AUCTORES
Globalize your Research
Research Article | DOI: https://doi.org/10.31579/2768-0487/166
1 Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt.
2Assistant lecturer of Maternal and Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt.
3 Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Menoufia University, Egypt.
*Corresponding Author: Hanan Elzeblawy Hassan., Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt.
Citation: Hanan E Hassan., Fatma H Abd-ELhakam., Enas KAli, (2025), Effect of Life Style Modification Implemented Program Among Infertile Women with Poly Cystic Ovary Syndrome on Obesity and Menstrual Regulation, Journal of Clinical and Laboratory Research, 8(2); DOI:10.31579/2768-0487/166
Copyright: © 2025, Hanan Elzeblawy Hassan. 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: 03 February 2025 | Accepted: 14 February 2025 | Published: 05 March 2025
Keywords: life style modification; poly cystic ovary syndrome; obesity; menstrual regulation
Background: Obesity raises the risk of sub-fecundity and infertility, which is mostly attributed to hypothalamic-pituitary-ovarian (HPO) axis dysfunction, low oocyte quality, and reduced endometrial receptivity. Another side effect of obesity is infertility, which is manifested by irregular menstrual cycles, lower spontaneous and aided pregnancy rates, and higher miscarriage rates. The risk of normal-gonadotrophic anovulation is increased by the distribution of body fat in the center and general obesity. Aim: evaluate the effect of life style modification implemented program among infertile women with poly cystic ovary syndrome on obesity and menstrual regulation. Subjects and Methods: A purposive sample of 116 women with polycystic ovary syndrome, overweight, and obesity, was selected. Results: It shows that 58.6% of the study and control groups had a 3–5-day duration of the menstrual cycle before the intervention, compared to 86.2% and 55.2% after the intervention. Also, 98.3% and 94.8%of the study group and control groups had irregular menstrual cycles before the intervention, compared to 60.3%of the study group having regular menstrual cycles and 51.7% of the control group having irregular menstrual cycles after the intervention. A significant association between the ovulatory function and physical activity level in the study group of infertile overweight and obese women with polycystic ovary. Conclusion and Recommendations: Life style modification implemented program positively affect menstrual cycle regularity and normal body mass index for infertile overweight and obese women. Disseminate results of the study to health care centers
Adult body fat can be calculated using a variety of techniques, such as total body weight, waist circumference, and hip circumference. These measures have led to the development of several obesity indicators, including the body mass index (BMI), which is the most often used indicator of body fat for height and weight. The BMI is calculated by dividing the weight in kilograms by the square of the height in meters [1-7]. Worldwide over 1.9 billion people were overweight in 2016; more than 650 million of them were obese, representing a nearly tripling of the prevalence of obesity since 1975 [8]. Obesity raises the risk of sub-fecundity and infertility, which is mostly attributed to hypothalamic-pituitary-ovarian (HPO) axis dysfunction, low oocyte quality, and reduced endometrial receptivity [9-14]. Another side effect of obesity is infertility, which is manifested by irregular menstrual cycles, lower spontaneous and aided pregnancy rates, and higher miscarriage rates. The risk of normal-gonadotrophic anovulation is increased by the distribution of body fat in the center and general obesity [15-20]. Even a 5% weight loss may help a woman respond better to ovulation induction or restore her ovulation [21]. A higher body mass index (BMI) is linked to a worse fertility prognosis, and obese women exhibit lower reproductive outcomes regardless of the method of conception [9-24]. As the most prevalent endocrine illness among women of reproductive age, polycystic ovarian syndrome (PCOS) is one of the major causes of infertility [25]. In case-control research, 52 women between the ages of 20 and 38 were divided into two groups (fertile-cases and infertile-controls), and it was discovered that obesity has a substantial detrimental impact on women's fertility (p = 0.017). Those who were infertile had a 7.5-fold higher likelihood of being fat than those who were fertile [26]. Women's body fat affects the hypothalamus-pituitary-ovarian (HPO) axis's functionality through both central and peripheral pathways. Clinical studies show that excessive leanness causes puberty to come on later than it should, whereas obesity causes puberty to come on earlier [27]. Obesity also affects the endometrium. These findings were supported by human investigations conducted in vitro and in vivo, where it was found that obese women had less stromal decidualization [27-30]. The pathophysiology of this phenomenon may be attributable to proinflammatory cytokines and ROS that cause endothelial dysfunction; endometrial levels of expression of this inflammatory marker were shown to be higher in obese women who experienced recurrent miscarriages [31]. Around the world, obesity has emerged as a serious health issue. One-fifth of women in the UK suffer from obesity, with 18.3% of women in the reproductive age range (16-44 years) being classified as obese [32]. It is well-known that many PCOS patients are overweight, but not all of them. Since adipose tissue is regarded to be an endocrine organ that produces androgens, there is growing evidence that PCOS in some women develops as a result of obesity [33]. A higher risk of infertility is linked to oligo anovulation, and PCOS is the most common cause of ovulatory problems. Primary infertility was observed in 50% of cases and secondary infertility in 25% of instances in a large group of 1,741 women with PCOS [34].
Aim of the study:
This study aims to evaluate the effect of life style modification implemented program among infertile women with poly cystic ovary syndrome on obesity and menstrual regulation
Study hypotheses:
Infertile overweight and obese women who will receive life style modification implemented program will experience regular menstrual cycle and normal body mass index.
Subjects And Methods
Tool I: Personal data: The Arabic structured interview questionnaire collects basic data and women's menstrual cycle data. BMI categories: Underweight: < 18.5 kg/m², Normal: 18.5- 24.9 kg/m², Overweight: 25 -29.9 kg/m², Obese: 30- 39.9 kg/m
Tool iii diet habits characteristics:
Part I nutritional habit: The study measures women's nutrition habits, including food and soft drinks, using a five-point scale. Poor habits are scored below 60% of total scores, while good habits are scored ≥ 60% .
Table (1) revealed a statistically significant relationship between the intervention and modified quality of life program for overweight and obese infertile women's anthropometric measures.
Figure (1): Portrays ovulatory function and anthropometric measures of the studied infertile overweight and obese women with polycystic ovary syndrome. It shows that 58.6% of the study and control groups had a 3–5-day duration of the menstrual cycle before the intervention, compared to 86.2% and 55.2% after the intervention, respectively. Meanwhile, 81.1% and 77.6% of the study and control groups had irregular cycles before the intervention, compared to 31.0% and 67.2%after the intervention, respectively. Also, 51.7% of the study group had an average menstrual cycle of 35–90 days, and 60.3% of the control group had more than 90 days before the intervention, compared to 41.4% of the study group having 21–34 days and 50.0% of the control group having more than 90 days after the intervention, respectively.
Figure (2) shows the symptoms experienced by the studied infertile overweight and obese women with polycystic ovary syndrome. It reveals that 98.3% and 94.8%of the study group and control groups had irregular menstrual cycles before the intervention, compared to 60.3%of the study group having regular menstrual cycles and 51.7% of the control group having irregular menstrual cycles after the intervention. Moreover, 53.4% and 51.7% of the study and control groups had an absence of the menstrual cycle before the intervention, compared to 84.5% of the study group having no absence of the menstrual cycle and 43% of the control group having an absence of the menstrual cycle after the intervention, respectively.
Figure (3) showed that there was a significant association between ovulation and lifestyle in the study group of infertile overweight and obese women with polycystic ovary syndrome (n = 58). About 87.5%, 83%, and 77.7% of poor nutrition Habits of the study group women are Duration of the menstrual cycle less than days (hypomenorrhea), irregular cycle, and a long average menstrual cycle is more than 90 days (oligo amenorrhea) before intervention. Compared to 78%, 75.6%, and 83.3% of good habits, the duration of the menstrual cycle is 3-5 days, the regular cycle, and the long average of the menstrual cycle is 21-34 days after intervention.
Figure 4 showed that there was a significant association between the ovulatory function and physical activity level in the study group of infertile overweight and obese women with polycystic ovary syndrome (n = 58). About 87.5%, 93.6%, and 77.7% of Mild Physical Activity (sedentary lifestyle) of the study group women have a duration of menstrual cycle of less than 3 days (hypomenorrhea), an irregular cycle, and a long average menstrual cycle of more than 90 days (oligo amenorrhea) before intervention. Compared to 68%, 80%, and 83.3% of moderate physical activity had a normal duration of the menstrual cycle of 3-5 days, a regular cycle, and the long average of the menstrual cycle is 21-34 days after the intervention.
| Variables | Before the intervention | χ2 P –value | After the intervention | χ2 P –value | ||
| Study(n=58) | Control (n=58) | Study(n=58) | Control (n=58) | |||
| BMI | ||||||
| BMI 18.5-24.9: normal | 0.00% | 0.00% | t 0.18 > 0.05 ns | 5.2% | 0.00% | t 4.45 ≤ 0.001** |
| BMI ≥25.0: overweight | 29.3% | 36.2% | 60.3% | 41.4% | ||
| BMI ≥30.0: Obesity | 70.7% | 63.8% | 34.5% | 58.6% | ||
| Waist circumference | ||||||
| ≤88 | 22.4% | 32.7% | t 1.92 > 0.05 ns | 53.4% | 36.2% | t 1.96 ≤ 0.05 |
| ≥88 | 77.6% | 67.3% | 46.5% | 63.8 | ||
Table 1: Anthropometric Measures of the Studied Infertile Overweight and Obese Women with Polycystic Ovary Syndrome (n = 116).
NB: ns non-statistically significant (p≥0.05) **highly statistically significant (p≤0.001)
Figure 1: Ovulatory Function and Anthropometric Measures of the Studied Infertile Overweight and Obese Women with Polycystic Ovary Syndrome (n = 116).
Figure 2: Symptoms Experienced among Studied Infertile Overweight and Obese Women with Polycystic Ovary Syndrome (n = 116).
Figure 3: Relationship between Ovulatory function and lifestyle dietary habits in the Study group of Infertile Overweight and Obese Women with Polycystic Ovary Syndrome (n = 58).
Figure 4: Relationship between Ovulatory function and physical activity level among the Study group of Infertile Overweight and Obese Women with Polycystic Ovary Syndrome (n = 58).
Numerous research studies have shown that obesity is not a simple issue but rather a complicated health issue caused by a mix of individual elements (genetics, learned behaviors) and significant causes (unhealthy societal or cultural eating habits, food deserts) [35]. Regarding the duration of the menstrual cycle, the findings of the current study showed that the present study revealed that, there were highly statistically significant improvements in menstrual cycle irregularities in the study, more than half of the study and control groups had a 3–5-day duration of the menstrual cycle before the intervention compared to the majority of the study group had had a 3-5 day duration of the menstrual cycle after the intervention. These findings are similar to the study done by Öberg, (2022). They studied "Effects of Lifestyle Intervention in Overweight Women with Polycystic Ovary Syndrome. From the researcher's point of view, lifestyle interventions have been shown to have positive effects in terms of improved menstrual cycle irregularities [36]. Regarding relationship between anthropometric measures and menstrual cycle regularity among the study group infertile overweight and obese women with polycystic ovary syndrome; the current study findings revealed that there is a positive correlation between anthropometric measures and menstrual cycle regularity about majority obese of the study group had irregular menstrual cycles before intervention. Compared to major of the study group overweight and normal weight the study group had regular cycles after intervention. These findings came in agreement with Marzouk, et al., (2015( who studied “Effect of dietary weight loss on menstrual regularity in obese young adult women with polycystic ovary syndrome” and showed that menstrual regularity was recorded with weight reduction. According to the researcher’s point of view, this may be justified as Obesity is associated with much comorbidity and obese women frequently suffer from reproductive disorders, including menstrual irregularity [37]. In contrast, Neubronner, et al., )2021), a study on healthy women between the ages of 21 and 45 who were selected from participants in an annual health screen at Singapore's National University Hospital (NUH) found that women with normal or high BMIs were equally at risk for oligomenorrhea [38]. Regarding the symptoms experienced, the current study findings revealed that all of the study group and control groups suffered from obesity before and after the intervention. These findings came in agreement with Alwahab, et al., (2018), who studied “A ketogenic diet may restore fertility in women with polycystic ovary syndrome", and revealed that all groups suffered from obesity before the intervention [39].These findings were incongruous with those of Aldossary et al. (2020), who studied the “Prevalence of polycystic ovary syndrome, and relationship with obesity/overweight", who revealed that most of the groups suffered from obesity before and after the intervention [40]. Regarding menstrual irregularity, the current study findings revealed that there is a significant improvement in menstrual regularity after intervention. About major of the study group and control groups had irregular menstrual cycles before the intervention, compared to two-thirds of the study group having regular menstrual cycles and 51.7% of the control group having irregular menstrual cycles after the intervention. On the contrary, these findings were incongruous with those of Li, et al., (2022), who studied “The degree of menstrual disturbance is associated with the severity of insulin resistance in PCOS”, who showed that the incidence of IR is as high as the major of obese PCOS subjects [41]. Another study conducted by Abdolahian et al., (2020), who studied “Lifestyle modifications on anthropometric, clinical, and biochemical parameters in adolescent girls with polycystic ovary syndrome." revealed that after three–to 12 months of intervention and documented improvement in menstrual cycle irregularities after the program [42]. Regarding lifestyle and daily dietary habits, in the present study, there was a highly statistically significant difference between data for habits and lifestyle modification of the pre and post-intervention after 6 months. The present study revealed that about half of the study group and control groups rarely had 2 to 3 times breakfast outside the house before the intervention, compared to two-thirds of the study group rarely had breakfast outside the house after the intervention. These findings came in agreement with Eleftheriadou, et al., (2015), who studied “Dietary habits in adolescent girls with polycystic ovarian syndrome", which revealed that more than half of adolescents with PCOS ate high sugar content items and fast food for breakfast, such as cakes, croissants, toast with honey or jam [43]. According to the researcher’s point of view, this may be justified as that kind of food is due to their favorable taste, color, shape, easy accessibility, and advertisements.
Life style modification implemented program positively affect menstrual cycle regularity and normal body mass index for infertile overweight and obese women. Disseminate results of the study to health care centers.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
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.
