AUCTORES
Globalize your Research
Case Report
*Corresponding Author: Bhupesh Dewan, Medical Services, Zuventus Healthcare Limited, Mumbai, India.
Citation: Bhupesh Dewan, Siddheshwar Shinde. (2023), Acute Tocolysis Using a Single Bolus Dose of Atosiban for Preterm Labor Management: A Prospective Study, J. Women Health Care and Issues, 6(4); DOI:10.31579/2642-9756/165
Copyright: © 2023, Bhupesh Dewan. 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: 08 August 2023 | Accepted: 23 August 2023 | Published: 25 August 2023
Keywords: preterm labor; atosiban; tocolytic treatment; bolus dose; delivery postponement; tocolytic alternatives
Background: Preterm labor poses a significant challenge within obstetrics, carrying the potential for diverse complications for both maternal and neonatal well-being. Extensive clinical data indicates that atosiban stands as a secure and well-tolerated therapeutic alternative, exhibiting fewer adverse effects on both the mother and fetus compared to other tocolytic treatments. This investigation aimed to assess the feasibility of achieving optimal medical care by employing a solitary atosiban bolus dose. This approach holds the promise of mitigating the necessity for hospitalization, potentially enabling outpatient management of the condition.
Aim: The purpose of the study was to assess the efficacy and safety of using a single bolus dose of atosiban to delay premature delivery.
Material and Methods: The study included 75 patients experiencing symptoms of preterm labor. These patients were administered a single bolus dose of atosiban (6.5 mg/0.9mL). The study was conducted between August 2019 and July 2023.
Results: The study successfully used a single bolus dose of atosiban to delay delivery by up to 48 hours, enabling corticosteroid prophylaxis. The participants' average gestational age was 32.1 weeks. Atosiban effectively delayed delivery in 68% of patients for an average of 13.3 days, with a range of 0-62 days. No adverse effects were reported by either mothers or fetuses during the study period.
Conclusion: The study findings suggest that a single bolus dose of atosiban is an effective and safe treatment option for delaying preterm labor. This treatment provides short-term relief for an average of 13 days, with potential benefits over other tocolytics like isoxsuprine, ritodrine, and nifedipine due to fewer side effects. The intravenous bolus dose of atosiban has a quick onset and long-lasting effects, making it convenient for both patients and physicians. The approach is cost-effective and could be repeated after a few days if necessary. Overall, the study demonstrates the potential of using a single bolus dose of atosiban as an outpatient treatment to manage preterm labor effectively, offering benefits in terms of safety, convenience, and cost.
The underlying causes of preterm labor remain elusive, yet the ramifications of premature birth are well-documented.[1] Gestational age at birth emerges as a pivotal determinant influencing the peril of neonatal morbidity and mortality. With the progression of gestational age, the susceptibility to both morbidity and mortality experiences a noteworthy reduction.[2] Employing tocolytic agents to extend pregnancy during instances of preterm labor is contingent upon patient-specific conditions and healthcare institution protocols.[3] The overarching objective frequently centers on stalling labor, thereby facilitating the administration of corticosteroids or facilitating maternal transfer to specialized facilities. The contemporary landscape witnesses an extension of tocolytic use beyond their intended scope in the realm of preterm labor. This broadened utilization can be attributed to their ability to selectively target uterine smooth muscle, which has led to their adoption for off-label applications. It is evident from clinical observations that complications arising from tocolysis are largely specific to the medication employed. Flushing, typically linked to tocolytics, exhibits mild characteristics primarily tied to peripheral vasodilation.[4] On the contrary, cardiac ramifications (including cardiac arrhythmias, hypotension, fetal tachycardia), pulmonary edema, and respiratory arrest align with beta-mimetics (ritodrine, terbutaline, isoxsuprine) [5], nifedipine [6], and magnesium sulfate [7]. In contrast, the oxytocin receptor antagonist, atosiban, displays a uterine-specific effect and boasts commendable tolerability, showcasing minimal maternal side effects across the spectrum.[8] Furthermore, its administration remains unhampered by contraindications such as cardiac ailments, diabetes mellitus, thyroid disorders, or renal and hepatic impairments.[9] Numerous randomized clinical trials have substantiated atosiban's efficacy as a tocolytic agent.[10-12] However, while the recommended dosage regimen of atosiban holds efficacy, its extended duration of administration contributes to prolonged hospital stays and augmented medication costs.[13] Noteworthy successes in prolonging pregnancy has been observed with a concise regimen lasting merely 14 hours.[14] Both the extended and abbreviated regimens share a commonality in initiating treatment with a solitary bolus dose (6.75mg/0.9mL) of atosiban. This prompts the pertinent query regarding the feasibility of managing acute preterm labor effectively and economically through the administration of a single atosiban bolus injection. In our exhaustive review of existing literature, a conspicuous absence of focused clinical investigations evaluating the impact of an atosiban bolus dose in acute preterm labor was observed. The preliminary exploratory study has demonstrated the efficacy of a 5 mg atosiban dosage in inhibiting uterine contractions.[15] Moreover, two pilot studies have exhibited the capacity of a 6.75 mg intravenous atosiban bolus dose to effectively mitigate uterine hyperactivity during active labor.[16,17] It is crucial to underline the paucity of comprehensive literature in this specific domain, warranting further research to ascertain the optimal atosiban dosage and its potential merits as a bolus treatment for managing acute preterm labor. Given the pivotal role of clinical evidence in guiding healthcare decisions, this study was undertaken to meticulously evaluate the efficacy and safety profile of a single atosiban bolus dose in the context of preterm labor, and its place of therapy in an outpatient care setting.
This prospective study was exclusively conducted at the Obstetric Unit of Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College (LTMGH-LTMMC), located in Mumbai, India. The study spanned a comprehensive duration of four years, ranging from August 2019 to July 2023. Ethical clearance for the study was granted by the institutional ethics committee of LTMGH-LTMMC, adhering diligently to the principles of good clinical practice and the Declaration of Helsinki. Before enrolment, written informed consent was meticulously obtained from each participating patient. A total of 75 patients, with a gestational age exceeding 24 weeks and presenting with preterm labor, were enrolled in the study. The selection process involved excluding women with instances of lethal fetal abnormalities, chorioamnionitis, ruptured membranes, vaginal bleeding, and preeclampsia. A solitary measured intravenous bolus dose (6.75mg/0.9mL) of Atosiban (TosibanTM, Zuventus Healthcare Limited, India) was administered over a span of one minute. Following drug administration, vigilant monitoring was maintained to promptly detect any potential adverse events. Over a span of 48 hours, labor progression was carefully observed, and comprehensive delivery information was obtained from the patients, enabling the evaluation of in-utero time gained. This metric was quantified as the additional number of days beyond the initiation of preterm labor subsequent to the introduction of tocolysis.
The average age of the participating patients was 26.51 ± 5.11 years, with a range from 18 to 46 years. The mean gestational age stood at 32.1 ± 2.8 weeks, encompassing a range from 24 to 36 weeks. Approximately half of the patients (48%) were experiencing their first pregnancy, while multigravida patients (60%) were more prevalent in the study. Among the participants, a noteworthy 68% of patients experienced a prolongation of pregnancy exceeding 48 hours (Table 1). On average, patients demonstrated an extension of 13.3 (± 15.58) days, with the range spanning from 0 to 62 days following the administration of a solitary bolus dose. The collective rate of deliveries that occurred after the 34-week mark amounted to 58.66%. Notably, among these instances, full-term deliveries were recorded for 16 patients, accounting for 21.33% of the cases. The mean gestational age at the time of delivery was 34.17 ± 3.21 weeks. In terms of tocolytic success rates at the 48-hour juncture, comparable outcomes were noted among patients stratified based on cervical dilation at enrollment, 76.19% (32 out of 42) success rate in patients with <2 p=0.086,> 6 hr n (%) 12 hr n (%) 24 hr n (%) 48 hr n (%) Day 7 n (%) aParameters 24 to <28> 8/8 (100) 8/8 (100) 8/8 (100) 6/8 (75) 5/8 (62.5) 28 to 32 weeks 19/21 (90.48) 18/21 (85.71) 13/21 (61.90) 8/21 (38.10) 7/21 (33.33) ≥32 to 37 weeks 44/46 (95.65) 44/46 (95.65) 43/46 (93.48) 37/46 (80.43) 21/46 (45.65) Overall 71/75 (94.67) 70/75 (93.33) 64/75 (85.33) 51/75 (68) 33/75 (44)
a Based-on patient-reported data
Table 1: Tocolytic efficacy of single bolus dose of atosiban
| Tocolytic Agent | Study | Acute Tocolysis Dosage | Tocolytic Efficacy | Adverse Events (Incidences in %) |
| Atosiban | The present study | Single IV injection 6.75 mg/0.9 mL | 85.33% in 24 h 68% in 48 h | None |
| Isoxsuprine | Khoiwal S et al. [22] | 10 mg IM injection every 6 h for 48 h | 84.37 in 48 h | Hypotension (15.62%), Tachycardia (9.37%) |
| Mahajan A, et al. [23] | 40 mg IV infusion then 10 mg IM injection every 6 h for 24 h | 66% in 48 h | Hypotension (18%), Tachycardia (14%), Nausea (8%) | |
| Jain P, et al. [24] | 40 mg IV infusion then oral 10 mg every 8 h for 7 days | 76% in 48 h | Tachycardia (50%), Hot flushes (39%), Hypotension (36%), Nausea/Vomiting (34%) | |
| Ritodrine | Jaju P, et al. [25] | 100 mg infusion for 24 h | 68.3% in 48 h | Palpitation (41.6%), Breathlessness (5%), Pulmonary edema (4%) |
| The Canadian Preterm Labor Investigators Group Study [26] | Infusion for at least 6 h then 10 mg x 12 tablets daily for 5 days | 78.6 % in 48 h | Palpitation (53.4%), Tremor (39.2%) Hypokalemia (39.2%) Dyspnea (15.1%) Pulmonary edema (0.3%) | |
| Kim et al. [27] | 6.4 mg/h with increments of 3.2 mg/h infusion every 15 minutes until the cessation of uterine contractions | 79.6% in 48 h | Palpitation (81.7%), Tremor (57.9%), Tachycardia (47%), Tachypnea (20.7%) Pulmonary edema (3%) | |
| Nifedipine | Khooshideh M, et al. [28] | 10-20 mg oral every 6 h for 48 h | 70% in 24 h 14.5% in 48 h | Hypotension (6.4%) Postpartum hemorrhage (0.9%) |
| Al-Omari et al. [29] | 10-40 mg oral every 4-6 h for 48 h | 65.6 % in 48 h | Flushing (50%), Headache (46.9%), Hypotension (43.8%), Palpitation (40.6%) | |
| Dhawle et. al. [30] | 20 mg oral every 6 h for 48 h | 88.4% in 48 h | Tachycardia (25.6%), Palpitations (9.3%), Hypotension (4.7%) |
Table 2: Efficacy and safety of various tocolytics used in acute preterm labor
In this study, our focus cantered on assessing the efficacy and safety of a single bolus dose of atosiban in preventing preterm labor. This particular approach holds the potential to shed light on the benefits of atosiban usage in cases of acute preterm labor where comprehensive medical resources might not be readily accessible. The study's findings revealed that following atosiban bolus administration, more than 90% of patients sustained their pregnancies for the initial 12 hours post-tocolysis. Intriguingly, insights gleaned from the Effective Perinatal Intensive Care in Europe (EPICE) study highlighted a noteworthy association between corticosteroid administration and mortality risk. According to the study, administering corticosteroids between 6 to 12 hours prior to delivery correlates with a remarkable 51% reduction in mortality risk.[18] This underscores the significance of delaying delivery through prompt initial treatment within primary care settings, allowing crucial time for interventions aimed at enhancing fetal development. The recorded 58.66
This study culminates in offering invaluable insights into the efficacy and safety of employing a solitary bolus dose of atosiban. The therapeutic approach proffers a succinct yet meaningful respite spanning up to 62 days (with an average duration of 13 days). Noteworthy is the regimen's manifestly reduced incidence of side effects in comparison to isoxsuprine, ritodrine, and nifedipine, positioning it as a notably favorable treatment modality for preterm labor. The prompt onset and sustained impact achievable through an intravenous bolus dose of atosiban, administered within a brief 1-minute interval, serve to distinguish it from the daily doses of alternative tocolytics. Moreover, the added advantage of avoiding hospitalization further amplifies its appeal, contributing to the convenience of administration for both medical practitioners and patients alike. The cost-effectiveness of this regimen, coupled with its ease of administration, presents a win-win situation for both healthcare providers and patients, even if repeat dosing may be required after a few days. In summation, the study underscores the potential of a single bolus dose of atosiban as a paramount strategy in the management of preterm labor. Its distinct advantages in terms of efficacy, safety, rapid action, and convenience make it a cornerstone in the armamentarium against preterm labor. However, it is essential to acknowledge that while the study's outcomes are promising, the limitation of a modest sample size and absence of a control group necessitate further exploration through extensive randomized trials. This endeavor would robustly validate the pivotal role that the atosiban bolus regimen can play in transforming the landscape of preterm labor management.
We would like to thank Dr. Rahul Mayekar (Lokmanya Tilak Municipal General Hospital and General Hospital, Mumbai, Maharashtra, India) for conducting the clinical trial.
Bhupesh Dewan contributed to the study design, interpretation of the data, and manuscript editing and revising. Siddheshwar Shinde contributed to the data acquisition, drafting the manuscript. Both authors are responsible for the integrity of the data and the accuracy of the analysis and approved the final version of the manuscript for submission.
None
The authors have no conflicts of interest.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
