Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder

Case Report | DOI: https://doi.org/10.31579/2690-1919/577

Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder

  • A.A. Sinelnyk *
  • S.G. Shmyh
  • I.G. Matiyashchuk
  • M.O. Klunnyk
  • M.P. Demchuk
  • O.O. Honza
  • I.S. Vinychuk
  • I.A. Susak
  • K.O. Kuzmak
  • M. S. Nahrebelna
  • M.V. Skalozub
  • D.V. Vatlitsov
  • A.V. Tkachenko
  • K.I. Sorochynska

Cell Therapy Center EmCell, Kyiv, Ukraine.

*Corresponding Author: A.A. Sinelnyk, MD, Cell Therapy Center EmCell, 40A Metrolohichna Street, Kyiv 03143, Ukraine.

Citation: A.A. Sinelnyk, S.G. Shmyh, I.G. Matiyashchuk, M.O. Klunnyk, M.P. Demchuk, et al, (2025), Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder, J Clinical Research and Reports, 21(1); DOI:10.31579/2690-1919/577

Copyright: © 2025, A.A. Sinelnyk. 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: 03 September 2025 | Accepted: 10 September 2025 | Published: 17 September 2025

Keywords: autism spectrum disorder; cognitive epileptiform disintegration; evoked cognitive potentials; fractional anisotropy; diffusion tensor MR imaging; standardized psychiatric diagnostic methods

Abstract

There are certain limitations in modern pharmacotherapy and rehabilitation psychotherapy for children with autism spectrum disorders (ASD). Existing therapeutic approaches are not able to assure a complete cure for the patients with ASD. Stem cell therapy is one of the promising and innovative methods that has recently gained popularity. To objectively assess the treatment effectiveness in medicine, both standardized psychiatric diagnostic methods and the instrumental investigations have been efficiently used. The neuroimaging methods are among them, especially, functional magnetic resonance imaging (fMRI) and diffusion tensor MR imaging (DTI); electroencephalography (EEG) and evoked cognitive potentials; dynamic monitoring of the treatment results. All these methods allow objectively evaluating the effects of stem cell therapy. This case report describes a clinical case of successful treatment with application of fetal stem cells in a child with ASD, complicated by the cognitive epileptiform disintegration. The child's general condition and assessment of positive changes by the caregivers were monitored during a period of 12 months. During one year of child’s observation, the family noticed significant improvements proved by the results of the ATEC questionnaire, EEG data and the fractional anisotropy (FA) results. The presented clinical case demonstrates the potential of fetal stem cell (FSC) therapy as an effective treatment method for children with ASD, which is also confirmed by the obtained objective results.

Introduction

Autism spectrum disorder (ASD)! What do we know about this disease today? We would like to give some latest updates about this health problem. The scientists still don’t know the exact causes of ASD. It is thought to be caused by a combination of some genetic and environmental factors [1]. According to the latest statistic report from the Center for Disease Control and Prevention (CDC), 1 in 31 of 8-year-old kids in the United States has been diagnosed with autism. The prevalence of autism in the United States has increased by 312% since 2000. In 2000, the CDC data estimated that autism affects 1 in 150 among the 8-year-olds, or 6.7 cases per 1,000 children. Since then, a new report has been published every two years and the prevalence rate of ASD has been increasing each time [2].  As recorded, around 26.7% of the 8-year-olds with autism in the United States have an advanced autism grade with their symptoms so severe that kids eventually might need a 24-hour care for the rest of their lives. Another study found that children with ASD are 40 times more likely to suffer fatal injuries if compared to their peers without autism [3,4]. About 50% of mothers of ASD kids demonstrated the symptoms of depression. According to a report issued in 2022, the researchers at the University of California, San Francisco observed the higher levels of depression symptoms in about half of all mothers of ASD children over the 18-months period of follow up. Meanwhile, the rates of depression among the mothers of children without autism ranged from 6% to 13.6% [5]. A high comorbidity between epilepsy and ASD has been characteristic for up to 30% of autistic cases. Likely co-occurrence of both disorders is the result of some genetic and structural differences in the brain [6,7]. However, epilepsy is not the only condition associated with ASD. Gastrointestinal disorders are 8 times more common in children with ASD and 7 out of 10 patients diagnosed with ASD have problems with eating habits and feeding [1]. At present, there is an evidence suggesting that stem cell (SCs) therapy significantly improves the condition of ASD patients and does not cause serious side effects [8,9,10,11]. SCs can be split depending on their origin: embryonic SCs (including induced pluripotent SCs), fetal stem cells (FSCs) and adult SCs (from umbilical cord blood, placenta, bone marrow, immobilized blood, adipose tissue, etc.) [12,13].  We would like to share our clinical experience of dynamic observation for a child with ASD who received a single course of FSCs treatment and its effectiveness was confirmed by the Autism Treatment Evaluation Checklist (ATEC) questionnaire and the MRI - diffusion tensor MR imaging findings.

Case presentation

The parents of a 12-year-old child visited EmCell clinic for SCs treatment. The patient’s mother reported the following chief complaints: expressive language impairment, emotional and volitional disorders, the child cannot use his skills to communicate, the patient also has impaired writing (child can lose his writing skills which are gradually restored after that). The patient reveals poor reading and behaves aloof with the other children. The child has mood swings, with remarkable shyness and showing interest in imitating the behavior of the older boys. The mother noted that child has problems with body coordination at time of riding a bicycle, the patient has to wrap himself tightly in a blanket when trying to fall asleep. The patient's body weight at birth was 4000 g; and height was 55 cm. Apgar’s range after birth made up 9-10 scores. The child received breastfeeding for up to the age of 9 months. According to mother, she noticed some neurodevelopmental problems in the child’s age of 1.5 years. After a certain period of time, mother revealed a regression in child’s speech skills, with remarkable “facial dolorosa” on the photo, and “acetone smell” which occasionally appeared too. In this regard, the patient was engaged into special correctional classes with a teacher. At the age of 4 years, as recorded from mother, the child was consulted by a psychiatrist and a firm diagnosis of autism was confirmed. Since his age of 6 years, the patient has been under the constant supervision by the pediatric psychiatrist at the “Treatment and Diagnostic Center of Neurology and Epileptology” in Bila Tserkva Town, where the child’s diagnosis was identified as follows: “Autism spectrum disorder. Delayed psychomotor development. Cognitive epileptiform disintegration”. After establishing the diagnosis, the child has been regularly receiving trainings with a psychologist, pedagogical classes and speech therapy correction. Besides, Ospolot (Sultiam) drug 100 mg/day was prescribed. When family changed their residence place (moved to another country due to russia's military aggression against Ukraine), the mother noted regress of child’s speech and communication; however, a year later, upon returning to Ukraine, positive child’s dynamics appeared. 

From the age of 9 years, child began attending a specialized educational institution. The patient’s skills of writing and reading were gradually developing. At the age of 10 years, child had a consultation with a local psychiatrist and the treatment scheme was corrected: Depakine chrono-300 was prescribed ½ tab. 2 times a day for continuous administration, after which the mother reported some positive dynamics in child’s communication skills. Subsequently, child’s therapy with Depakine chrono had been taken as a life-long prescription. The child attends inclusive program at school; mother is the child’s assistant at school (Figure 1).

Figure 1: Mother and child during the school classes.

Examination results 

ASD was diagnosed in accordance with the diagnostic criteria due to the International Classification of Diseases, 10th revision (ICD-10) [14]. It involved the detection of speech development disorders (delayed receptive and expressive speech), including problems with social and functional interaction in a child under the age of three. The evaluation was carried out by means of the interviews with the parents to analyze autistic behavior by the ADI-R+ADOS assessment scale and the ATEC questionnaire application [15], the latter was also used to evaluate the effectiveness of ASD treatment. The results received by the ATEС assessment scale at the beginning of the study: language/communication level - 10 scores, socialization - 22 scores, sensory/cognitive skills - 12 scores, health/physical development/behavior - 21 scores. The child met the criteria for moderate childhood autism (65 scores).

EEG in awakening was performed before the treatment and demonstrated the sharp-wave elements in the following zones: right frontocentral, right central-parietal, with impulse conductivity to the left frontocentral and vertex zones. The single episodes of diffuse spread of epiactivity lasting up to 1 second are shown during this investigation. The index of epileptiform activity is low/medium and the greatest presentation is during child’s falling asleep. According to the results of MRI of the brain and diffusion tensor MR imaging before treatment (Philips Ingenia 3T magnetic resonance tomograph):

1) the architectonics of the corpus callosum associative fibers is unchanged, whereas the average FA values remain within the age norm - (FA) 0.413+/-0.207;

2) the arcuate fasciculus fibers between Wernicke's and Broca's areas are clearly visualized; their architectonics is not disrupted; the FA values are moderately reduced 0.397+/-0.179 (n-0.450+/-0.08), which may lead to impaired connectivity of expressive-receptive speech areas (impact on the child’s ability to reproduce language sounds and perceive such sounds as linguistically significant);

3) the corticospinal tracts are relatively symmetrical and their architectonics is not affected, the average anisotropy indicators are without any deviations from the normal range: right - (FA) 0.454+/-0.199, left - (FA) 0.471+/-0.201.

Figure 2: Diffusion tensor MR imaging findings before treatment.

Conclusion

MR signs of arachnoid cyst in the left temporal-polar zone (type I after Galassi). The changes at the level of the left hippocampus are corresponding to Incomplete Hippocampal Inversion (IHI). No volumetric-focal pathology in the brain was detected during the examination. A moderate decrease in the average FA does not exclude a “violation of connectivity” between Wernicke's and Broca's areas (impact on the child’s ability to reproduce speech sounds and perceive them as linguistically significant). The results of routine laboratory blood tests prior to treatment did not show any significant deviations from the reference values. The results of biochemical blood tests revealed a preliminarily increased level of alkaline phosphatase (286.6 U/l; RR 53-128 U/l) and total creatinine phosphokinase (198.4 mmol/l; RR <171>

Figure 3: Diffusion tensor MR imaging findings before treatment.

Treatment

The patient received the course of FSCs therapy, hyperbaric oxygenation sessions (19.1 psi, 40 min, Fortius420® Hyperbaric Chamber) and training classes with an occupational therapist [16, 17, 18]. The SCs treatment protocol included intravenous administration of the fetal hemopoietic and mesenchymal SCs, subcutaneous and intranasal administration of neural SCs [11]. The child also received treatment with inhalation of exosomes isolated from the FSCs. No adverse reactions associated with SCs therapy were recorded during the treatment and within the whole period of observation [19].

Examination post-treatment

During the doctor’s examination over 6 months post-treatment, positive dynamic was noted in the form of improved perception of the addressed speech (ability to perform simple and complex instructions, no need for additional explanations or examples), improved child’s ability to explain verbally. Partial inconsistency between the age and development of social dialogue language remained. No difficulties were reported with understanding of logical and grammatical constructions, as well as establishing the cause-and-effect relationships. Understanding of the social and emotional context of situations was present, duration of child’s concentration and ability to maintain attention improved. The patient’s impulsivity changed from constant to sporadic. However, the child still has moderate deficit with ability to organize the educational process. After the course of SCs therapy, mother also noticed a number of positive changes in the child: the process of self-care following defecation improved, writing skills returned to the initial levels, patient’s volume of processing for the information read and understanding of its contents was accelerated, child’s preferences for watching television changed (patient prefers movies for kids, but previously child liked the animated cartoons). The patient tries to establish eye contact when it is necessary for communication and there is demonstration of satiety feelings when child consumed some foods. Mother also noted a positive behavioral and psycho-emotional background in the child. The patient’s preferences in a style of clothing, haircut and behavior changed, which child could copy from the older boys.

Figure 4: Diffusion tensor MR imaging findings after treatment.

The results of dynamic brain MRI investigation and diffusion tensor MR imaging (Philips Ingenia 3T magnetic resonance imaging) over 6 months after SCs therapy, compared with the data of the previous MR study, showed increasing of the average FA over the associative corpus callosum fibers and arcuate fasciculus in Wernicke/Broca’s area, which may have a positive effect on the associative connectivity between the cerebral hemispheres and ability to reproduce speech sounds and perceive them as linguistically significant (Table 1).

TractFractional anisotropy (FA) before treatment Fractional anisotropy (FA) over 6 months after the treatment
Architectonics of the corpus callosum associative fibers0.413+/-0.207

0.492 +/- 0.204

 

Arcuate fasciculus fibers between Wernicke and Broca's areas

0.397 +/- 0.179

(n- 0.450 +/- 0.08)

0.418+/-0.177
Right corticospinal tracts0.454 +/- 0.1990.475+/-0.200
Left corticospinal tracts0.471+/-0.1990.489 +/- 0.201

Table 1: Results of dynamic brain MRI investigation and diffusion tensor MR imaging

Diagram 1: Dynamics by the ATEC scale and sub-scales with the scores.

In accordance with the ATEC scale, the results showed a gradual decrease from 65 scores to 42 scores over the first 6 months and remained at that level over the next 6-month period of observation (42-41 scores).

It is worthy to emphasize that in isolation these changes affected the behavior and socialization sub-scales (Diag. 1). 

The analysis of all data indicates a correlation between the results of MRI – diffusion tensor MR imaging, the scores by the ATEC questionnaire, and the reported mother’s subjective opinion.

According to the EEG results in dynamics: positive advantages have been identified in the form of decreasing the index and amplitude of epileptiform activity, the area of its distribution, and increasing alpha rhythm frequency.

Discussion

The existing results of scientific studies indicate that SCs therapy does not cause any serious side effects. The use of SCs significantly improves the condition of the patients with ASD [8]. The SCs, as the tissue units of biological systems, are responsible for the regeneration and development of the organs, tissues – that is, they promote a self-renewal and differentiation into the cell lineages of different groups [9]. FSCs have a number of advantages making their clinical use the most effective method of SCs therapy, which is a promising factor for the treatment of ASD in kids. These SCs, derived from fetal tissues, possess higher potential for differentiation and capacity to self-renewal. FSCs induce an extensive differentiation potential compared to the adult SCs, as well as the lower chances of genetic and epigenetic mutations, a tendency to form tumors and immunogenicity compared to the pluripotent SCs [20]. FSCs developed ability to multiply rapidly and can differentiate into various cell types, which makes them valuable for effective clinical use. If we compare the embryonic SCs versus FSCs, fetal cells are less likely to induce an adverse immune reaction and do not lead to tumor formation.  This case of the child who received treatment with FSCs deserves a particular attention. Positive results of clinical examinations are 

confirmed by the objective instrumental data. The use of screening methods of examination and cognitive tests to identify ASD in children is regarded as universal, but not optimal tool for monitoring the treatment effectiveness. Genetic testing helps to identify certain genetic abnormalities that may be associated with the disease, but they are also not decisive for the diagnosis and assessment of the effectiveness of therapy.

Brain MRI and diffusion tensor MR imaging are ensured due to digitally processed diffusion tensor imaging (DTI) which is a modern brain imaging technique with application of a magnetic resonance imaging (MRI) to visualize the structures and connective links of the brain. Most of DTI studies in the patients with ASD demonstrate tract alterations, namely lower FA and/or higher values of the mean diffusivity (MD) over the distant anterior-posterior and interhemispheric fiber tracts [21]. For example, DTI studies have revealed abnormalities in associative tracts such as the superior longitudinal fasciculus, arcuate fasciculus, cingulum, and corpus callosum. Children with ASD have shown the altered FA, which is an evidence of atypical white matter microstructure. These changes have been correlated with the level of speech development among the patients [22,23]. Patients with ASD show a reduced structural-functional connectivity within the associative tracts such as the sagittal layer and internal capsule. Such advantages correlate with the severity of ASD symptoms, which eventually highlight the importance of a comprehensive approach to cerebral white matter investigations [24]. The clinical case that is presented above suggests a clear example of effective treatment of ASD, which is confirmed by the results of FA at the individual conductive pathways in the brain and the results of EEG monitoring. The rapid development of positive changes in the socialization and behavior of the child after the SCs therapy has been demonstrated, which is proved by the results after ATEC questionnaire assessment. Already over 1 year, we observed significant changes in the psychological and behavioral status of the child. During SCs therapy and within the whole period of follow up for a child, there was no increase of temperature, graft-versus-host reaction or the other undesirable phenomena. No activation of epileptic activity had been detected; on the contrary, FSCs treatment contributed to improvement of the bioelectrical activity of the brain.

Conclusion

The case study in a child with ASD presented here demonstrates a high therapeutic effectiveness of FSCs. Initial results showing significant clinical improvements look rather encouraging, but further observation on the stability of all treatment effects and a study on the larger number of ASD patients is needed. The treatment with FSCs administration is a promising and safe method of ASD therapy in children.

References

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Dr Maria Regina Penchyna Nieto

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.

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Dr Marcelo Flavio Gomes Jardim Filho

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!”

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Zsuzsanna Bene

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

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Dr 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.

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Lin-Show Chin

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.

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Sonila Qirko

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.

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Luiz Sellmann

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.

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Zhao Jia

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."

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Thomas Urban

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.

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Cristina Berriozabal

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.

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Dr Tewodros Kassahun Tarekegn

"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".

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Dr Shweta Tiwari

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.

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Dr Farooq Wandroo

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.

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Dr Anyuta Ivanova

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.

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Dr David Vinyes

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.

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Gertraud Teuchert-Noodt

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

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Dr 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.

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Dr Oleg Golyanovski

Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.

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Dr Susan Anne Smith

Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.

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Dr Farahnaz Fallahian

Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.

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Dr Victor Olagundoye

Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.

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Dr Susan Anne Smith

Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD

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Dr Eric S Nussbaum

Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.

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Hala Al Shaikh

Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.

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Dr Rakhi Mishra

Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.

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Dr Walter F Riesen

Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.

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Dr Jelle Lettinga

Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora

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Dariusz Ziora

Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.

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Dr Ravi Shrivastava

Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.

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Dr Aline Tollet

Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.

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Dr Chiara Giuseppina Beccaluva

Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti

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Dr Claudio Ligresti

Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.

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Dr Matteo Bonori

I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.

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Edouard Kujawski

Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell

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Dr Andriy Sinelnyk