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Research Article | DOI: https://doi.org/10.31579/2690-8816/167
Department of Medical Laboratory Science Imo State University, Owerri.
*Corresponding Author: Ikaraoha Chidiebere Ikechukwu. Department of Medical Laboratory Science Imo State University, Owerri.
Citation: Egbeonu Nwamaka, Ikaraoha C. Ikechukwu, Johnkennedy Nnodim, (2025), Assessment of Certain Serum Proteins, pH and C Reactive Protein in Patients with Urinary Tract Infections in Owerri, J Clinical Research Notes, 6(3); DOI:10.31579/2690-8816/167
Copyright: © 2025, Ikaraoha Chidiebere Ikechukwu. 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: 24 March 2025 | Accepted: 02 April 2025 | Published: 08 April 2025
Keywords: serum proteins; pH; C reactive protein; urinary tract infections; bladder
The levels of certain serum proteins and C reactive proteins in Owerri patients suffering from urinary tract infections are assessed in this study. This research involved the recruitment of 150 individuals in total. Fifty respondents appeared to be in good health, while 100 patients had urinary tract infections. A statistical analysis and laboratory analysis were performed. CRP levels in UTI patients were noticeably higher (30.24 ± 5.40 mg/L) than in controls (23.74 ± 8.28 mg/L; p = 0.000), suggesting a strong inflammatory response. Urine pH increased significantly (7.17 ± 0.966 vs. 5.54 ± 0.76; p = 0.000), Serum albumin levels were significantly lower in UTI patients (45.41 ± 4.02 g/L) compared to controls (48.48 ± 3.09 g/L; p = 0.002), whereas total protein levels showed no significant difference (p = 0.766). Gender-based differences revealed higher total protein levels and CRP levels in female UTI patients than males.
Urinary tract infections or UTIs, are very common, particularly among older, pregnant, and lactating people. In their lifetime, one in two women and one in twenty men will get a UTI. By controlling the blood's water content and filtering waste products out of the blood, the kidneys create urine. The tubes called ureters connect each kidney to the bladder. Urine travels from the kidneys to the bladder through the ureters. The bladder "signals" the urge to urinate, and through the urethra tube, urine leaves the body. A serious kidney infection is less likely thanks to the urinary system. By preventing urine from flowing backward from the bladder to the kidneys, it does this [1].
A urinary tract infection (UTI) is an illness that affects a section of the urinary tract. Lower urinary tract infections may affect the bladder or urethra, whereas upper urinary tract infections harm the kidney. Signs of a lower urinary tract infection include pain when urinating, frequent and urgent urination even when the bladder is empty, and suprapubic tenderness. On the other hand, lower UTI symptoms like fever or flank pain are usually accompanied with kidney infection symptoms, which are more common. Blood in the pee is an uncommon occurrence. Patients' symptoms may be vague or nonspecific at the extremes of age (i.e. in extremely young or old patients). Escherichia coli is the most common cause of infections, while other bacteria or fungi can also infrequently cause them [2].
Risk factors include female anatomy, family history, diabetes, obesity, sexual activity, and catheterization. Urinary tract infections (UTIs) are not considered STIs (sexually transmitted illnesses), however sexual activity is a risk factor. Pyelonephritis is typically caused by ascending bladder infections, although it can also be caused by a blood-borne bacterial infection. Only the symptoms of young, healthy women can be used to make a diagnosis. Since germs can exist without causing sickness, diagnosing persons with vague symptoms can be difficult. When treatment fails or in complex cases, urine cultures can be useful [3]. It is important to keep in mind that hematuria is present in 68–91.7% of UTIs, and proteinuria is present in 63–80% of UTIs. The protein and albumin pads may therefore produce falsely positive results for UTI patients. Although blood includes protein, healthy kidneys should only filter extremely little amounts of protein from the urine because most protein molecules are too large for the kidneys to filter. Urine protein loss is uncommon [4].
When it happens, it's called "proteinuria. "Although there are many different proteins seen in urine, albumin is the one most strongly linked to kidney disease. Even though protein in urine is rarely visible, it can occasionally be detected with a simple dip-stick test or more sensitive lab testing. Sometimes renal disease and other health problems might be indicated by urine protein levels [5,6] Urinary tract infections (UTIs), which are the most common bacterial ailment in adult males and females, also have a high recurrence incidence. Despite the high frequency of UTIs, there is currently no accurate detection method for their prompt identification [7]. A common diagnostic method for UTIs, the urine dipstick has poor sensitivity and specificity. The average time to diagnose a patient is 72 hours, despite the fact that urine cultures are more accurate. Therefore, developing rapid, simple, and reliable point-of-care diagnostic tests for UTIs is crucial. Part of a UTI is an inflammatory disease. Urine from UTI patients has changed proteins. UTI biomarkers for diagnosis and/or prognosis may be found in urinary proteins [8,9,10].
Investigating the variations in albumin and total protein among patients with UTIs is the primary objective of this study. Due to the paucity of data and contradictory patient reports on serum albumin and total protein levels, this study attempts to investigate these parameters in individuals with UTIs.
Study Area
The study was carried out in three different private laboratories in Imo State, Owerri, Nigeria.
Ethics, Advocacy, and Pre-Survey Contacts
The Ethical approval was obtained from the Federal Teaching Hospital, Owerri,
Study Population/Sample
Size
The study population consisted of patients aged 20 to 60 years who were confirmed to have urinary tract infections through culture. They were age-matched with apparently healthy individuals who were confirmed not to have UTIs via culture. A total of one hundred urinary tract-infected patients were recruited for the study, while 50 subjects were apparently healthy individuals.
Selection Criteria
Inclusion Criteria
(i) Subjects between the ages of 20-60 years.
(ii) Subjects who gave consent to participate in the study.
(iii) Subjects with no infection.
Exclusion Criteria
(i) Subjects below the age of 20 years and above the age of 60 years.
(ii) Subjects who did not give consent to participate in the study.
(iii) Subjects with infections.
Study Design
A case-control study was carried out among urinary tract-infected patients. The test group comprised 50 participants within the age range of 20-60 years, while the control group comprised 50 apparently healthy individuals whose ages matched the test population. A structured questionnaire was issued to them for the purpose of obtaining information regarding their medical and demographic characteristics, in addition to their hospital records. Those who qualified to participate in the research signed a written letter of consent.
Sample Collection
Blood and urine samples were collected to evaluate some serum proteins, hematological indices, proteinuria, and hematuria by a trained health care professional using aseptic measures. Blood samples were collected aseptically by venipuncture using a 5ml sterile disposable syringe and needle from all subjects and dispensed into a labeled plain dry specimen container. The samples were centrifuged at 3,000 rpm for 5 minutes after clotting to separate and obtain the serum. The sera were extracted using a Pasteur pipette, put into an appropriate specimen container, and stored at -20°C prior to use.
Laboratory Procedures
All reagents were commercially purchased, and the manufacturer’s standard operational procedures (SOP) were strictly followed.
Determination of Serum Total Protein (Biuret Method) (Using Randox Total Protein Assay-Tp245)
Principle: The principle was based on the reaction between cupric ions in the reagent and the peptide bonds of the protein molecules in an alkaline solution to form blue-violet or purple-colored complexes. The absorbance of the color was measured using a spectrophotometer at 540 nm.
Determination of Serum Albumin (Bromocresol Green Method) (Using Randox Albumin Assay-AL145)
Principle: Under acidic conditions, serum albumin binds specifically with bromocresol green to form a green-colored complex. The absorbance was read at 640 nm.
Determination of C-Reactive Protein
Principle of C-Reactive Protein Test: The C-Reactive Protein test is based on the principle of latex agglutination. When latex particles complexed with human anti-C-reactive protein were mixed with a patient’s serum containing C-reactive proteins, a visible agglutination reaction took place within 2 minutes.
All data generated in this study were subjected to statistical analysis using SPSS version 23. Mean and standard deviation, Student's t-test, and correlation were determined. The level of significance was taken at p<0>
4.1 Mean ± SD Values of Serum Total Protein, Albumin, CRP And Urine pH In All UTI Subjects Versus All Controls
There was a significantly higher (p = 0.000) Mean CRP in All UTI subjects (30.24 ± 5.40) compared to control subjects (23.74 ± 8.28). There was a significantly higher (p = 0.000) Mean Urine pH in All UTI subjects (7.17 ± 0.966) compared to control subjects (5.54 ± 0.76). There was a significantly lower (p = 0.002) Mean Albumin in All UTI subjects (45.41± 4.02) compared to All control subjects (48.48 ± 3.09). There was no significant difference (p = 0.766) in Mean Total Protein of All UTI subjects (68.55 ± 6.57) compared to Control subjects (68.20 ± 4.06) (Table 4.1).
Variable (mean ± SD) | All UTI subjects (n=50) | All Control subjects (n=50) | t-value | p-value |
Total Protein (mg/dl) Lower 95% C.I Upper 95% C.I | 68.55 ± 6.57 66.68 70.41 | 68.20 ± 4.06 67.04 69.35 | 0.299 | 0.766 |
Albumin (mg/dl) Lower 95% C.I Upper 95% C.I | 45.41± 4.02 44.27 46.56 | 48.48 ± 3.09 47.60 49.36 | -4.081 | 0.000 |
CRP(mg/l) Lower 95% C.I Upper 95% C.I | 30.24 ± 5.40 28.70 31.77 | 23.74 ± 8.28 21.38 26.09 | 5.638 | 0.000 |
Urine pH Lower 95% C.I Upper 95% C.I | 7.17 ± 0.966 6.89 7.44 | 5.54 ± 0.76 5.32 5.75 | 9.548 | 0.000 |
Table 4.1: Mean ± SD Values of Serum Total Protein, Albumin, CRP And Urine pH In All UTI Subjects Versus All Controls
4.2 Mean ± SD Values of Serum Total Protein, Albumin, CRP And Urine pH In Male UTI Subjects Versus Male Controls
There was a significantly higher (p = 0.003) Mean CRP in Male UTI subjects (29.33 ± 4.51) compared to control subjects (24.43 ± 9.31). There was a significantly higher (p = 0.000) Mean Urine pH in Male UTI subjects (7.14 ± 0.95) compared to control subjects (5.48 ± 0.714). There was a
significantly lower (p = 0.002) Mean Albumin in Male UTI subjects (44.64 ± 4.88) compared to control subjects (49.11 ± 3.61). There was no significant difference (p = 0.201) in Mean Total Protein in Male UTI subjects (67.82 ± 8.63) compared to Control subjects (70.41 ± 3.87). (Table 4.2).
Variable (mean ± SD) | Male UTI subjects (n=25) | Male Control subjects (n=25) | t-value | p-value |
Total Protein (mg/dl) Lower 95% C.I Upper 95% C.I | 67.82 ± 8.63
64.26 71.38 | 70.41 ± 3.87
68.81 72.01 | -1.315 | 0.201 |
Albumin (mg/dl) Lower 95% C.I Upper 95% C.I | 44.64 ± 4.88
42.62 46.66 | 49.11 ± 3.61
47.62 50.60 | -3.438 | 0.002 |
CRP (mg/l) Lower 95% C.I Upper 95% C.I | 29.33 ± 4.51
27.46 31.19 | 24.43 ± 9.31
20.58 28.27 | 3.249 | 0.003 |
Urine pH Lower 95% C.I Upper 95% C.I | 7.14 ± 0.95 6.74 7.53 | 5.48 ± 0.714 5.18 5.77 | 6.481 | 0.000 |
Table 4.2: Mean ± SD Values of Serum Total Protein, Albumin, CRP And Urine pH In Male UTI Subjects Versus Male Controls
4.3 Mean ± SD Values of Serum Total Protein, Albumin, CRP And Urine pH In Female UTI Subjects Versus Female Controls
There was a significantly higher (p = 0.002) Mean Total Protein in Female UTI subjects (69.27 ± 3.54) compared to Control subjects (65.98 ± 2.92). There was a significantly higher (p = 0.000) Mean CRP in Female UTI subjects (31.15 ± 6.12) compared to control subjects
(23.05 ± 1.44). There was a significantly higher (p = 0.000) Mean Urine pH in Female UTI subjects (7.20 ± 1.00) compared to control subjects (5.60 ± 0.81). There was a significantly lower (p = 0.021) Mean Albumin in Female UTI subjects (46.19 ± 2.81) compared to control subjects (47.85 ± 2.38) (Table 4.3).
Variable (mean ± SD) | Female UTI subjects (n=25) | Female Control Subjects (n=25) | t-value | p-value |
Total Protein (mg/dl) Lower 95% C.I Upper 95% C.I | 69.27 ± 3.54 67.81 70.74 | 65.98 ± 2.92 64.78 67.19 | 3.412 | 0.002 |
Albumin (mg/dl) Lower 95% C.I Upper 95% C.I | 46.19 ± 2.81 45.03 47.35 | 47.85 ± 2.38 46.86 48.83 | -2.479 | 0.021 |
CRP (mg/l) Lower 95% C.I Upper 95% C.I | 31.15 ± 6.12 28.62 33.68 | 23.05 ± 1.44 20.05 26.04 | 4.724 | 0.000 |
Urine pH Lower 95% C.I Upper 95% C.I | 7.20 ± 1.00 6.78 7.61 | 5.60 ± 0.81 5.26 5.93 | 6.928 | 0.000 |
Table 4.3: Mean ± SD Values of Serum Total Protein, Albumin, CRP And Urine pH In Female UTI Subjects Versus Female Controls
4.4 Mean ± SD Values of Serum Total Protein, Albumin, CRP And Urine pH In Male UTI Subjects Versus FemaleUTI Subjects
There was no significant difference (p = 0.418) Mean Total Protein in Male UTI subjects (67.82 ± 8.63) compared to Female UTI subjects (69.27 ± 3.54). There was no significant difference (p = 0.246) in Mean Albumin in Male
UTI subjects (44.64 ± 4.88) compared to Female UTI subjects (46.19 ± 2.81). There was no significant difference (p = 0.146) in Mean CRP in Male UTI subjects (29.33 ± 4.51) compared to Female UTI subjects (31.15 ± 6.12). There was no significant difference (p = 0.854) in Mean Urine pH in Male UTI subjects (5.48 ± 0.71) compared to Female UTI subjects (5.60 ± 0.81)
Variable (mean ± SD) | Male UTI subjects (n=25) | Female UTI subjects (n=25) | t-value | p-value |
Total Protein (mg/dl) Lower 95% C.I Upper 95% C.I | 67.82 ± 8.63 64.26 71.38 | 69.27 ± 3.54 67.81 70.74 | -0.824 | 0.418 |
Albumin (mg/dl) Lower 95% C.I Upper 95% C.I | 44.64 ± 4.88 42.62 46.66 | 46.19 ± 2.81 45.03 47.35 | -1.190 | 0.246 |
CRP (mg/l) Lower 95% C.I Upper 95% C.I | 29.33 ± 4.51 27.46 31.19 | 31.15 ± 6.12 28.62 33.68 | -1.503 | 0.146 |
Urine pH Lower 95% C.I Upper 95% C.I | 7.14 ± 0.95 6.74 7.53 | 7.20 ± 1.00 6.78 7.61 | -0.186 | 0.854 |
(Table 4.4). Mean ± SD Values of Serum Total Protein, Albumin, CRP And Urine pH In Male UTI Subjects Versus Female UTI Subjects
4.5 Mean ± SD Values of Serum Total Protein, Albumin, CRP And Urine pH In Male Control Subjects Versus Female Control Subjects
There was a significantly higher (p = 0.002) Mean Total Protein in Male Control subjects (70.41 ± 3.87) compared to Female Control subjects (65.98 ± 2.92). There was a significantly lower (p = 0.021) Mean Albumin in Male
Control subjects (49.11 ± 3.61) compared to Female control subjects (47.85 ± 2.38). There was a significantly higher (p = 0.000) Mean CRP inFemale UTI subjects (24.43 ± 9.31) compared to control subjects (23.05 ± 7.24). There was a significantly higher (p = 0.000) Mean Urine pH inFemale UTI subjects (5.48 ± 0.71) compared to control subjects (5.60 ± 0.81) (Table 4.5).
Variable (mean ± SD) | Male Control subjects (n=25) | Female Control subjects (n=25) | t-value | p-value |
Total Protein (mg/dl) Lower 95% C.I Upper 95% C.I | 70.41 ± 3.87 68.81 72.01 | 65.98 ± 2.92 64.78 67.19 | 4.414 | 0.000 |
Albumin (mg/dl) Lower 95% C.I Upper 95% C.I | 49.11 ± 3.61 47.62 50.60 | 47.85 ± 2.38 46.86 48.83 | 1.537 | 0.137 |
CRP (mg/l) Lower 95% C.I Upper 95% C.I | 24.43 ± 9.31 20.58 28.27 | 23.05 ± 7.24 20.05 26.04 | 0.545 | 0.524 |
Urine pH Lower 95% C.I Upper 95% C.I | 5.48 ± 0.71
| 5.60 ± 0.81
| -0.486 | 0.632 |
Table 4.5: Mean ± SD Values of Serum Total Protein, Albumin, CRP And Urine pH In Male Control Subjects Versus Female Control Subjects
The current findings on serum total protein, albumin, C-reactive protein (CRP), and urine pH are compared with existing literature to highlight correlations and implications for clinical practice. Urinary tract infections (UTIs) are common bacterial infections that can cause significant physiological alterations, including changes in serum proteins, haematological indices, and urine parameters. Studies have looked at these biomarkers to improve diagnostic and prognostic approaches regarding UTI management.[11] Our data indicated significantly higher CRP levels in UTI individuals compared to controls This is consistent with research by [12], which found that systemic inflammatory responses caused CRP levels to rise in UTI patients.
A considerable rise in urine pH among UTI individuals compared to controls is similar with findings by [13] who reported alkaline urine in patients with bacterial infections, particularly those caused by urea-splitting bacteria like Proteus mirabilis.
Male UTI patients and healthy controls differ significantly in a few biochemical indicators, according to the investigation. In particular, compared to control participants, male UTI subjects had lower mean albumin levels, higher mean C-reactive protein (CRP) levels, and higher urine pH. The mean amounts of total protein in the two groups did not differ significantly.
This is consistent with the findings of [14], which likewise found no discernible variation in the groups' levels of total protein.
Male UTI individuals had higher mean CRP levels than controls, which may indicate that UTIs are linked to an increased inflammatory response. Elevated levels of CRP, an acute-phase protein that rises in response to inflammation, are frequently seen in bacterial infections, particularly urinary tract infections. Higher CRP levels have been shown in studies to help differentiate between upper and lower UTIs, and they are frequently linked to acute pyelonephritis [2]. Male UTI participants' mean urine pH was noticeably higher than that of controls, suggesting that infected people's urine is becoming more alkaline. Urea-splitting bacteria, such Proteus mirabilis, can cause alkaline urine by producing ammonia and raising the pH of the urine. This change in urine pH is a known feature of several bacterial urinary tract infections. This is in accordance with research by [15], who found that individuals with bacterial infections—especially those brought on by urea-splitting bacteria such Proteus mirabilis—had alkaline urine. The body's acute-phase reaction to infection may be reflected in the male UTI sufferers' reported drop in mean albumin levels as compared to controls. While the synthesis of other proteins, such as albumin, is downregulated during such reactions, the liver produces more acute-phase proteins, such as CRP [16]. Lower serum albumin levels can also result from increased urine albumin excretion caused by UTIs. Similar patterns were noted by [9], who hypothesized that systemic inflammation and increased urine protein loss may be connected to hypoalbuminemia in UTIs. When albumin levels fall, other serum proteins may rise to make up for it, preserving overall total protein levels, as indicated by the lack of a significant difference in mean total protein levels between male UTI subjects and controls. The increased synthesis of acute-phase proteins, which are a component of the body's early reaction to infection, may be the cause of this compensatory [20].
Therefore, the results of higher CRP, higher urine pH, and lower albumin levels in male UTI patients are consistent with the body of knowledge regarding the inflammatory and physiological alterations linked to UTIs. A complicated interaction between protein synthesis and degradation during the acute phase response to infection is suggested by the maintenance of total protein levels in spite of decreased albumin. When comparing female patients with urinary tract infections (UTIs) to healthy controls, the research shows notable changes in biochemical markers. These results provide information on the pathophysiological alterations linked to UTIs and are consistent with the report of [7].
When compared to control patients, female UTI subjects had significantly higher mean total protein levels, which may indicate a systemic reaction to infection. Increased production of acute-phase proteins, like C-reactive protein (CRP), during the inflammatory response to UTIs may lead to elevated total protein levels. This is in line with research by [9], which showed that systemic inflammatory responses in UTI patients resulted in higher CRP levels. The inflammatory nature of UTIs is highlighted by the notable increase in mean CRP levels in female UTI sufferers when compared to controls. Elevated levels of CRP, a well-known indicator of inflammation, are frequently linked to bacterial infections, especially urinary tract infections. Research has indicated that CRP's function as a marker in UTI patients is supported by the fact that its plasma levels might rise noticeably during bacterial infections.
Female UTI subjects' mean urine pH significantly increased as compared to controls, suggesting that infected people's urine is becoming more alkaline. The presence of urea-splitting bacteria, like Proteus mirabilis, which generate ammonia and raise urine pH, may be the cause of this alkalization. UTIs brought on by these bacteria have been linked to elevated urine pH, which aids in the pathophysiology of the illness. When compared to the controls, the observed considerable decrease in mean albumin levels in female UTI subjects raises the possibility of systemic inflammation or renal involvement. Reduced hepatic synthesis during acute-phase reactions or increased urine albumin loss from renal impairment can also cause hypoalbuminemia in UTI patients. Research has shown that UTIs can cause albuminuria, which emphasizes how crucial it is to keep an eye on these patients' albumin levels.
These results are in line with the study by [17], which focused on the notable biochemical changes in female UTI patients. The systemic inflammatory response and possible renal consequences linked to UTIs are reflected in increases in total protein, CRP, and urine pH as well as decreases in albumin levels. By giving important information on the severity and course of the infection, monitoring these measures can help with UTI assessment and management. When compared to control persons, patients with urinary tract infections (UTIs) exhibit notable changes in their blood and urine parameters. These results are consistent with a publication by [4] that sheds light on the pathophysiological alterations linked to UTIs.
This study also found that the mean CRP level was significantly higher in UTI subjects than in controls. Elevated CRP levels are a common indicator of systemic inflammation and can help distinguish between upper and lower UTIs, with higher levels typically associated with upper UTIs. The body's acute-phase response to infection is reflected in the elevated CRP. The mean urine pH was significantly higher in UTI subjects than in controls. The presence of urea-splitting bacteria, like Proteus mirabilis, can cause urine to become alkaline, which can favor certain pathogens and may have an impact on the development of urinary calculi. Also, there was substantial decrease in mean serum albumin was reported in UTI individuals compared to controls. One possible explanation for hypoalbuminemia in UTI patients is systemic inflammation, which raises vascular permeability and causes albumin loss. Lower serum albumin levels may also result from protein loss through urine brought on by glomerular or tubular injury during illness. The mean total protein levels of UTI subjects and controls did not differ significantly, though, indicating that other serum proteins may make up for the loss of albumin and keep overall protein levels stable [18]. Gender-specific data analysis revealed that male UTI subjects had significantly higher mean urine pH and CRP levels than male controls (p = 0.000). Additionally, their mean albumin levels were much lower.
Male and female UTI subjects showed no significant differences in mean total protein, albumin, CRP, or urine pH levels, suggesting that the biochemical response to UTIs is comparable between genders. It is noted that CRP is an acute-phase protein that increases in response to inflammation. The significantly higher mean CRP levels observed in both male and female UTI subjects compared to their respective control groups align with existing research indicating elevated CRP levels during UTIs. Female UTI subjects also showed a significantly lower mean albumin and a significantly higher mean total protein, CRP, and urine pH in comparison to female controls.
According to studies, CRP levels can help differentiate between upper and lower UTIs, with greater levels typically being linked to upper UTIs. However, the UTI classification is not specified in the existing data, which may have an impact on CRP levels. The research indicating that some uropathogens can change urine pH is supported by the observed rise in mean urine pH in UTI subjects when compared to controls. For example, by hydrolyzing urea into ammonia, urease-producing bacteria such as Proteus mirabilis can raise the pH of urine. The precise infections implicated in these cases, however, were not identified, which might have shed more light on the pH changes. An acute-phase response, in which albumin levels fall during inflammation or infection, may be the cause of the considerably decreased mean albumin levels in both male and female UTI sufferers when compared to controls.
Increased vascular permeability and albumin redistribution during inflammatory conditions can both lead to hypoalbuminemia. Serum albumin levels may be lowered as a result of urine albumin loss brought on by renal involvement in UTIs [11].
While there was no discernible difference between male UTI individuals and their controls, the results indicate that female UTI subjects had a considerably greater mean total protein than their female counterparts. Albumin and globulins make up total serum protein; as part of the immunological response to infections, globulin levels, especially immunoglobulins, may rise. The mean values of total protein, albumin, CRP, and urine pH did not significantly differ between male and female UTI individuals. This implies that in this cohort, the metabolic reactions to UTIs are comparable for both sexes. Males showed considerably greater mean total protein levels than females in control subjects, nevertheless, which is consistent with research suggesting that males may have higher blood protein concentrations. Therefore, the biochemical alterations seen in UTI patients are in line with inflammatory reactions and the findings of [19].
Significant hematological and biochemical changes in patients with UTIs are highlighted in this study. Increased white blood cell counts and elevated C-reactive protein (CRP) values highlight the systemic inflammatory response to UTIs. Increased vascular permeability and possible renal involvement during infection could be the cause of the observed drop in serum albumin levels. Furthermore, the existence of urea-splitting bacteria, like Proteus mirabilis, which can alkalinize urine, is suggested by the rise in urine pH. These results are consistent between male and female patients, suggesting that both sexes have the same metabolic reaction to UTIs. A compensatory rise in other serum proteins, perhaps acute-phase reactants, is implied by the maintenance of total protein levels in spite of decreased albumin.
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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.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
