet count measurements were done in every 4 days interval up to 32 days of the therapy. All necessary and relevant data were processed. Data were evaluated by standard statistical methods. Analysis was done by Statistical package for social science (SPSS) 16 by applying appropriate formula. Bone marrow recovery was evaluated by Mean, Median, Mode and ANOVA test.

Results

In this study fifty (50) children with ALL were enrolled. The age limit was between 8 months to 15 years of age and mean age of the patients was 5.5±3.2 years (Table 1). Maximum patients were male. Male and female ratio was 1.5:1(Table 2). In this study, during induction remission phase hemoglobin (Hb) level were gradually decreased up to 12th day (p=0.05) (Paired t-test). At diagnosis mean total count of WBC was 14.74±25.47 (x109 /L). During induction remission total count of WBC was sharply declined at day 8 and continued up to last follow up. Statistically significant differences were observed between different follow-ups day. This study found mean distribution of Ret percentage, Ret abs, and platelet count according to recovery of the study patients. In this study Ret percentage significantly declined up to day 4 and then gradually increased or remain the same with diagnosis day in both automated and manual method. Ret percentage recovery occurred first day of persistent 3 days’ rise of the reticulocyte from the 18th to 28 days.  It recovered at a median of 18 days and the mean ±SD Ret percentage was 18.5 ±6.8 days,28. ±7.4 days and 24.3±6.7 in early, late and same recovery respectively (Table 3). The absolute reticulocyte concentration significantly declined up to day 4 then it remains the same up to last follow up. The mean ±SD Ret abs was 18.3±4.7 days in early recovery,24.4±5.3 days in late recovery and 20.7±3.5 days in same recovery (Table 3). The platelet count was declined significantly p lessthan0.05 up to 16th days then remain the same with the baseline status. The mean platelet count was 24.1±6.5 days in early recovery,28 ±6.4 days in late recovery and 20.5±5.7 days in same recovery (Table 3). Ret  percentage, Ret abs and platelet recovery were statistically significant plessthan0.05 in different status. Recovery of Ret  percentage at a median of 20 days, ret abs 18 days and platelet counts occurred at a median of 24 days, which was 4 days delayed than ret  percentage,6 days delayed than Ret abs (Table 3).

Age group yearsNumber of patientsPercentage
 £ 52958.0
6 – 101836.0
11 – 1536.0
Mean  ±SD5.5  ±3.
Range (min – max)(8 mo-15 years)

                                                                                            Table 1: Age distribution of the patients (n=50).

SexNumber of patientsPercentage
Male3060.0
Female2040.0

                                                                                           Table 2: Sex distribution of the studied patients (n=50).

 Early recoveryLateSamep value
Ret    
Mean+- SD18.5+-6.828.4+-7.424.3 6.70.013s
Median202824 
Mode182420 
Range18-2620-3218-32 
Ret abs    
Mean+- SD18.3 4.724.4 5.320.73.50.001s
Median182420 
Mode201020 
Range Min-Max16-3220-3214-32 
Platelet    
Mean+- SD24.1+-6.528+-6.420.5+-5.70.001s
Median242822 
Mode242420 
Range16-3220-3216-32 

                                                   Table 3: Comparison of Ret %, Ret abs and Platelet count with recovery in days (n=50).

Discussion

Few studies were performed to evaluate utility of using flowcytometric analysis of reticulocytes to predict the bone marrow recovery after chemotherapy. Though the high cost of using flowcytometry or third generation automated blood cell counters for automated reticulocyte counts are presently a limiting factor in developing countries such as Bangladesh. But despite the fact, ret percentage, ret abs can effectively serve as an additional index to indicate bone marrow recovery other than platelet count. Ret percentage, ret abs and platelet recovery were found statistically significant p lessthan0.05 in different status in this study. The mean ±SD Ret  percentage was 18.5 ±6.8 days,28. ±7.4 days and 24.3±6.7 in early, late and same recovery respectively. Ret percentage recovered at a median of 20 days. Dekoninck et al (2002) found Ret  percentage recovery from 5 to 33 days (median 19), which was 1 day earlier than this study11. But this study found recovery of ret abs was in 18 days and the mean ±SD Ret abs was 18.3±4.7 days in early recovery,24.4±5.3 days in late recovery and 20.7±3.5 days in same recovery. Kuse et al. (1996) confirmed that ARC recovered at a median of 10 days in acute leukaemia which was 8 days earlier than our study12. The mean platelet was 24.1±6.5 days in early recovery,28. ±6.4 days in late recovery and 20.5±5.7 days in same recovery. Dalal et al found platelet recovery was a median of 29 days in a study that was 5 days delayed recovery from our study13. Dekononck showed platelet recovery occurred in a median of 17.2 days compared to ret on 8.7 days that was earlier than our outcome. Bhatnagar et al. in a study found, platelet recovery 1 day delayed than ret  percentagewhich was nearly consistent with our study14. 85.7 percentage percent of them had thrombocytopenia where platelet was lessthan 100x 109/l. In this study, recovery of Ret percentage at a median of 20 days, ret abs in 18 days and platelet counts occurred at a median of 24 days; platelet recovery was 4 days delayed than ret  percentage,6 days delayed than Ret abs. So, our study confirmed, ret abs was the earlier marker than ret  percentage and platelet count.

Conclusion

This study concluded that the reticulocyte parameter showed earlier hematopoietic recovery than the   platelet recovery for monitoring in children with acute lymphoblastic leukemia after chemotherapy. This early laboratory indicator will guide the clinicians to make important therapeutic decisions, which will be economic savings and as well as live saving. Nowadays, reticulocyte is offered in most of the third-generation haematology analyzer. Moreover, this test is simple, quick, cost effective, reproducible and reliable tool on the automated haematology analyzer. Thus, its potential use as a routine test to see the bone marrow recovery is important. 

Acknowledgement

I would like to thank all the consultants, doctors and staff of the Department of Laboratory Medicine, BSMMU, Dhaka for their sincere help in conducting this study. 

Conflict of interest

There is no conflict of interest relevant to this paper to disclose.

References

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.

img

Virginia E. Koenig

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.

img

Delcio G Silva Junior

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.

img

Ziemlé Clément Méda

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.

img

Mina Sherif Soliman Georgy

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.

img

Layla Shojaie

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.

img

Sing-yung Wu

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.

img

Orlando Villarreal

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.

img

Katarzyna Byczkowska

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.

img

Anthony Kodzo-Grey Venyo

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.

img

Pedro Marques Gomes

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.

img

Bernard Terkimbi Utoo

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.

img

Prof Sherif W Mansour

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.

img

Hao Jiang

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.

img

Dr Shiming Tang

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.

img

Raed Mualem

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.

img

Andreas Filippaios

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.

img

Dr Suramya Dhamija

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.

img

Bruno Chauffert

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!

img

Baheci Selen

"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".

img

Jesus Simal-Gandara

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.

img

Douglas Miyazaki

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.

img

Dr Griffith

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.

img

Dr Tong Ming Liu

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.

img

Husain Taha Radhi

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.

img

S Munshi

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.

img

Tania Munoz

“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”.

img

George Varvatsoulias

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.

img

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.

img

Khurram Arshad

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.

img

Gomez Barriga Maria Dolores

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.

img

Lin Shaw Chin

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.

img

Maria Dolores Gomez Barriga

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.

img

Dr Maria Dolores Gomez Barriga

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¨.

img

Dr Maria Regina Penchyna Nieto

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.

img

Dr Marcelo Flavio Gomes Jardim Filho

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!”

img

Zsuzsanna Bene

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

img

Dr Susan Weiner

My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.

img

Lin-Show Chin

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.

img

Sonila Qirko

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.

img

Luiz Sellmann

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.

img

Zhao Jia