AUCTORES
Globalize your Research
Research Article
*Corresponding Author: Saeed Shoja Shafti, Professor of Psychiatry, University of Social welfare and Rehabilitation sciences, Razi Psychiatric Hospital, Tehran, Iran.
Citation: Shoja Shafti S., Memarie A., Rezaie M., Hamidi M. (2019) Prevalence and Clinical Features of Seizure Attacks in Psychiatric Wards: A Local Review, J Neuroscience and Neurological Surgery. 5(1): Doi: 10.31579/2578-8868/093
Copyright: © 2019 Saeed Shoja Shafti. 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: 18 September 2019 | Accepted: 11 October 2019 | Published: 15 October 2019
Keywords: seizure; epilepsy; schizophrenia; mood disorder; neuropsychiatry
Introduction: Behavioral and cognitive dysfunction is frequently observed in patients with recurrent seizures and represents an important challenge in treating these patients. In the present assessment the incidence and clinical profile of seizure attacks have been probed among a great sample of non-western psychiatric inpatients and compared with the available data in literature regarding prevalence and other associated clinical physiognomies
Methods: All inpatients that had suffered seizure attack during the last sixty-four months had been included in the present study. Clinical diagnosis, as well, was in essence based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).
Results: While epilepsy had been identified as the primary cause of seizure (82.92%), 17.64% of them had experienced their first attacks during hospitalization. Annual incidence of seizure in psychiatric iseizure; epilepsy; schizophrenia; mood disorder; neuropsychiatry.npatients, on the whole, was around 0.07%. It was almost 0.06 in identified epileptic cases and about 0.01% with respect to the first time unprovoked epileptic attack. Also, the seizure attacks were significantly more prevalent among male psychiatric inpatients than female patients. Schizophrenia and bipolar disorder were significantly more prevalent than substance abuse, schizoaffective and depression, as comorbid psychiatric disorders among patients who had suffered seizure attacks, generally, and known cases of epilepsy, particularly.
Conclusion: While, etiologically, epilepsy had been identified as the primary cause of seizure in psychiatric inpatients, schizophrenia and bipolar disorder were significantly more prevalent, as comorbid psychiatric disorders, in comparison with other primary psychiatric illnesses. Male gender, as well, could be considered as a risk factor.
It is notable that the incidence of unprovoked seizures in the placebo arms of RCTs of antidepressants and antipsychotics is approximately 15‐fold higher, proposing that both depression and psychosis are risk factors for seizures [1]. More recently, a bidirectional link between epilepsy and several psychiatric diseases has been revealed, whereby not only do people with epilepsy have a higher risk of developing a psychiatric illness, but people with psychiatric disorder have a higher risk of developing epilepsy [2, 3]. This bidirectional relationship exists for depression, anxiety, psychosis and suicidality [4]. Thus, the occurrence of seizures may, in some cases, be the expression of the natural progression of a psychiatric disorder, unrelated to the use of psychotropics [1]. Alternatively, people with epilepsy have an elevated prevalence of several psychiatric disorders including depression (22.9%), anxiety (20.2%) and psychosis (5.2%) [4, 5]. Mania is considered rare [6]. Suicide is fivefold higher in epileptic patients compared to the general population [7] and is an important cause of premature mortality [8]. The link between epilepsy and mental illness is bidirectional as patients with depression, anxiety and psychosis have an augmented risk of developing new‐onset epilepsy [3]. Suicide attempts are also associated with the development of epilepsy [7]. It deserves to be mentioned that while in most developed countries, incidence rates of epilepsy range from 40 to 70 per 100,000 (9, 10), in developing countries, the rates may be as high as 100 to 190 per 100,000 [9]. Also, Men are 1.0 to 2.4 times more likely to have epilepsy than are women [9]. As said before, behavioral and cognitive dysfunction is frequently observed in patients with epilepsy and denotes an important challenge in treating these patients. A complex array of factors influence the neuropsychiatric effect of epilepsy, including the cause of the epilepsy, location of epileptogenic focus, age at onset, nature of the epilepsy syndrome, seizure type, frequency, duration of epilepsy, medications used for treatment, and psychosocial factors. Behavioral disturbances are most common with complex partial seizures and seizures involving foci in the temporolimbic structures [6]. People with epilepsy have nearly 2.5 times the risk of developing schizophrenia and almost 3 times the risk of developing a schizophrenia-like psychosis compared with the general population. The data suggested that the risk also increases with an increasing number of hospital admissions for epilepsy and with people first admitted for epilepsy at later ages. The underlying causal mechanism for the association of epilepsy with schizophrenia or schizophrenia-like psychosis is unknown but may have features in common with postictal psychosis and likely involves bilateral cerebral dysfunction within frontal subcortical circuits and probably, temporal subcortical circuits, as well [6]. In this regard, hippocampus is considered the regional focal point of the brain, playing an important role in cognition, psychosis, and seizure activity and potentially suggesting common etiologies and pathophysiology of temporal lobe epilepsy (TLE) and schizophrenia [11]. On the other hand, the association with epilepsy is not limited to schizophrenia and other psychiatric disorders, such as acute stress disorder, anxiety, depression, bipolar disorder, attention deficit hyperactivity disorder, sleep disorders, and movement disorders, as well, may be involved. Moreover, it is conceivable that persons with schizophrenia are susceptible to epilepsy [12, 13]. Coincidentally, the onsets of schizophrenia as well as temporal TLE frequently occur around adolescence, the final stage of the brain’s development. Perhaps, it would be reasonable to speculate that recurrent and prolonged seizures result in alterations to the developing brain architecture, which serves as a trigger to disassemble the molecules involved in forming improper neural networks. Formation of improper neuronal networks could be deleterious to brain functionality, leading to devastating psychiatric conditions [12]. Though psychoses correlate positively with the multiplicity of seizures and inversely with their frequency, it is the highest in pharmoco-resistant cases. A genetic factor, as well, is likely to play a role [14]. While the temporal lobe hypothesis of schizophrenia put forward in the 1960s notes that episodes with paranoid psychoses are more prevalent in TLE, some of the scholars believe that psychosis of epilepsy is a distinct nosologic entity differing from schizophrenia not only in clinical details but also in neurobiological aspects [15], and mood disorder symptoms, such as depression and mania, are seen less often in epilepsy than are schizophrenia-like symptoms [16]. In the present assessment the incidence and clinical profile of seizure attacks have been probed among a great sample of non-western psychiatric inpatients and compared with the available data in literature regarding prevalence and other associated clinical physiognomies.
Methods:
Razi psychiatric hospital in south of capital city of Tehran, as one of the largest and oldest public psychiatric hospitals in the Middle East, which has been established formally in 1917 and with a capacity around 1375 active beds, had been selected as the field of study in the present retrospective assessment. For evaluation, all inpatients that had suffered seizure during the last sixty-four months had been included in the present study. Clinical diagnosis, as well, was in essence based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) [17].
Statistical analysis:
Analysis of dependent variables had been accomplished by ‘t-test’ and appraisal of independent variables had been explored by means of ‘comparison of proportions’. Statistical significance, as well, had been defined as a p value ≤0.05. MedCalc Statistical Software version 15.2 was used as statistical software tool for analysis.
Results:
As said by results, among 20118 psychiatric patients hospitalized in razi psychiatric hospital, during the last sixty-four months (April of 2014-August 2019), eighty two had experienced at least one seizure attack during their inpatient management. So, while annual incidence of seizure in inpatients, in general, was around 0.07%, it was almost 0.06 in identified epileptic cases and about 0.01% with respect to the first time unprovoked attack with no detectable medical reason. Also, with respect to gender difference and according to data, while there was no significant difference regarding age between male (mean: 42.74±12.725 y/o) and female (mean: 48.03±15.34 y/o) group of patients (t = 1.66, p< 0.10, CI 95%: -1.04,11.63), in the present estimation the seizure attacks were significantly more prevalent among male psychiatric inpatients than female inpatients (z= 4.06, p<0.00, CI 95%:0.16, 0.47). Concerning etiology, in the current appraisal, epilepsy had been identified as the main cause of seizure attacks (82.92%) (Table 1). Among them 17.64% (n=12) had experienced their first attacks during hospitalization and the remaining had experienced it in the past, in different occasions during the last 12 years (mean: 7.45± 4.37 years). Two patients had experienced their first attacks shortly after termination of their prescribed electroconvulsive therapy (six-session). Moreover, with respect to prevalence of primary psychiatric disorders among patients, who have experienced seizure attacks during the last 64 months, there was no significant difference, in general, between thought disorders (schizophrenia plus schizoaffective) and mood disorders (bipolar disorder plus major depressive disorder) (z=1.75, p<0.07, CI 95%: -0.01, 0.28), from one hand, and between schizophrenia and bipolar disorder (z=1.30, p<0.19, CI 95%: -0.04, 0.24), on the other hand. But both schizophrenia and bipolar disorder were significantly more prevalent than substance abuse (z=4.72, p<0.00, CI 95%: 0.18, 0.44, and z= 3.54, p<0.00, CI 95%: 0.09,0.34, respectively), schizoaffective and depression (Table 2). The same pattern was relatively valid as regards the identified epileptic cases (Table 3).
Discussion:
While psychiatric ailments repeatedly occur in patients with epilepsy, the diagnosis is regularly missed and therapeutic opportunities are often lost. These comorbidities assume greater importance as epidemiological data show their frequent relationship with decreased function and quality of life, and advances in neurobiology better define their pathophysiological association and therapies. So, maybe epilepsy presents a model for understanding psychiatric illness. Decoding the role of different biological and environmental risk factors may help identify high-risk patients and allow for early intervention. Antiepileptic drugs are frequently used to manage psychiatric syndromes although the mechanisms of their psychotropic action remain ambiguous. As recognition and management of comorbid psychiatric disorders in epilepsy remain suboptimal, we need to increase the awareness of physicians, patients, their caregivers, and the health care system. Better recognition will help to improve and implement proper diagnostic and treatment plans, and improve functional outcomes and quality of life in people with epilepsy (18). While the main psychiatric complications in epilepsy include depression, anxiety disorders, and psychosis, comorbidity of epilepsy may be due to a shared pathophysiological mechanism. Nonetheless, coincidence or selection bias cannot at all times be excluded. In addition, genetic, psychosocial and iatrogenic factors may also contribute to the comorbidity [19]. On the other hand, TLE and psychosis coexist more commonly than chance would foresee. The discovery of shared mechanisms and/or affected neurochemicals in temporal lobe epilepsy and schizophrenia might disclose important clues on the vulnerability of such patients to psychotic symptoms and be an opportunity for new treatment development [20]. Impairment and deregulation among critical anatomical regions, such as the hippocampus, amygdala, thalamus, and the temporal, frontal and cingulate cortices, might predispose TLE brains to psychosis. Studies of the effects of kindling and injection of neuroactive substances on performance and electrophysiological configurations may offer a model of how limbic seizures in humans raise the vulnerability of epileptic patients to psychiatric illnesses [12]. Back to our study and along with the results, while the annual incidence of seizures, on the whole, in our study was somewhat similar to Sander (9), with respect to its rate in developed countries, and higher than Ngugi AK et al. [10], it was very lower than estimation of Sander [9], with respect to its rate in developing countries. Also, with respect to the first time unprovoked attack our assessment was lower than both of them. With respect to gender difference, as well, our finding was to some degree analogous with the estimates of Sander [9]. Respecting prevalence of psychiatric comorbidities, our conclusions were not in harmony with the findings of Cunningham et al. [6] and Vuilleumier et al. [14], who had found depression as the most prevalent comorbidity and psychosis as the fewest one. On contrary, among our samples, the schizophrenia was the most prevent psychiatric comorbidity, which was significantly more prevalent than depression. Also, bipolar disorder was the second most prevalent psychiatric disorder among our epileptic cases, which was not in accord with the findings of Cunningham et al. [6], who had considered it a rare comorbidity in epileptic patients. Then again, our results were to some extent consistent with the verdicts of Lavery et al. [16], who has indicated that mood disorder symptoms, such as depression and mania, are seen less often in epilepsy than are schizophrenia-like symptoms. Furthermore, in opposite to Scott et al.[4], no remarkable anxiety disorder had been detected in the current survey. In general, patients who have epilepsy or recurrent seizure attacks face many challenges resulting from their ailment and have frequent psychiatric comorbidities. Recognition of these disorders is increasing and is having a positive impact on patients' quality of life. Recent recommendations about a new classification system for psychiatric disorders related specially to epilepsy and based on the relationship of symptoms to seizures, antiepileptic medications, and electroencephalogram changes demand further investigations [21]. Principally insofar psychiatric syndromes specific to epilepsy can be identified, correlation of clinical phenomena with relatively well-understood pathophysiology in epilepsy will permit progresses in the understanding of psychiatric disorder. This progress should move the management of patients who have recurrent seizure attacks toward an all-inclusive biopsychosocial model that focuses on the whole person rather than simply on the disease process [21]. Restricted period of study, due to inadequate registration and documents in the last decades, and thus insufficient number of cases who had suffered seizure attacks, as accessible samples, in spite of greatness of the field of study, do not permit generalization of outcomes to more than a preliminary survey. No doubt, further methodical studies in future will improve our clinical idea concerning diagnosis and management of this vital problem.
Conclusion:
While, etiologically, epilepsy had been identified as the primary cause of seizure in psychiatric inpatients, schizophrenia and bipolar disorder were significantly more prevalent, as comorbid psychiatric disorders, in comparison with other primary psychiatric illnesses. Male gender, as well, could be considered as a risk factor
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
