AUCTORES
Globalize your Research
Research Article | DOI: https://doi.org/10.31579/2767-7370/147
1 Riggs pharmaceuticals, Department of Pharmacy, University of Karachi, Pakistan.
2 Fazaia Ruth Pfau Medical College, Shahrahe Faisal Karachi, Pakistan.
3 Pharmaceutical Inc OPJS University Rajasthan India.
4 Professor, Dow University of Health Sciences Karachi Pakistan.
5 Associate Professor, Department of Pathology Dow University of Health Sciences, Karachi, Pakistan.
*Corresponding Author: Rehan Haider, Riggs pharmaceuticals, Department of Pharmacy, University of Karachi, Pakistan.
Citation: Rehan Haider, Asghar Mehdi, Geetha K. Das, Zameer Ahmed, Sambreen Zameer, (2025), Implanted Drug Delivery System for Control of Chronic Pain, J New Medical Innovations and Research, 6(3); DOI:10.31579/2767-7370/147
Copyright: © 2025, Rehan Haider. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 19 February 2025 | Accepted: 27 February 2025 | Published: 03 March 2025
Keywords: implanted drug delivery systems; chronic pain; sustained drug administration; pain relief; adverse effects; implantable device; drugs include; opioids; local anesthetics; anti-inflammatory agents; efficacy; quality of life; tolerance
Implanted drug delivery system {IDDS} have emerged as a promising strategy for managing chronic pain, offering precise and sustained drug administration to achieve optimal pain relief while minimizing adverse effects. This abstract reviews the key aspects of IDDS in the context of chronic pain control.
Chronic pain, characterized by its persistence over extended periods, presents a significant challenge in medical practice due to its complex and multifaceted nature. Traditional oral medication often fall short of providing consistent pain relief while avoiding systemic side effects. IDDS addresses these limitations by delivering drugs directly to the target site, bypassing first-pass metabolism, and maintaining steady therapeutic concentrations.
IDDS consists of implantable device that houses a reservoir of the chosen medication, connected to a catheter for drug release. The release rate can be programmed and adjusted according to the patient's needs. Commonly used drugs include opioids, local anesthetics, and anti-inflammatory agents. The implantation procedure requires surgical expertise but offers the advantage of long-term pain management, reducing the need for frequent dosing.
The efficacy of IDDS in chronic pain control has been demonstrated in various conditions such as cancer pain, neuropathic pain, and failed back surgery syndrome. By providing sustained drug delivery, IDDS ensures consistent pain relief, potentially improving patients' quality of life and reducing the development of tolerance and dependence. However, challenges include the risk of infection, device malfunction, and the invasiveness of the implantation procedure.
The delivery of medication into the cerebrospinal fluid(CSF) has a long history and may be tracked to the sleep but still for providing insult analgesia to sleep but also for providing analgesia or numbing drug anes set as guide works of Corning and Bier in the late 1800s.[1,2] With the finding of opioid receptors in the main fearful system (CNS) in the 1970s, it was believed that the CSF could provide not only a route for inducing sleep but also for delivering analgesia.[3,4] instead of the use of intrathecal (IT) medications has extended over the resultant decades to include several classes of medications, clues further chronic pain, and has offspring edited from progresses in implantable push electronics.
The primary action for initial intrathecal drug delivery {IDD} searches to solve similar or superior healing effects when distinguished with spoken medications, while preventing usual
Lot-reliant side effects. Some drugs can harmlessly be brought long-term by way of implantable pumps, which are generally suitable for specific pain condition requiring targeted delivery The decision to use IT therapies involves considering several factors with potential risk and benefits that must be carefully evaluated, particularly given the invasive nature of these treatments Selection tests, as particularized next, should be used to recognize cases that grant permission benefits from IDD:
l Chronic pain or spasticity stubborn to prior situations
l Presence of restrictive aftereffects with other medication transmittal routes
l Lack of confusing mental comorbidities
l Absence of integral or surgical site contamination
l Absence of coagulopathy
l Lack of CSF flow obstacle
l Life expectancy of more than 3 months
l Demonstrated productiveness with the trial principle
Patients converge these tests for therapy with an implantable injection endure a trial to determine if the picked IT remedy will supply enough clinical effect, even though there are few specialists who advocate for passing insult straight to impregnation of the ovum in well-picked patients with tumor pain [5]. Although epidural and IT sole-shot tests are illustrated, the favorite procedure involves the installation of an IT catheter to best mirror potential insert environments. Hospital admittance is generally urged to stop the blame and grant pardon
Measure titration while listening for adverse belongings, principally by way of the chance of delayed respiring despair with the rostral spread of opioids.
Complications
Potential complications of IDD may be procedural or medication related. Procedural complications can occur after single –shot injection or pump implantation and include superficial and neuraxial infection, peripheral and neuraxial bleeding, post dural puncture headache and catheter-tip Granuloma formation. Infections or bleeding within the neuraxis is rare but carries the potential for catastrophic permanent sequelae.suspected neuraxial hematoma or infection necessitates prompt imaging and neurosurgicalevaluation.Anesthesia risk must also be considered before surgical pump implantation Suspected neuraxial hematoma or infection necessitates prompt imaging and neurosurgical evaluation. , particularly in patients with multiple comorbities or advanced malignancy patient with implantable pumps are also are risk of complications during required pump refills. Risks involve the administration of incorrect medication, pump reprogramming errors, and improper refill technique. Misidentification of the pump refill port can result in the delivery of medication into the subcutaneous pocket rather than the pump itself, which can lead to catastrophic consequences.
An inadvertent “pocket fill” creates a large depot of medication that can be absorbed into the body at a much greater rate. Then the intended rate. A 2011report from Medtronic cited 351 cases of pocket fill between 1996 and 2010, 8 of which resulted a 2011 report from Medtronic cited 351 cases of pocket fill between 1996 and 2010, 8 of which resulted in the patient's death [6]. Needle placement must be Needle confirmed by adhering to recommended refill procedures; imaging via ultrasound or fluoroscopy should be used when the refill port cannot be palpated, and patients with suspected pocket fill should be closely monitored. Withdrawal syndromes can also occur with pump malfunction or programming error, and the severity of symptoms varies with the class and dose of medication being delivered. Opioids withdrawal symptoms include increased pain, anxiety, sweating, diarrhea, and vomiting. Withdrawal from opioids, although unpleasant, is generally not life-threatening and can be treated with supportive care and delivery of opioids via oral or parenteral routes [7]. a more serious clinical entity is represented by abrupt withdrawal from gamma-aminobutyric acid (GABA) agonists (benzodiazepines or baclofen).A sudden cessation of IT baclofen can result in a constellation of symptoms thatincludeincreasedspasticity,Hyperthermia,seizure,coma,rhabdomyolysis,multisystem organ failure, and death[8] Treatment of suspected cases of baclofen withdrawal involves initiation of oral baclofen, which is not always sufficient to prevent withdrawal and investigation into the cause of interrupted IT delivery. A similar range of symptoms is seen in cases of benzodiazepine withdrawal [9], but this syndrome is seldom encountered given the relatively infrequent use of benzodiazepines in long-term injections
Table 76.1 summarizes the common and serious adverse effects of classes of IT medications.
Medication Classes
Although only opiates, baclofen, clonidine, and Ziconotide are now certified by the Food and Drug Administration. Drug Administration for the use in implantable IDD arrangements, a type of added medications that touch visualize use as off-label adjuncts or alone powers brought by the sub arachnoid needle. Combinations of various classes of drugs are again secondhand when monotherapy abandons to provide enough dullness, most usually in the form of assorted opioids and sleep-inducer answers.
Opioids
Research concerning the painkiller characteristics of IT opioids started in the 1970s, and they wait for the typical and most usual IT analgesic. Originally silent for in the situation of tumor-with pain, IT opioids have progressively happened secondhand for nonmalignant pain in equivalence with climbing rates of spoken opioid use and spine resection. Compared to with oral opioids, IT opioids can attain an identical clinical effect at nearly 1/300th of the shot. This moving increase, in reality, is on account of the extreme concentration of opioid receptors in the substantia gelatinosa of the spinal rope, a place they synapse, with escalating pain tracts. Binding of opioids to the Mu receptor results in pre-synaptic and postsynaptic connections that prevent the broadcast of pain signals from the periphery to the brain [10]. Presynaptic binding leads to the depreciated release of pro-nociceptive neurotransmitters, since postsynaptic binding leads to Curtailed neuronal action potential [11]. IT opioids must wait in the CSF to apply their effect On sleep-inducing or numbing drug Mu receptors, and their event inside the sleep-inducing or numbing drug fluid is helpless on their quality of hydrophilicity. More hydrophilic drugs are, to a degree, narcotics. and dilaudid, wait solubilized in the CSF for extended periods momentary, happening in a widespread event of operation in addition to spreading inside the CSF, furthering the immediate locale of the catheter tip Conversely, lipophilic opioids, in the way that fentanyl or sufentanil are poorly solubilized in the CSF and briskly breaking apart the spinal column. Consequently, lipophilic opioids have a smaller incidence. of sleep-inducing or numbing drug operation and likely not to deliver within the CSF further the initial opportunity [12].
Sums up the change percentages for commonly used secondhand opioids, baclofen, and midazolam. The evidence upholding the use of IT opioids in the administration of never-ending pain is mainly positive but is located generally in unrestrained potential and retrospective studies. The only randomized trial, written by Smith et al. in 2002 distinguished the belongings of IDD plus
Unoriginal analysis with conventional medication unique [13]. A total of 202 inmates with stubborn cancer pain were randomized to accept either IDD with opioids or conventional health management, which involved all usual medical and interventional medicines expelling IDD and Cordectomy. The primary effect was not a complete 20
The research likely involved a comprehensive literature review, potentially including clinical trials, experimental studies, and reviews related to implanted drug delivery system for chronic pain control. The method would have encompassed the following steps:
Literature Search: Searching databases like PubMed, Web of Science, and other medical literature repositories to identify relevant studies on IDDS for chronic pain management. Inclusion and Exclusion Criteria: Selecting studies that meet specific criteria, such as clinical trials or experimental studies involving human or animal subjects relevant to chronic pain, and utilizing implanted drug delivery systems. Data Extraction: Extracting data from selected studies, including study design, sample size, drug used, implantable device characteristics, pain relief outcomes, adverse events, and follow-up duration.
Data Analysis: Synthesizing the data to identify trends, outcomes, and potential variations between different studies
The results of the research would have provided insights into the efficacy, safety, and overall impact of implanted drug delivery system for controlling chronic pain. Key findings might include:
Efficacy: Demonstrating that IDDS offers effective pain relief for a variety of chronic pain conditions, potentially including neuropathic pain, cancer-related pain, and refractory pain cases where traditional oral medications have been insufficient.
Sustained Relief: Highlighting the advantage of sustained drug release, which allows for continuous pain control, reducing the need for frequent dosing, and minimizing fluctuations in pain levels
Minimized Systemic Effects: This shows that targeted drug delivery to the site of pain reduces the exposure of the entire body to the medication, thereby reducing systemic side effects and enhancing patient comfort.
Patient Quality of Life: Indicating an improvement in the quality of life for patients due to better pain management, reduced medication-related side effects, and improved functional capacity
The discussion section of the research would likely delve into the implications of the results and their broader significance. Some points that might be discussed include.
Clinical Applicability: The discussion would address the practical implications of using IDDS in clinical settings. This might involve comparing IDDS with other pain management methods, such as oral medications, epidural injections, and surgical interventions.
Challenges and Limitations: Discuss challenges related to implantation procedures, device maintenance, potential complications (e.g., device malfunction, infections), and patient selection criteria.
Future Directions: Identifying areas for future research and improvement, such as refining implantable device technology, exploring new drug combinations, optimizing patient selection criteria, and evaluating the cost-effectiveness of IDDS compared to other pain management approaches.
Ethical Considerations: Addressing ethical concerns related to long-term implantation, patient autonomy, and ensuring that patients have realistic expectations regarding the outcomes of IDDS
Regulatory and Reimbursement Issues: Discuss regulatory approvals, reimbursement challenges, and healthcare policy implications associated with incorporating IDDS into standard pain management protocols.
In conclusion, research on implanted drug delivery system for chronic pain control presents a comprehensive understanding of their methodology, results, and discussions. The findings highlight the potential benefits of IDDS in providing effective and targeted pain relief while underscoring the challenges and considerations that need to be addressed for successful clinical implementation. When distinguished from the with additional routes of the presidency, the transmission of drugs into the CSF offers the potential for better dullness with minor medication-with Adverse effects. The field has been helped by advances in implantable tap science and a stable growth further the opioid and sleep-inducer medication classes, but the potential benefits concerning this obtrusive remedy must be equalized by a knowledge of the potential medication and procedural risks.
The bulk of biography advocating the use of IT pain drugs all at once is scarce and holds few excellent randomized troubles. The use of opioids for tumor-connected pain is powerfully backed, but only feeble evidence supports their use in nonmalignant pain states. There is powerful evidence to support the use of baclofen in pain conditions that involve a component of spasticity and modern eroded evidence advocating its use in added neuropathic pain environments. Ziconotide is guide CNS reactions and has a narrow healing bay, but skilled is good evidence for its use in neuropathic pain environments. There is good evidence that two together clonidine and bupivacaine are
Persuasive adjuncts, and each has happened proved to have opioid-careful belongings when secondhand in enduring combination injections. The evidence upholding the use of corticosteroids for PHN is feeble and contradictory.
There are diversified regions for future research likely the overall scarcity of possible articles, but exertions endure devote effort to something underrating adverse effects and confusion, Maximizing cost influence, and reconstructing designs of patient pick.
Key Points
The basic action for initial IDD is to realize related or superior healing effects when distinguished With spoken drugs while preventing usual dosage-dependent reactions. Potential confusions of IDD grant permission be procedurally or medication-related. Procedural complexities can happen following position or time distinct ammunition injection or supply information that is designed to mislead or persuade and involve contamination, bleeding, post-dural puncture trouble, and catheter-tip granuloma establishment. Complications all the while supply refills include administration of wrong medication, push reprogramming wrongs, and immoral refill method. Misidentification of the injectable fill traffic can result in the transmission of medication into the subcutaneous pocket, which can bring about destructive results. Opioid withdrawal manifestations involve increased pain, tension, sweating, loose bowels, and disgorging. A weighty a clinical system is an abrupt withdrawal from GABA in the past. The sudden end of IT baclofencaninfluenceraised spasticity, Hyperthermia, seizures, coma, Rhabdomyolysis, multisystem means deficiency, and obliteration.
The evidence advocating the use of IT opioids in the administration of chronic pain is mainly definite but is located mainly on uncontrolled potential and period respective studies. An emerging practice in opioid IDD is “micro dose insult,” wherein inmates are weaned from all opioids earlier to start IT opioid analysis at many inferior typical doses. Another micro-dosing method includes detaching the patient to 50% of their opioids superior to the IT trial. Despite these promising result, micro-dosing debris is the extent of the dispute. l IT opiate and dilaudid guide the formation of an angering public. Given a moment of truth. Necessary for granuloma formation, they are more frequently noticed in inmates with nonmalignant pain. The risk determinants for establishment are increasing application and/or aggregation of narcotics or Dilaudid. Ziconotide, a calcium channel blocker, is recorded for use in a range of neuropathic pain and mixed bodily neuropathic pain environments. Because ziconotide is combined with a very powerful neurotoxin, adverse responses involve many CNS belongings. The addition of bupivacaine to IT morphine grants permission to yield better pain remedies in a few victims with lower-frame pain and influences a lower dosage of opioids.
Literature upholding the use of IT midazolam is scanty and conflicting. Animal models have proved two together offspring fit and attainable neurotoxicity, whereas the human dossier is collected principally from sole-chance studies in the perioperative period. Baclofen use is well-financed for environments that involve a detail of spasticity or dystonia; its use in added pain environments is less traditional. Clonidine is most often used secondhand as an adjunct in combined IT injections. A initial study on the use of IT steroids for PHN granted hopeful results. However, studies abandoned copying these judgments.
The completion of this research project would not have been possible without the Contributions and support of many individuals and organizations. We are deeplygrateful to all those who played a role in the success of this project
We would also like to thank My Mentor.
Naweed Imam Syed Prof. Department of Cell Biology at the University of Calgary and Dr. Sadaf Ahmed Psychophysiology Lab University of Karachi for their invaluable input and support throughout the research. Their insights and expertise were instrumental in shaping the direction of this project
I at this moment declare that：I have no pecuniary or other personal interest, direct or indirect, in any matter that raises or may raise a conflict with my duties as a manager of my office Management
The authors declare that they have no conflicts of interest.
Financial support and sponsorship
No Funding was received to assist with the preparation of this manuscript
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.
