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Research | DOI: https://doi.org/DOI:10.31579/2768-0487/186
1 Department of Haematology and Blood Transfusion, Abia State University, Uturu, Nigeria.
2 Department of Obstetrics and Gynaecology, Abia State University Teaching Hospital, Aba, Nigeria.
3 Department of Paediatrics, Abia State University Teaching Hospital, Aba, Nigeria.
4 Department of Surgery, Abia State University Teaching Hospital, Aba, Nigeria.
5 Department of Haematology, Federal Medical Centre, Umuahia, Abia State, Nigeria.
6 Department of Community Medicine, Abia State University, Uturu, Nigeria.
7 Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos/ Lagos University Teaching Hospital Idi–Araba, Nigeria.
8 Department of Physiology, Gregory University, Uturu, Abia State, Nigeria.
9 Department of Haematology and Immunology, Obafemi Awolowo University and Teaching Hospitals Complex, Ile-Ife, Nigeria.
10 Department of Biochemistry, Lead City University Ibadan, Oyo State, Nigeria.
*Corresponding Author: Uche CL, Department of Haematology and Blood Transfusion, Abia State University, Uturu, Nigeria.
Citation: Uche CL, Ndukwe PE, Ngwudo S, Ndukwe CO, Chikezie K, et al., (2025), Assessment of Quality Assurance Level and Compliance of Abia State Blood Banks to National Guideline on Blood Transfusion: A Multi-Centred Study, Journal of Clinical and Laboratory Research, 8(4); DOI:10.31579/2768-0487/186
Copyright: © 2025, Uche CL. 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: 06 August 2025 | Accepted: 18 August 2025 | Published: 28 August 2025
Keywords: quality assurance; blood bank; health institutions; abia state; sops; blood transfusion; nigeria
Background: Ensuring quality assurance in blood transfusion services is essential for the safety and effectiveness of blood products. This study evaluates the quality assurance practices of blood bank units in healthcare institutions in Abia State, Nigeria.
Materials and Methods: A retrospective cross-sectional six-month retrospective study was conducted from November 2023 to February 2024 across 13 health facilities in Abia State, including both public and private institutions. The study spanned the three senatorial zones of Abia State: Abia North, Abia South, and Abia Central. Data were collected using a well-semi-structured pretested interviewer-administered questionnaire adapted from the National Blood Transfusion Service (NBTS) and blood bank records. Key areas of quality assurance, including the presence of Standard Operating Procedures (SOPs), dedicated staff, quality officers, and feedback mechanisms, were evaluated.
Results: The study revealed that only 30.8% of blood bank units had SOPs for all activities and procedures, and 7.7% had a Blood Transfusion Quality Officer. Furthermore, no health institution had a haemovigilance officer or a system for feedback and complaints from blood donors and recipients. A minority of the facilities (7.7%) were linked to the NBTS centre for blood activities. Internal quality assurance mechanisms were present in 76.9% of the facilities, but external quality assurance schemes were severely lacking (7.7%).
Conclusion: The quality assurance level in blood bank units in Abia State is suboptimal, with significant gaps in the presence of essential quality assurance components. Strengthening these areas is vital to improving the safety and effectiveness of blood transfusion services in the region.
Blood transfusion is critical to modern healthcare systems, saving millions of lives each year. The availability of safe and adequate blood is essential to support treatments for various medical conditions, including surgeries, cancer treatments, childbirth complications, and trauma care. However, blood and blood products' safety and quality are paramount to successful transfusions [1]. In many low- and middle-income countries (LMICs), including Nigeria, there are significant challenges in maintaining the safety and quality of blood due to gaps in regulatory frameworks, quality assurance (QA) systems, and compliance with national guidelines. In Nigeria, the National Blood Transfusion Service (NBTS) has developed guidelines aimed at standardizing blood donation, testing, processing, and transfusion practices across the country. These guidelines, encapsulated in the National Blood Policy and National Guidelines on Blood Transfusion, are designed to ensure that all blood banks operate under stringent safety standards to prevent the transmission of infectious diseases, such as HIV, hepatitis, and malaria, and to reduce the risk of adverse transfusion reactions [1]. Despite the existence of these guidelines, the level of compliance among blood banks across Nigeria remains inconsistent. Studies have shown that a significant number of blood banks, particularly in rural and underserved areas, may lack the infrastructure, technical expertise, and financial resources to fully adhere to national standards [2]. These challenges can compromise the safety of the blood supply and increase the risk of transfusion-related complications. Quality assurance (QA) in blood banking refers to the systematic monitoring and evaluation of all aspects of the blood donation and transfusion process to ensure compliance with national and international safety standards. It encompasses a wide range of activities, including donor selection, blood testing, component separation, storage, and the distribution of blood and blood products. Effective QA systems are designed to detect and prevent errors, ensure traceability, and minimize the risk of contamination or degradation of blood products [3]. The World Health Organization (WHO) emphasizes the importance of establishing comprehensive QA programs within national blood systems, particularly in LMICs, where the prevalence of transfusion-transmissible infections (TTIs) remains high [3]. In Nigeria, the NBTS has outlined specific QA protocols that blood banks must follow, including the mandatory testing of all blood units for HIV, hepatitis B and C, syphilis, and malaria, as well as the proper labelling, storage, and transportation of blood products [1]. Blood banks are also required to maintain detailed records of all blood donations and transfusions, conduct regular audits, and ensure that their staff are adequately trained. Compliance with the National Guidelines on Blood Transfusion is crucial to ensuring the safety and efficacy of blood transfusion services. In Nigeria, these guidelines are based on internationally accepted standards and cover a wide range of procedures, including donor recruitment and retention, blood collection, testing, processing, and transfusion practices [4]. However, the degree of compliance among blood banks in different states varies significantly. In Abia State, the performance of blood banks has come under increasing scrutiny, particularly concerning their adherence to national guidelines. Abia State, located in southeastern Nigeria, is home to a mix of public and private healthcare facilities, many of which operate blood banks. The effectiveness of these blood banks in ensuring the safety of blood products has been a matter of concern, as several reports suggest that compliance with the national guidelines is inconsistent [5]. Key areas where compliance has been problematic include the screening of blood for TTIs, proper storage and handling of blood products, and the implementation of QA protocols. A multi-centred study conducted in Lagos, Nigeria, revealed that while some blood banks adhered to the national guidelines, many private and smaller facilities failed to meet basic safety standards due to a lack of resources and trained personnel [6]. These findings raise concerns about the safety of blood transfusion services in other states, such as Abia, where similar systemic challenges are likely to exist. Given the critical role that blood banks play in public health, assessing the level of QA and compliance with national guidelines in Abia State is essential. This study aims to fill the gap in the literature by providing a comprehensive evaluation of blood banks across multiple centres in the state. By examining the extent to which these blood banks adhere to national guidelines, the study will provide valuable insights into the factors influencing compliance and the barriers that need to be addressed to improve blood safety. The findings of this study are expected to contribute to the ongoing efforts to strengthen Nigeria's blood transfusion system, particularly in regions with significant public health challenges. It will also provide evidence-based recommendations for policymakers, healthcare providers, and stakeholders on how to improve QA systems and ensure that all blood banks in Abia State meet national and international safety standards. The significance of this study lies in its potential to improve public health outcomes by enhancing the safety and quality of blood transfusions in Abia State. By identifying gaps in compliance and QA practices, the study will help to inform interventions aimed at strengthening the regulatory oversight of blood banks and improving the quality of care for patients requiring transfusions. Furthermore, the study's findings could serve as a benchmark for assessing blood bank performance in other regions of Nigeria and contribute to the broader discourse on healthcare quality improvement in the country.
Study design
A cross-sectional six-month retrospective study was conducted in both Abia state public and private health institutions. Health facilities that met the inclusion and exclusion criteria were recruited in the study. The three Senatorial zones in Abia state were involved: Abia North, Abia South and Abia Central. Four to five health institutions that met the inclusion and exclusion criteria were recruited from each of the three senatorial zones respectively.
Study Area
Abia State is a state in the Southeast geopolitical zone of Nigeria, it is bordered to the north and northeast by the states of Enugu, and Ebonyi, Imo State to the west, Cross River State to the east, Akwa Ibom State to the southeast, and Rivers State to the south. Abia State occupies about 6,320 square kilometres of land with an estimated population of over 3,720,000 as of 2016. It has three Senatorial zones: Abia North, Abia South and Abia Central as shown in Appendix 2. Each senatorial zone consists of 6, 6, and 5 LGAs respectively. On the whole Abia state has a total of 17 Local govt. area (LGA). Abia state has about 200 registered hospitals and clinics.
Ethical Consideration
The ethical clearance for this study was obtained from the Health Research Ethics Committee (HREC) of the Federal Medical Centre Umuahia, Abia State with reference number FMC/QEH/.596./Vol.10/690.
A well-semi-structured pretested interviewer-administered questionnaire (adapted from the National Blood Transfusion, Ministry of Health) was used for the study. Blood bank records were used where necessary. Information was obtained from data covering January to June 2022. The data was collected between November 2023 and February 2024 in Health facilities in Abia State and a total of 13 health facilities were used.
Data was analyzed using the SPSS version 23 statistical package. Continuous variables were analyzed using descriptive (means, standard deviation, median) while categorical variables were analyzed in frequency and proportions.
The sociodemographic distribution and institutional characteristics, as presented in Table 1, show a balanced distribution of healthcare institutions across the three senatorial zones in Abia State, with Abia Central slightly leading at 38.5%, followed by Abia North and Abia South, each at 30.8%. The majority of institutions surveyed are secondary healthcare facilities (77%), with a smaller proportion being tertiary institutions (23%). Regarding the blood transfusion units' staffing, only 23% of institutions have two or more dedicated staff members, indicating a potential understaffing issue in many units. Additionally, none of the institutions surveyed has an active blood transfusion committee, nor do they have a quality officer specifically assigned to blood issues. The absence of these critical components suggests a significant gap in ensuring quality and safety in blood transfusion practices across these institutions. Notably, 69.23% of institutions have a record-keeping system that can identify blood donors, although all records are maintained manually, with no computerized systems reported. Table 2 focuses on the quality assurance level within blood bank units. It highlights severe deficiencies, with 69.2% of institutions lacking Standard Operating Procedures (SOPs) for blood bank activities. A staggering 92.3% of institutions lack a Blood Transfusion Quality Officer, and none have a Haemovigilance Officer or a system for donor feedback and complaints, reflecting a lack of oversight and accountability in blood transfusion practices. While 76.9% of institutions report having an internal quality assurance mechanism, only 7.7% participate in an external quality assurance scheme. This lack of external validation further underscores the vulnerability of the current quality assurance practices. Additionally, only one institution (7.7%) is linked to the National Blood Transfusion Service (NBTS) for blood activities, which could limit the quality and safety of blood transfusion services across the state.
| Senatorial Zone | Frequency | Percentage |
| Abia North | 4 | 30.8 |
| Abia South | 4 | 30.8 |
| Abia Central | 5 | 38.4 |
| Type of Institution | ||
| Secondary | 10 | 76.9 |
| Tertiary | 3 | 23.1 |
| Specialty | ||
| Monospecialty | 0 | 0.0 |
| Multispecialty | 13 | 100.0 |
| Number of dedicated staff per blood Bank | ||
| One staff | 7 | 53.8 |
| Two staff | 3 | 23.1 |
| ≥ 3 staff | 3 | 23.1 |
| Voluntary Blood Recruitment unit | ||
| Yes | 1 | 7.7 |
| No | 12 | 92.3 |
| Blood bank record keeping technique | ||
| Manual | 9 or 13 | 100.0 |
| Computerized | 0 or 3 | 0.0 |
Table 1: Sociodemographic distribution and Institutional Characteristics.
| Personnel/ Committee | Frequency | Percentage |
| Hospital Transfusion Committee | ||
| Yes | 1 | 7.7 |
| No | 13 | 92.3 |
| Blood Transfusion Quality Officer | ||
| Yes | 1 | 7.7 |
| No | 12 | 92.3 |
| Haemovigilance officer | ||
| Yes | 0 | 0 |
| No | 13 | 100 |
| Do blood bank Personnels receive any training? | ||
| Yes | 6 | 46.2 |
| No | 7 | 53.8 |
Table 2a: Quality assurance: Key personnel.
| Frequency | Percentage | |
| Existing quality management policy | ||
| Yes | 2 | 15.4 |
| No | 11 | 84.6 |
| Existing quality assurance manual | ||
| Yes | ||
| No | ||
| Availability of Standard Operating Procedures | ||
| Yes | 4 | 30.8 |
| No | 9 | 69.2 |
| Blood Donor traceability record | ||
| Yes | 9 | 69.2 |
| No | 4 | 30.8 |
| Are incident reports available? | 0 13 | 0 100 |
| Yes | ||
| No | ||
| Documentation of adverse effect | ||
| Yes | 0 | 0.0 |
| No | 13 | 100.0 |
Table 2b: Quality assurance: Documentation.
| Frequency | Percentage | |
| Is there a channel for feedback or complaints from blood donors/recipents in Place? | ||
| Yes | 0 | 0 |
| No | 13 | 100.0 |
| Is there a standard monitoring and evaluation system in place? | ||
| Yes | 0 | 0 |
| No | 13 | 100.0 |
| Is there a quality assurance mechanism in place? | ||
| Yes | 10 | 76.9 |
| No | 3 | 23.1 |
| Is there an external quality assurance programme in place? | ||
| Yes | 1 | 7.7 |
| No | 12 | 92.3 |
| Is the hospital linked to any NBTS center for blood activities? | ||
| Yes | 1 | 7.7 |
| No | 12 | 92.3 |
Table 2C: Quality assurance: other processes.
Fifteen variables were used to assess Quality assurance levels in the Abia state health institution’s blood bank. The majority of the health institutions had good internal quality assurance in place. However other aspects of the quality management system were suboptimal or nonexistent.
| Variables | Frequency n= 13 | Percentage (%) |
| Quality assurance level | ||
| Poor (Score: 1 – 3 points) | 12 | 92.3 |
| Fair (Score: 4 – 6 points) | 1 | 7.7 |
| Good (Score: >6 points) | 0 | 0 |
Table 2d: Quality Assurance Level.
Quality assurance levels in the Abia State Health Institution’s blood bank are poor.
| Variables | Health Institutions (H) | ||||||||||||
| H1 | H2 | H3 | H4 | H5 | H6 | H7 | H8 | H9 | H10 | H11 | H12 | H13 | |
| Voluntary non-remunerated | 0 | 5 | 0 | 10 | 0 | 5 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| PCV SCREENING | 10 | 10 | 10 | 10 | 10 | 10 | 10 | 10 | 10 | 10 | 10 | 10 | 10 |
| Screening for TTI with ELISA | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Use of blood component | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Blood transfusion committee | 0 | 0 | 0 | 10 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Haemovigilance Officer | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Use of SOP | 0 | 10 | 0 | 10 | 0 | 10 | 0 | 10 | 10 | 10 | 0 | 10 | 10 |
| Medically qualified coordinator | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Staff training | 0 | 5 | 5 | 10 | 0 | 5 | 5 | 0 | 5 | 0 | 0 | 0 | 0 |
| Documented adverse effect | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Storage of blood in the standard blood bank | 0 | 10 | 0 | 10 | 10 | 10 | 0 | 0 | 10 | 0 | 0 | 10 | 0 |
| Deferrals | 0 | 5 | 0 | 10 | 0 | 0 | 0 | 0 | 5 | 0 | 0 | 0 | 0 |
| Total | 10 | 45 | 15 | 70 | 20 | 35 | 15 | 20 | 40 | 20 | 10 | 30 | 20 |
| Total (100%) | 8.3 | 37.5 | 12.5 | 58.3 | 16.7 | 29.1 | 12.5 | 16.7 | 33.3 | 16.7 | 8.3 | 25 | 16.7 |
Table 3a: Compliance of Health Institutions to National Guideline on Blood Transfusion Services.
H= Health institution
Only one health institution had a total of 58.3%. None of the health Institutions used ELISA for screening. Two health institutions Practiced voluntary non-remunerated donation. Half of the health institutions did not use blood banks. None had medically qualified as a coordinator, none produced blood components, and no documented adverse blood transfusion reaction. Adherence concerning PCV screening and the use of SOP is good.
| Variable | Score (%) | Frequency (n= 13) | Percentage (%) |
| Compliance level | |||
| Very Poor | 0-29.9 | 8 | 61.5 |
| Poor | 30- 49.9 | 4 | 30.7 |
| Fair | 50-69.9 | 1 | 7.7 |
| Good | ≥70 | 0 | 0 |
Table 3b: Compliance Level of the Health Facilities.
The table showed a very poor compliance level of the majority (61.5%) of health facilities in Abia state to National guidelines on blood transfusion services.
A quality assurance (QA) programme is the sum of all activities and procedures undertaken by medical laboratories to improve the quality and clinical usefulness of laboratory test results. Quality assurance includes training of personnel, purchase and maintenance of equipment and reagents, the analytical process itself, and reporting and interpretation of results. The present study discovered that non-availability of standard operating procedure (SOP) for all activities in the blood bank was found in about 69% of the health Institutions. A multi-centred study conducted in south-south Nigeria amongst 80 medical laboratories showed that only 45% of medical laboratories used SOP [7]. However, a study done in Kenya listed workload, inadequate number of staff and long working hours as determinants of adherence to standard operating procedure among laboratory personnel and adduced that factors that promote adherence to SOPs are professional education, leadership factors, and work environment and suggested professional education and leadership for the sustenance of intervention [8]. SOPs are written step-by-step instructions on how to carry out procedures correctly. SOPs are meant to ensure consistency, accuracy, and quality of data. SOPs harmonize laboratory practices, reduce user errors, and can be used as training tools. Moreover, they help ensure compliance with the study protocol, regulations, and international standards. SOPs are the main building blocks of a laboratory quality assurance framework and as such, failure to use it is a recipe for unreliable and poor-quality results that may lead to wrong diagnoses and treatment. Surprisingly, this study revealed that no health institution had a Haemovigilant officer, no standard monitoring and Evaluation system in place and only one health Institution had a quality officer, the same health institution participated in the external quality assurance process and also received blood from the regional branch of National blood transfusion service (NBTS) and had blood transfusion committee (7.7%) in place. Haemovigilance is defined as the surveillance of adverse reactions occurring in donors and in recipients of blood components and as epidemiological surveillance of donors. The ultimate purpose of haemovigilance is to prevent the repetition of adverse events and reactions [9]. The practice of haemovigilance in this country has been a concern, Aneke et al [10] study showed that the practice of key elements of haemovigilance was suboptimal among health professionals. The lack of well-coordinated haemovigilance practices in the whole state even in the country at large is very worrisome, there is therefore need for a state and national level of registration of severe adverse reactions connected with the collection, processing and storage of blood and blood components, hence the need for well-coordinated hemovigilance office A Hospital Blood Transfusion Committee (HBTC) is a governance body established within the hospital to ensure appropriate blood product use, audit blood use, and monitor and prevent adverse events by developing local policies and educating clinicians [11]. World Health Organization recommends “Blood transfusion committee should be established in each hospital to implement the national policy and guidelines and monitor the use of blood and blood product at the local level” [12]. The primary goal of HBTC is to promote the safe and effective use of blood and blood components. Only one health institution in Abia state had a blood transfusion committee. This is glossily unacceptable as quality is sacrificed. To buttress the importance of blood transfusion, a multicentered study done in South-South Nigeria showed that established transfusion committees were present in 63.4% of the services visited and transfusion incidents were reported by 53 (36.8%) transfusion services with transfusion committees and eight (9.6%) without transfusion. The study revealed that the incidence of notification and investigation of the causes of transfusion reactions was higher in transfusion services where a transfusion committee was present [7]. This is an eye-opener that the lack of a blood transfusion committee in Abia state must have hidden a lot of data that should have served as a recipe for change. There is therefore a need for a clarion call for complete overhauling of Abia state blood transfusion practices, the need for the establishment of a hospital blood transfusion committee followed by intensive training and monitoring through the process of monitoring and evaluation. Participation in external quality assurance (EQA) is quite low as only one health institution participated. A similar scenario was seen with regard to participation in external quality assessment (EQA) schemes where 9 out of 88 laboratories were under study. This state of practice is not consistent with international quality management best practices and is certainly undesirable for blood transfusion practices this 21st century. However, 76.9% of the Health Institutions practice internal quality assurance mechanisms. This is similar to a multi-centred study where 88% of laboratories adhered to quality control even though they could not show a quality control chart [7]. The National blood policy, for ease of availability, accessibility and affordability, structured blood transfusion services in Nigeria under the following strata: (i) the national blood transfusion service (NBTS), (ii) the zonal blood service centres, (iii) state and local government areas blood service centres, (iv) the armed forces blood service, and (v) private and other nongovernmental health establishments. The above stratification aimed to ensure universal coverage of the country, from National to local government councils [13]. This present study showed that only 7.7% (1) of the health institutions had a link with the National Blood Transfusion Service (NBTS). This finding had totally defeated the aim of this establishment. The reason given by some health Institutions during the Interview includes poor accessibility because of the distance, not being sure of the availability of blood and lack of awareness. The regional or zonal arm of National Blood Transfusion Services resides at Owerri (Imo State) which is very far from the majority of Health Institutions in Abia State. The need for the establishment of a state arm of the National blood transfusion service is inevitable. This will enhance easier coordination. Holistically, the quality assurance level in Abia state blood transfusion services was found to be poor. The importance of quality assurance in the blood bank cannot be over-emphasized as without a good quality management system in place in the blood bank all the results emanating from it cannot be guaranteed.
The assessment of the quality assurance level of blood bank units in health institutions across Abia State, Nigeria, reveals significant deficiencies in adherence to standard quality practices. The study highlights that the majority of institutions, particularly secondary health facilities, lack the necessary infrastructure, personnel, and standard operating procedures (SOPs) to ensure high-quality blood transfusion services. Key findings include the absence of dedicated blood transfusion quality officers, haemovigilance officers, and effective monitoring and evaluation systems across all surveyed institutions. Additionally, the lack of external quality assurance schemes and the absence of hospital transfusion committees further underscore the challenges faced by these institutions in maintaining optimal blood transfusion practices. The overall quality assurance level in the majority of the blood bank units was found to be poor, posing potential risks to patient safety and the efficacy of blood transfusion services in the state.
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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
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
