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Review | DOI: https://doi.org/10.31579/2768-0487/181
1Medical Microbiology Department, College of Health Sciences, Hawler Medical University.
2Department of Biology, College of Education, Salahaddin University-Erbil, Kurdistan Region, Iraq.
3Midwifery department, Erbil technical medical institute, Erbil polytechnic university, Kurdistan region/Erbil/ Iraq.
4Medical Laboratory Technology Department, Kalar Technical College, Garmian Polytechnic University, Kalar, Iraq.
*Corresponding Author: Fattma Abody., Medical Microbiology Department, College of Health Sciences, Hawler Medical University.
Citation: Al-Daoody AA, Fattma A. Ali, Sawsan M. Sorche, Media A. Othman, Dlawar Q. Ali, (2025), Echinococcus Granulosus Infection and Detection in Human and Animals, Journal of Clinical and Laboratory Research, 8(3); DOI:10.31579/2768-0487/181
Copyright: © 2025, Fattma Abody. 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: 04 June 2025 | Accepted: 20 June 2025 | Published: 04 July 2025
Keywords: granulosus echinococcus; zoonosis; cystic echinococcosis
Cystic echinococcosis The disease is commonly seen in rural areas where the local population is in close contact with livestock and dogs. The larval stage of Echinococcus granulosus, known as metacestodes, is the cause of cystic echinococcosis (CE), a zoonosis. Despite being classified as a neglected illness by the World Health Organization (WHO), CE is the second most common foodborne parasite disease and, given its potential morbidity and zonal endemicity, continues to be a significant public health concern. One important WHO goal is the prevention and control of CE, particularly from a One Health standpoint. , since the illness impacts the food chain in addition to humans and animals. There is continuing research regarding the precise geographic prevalence of the disease, as there are relatively little recent epidemiological data available due to the fact that not all nations have a CE surveillance strategy, reporting system, or particular management protocols. We have examined and gathered data from national guidelines and numerous medical databases to provide fresh insights on the topic. After certain inclusion and exclusion criteria were applied, only 52 of the 751 research articles that were initially found were included in the analysis. Featured are noteworthy global initiatives that have made important contributions and had a good effect. The available statistics were compared to WHO guidelines on the matter, highlighting the steps that have been taken and those that remain to effectively restrict the disease's spread.
According to recent investigations, the genus Echinococcus has a well-established taxonomy with 8–10 species, 6 of which are considered harmful to humans: Echinococcus canadensis, Echinococcus ortleppi, Echinococcus vogelii, Echinococcus multilocularis, Echinococcus granulosus sensu stricto, and Echinococcus oligarthr (Knapp et al., 2022) Global zoonotic disease cystic echinococcosis (CE) is brought on by the larval and metacestode stages of Echinococcus granulosus. The zoonotic cestodes of the species complex Echinococcus granulosus sensu lato (Taeniidae: Cestoda) are the cause of cystic echinococcosis (CE), also referred to as hydatid disease or hydatidosis. E. granulosus can have a domestic or sylvatic life cycle, with a carnivore and a herbivore usually involved. People may unintentionally become dead-end hosts and get CE. According to the Foodborne Disease Burden Epidemiology Reference Group of the World Health Organization (WHO), CE costs 184,000 disability-adjusted life years worldwide per year in humans. An estimated $2 billion is lost annually in producing animals due to decreases in carcass weight, milk production, fecundity, and wool/hide production (Tamarozzi et al., 2020). To finish its life cycle, Echinococcus granulosus needs two hosts: a canid definitive host and an intermediate host. E. granulosus eggs excreted in the feces of infected canine hosts are what give humans and other intermediate hosts the illness. The parasite's metacestode develop in intermediate hosts, This is called a hydatid cyst. Humans are not infected by the cysts; only canid definitive hosts are. In the United States, dogs (WHO, 2015) According to estimates, the prevalence of E. granulosus s.l. in Iran is 4.2% in humans, 15.6% in intermediate hosts, and 23.6% in definitive hosts. This illness is endemic in Iran, where many instances of infection are documented each year. Thus, the goal of the current investigation was to ascertain the genotypes and prevalence of E. granulosus s.l. isolated from domestic and stray dogs in the northeastern Iranian province of Khorasan Razavi (Hejazi et al., 2024). Echinococcus granulosus infections in cats are rare because cats do not belong to the parasite life cycle that is represented by carnivorous and herbivorous animals. However, it can accidentally when consuming food or water tainted with the worm's larvae, particularly when the final host is present (Al-Ardi, 2024).
Literature review
Echinococcus spp. are Taeniidae cestode parasites. There are now eight species recognized in the genus Echinococcus, and only one genotypic cluster (E. canadensis) within it. The genus is worldwide in distribution, with the exception of Antarctica, and these parasites use a predator-prey interaction to spread. Certain Echinococcus species are spread by predator-prey relationships involving domestic animals, whereas other species rely on wildlife lifecycles, although domestic animals may also play a role in transmission (Romig et al., 2017). While all species in the genus have been identified as zoonotic, two species— Senu lato (s.l.) E. granulosus and E. multilocularis represent a serious threat to public health because they are known to cause alveolar echinococcosis (AE) and cystic echinococcosis (CE), respectively. These parasites are two of the most common zoonoses of medical significance, causing sickness in both humans and animals and causing major health and economic issues (Tamarozzi et al., 2020). The parasitic zoonotic Human cystic echinococcosis (CE) is caused by Echinococcus granulosus. Infection occurs when hosts eat Echinococcus eggs, which then develop into the larval (metacestode) stage. Canids are the only animals that the adult-stage parasite can parasitize in terms of host. The hydatid metacestode stage of the parasite is found in domestic ruminants, including sheep, cattle, and camels. The fecal–oral pathway is the means by which transmission from definitive to intermediate hosts happens. Humans are unintentionally dead-end intermediate hosts for the parasite since they are unable to support its life cycle biologically (Tamarozzi et al., 2020).
1.1 Transmission and life cycle
Echinococcosis is spread by a variety of hosts in endemic areas, including intermediate (cattle, pig, sheep, etc.) and definitive (domestic dogs, lions, etc.). Numerous routes of transmission have been identified, including the fecal-oral route, which involves consuming contaminated water, eating raw produce without washing it, and coming into contact with contaminated soil. Other routes of transmission include coming into contact with dogs and livestock (especially ruminants), either directly or by coming into contact with contaminated fur. The fact that the mode of transmission of echinococcosis varies geographically and is influenced by host availability, social and cultural norms, public health awareness, and environmental factors should be especially noted while discussing the disease. Although it has long been believed that direct contact with canine hosts is the primary means of transmission to humans, the association is not strong (Chaâbane-Banaoues et al., 2015). There are endemic areas where there is little to no contact with dogs despite their presence, or where the prevalence of the disease and the number of infected dogs are unrelated. This has led to the conclusion that, even while direct contact isn't usually the cause, soil pollution is probably the main method that the high environmental quantity of Echinococcus eggs contributes to transmission. The eggs go through their larval stage after transmission and become metacestodes. The organs of the intermediary hosts are then where the metacestodes develop; they especially like the liver and lungs. The cycle is completed when adult worms form as a result of dogs consuming these diseased organs Determining the exact moment and mode of transmission in a patient is challenging due to the various routes of transmission and the inability to precisely ascertain the time of infection based on the metacestode itself (Tamarozzi et al., 2020).
Figure 1: Life cycle of the Echinococcus granulosus.
The eggs release oncospheres, which adhere to the intestinal wall after being consumed by the intermediate host. Through the portal venous system, the oncospheres go from the colon to different organs where they form cysts and daughter cysts. 1-4 The liver accounts for 70% of cases,with the lungs coming in second with 20%. The kidneys, heart, and spleen, peritoneum, CNS , and bones are among the infrequent locations.The growth rate of hidatid cysts is sluggish, ranging from 1 to 10 mm annually; liver cysts grow more slowly than lung cysts (Tsoulfas et al., 2020). The CE cyst is a circular cystic lesion that is characterized by an exterior, acellular, laminated layer called the ectocyst and an interior, germinal layer called the endocyst. Little vesicles known as brood capsules are produced by the inner germinal layer; these capsules divide asexually to produce several protoscolices (Figure 2). The pericyst is a granulomatous, adventitial layer that surrounds the echinococcal laminated layer. This layer, which is frequently observed in imaging investigations, is created by the immunological system of the host to ward off the cystic infection (Calame et al., 2022).
Figure 2: Illustration of the layers of a liver hydatid cyst, comprising the outside (laminated) acellular layer, the inner (germinal) nucleated layer, and the granulomatous layer (adventitial layer), which is created by the host immune system to fend off the cystic infection. Here, the daughter cyst is visible floating inside the primary cyst, and the protoscolex—the future head of the adult worm—is observed budding from the germinal layer. A sonographic finding that combines cystic fluid with protoscolices is called the hydatid sand (Tsoulfas et al., 2020).
1.2 Echinococcus granulosus in livestock
The hydatid cysts in livestock's bodies develop after they consume these eggs through food, water, or vegetables. Hydatidosis is caused by the worm's larvae (cysts) establishing themselves in several organs, including the liver and lungs, and occasionally the brain, heart, and spinal cord of the intermediate host, such as humans, even though infection of carnivores with the worm's mature stage does not pose a specific threat. But a ruptured cyst can also lead to more serious problems, such as internal injuries and trauma. The quantity, size, and location of the developed cysts determine the clinical signs and symptoms of hydatidosis in people and animals. In humans, the disease is relevant because it affects vital organs like the liver and lungs, but in domestic cattle and livestock, it is significant because of the financial loss . Hydatidosis is regarded as one of the main health and economic issues because of the significant financial losses it causes in the cattle and public health sectors (Hosseini-Safa et al., 2016).
1.3 Clinical prestation
In the early stages of the disease, patients may have nonspecific signs and symptoms or be completely asymptomatic. Patients with intra-abdominal CE often show symptoms much later in the course of the illness. This could be because the cysts are growing slowly or because the granulomatous adventitial layer was initially used by the immunological system of the host to seal off the infection with cysts. Cystic development is more rapid in AIDS-positive CE patients, suggesting that an immunological condition may contribute to the progression of the disease (Wen et al., 2019). Hepatic mass, nausea, vomiting, and right hypochondrial discomfort are examples of chronic presenting problems. If the biliary system is compressed by a nearby liver cyst, obstructive jaundice may result. 2,4 Abdominal distension or hepatomegaly may be observed on a physical examination. When a cyst is large (diameter greater than 10 cm) or occupies 70% of the organ volume, signs of liver involvement usually appear ) (El Nakeeb et al., 2017). Patients with complex illnesses may also have spontaneous or sporadic cystic rupture following forceful abdominal trauma. Rupture is a potentially lethal complication, despite its uncommon manifestation. If burst cysts communicate with the biliary system, cholangiolitis may be present as a result of biliary tree obstruction. An immune response to a spontaneous intraperitoneal rupture may cause an allergic reaction, the most serious of which is anaphylactic shock. Additionally, live protoscolices may "seed" in the peritoneum as a result of cystic rupture, leading to secondary hydatidosis Rarely the breaking open of a liver cyst by the diaphragm may result in subsequent pulmonary involvement (Kern et al., 2017; Keong et al., 2018).
Diagnosis
To diagnose hepatic CE, a thorough clinical assessment of the patient is essential. This entails a comprehensive history that highlights any interactions with dogs, wildlife, or trips to endemic regions, as well as a targeted physical examination. When a patient presents with questionable clinical findings, additional laboratory and radiographic tests may be necessary to confirm the diagnosis (Junghanss et al., 2008).
Laboratory investigations
A useful supplement to radiographic studies in the diagnosis of liver hydatid disease is serology for CE. It does have certain drawbacks, though, such as serology's incapacity to differentiate between active and dormant cysts when the ultrasound results are unclear. Western blotting (WB), indirect hemagglutination assay (IHA), and enzyme-linked immunosorbent assay (ELISA) are three laboratory techniques that may be used to diagnose liver CE. For liver-only hydatid involvement, the gold standard serological test is thought to be the enzyme-linked immunosorbent assay (ELISA). E. granulosus-specific antigen is detected by immunoglobulin IgG (G) ELISA, which has a sensitivity of 93.5% and specificity of 89.7%., and 18 Nonetheless, cysts in their early stages wherein the endocyst contains E. granulosus antigens frequently have seronegative findings. The host's immune system's reaction to the parasite infection is then cut off from the antigens. When the cysts calcify in the later stages of the illness process, there is an identical lack of immune response that frequently yields a seronegative result (Keong et al., 2018; Calame et al., 2022). Eighty to one hundred percent sensitivity and the specificity of 88–96% are associated with WB serology for liver CE. The high cost of the test and the sharp decline in sensitivity rates in extra-hepatic illness are the drawbacks of WB.IHA testing has a 90% sensitivity rate, yet if the result is positive, it can stay that way for a number of years. Regular blood tests may reveal vague alterations. Liver function tests are abnormal in only around 40% of individuals. Alkaline phosphatase is frequently increased in cases of derangement, whether or not hyperbilirubinemia is present. In 25–40% of patients, a differential white cell count may reveal eosinophilia (Rashid et al., 2018; Tsoulfas et al., 2020).
Imaging
The preferred diagnostic method for liver CE is ultrasound imaging, which has a sensitivity of 90% to 95%. Liver CE can show up on ultrasonography as a solid mass or as a single, anechoic lens cyst with characteristics of a basic cyst, depending on the situation.20 Real-time imaging reveals a "falling snowflake pattern" as the patient shifts positions. This pattern is made by several echogenic foci that are created when cystic fluid and protoscolices are combined, commonly referred to as "hydatid sand (Kern et al., 2017). "Floating membranes" are the result of the endocyst's separation from the pericyst. Furthermore, a "wheel-spoke" form may result from a multivesicular mother cyst wit Hydatid cysts have been categorized by the World Health Organization Informal Working Groups about the WHO-IWGE Echinococosis according on sonographic characteristics. Cysts are categorized from CE1 to CE5 according to this categorization, which is based on many ultrasonography findings (Table 1). The CE1 and CE2 types correlate with the disease's "active" stage. According to Figure 3, CE3a and CE3b are in the "transitional" stage, whereas CE4 and CE5 are in the "inactive" stage. This method directs additional management in addition to aiding in the general classification of liver hydatid cysts. offspring cysts divided by radiating septae that depict the hydatid sand/matrix and the cyst walls (Fadel et al., 2019).
Figure 3: Imaging of liver cystic echinococcosis (Illuri et al., 2018).
Treatment
Routine care of hepatic patients involves considerations of the patient's symptoms, radiological stage, size and location of the cyst(s), presence of comorbidities, and treating physicians' ability (Velasco-Tirado et al., 2018). Medical therapy, a "watch and wait" strategy, percutaneous therapy, and surgical procedures are among the available management options (Tsoulfas et al., 2020).
Watch and wait’ approach
With interval ultrasonography monitoring, inactive, degenerating CE4 and all CE5 cysts can be seen without the need for medication or surgery (Mönnink et al., 2021).
Surgery
Options for liver surgery There are two types of CE approaches: radical and conservative (Figure). The radical treatment has drawn criticism for being a severe kind of therapy associated with high morbidity for a relatively benign disease process. It includes total cystectomy and hepatic resection. Additionally, patients must typically have surgery in a specialized hepatobiliary unit due to the high technical difficulty of the procedure.These factors make the conservative strategy with a partial cystectomy more popular. Under albendazole cover, this entails removing the cyst's contents, sterilizing the cavity that remains, and partially resecting the cyst (Vagholkar et al., 2016; Tsoulfas et al., 2020). The hepatic cyst(s) are accessed and exposed by a suitable incision in the partial cystectomy technique. Abdominal swabs soaked in a scolicidal substance (20% hypertonic saline) are used to protect the operative field. In the unlikely case of a spill during the evacuation of cyst-content, this helps to prevent contamination. Next, a selected scolicidal substance is injected into the cyst after it has been pierced and aspirated. Similar to PAIR, if the cyst aspirates bile, There is biliary communication and avoidance of the scolicidal agent. The contents are re-aspirated after 15 minutes, and the cyst is then opened and the endocyst's contents are suctioned out, Subsequently, the cyst is exposed by removing the cyst wall external to the liver parenchyma. A cysto-biliary fistula can be sutured closed if it is discovered during surgery. After the contents of the cystic cavity are removed, the cavity must be completely destroyed using either omentoplasty or capitonnage (Mihmanli et al., 2020). An intraoperative picture of a partial cystectomy with biliary connections for a liver hydatid cyst (Deo et al., 2020)
Figure 4: bile-stained floating membrane removed after a partial cystectomy is seen in an intraoperative picture (Tsoulfas et al., 2020).
Preventive strategies
Enacting legislation requiring the use of safe slaughter procedures and efficient canine deworming programs, as observed in New Zealand and Tasmania, can lead to the eradication of CE. By deworming their dogs, other nations including Uruguay, Chile, and Argentina saw a comparable decline in CE. The programs used supervised praziquantel deworming for dogs four to eight times a year (Craig et al., 2017). Vaccinating sheep with the EG95 vaccine is a more recent method to stop the spread of CE. As an extra intervention to lessen CE transmission, it is presently registered for usage in Argentina and China. For poorer nations where CE is typically endemic, this strategy is not feasible due to the high cost of the immunization. Although dog vaccination attempts have been documented, no quantifiable results have been demonstrated in terms of reducing the spread of CE (Wen et al., 2019). It is possible to take preventive actions to help lower the spread of CE. Public health initiatives including routine canine deworming programs, tightly enforced safe slaughter procedures reinforced by local laws, and public awareness campaigns regarding the illness process could help reduce the spread of the disease among endemic populations (Junghanss et al., 2008; Keong et al., 2018).
The true worldwide burden of CE is significantly underestimated since epidemiological data from endemic areas are scarce. Over two-thirds of cases of this disease process involve hepatic infection, making humans the unintentional intermediate hosts. Most symptoms and signs are non-specific, particularly in the early stages of the illness Consequently, especially in endemic areas, doctors ought to have a low bar for considering the diagnosis in patients with positive serology and suggestive radiological features. The patient's symptoms and the radiographic stage determine the standard course of treatment for liver CE , the cyst's location and size, any problems, and the knowledge of the medical professionals. The WHO's well-established public health protocols must be put into practice in order to reduce the substantial yearly expenses related to CE. Even though the condition is most common in developing nations, increased migration and travel force medical professionals to include CE in their differential diagnosis for any worrisome liver cyst.
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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.
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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
