AUCTORES
Research Article
*Corresponding Author: Gökhan Doğukan Akarsu, Yozgat Bozok University Vocational School of Health Services, Pharmacy Services, Yozgat, Turkey.
Citation: Gökhan D. Akarsu, (2023), Determination of Medicine Addiction Dimension in Young Adults, J. Addiction Research and Adolescent Behaviour, 6(1) DOI:10.31579/2688-7517/067
Copyright: © 2023, Gökhan Dogukan Akarsu. 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: 12 April 2023 | Accepted: 21 April 2023 | Published: 28 April 2023
Keywords: medicine addiction; addicion; young adults addiction; harm to health; medicine
Aim: The aim of this research is to raise awareness about medicine use and frequency of medicine use among young adults in Turkey.
Material and Methods: This descriptive and cross-sectional study was conducted in a university state in the Central Anatolia region of Turkey. The data of the study were collected by the researcher by examining the literature and using a data collection form.
Results: The mean age of the participants in the study, 20.13±1.82 years, 48.4% have a medium income, 97.2% buy their medicines from pharmacies. In addition, 89.8% of the employees stated that a doctor's approval is required to use drugs. 42.2% of them decide on their own whether they need to use medication, 39.7% of them use medicine every 48 hours, 90.5% of them use the medicine given by the doctor. 6.3% of the participants stated that they used medicine for distraction, 6.7% for anxiety, 9.5% for stimulant and sedative medicine, 8.8% for hormone-derived medicine.
Conclusion: In the light of the data obtained from the research, all of the hormones, sedatives, tranquilizers and anxiety-relieving medicine are not used under the control of a doctor, the society should be informed about the harms of such medicine, 1 out of every 2 medicine used is painkillers, the dosage of the medicine prescribed by the doctor should be given orally. It may be useful to inform the patient of the effects of under- or over-dose use and not using it in the recommended time after the medicine is expressed.
A medicine can be medically described as a chemical molecule given to the sick person by adjusting the dose and time, in order to cure the disease or any condition. The use of medicine has increased due to the discovery of therapeutic properties of new molecules, and there are greater usage rates than ever before in the world. The fact that the use of medicine increases the outpatient treatment options and decreases the bed treatment option ensures that it always maintains its popularity.However, it is expected that the molecules given for treatment will cause some side effects. These side effects are given in detail in the package insert in the medicine box, under the frequency of occurrence and side effects. It has been reported that in case of occurrence of effects not mentioned in the content, it is necessary to go to a pharmacy or a doctor as soon as possible.Medicine use is evaluated on the axis of profit and loss, and is used by physicians by adjusting the dose and duration. Here, the dose adjustment is completely left to the physician and a solution to the disease can be found with the appropriate dose amount, and the appropriateness of the dose amount is evaluated in the follow-up examination.
Especially in recent years, there has been a growing trend towards individual medicine therapy. However, this is not a treatment method and should not be applied. According to the literature, in recent years, the treatment method using individual medicine varies between 11.2% and 93.7%, depending on the region [1].
Medicines, which are described as OTC, can be taken in consultation with the pharmacist, and for which there is sufficient knowledge about their harm, can be taken easily by people [2].
However, physicians can prescribe OTC type medicine after examination. Some medicine are not OTC type and are only given by physicians. Physicians prescribe these medicine prescribed to their patients to be used within the given dose and time, and the patient's recovery depending on the medicine. However, recent studies have reported that between 5% and 40% lifetime use of prescription stimulants (NMUPS) among young adults [3-4].
He reported that some patients misrepresented themselves to the physician and produced false symptoms in order to be able to take the medicine they wanted, thus succeeding in taking their medication [5].
Long-term medicine use without a doctor's approval can be considered addiction. Another situation is the non-compliance with the dose and duration given by the patient. For example, some patients are asked to use 14 of the 20 medicine in the medicine box, and to come back for the control by using it in the morning and evening within 7 days. However, the patient uses the tablet 3 times a day or for 10 days, morning and evening, and comes to the control when the box is finished. When it is stated here that the doctor did not follow the instructions given to him, he may try to deceive the doctor by saying that he did not fully recover, that he misunderstood.
In fact, it is a known fact that patient do not pay enough attention to the duration and dose of medicine use. However, due to the growth of the pharmaceutical industry, the use of many different molecules and the differentiation of the harms it can cause, it is an issue that needs more attention than ever before.
Type of Study: This descriptive and cross-sectional study was conducted to increase awareness and compliance with the dose and duration of the medicine prescribed by the doctor among young adults and adults.
Sample: The research was conducted at a university campus in Central Anatolia. The research was conducted with young adults aged 18-29 years. All students who accepted to participate in the study without sampling selection were included in the study. The research was completed by reaching 80% of the universe with 1141 students.
Data Collection Tools: Data were collected by using a questionnaire prepared in line with the literature as a result of the research conducted by researcher.
Questionnaire form: A 24-item questionnaire was used, which included questions to determine students' demographic characteristics (age, gender, class, marital status, etc.) and medicine addiction.Application of Data Collection Tools: Data were collected by the researchers by interviewing young people face-to-face and using a questionnaire.
Evaluation of Data: Data were evaluated using numbers, percentages, means and standard deviations on the computer.
Ethical Dimension of the Study: xxxxx Ethics Committee approval (Approval No. 39/08) and permission from the institution where the research was conducted were obtained in order to conduct the research.
Type of Study: This descriptive and cross-sectional study was conducted to increase awareness and compliance with the dose and duration of the medicine prescribed by the doctor among young adults and adults.
Sample: The research was conducted at a university campus in Central Anatolia. The research was conducted with young adults aged 18-29 years. All students who accepted to participate in the study without sampling selection were included in the study. The research was completed by reaching 80% of the universe with 1141 students.
Data Collection Tools: Data were collected by using a questionnaire prepared in line with the literature as a result of the research conducted by researcher.
Questionnaire form: A 24-item questionnaire was used, which included questions to determine students' demographic characteristics (age, gender, class, marital status, etc.) and medicine addiction.Application of Data Collection Tools: Data were collected by the researchers by interviewing young people face-to-face and using a questionnaire.
Evaluation of Data: Data were evaluated using numbers, percentages, means and standard deviations on the computer.
Ethical Dimension of the Study: xxxxx Ethics Committee approval (Approval No. 39/08) and permission from the institution where the research was conducted were obtained in order to conduct the research.
The mean age of the participants in the study was 20.13±1.82 years, 77.1% were female, 77.1% had associate degree education, 77.6% lived in medium-sized cities, 77.2% They stated that they had a nuclear type family, 92.2% did not have a job other than being a student, 48.4% had a medium income level, and 97.2% bought their medicines from a pharmacy.
Features | ||
Averageage (years) | 20,13±1,82 | |
Gender | n | % |
Woman | 880 | 77,1 |
Male | 261 | 22,9 |
Study | ||
Highschool | 880 | 77,1 |
Undergraduate | 252 | 22,1 |
Graduate | 9 | 0,8 |
Marital Status | ||
Married | 41 | 3,6 |
Single | 1100 | 96,4 |
Income status | ||
Income less than expenses | 480 | 42,1 |
Income equal to expenses | 552 | 48,4 |
Income higher than expenses | 109 | 9,6 |
Working status | ||
Yes | 89 | 7,8 |
No | 1052 | 92,2 |
Family Status | ||
Nucleer family | 881 | 77,2 |
Extend Family | 260 | 22,8 |
Living Place | ||
Village | 260 | 22,8 |
Town | 625 | 54,8 |
City | 256 | 22,4 |
Table 1: Distribution of some socio-demographic characteristics of the students.
In our study, participants were asked questions about drug use. The answers given by the participants to these questions are given in Table 2
Categories | n | % |
For the using drugs needs to medicine approval by doctor? | ||
Yes | 1025 | 89,8 |
No | 116 | 10,2 |
Do you decide to use medication yourself? | ||
Yes | 481 | 42,2 |
No | 660 | 57,8 |
How often do you usually take medication (Day)? | ||
Never | 316 | 27,7 |
Every day | 136 | 11,9 |
1 in 2 days | 317 | 27,8 |
1 in 3 days | 4 | 0,4 |
1 in 5 days | 8 | 0,7 |
1 in 7 days | 16 | 1,4 |
1 in 10 days | 20 | 1,8 |
1 in 14 days | 4 | 0,4 |
1 in 15 days | 184 | 16,1 |
1 in 30 days | 136 | 11,9 |
Do you use the drugs according to the dose and duration given by the doctor? | ||
Yes | 1033 | 90,5 |
No | 108 | 9,5 |
Do you use painkillers instead of going to the doctor when you feel any pain? | ||
Yes | 888 | 77,8 |
No | 253 | 22,2 |
Table 2: Questions about drug use.
The use of stimulant drugs is becoming more and more common nowadays. Participants in the study were asked questions about their use of some stimulant drugs. These questions and the answers given to them are given in table 3.
Categories | n | % |
Have you used drugs against distraction? | ||
Yes | 72 | 6,3 |
No | 1069 | 93,7 |
Have you used hormone derivatives and/or drugs that stimulate hormone production? | ||
Yes | 100 | 8,8 |
No | 1041 | 91,2 |
Have you used medication to help relieve your anxiety? | ||
Yes | 76 | 6,7 |
No | 1065 | 93,3 |
Have you used stimulant (red prescription) and sedative (green prescription) drugs? | ||
Yes | 108 | 9,5 |
No | 1033 | 90,5 |
Have you used substances used to build muscle? | ||
Yes | 80 | 7,0 |
No | 1061 | 93,0 |
How long did you use substances used to build muscle? | ||
Never | 1049 | 91,9 |
1 month | 28 | 2,5 |
2 months | 12 | 1,1 |
3 months | 28 | 2,5 |
4 months | 12 | 1,1 |
6 months | 4 | 0,4 |
8 months | 4 | 0,4 |
24 months | 4 | 0,4 |
Do you know the ingredients of bodybuilding substances? | ||
Yes | 76 | 6,7 |
No | 1065 | 93,3 |
Do you know the side effects of bodybuilding substances? | ||
Yes | 124 | 10,9 |
No | 1017 | 89,1 |
Do you know the harm that bodybuilding substances can do to the body? | ||
Yes | 172 | 15,1 |
No | 969 | 84,9 |
Do you know that bodybuilding substances can cause death? | ||
Yes | 236 | 20,7 |
No | 905 | 79,3 |
Table 3: Information on using stimulant drug.
The use of drugs that should only be given under the supervision of a doctor with the approval of a doctor is given in Table 4.
Categories | n | % |
Have you received a doctor's approval while using hormone medication? | ||
Yes | 84 | 7,4 |
No | 1057 | 92,6 |
Have you received a doctor's approval while using anxiety medication? | ||
Yes | 71 | 6,2 |
No | 1049 | 93,7 |
Have you received a doctor's approval while using (red prescription) and sedative (green prescription) drug? | ||
Yes | 92 | 8,1 |
No | 1049 | 91,9 |
Table 4: Information about the drugs that should be given under the supervision of a doctor.
Information on the date of the last doctor's appointment and the medication prescribed for the patient to use after this appointment are given in Table 5.
Categories | n | % |
When was the last time you went to the doctor? | ||
I have never been in the last 1 year | 857 | 75,1 |
Yesterday | 16 | 1,4 |
2 days ago | 12 | 1,1 |
3 days ago | 12 | 1,1 |
7 days ago | 32 | 2,8 |
10 days ago | 12 | 1,1 |
14 days ago | 20 | 1,8 |
15 days ago | 8 | 0,7 |
21 days ago | 4 | 0,4 |
28 days ago | 4 | 0,4 |
30 days ago | 60 | 5,3 |
40 days ago | 4 | 0,4 |
60 days ago | 28 | 2,5 |
90 days ago | 4 | 0,4 |
120 days ago | 8 | 0,7 |
150 days ago | 8 | 0,7 |
180 days ago and below | 52 | 4,7 |
What medicine did you take the last time you went to the doctor? | ||
I did not take any medician | 837 | 73,4 |
Painkiller | 156 | 13,7 |
Cold medicine | 92 | 8,1 |
Eye medicine | 4 | 0,4 |
Toothache medicine | 4 | 0,4 |
Vitamin medicine | 8 | 0,7 |
Stomach medicine | 16 | 1,4 |
Menstrual medication | 8 | 0,7 |
Blood pressure medicine | 4 | 0,4 |
Heart medicine | 8 | 0,7 |
Skin cream | 4 | 0,4 |
Table 5: Information about the last doctor appointment date and the medication given.
The use of medicine is one of the most effective methods used for the treatment of diseases in the 21st century. Most of the medicines in Turkey are bought from pharmacies. However, some OTC-derived medicine, vitamins, protein-based products can be sold on websites, herbalists and even in gyms. The requirement for all these products to be approved by the Ministry of Health is not included in the official procedure. But full control by other institutions is not possible. In particular, the products purchased from foreign companies pass through the customs, while the substances brought illegally are used completely uncontrolled. However, our aim in this research, unlike all these, is to determine the consumer tendency regarding the use of medicine and the supply of medicine, and to provide resources for the literature in order to control the situations, especially among the youth, by working on them by the governments.
The mean age of the participants participating in our study was 20.13±1.82 years. Since this age average is more fortunate than previous generations in accessing information through the internet, which they actively use throughout their lives, it is important in terms of determining their exposure to their environment. 77.1% of the participants in the study are women. All participants who agreed to participate in the study between the specified dates without sampling were included in the study. Therefore, the proportion of female participants was higher.
When the educational status is examined from the demographic data, 77.1% of them are educated at the college level. 96.4% are single and 48.4% have the same income and expenditure, 92.2% are unemployed, 77.2% have a nuclear family, 77.2% are urban and large lives in the city.89.8% of the participants in the study stated that a doctor's approval is required to use medication. On the other hand, it has been stated that almost one out of every 10 people does not see a doctor's approval necessary to use medicine. Some OTC-derived vitamins can be taken with the advice of a pharmacist without the approval of a doctor, and some can be taken by consumers without the need for advice. The medicine used here is used through the information obtained from the environment, reading the prospectus or information obtained from the internet. It is a dangerous practice to use medicine without doctor control, that is, without patient evaluation. Because it is necessary to diagnose the disease, to report the side effects of the medicine that is planned to be used, to plan the dose to be used accordingly, and to be called for control again when necessary. However, none of these evaluations are made in medicine-focused approaches. Although the possible effects are reported in the package insert of the medicine, even the simplest OTC class medicine have much more effects. Tolerability of these effects may sometimes require further investigation. For this reason, the fact that one out of every 10 people does not need a doctor's approval in the use of medicine is considered as a big problem.42.2% of the participants in the study reported that they decided whether they needed medication or notto himself. It can be said that this result shows us that there is an awareness that the treatment will not be applied by almost one of every two people, even in diseases that can be cured by applying a series of simple methods such as resting, airing the environment frequently, using herbal teas before going to the doctor. For this reason, the density, especially in health institutions, will never decrease.39.7% of the participants in the study reported that they used medicine every 48 hours. 90.5% of the participants in the study reported that they used the medicine prescribed by the doctor and that the dose period given by the doctor was applied. On the other hand, it was determined that one out of every 10 people did not comply with the amount and duration of the dose given by the doctor. This has shown us that education should be given to raise awareness about the amount and duration of the dose in the society. Rickles (2010), in his study, included the importance of medicine compliance and the difficulties in medicine compliance, and included the importance of considering this situation by clinicians and also informing them [6]. 22.2% of the participants in the study reported that they use painkillers instead of going to the doctor when they have any pain. Some of the pain relievers are in the OTC classification. It is used with the approval of the pharmacist without requiring the approval of the doctor. The problem here is the fact that the possibility that some diseases can be masked by using painkillers can be ignored. Bicket et al. (2022), Kiluk et al (2022) and Kissin (2022) discuss painkiller addiction, Christie (2008), painkiller use, painkiller dependence and tolerance that can be shown when the use is stopped, Chavkin (2011) and Barry et al. (2010) gave extensive information about the problems of painkiller addiction in primary care. In fact, opioid addiction is still one of the major problems among all people. It is closely related to all states and societies (7-12).Distraction is becoming more and more common, especially among young people. Distraction, focusing problems due to developing technologies, increasing unemployment, exams and qualification commissions stress people and their concentration of thoughts makes it difficult to concentrate on a single point. In our study, 6.3% of the participants stated that they used medicine for to focus, 6.7% for anxiety relief, 9.5% for stimulant and sedative medicine, and 8.8% for hormone-derived medicine. Hormone-derived medicine are used for reasons such as growth and development, development of sex hormones, treatment of polycystic ovary, increased libido, treatment of deficient hormone levels. Hormones are special biological molecules used to stimulate tissues or organs. Considering that hormone is produced and used in µg, µl and µmol ratios, the magnitude of the damage caused by a small amount of uptake error is revealed. While some of the hormone-derived medicine are under the control of a doctor, some are used by consumers through internet shopping or illegally obtained without the approval of the Ministry of Health. Yasui et al. (2022) reported in their study that the prevalence of oral contraceptive hormone use was 6%, and those who received hormone replacement therapy were 13.8% [13].
7% of the participants in the study stated that they use the substances called protein powder, which is called body building substance. Of those who use protein powder, 95.7% know the content of these substances, 10.9% know the side effects of bodybuilding substances, 15.1% know the harmful effects of bodybuilding substances, 20.7% know that they can endanger life. expressed. Akarsu (2021) and Cawood et al. (2012), uncontrolled use harms many tissues, especially liver and kidneys (14-15).More than 15% of those who use hormone-derived medicine, 7.5% of those who use medicine for anxiety, and 7.7% of those who use addictive medicine stated that they use these medicine independently of the doctor. It is a huge problem that medicine that are so powerful and that can be reached in a limited way due to their side effects are available. In addition, social education on this issue should be started first.Considering that 1141 people participated in the study, when the frequency of visiting the pharmacy for each day in 30 days is evaluated, (30 days *frequency) approximately 97 people went to the pharmacy, this rate corresponds to 8.5% of the participants, which is 8% in 30 days, It was calculated that 5 of them went to the pharmacy at least once. In addition, it was observed that the most common reason for going to the pharmacy was to buy painkillers with 13%.
Medication is one of the easiest, fastest and cheapest solutions for diseases. Of course, it is possible with the appropriate medicine given by the doctor who is a competent person. In the light of the data obtained from the study, it was seen that not all of the hormones, sedatives, tranquilizers and anxiety-relieving medicine were used under the control of a doctor. In Turkey, such medicines are not given from pharmacies without a doctor's prescription. The conclusion drawn from this can be evaluated that such medicine are procured illegally or secretly. However, since this is a problem in all countries, it is considered that informing the public and informing them about the harms of such medicine will be the most effective method since it will reduce the demand. In addition, the fact that painkillers are consumed so much and that 1 of every 2 medicine used almost independently of the doctor is painkiller, has revealed another problem. In addition, after verbally expressing the dosage of the medicine prescribed by the doctor, informing the patient about the effects of using incomplete or excessive doses and not using them within the recommended time may be helpful in preventing medicine incompatibility.
Acknowledgments
Thanks to all the participants in the research for the unique information he provided.
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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.