AUCTORES
Globalize your Research
Chat with us
Research Article | DOI: https://doi.org/10.31579/2578-8965/232
1Specialist Obstetrics and Gynecology, Prime Hospital, Dubai UAE.
2Consultant surgeon, Prime Hospital, Dubai UAE.
3Student, Saint Mary’s Catholic school, Dubai UAE.
*Corresponding Author: Varsha Ojha, Specialist Obstetrician and Gynecologist, Prime Hospital, Dubai, UAE.
Citation: Varsha Ojha., Vinod Kumar., Riya Singhal.,(2024), Prevalence and management of iron deficiency anemia in pregnancy in a tertiary care hospital over a period of 2 years, J. Obstetrics Gynecology and Reproductive Sciences, 8(6) DOI:10.31579/2578-8965/232
Copyright: © 2024, Varsha Ojha. 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: 30 July 2024 | Accepted: 12 August 2024 | Published: 20 August 2024
Keywords: prevalence; Iron deficiency anemia; pregnancy; ferrous fumarate
Background and Objectives: Anemia in pregnancy is highly prevalent and can have a significant effect on both maternal and fetal outcome. The most prevalent kind of nutritional anemia that occurs during pregnancy is iron deficiency anemia. Even with the use of oral iron prevention during pregnancy, IDA remains a significant health concern for expectant mothers. The current study intends to examine the treatment response and prevalence of IDA in a pregnant population.
Methods: This is a retrospective cohort study looking into the prevalence of iron deficiency anaemia amongst pregnant women who delivered in a Tertiary care Hospital for a period of 2 years (Feb2022- Jan2024). All patients who got prenatal care at our hospital had their hemoglobin levels regularly evaluated at booking and at 28 weeks and 36 weeks pregnant and more often as needs by either a venous or capillary blood sample, are included in the inclusion criteria. We use the mid-trimester hemoglobin level to identify patients who are anemic among our study volunteers. SPSS was used for analysis.
Results- the prevalence of anemia was found to be 59.4% (N=297) mostly being Iron deficiency anemia. 6 patients were Thalassemia minor and 1 patient was Sickle cell carrier The most common age group was found to be 20-35 years in which 60.2% were anemic. Around 59% of anemic had tertiary form of education and parity 63% for 2-4. The most common category was mild anemia (82%), moderate in 15%. After 36 weeks the anemia levels were improved in all category only 12.4% had mild while no severe anemia was seen. But this was not statistically significant (p>0.05). The incidence of PPH were 2.7% in treated anemic patients while 1.7% in anemic
Conclusion: Anemia in Pregnancy is highly prevalent and if left untreated can have a significant effect on both Maternal and fetal outcome. Prevention, Health education on reproductive health from early childhood and Adolescent age is highly recommended.Eraly diagnosis and Prompt management of anaemia in Pregnant females by oral Iron or Iron infusion helps in a better outcome . Parenteral iron therapy should be used as soon as possible to enhance treatment outcomes. And also helps in avoiding the need for Blood transfusion.
Anemia is the most common form of Nutritional deficiency worldwide.
Due to the growth of the mother's red blood cell mass, the increasing demand by the fetoplacental unit, and the necessity to prepare for blood loss during birth, pregnancy dramatically increases the need for iron. As a result, women who don't have enough iron in their body will be unable to meet these demands, resulting in an iron shortage that could cause anemia during pregnancy. [1,2] Due to its well-established correlation with preterm labor, low birth weight babies, inadequate iron storage in the baby, and mother's diminished cognitive function and reduced job capacity, and also increased risk of blood loss , post part hemorrhage , need for Blood transfusions ,this is a serious health concern. [3] It is estimated that iron deficiency anemia, the most common nutritional deficiency during pregnancy, affects 41.8% of pregnant women worldwide.[4]
Research has shown that anemia is very prevalent in United Arab Emirates. A cross sectional study showed a prevalence of 31 % and 26.7 % in women of reproductive age. Despite the availability of numerous treatment modalities, this proportion has remained relatively stable over the previous ten years or more. [4,5]. Thus, it is a significant public health concern. There is currently a lack of local epidemiological data on the prevalence of iron deficiency anemia during pregnancy, the results of treatment, and if the Ministry of Health's aim is being fulfilled. There is a dearth of information on the effectiveness of treatment for iron deficiency anemia, and the majority of studies mainly examined the prevalence and demographic characteristics linked to anemia in pregnancy. [5]
Dietary intake alone is insufficient to rectify an iron-deficient state, so oral iron supplementation is the main treatment for iron deficiency. Typically, a daily dosage of 100–200 mg of elemental iron is given [6]. When it comes to side effect worries, parenteral iron therapy is not the first choice. Parenteral iron is used when there has been a poor response to oral iron or when there is a problem with compliance because of the adverse effects of oral iron therapy. Research indicates that parenteral iron therapy outperforms oral therapy in terms of iron reserve replenishment and hemoglobin level grows more quickly. Given that anemia persists as a significant health concern throughout pregnancy, more has to be done to address this issue. The purpose of this study is to determine the prevalence of iron-deficiency anemia in the pregnant population and assess the efficacy of the treatment plans used to address the condition.
This is a retrospective cohort study looking into the prevalence of iron deficiency anaemia among pregnant women who delivered in Tertiary care Hospital between for a period of 2 years ( Feb2022- Jan2024) .
All pregnant females who got prenatal care at our hospital and had their hemoglobin levels regularly evaluated at booking , and 28 weeks and at 36 weeks by either a venous or capillary blood sample are included in the inclusion criteria.
We use the mid-trimester hemoglobin level to identify patients who are anemic among our study volunteers. Anaemia is defined as hemoglobin concentration less than 11 g/dl. We further divide anemia into three categories: moderate (7-8.9 g/dl), severe (<7>
Our study included every postnatal mother who gave birth to a singleton child. Postpartum moms with antepartum hemorrhage-related anemia, underlying hemoglobinopathy, and non-singleton delivery were not included in the study. Ferrous fumarate 200 mg, which contains 65 mg of elemental iron and 5 mg of folic acid, was a frequently recommended iron supplement for every patient in this trial. It was recommended that patients who could not take ferrous fumarate take Haem Iron , folic acid and Vitamin B12 combination or Ferrous sulphate , ferrous Bisglycinate, Ferric Pyrophosphate. The dosage of oral iron is raised upon detection of iron deficient anemia.Parenteral iron, usually in the form of Iron Dextran is often provided to patients who exhibit inadequate adherence to oral therapy or who experience intolerable adverse effects. Iron sucrose was provided to patients who were allergic to iron dextran. Also Ferric Carboxymaltose infusion for a quicker recovery is given .Patients with severe anemia with symptomatic Hb levels less than 7 g/dL or those with moderate to severe anemia nearing their due date, where prompt correction is preferred, are eligible for blood transfusions.
Sample Size
The sample size of our study was estimated using the prevalence of anaemia in pregnancy reported as per NFHS-4 in 2019 (51%) [6]. Using the Cochrane formula, a sample size of 400 was calculated for this study. Data was collected from the patients’ case records and included socio-demographic information (age, ethnicity, and education level), clinical risk factors (including parity and inter-pregnancy interval), clinical data of anemic status, types of treatment, and pregnancy outcomes.
The collected data were entered into Statistical Package for Social Sciences (SPSS) Version 25 and examined. Whereas categorical variables were expressed as frequency and percentage, continuous variables were given as mean and standard deviation. The frequency, proportion, and mean of the data were reported. The use of the Chi-square Test was used to compare categorical data. The significance threshold was established at <0>
| Age group (year) | Parity | Pregnancy interval (years) (excluding primigravida) | |
| N | 0.05 | 0.550 | 0.366 |
| % | <20> | 1 | <2> |
| N | 4 | 27 | 51 |
| % | 2 | 13 | 25 |
| 11 | 56 | 86 | |
| 3.8 | 19 | 29 | |
| 15 | 83 | 137 | |
| 20 - 35 | 2-4 | 2-4 | |
| 160 | 150 | 125 | |
| 78.8 | 74 | 52 | |
| 179 | 188 | 154 | |
| 60.2 | 63 | 52 | |
| 339 | 338 | 279 | |
| >35 | ≥5 | ≥5 | |
| 39 | 26 | 27 | |
| 19.2 | 13 | 13 | |
| 107 | 53 | 57 | |
| 36 | 18 | 19 | |
| 146 | 79 | 84 |
Table 1: Demographic details and prevalence of Anemia in Pregnant females.
As per table 1 the prevalence of anemia was found to be 59.4% (N=297) and all being Iron deficiency anemia. The most common age group was found to be 20-35 years in which 60.2% were anemic. Around 59% of anemic had tertiary form of education and parity 63% for 2-4. The most common spacing years were 2-4 years around 52% in anemic participants. But no parameters were significant.
| Mild (9-10.9) | Moderate (7-8.9) | Severe (<7> | |
| N | 244 | 45 | 8 |
| % | 82 | 15 | 3 |
| N | 37 | 2 | 0 |
| % | 29.8 | 1.6 | 0 |
Table 2: Outcome of Treatment in Iron Deficiency Anemia (N=297).
As per table 2 We use the mid-trimester hemoglobin level to identify patients who are anemic among our study volunteers but after 36 weeks the haemoglobin levels were also seen. The most common category was mild anemia (82%), moderate in 15%. After 36 weeks the anemia levels were improved in all category only 12.4% had mild while no severe anemia was seen. But this was not statistically significant (p>0.05).
Mode of delivery Vaginal
| |
| 100 | 54 |
| 64 | 72 |
| 0.630 | |
| Caesarian | |
| 85 | 46 |
| 36 | 40 |
| Postpartum hemorrhage (PPH) | |
| 0.424 | |
| PPH | |
| 5 | 5.9 |
| 2.6 | 2 |
| No PPH | |
| 180 | |
| 97.4 | 94.1 |
| 110 |
As per table 3 around 62% of study participants were treated with vaginal delivery was the most common mode of delivery among anemia vaginal delivery was still common but it was not significant. The incidence of PPH were 2.7% in treated anemic patients while 1.7% in anemic patients but it was not significant which suggest that other causes will be involved.
In our study, we report the total prevalence of anemia as 59.4% (N=297), with iron deficiency anemias being the most common kind. The prevalence estimates are comparable to those of a previous local study that found that the overall prevalence of iron deficiency was 31.6% and anemia was 43.6%. [7] It is common knowledge that pregnant women require more iron than non-pregnant people do. 0.8 mg is the average daily requirement in the first trimester, 4-5 mg in the second, and 6-8 mg in the third trimester. Pregnancy-related anemia affects both the mother and the fetus. Research document the following impacts on mothers: exhaustion, palpitations, dyspnea, elevated susceptibility to infections, psychological problems such emotional instability, depression, and stress, poor performance on cognitive tests, and a general decline in quality of life. [8] The most essential period of pregnancy is the early stages, and iron shortage during this period affects fetal brain development, which may not be able to be corrected by later intervention with iron supplements. [9] Even with adequate treatment, children between the ages of 4 and 10 in Chile had poorer memory, according to a research on the subject. Eighty- two percent of the women in our research were diagnosed with mild anemia and started on oral iron therapy. 62% of the population (N=185) responds well to iron therapy overall. Anemia at the time of delivery decreased significantly from 82% of the mid-trimester to 29.8%. The majority of women who received parenteral iron had a success rate of 84.4%. These are the ladies who were started on parenteral iron therapy because they did not respond to oral iron. It is often known that serum ferritin, not hemoglobin level, is the most significant surrogate marker of iron deficient anemia. The therapeutic dose for mild to moderate IDA (Hb 8.0-10.5 g/dl) in the first and second trimester anemia is 200 mg elemental iron per day. The Hb concentration should increase by 0.3-1.0 g/dl per week. Treatment should be continued until Hb has optimised and serum ferritin is improved and is above 30-50 μg.23. However, the tolerance of iron deficiency anemia and its side effects that impair compliance provide a significant problem in its management. It is believed that just 49% of Malaysian pregnant women take their vitamins or supplements on a regular basis.25 Significant gastrointestinal side effects were observed by one meta-analysis that examined 17 randomized trials when oral iron was administered as opposed to parenterally. [10] Therefore, it is crucial to supply the right type and dosage to guarantee that iron stores are sufficiently restored. Numerous studies have been published, including systematic reviews and randomized controlled trials that compare the effects of oral and intravenous iron. Every study has shown that intravenous iron replenishes iron reserves more effectively and corrects anemia more quickly and quickly. Following intravenous iron, there was a notable difference in the ferritin level, with iron reserves only being restored in the intravenous group of women. [11] An increase in ferritin is thought to be connected to the iron sucrose complex, which releases iron to endogenous iron-binding proteins quickly and without causing any parenchymal tissue deposition. Iron sucrose has a half-life of around 5 to 6 hours and is readily available for erythropoiesis after being swiftly removed from serum. [12] Studies have shown that poor neonatal outcomes, including low birthweight and preterm birth, are associated with anemia in mothers and fetuses. Risk of postpartum hemorrhage and placental abruption are among the maternal outcomes. Severe anemia is linked to unfavorable results for both the mother and the fetus, though. [11,12] Our results are comparable, showing no statistically significant correlation with the majority of our patients' moderate anemia and postpartum hemorrhage. Our study has few limitations First, the observed relationships may have been distorted by the inability to quantify variables like iron supplementation and other dietary circumstances like compliance problems during pregnancy. This is mostly because the data are retroactive in nature. Furthermore, the results of our study cannot be broadly applied because we only included pregnant women who were seen in a single tertiary hospital.
Iron deficiency anemia in pregnancy is prevalent generally (59.4%), with the majority of cases being mild (9–11 g/dl). Oral iron raises hemoglobin in a manner similar to that of parenteral iron. Since oral iron is inexpensive and simple to take, efforts should be made to increase pregnant women's compliance by adopting forms and preparations that have the fewest adverse effects on the gastrointestinal tract. When it came to restocking iron stores, parental iron was superior to oral iron. This is crucial in low- and middle-income nations because, if their iron stores are not restored, lactating mothers can become anemic during the postpartum period. When treating iron deficiency anemia, intravenous (IV) iron sucrose is said to be more effective and safe than traditional oral iron supplements. Our study's strength is its synthesis of the data supporting mainstreaming parenteral therapy as a workable solution for IDA. Randomized controlled trials (RCTs) conducted in a local setting are required to verify our findings so that policymakers can formulate recommendations.
None declared
None
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!”
