AUCTORES
Globalize your Research
Review Article | DOI: https://doi.org/10.31579/2639-4162/275
1Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt.
2PhD Student in Maternal and Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt.
3Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Menoufia University, Egypt.
*Corresponding Author: Hanan Elzeblawy Hassan, Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt.
Citation: Hanan E. Hassan, Abd-ELhakam FH, Ali Kasem EK, (2025), Hyper-Androgenic Symptoms and Infertility in Northern Upper Egypt: Impact of Lifestyle Modification, J. General Medicine and Clinical Practice, 8(6); DOI:10.31579/2639-4162/275
Copyright: © 2025, Hanan Elzeblawy Hassan. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 16 May 2025 | Accepted: 06 June 2025 | Published: 25 June 2025
Keywords: lifestyle; modification; infertile women; hyper-androgenic symptoms
Background: Obese women with hyperandrogenism require dietary changes and regular exercise as first-line treatments.
Aim: Study the impact of a lifestyle adjustment program on overweight and obese hyperandrogenic infertile women.
Subjects and Methods: A purposive sample of 116 hyper-androgenic infertile overweight women at gynecological/infertility clinics/specialized medical centers at Beni-Suef university hospital used a quasi-experimental research design. Tools: (1): Arabic A structured interview questionnaire contains: (a) basic sociodemographic characteristics. (b) modified Ferriman-Gallwey, Global Acne Grading System, and Ludwig Scale. (2): Lifestyle habits, and Block Adult Physical Activity Screener.
Results: After intervention, significant associations were observed between alopecia, hirsutism, and vulgaris levels and physical activity/lifestyle dietary habits among infertile overweight and obese women (p<0.05). All women (100%) reported negative pregnancy tests before-intervention, while 36.2% got positive tests post-intervention. A statistically significant relationship was observed between the study and control group after lifestyle modification program implementation (p<0.05).
Conclusion: Lifestyle modification significantly improves androgenic alopecia, acne vulgaris, and hirsutism levels in infertile overweight and obese women, thereby enhancing their fecundity-related decline and hyper-androgenism.
Recommendations: Nurses as counselors should provide counseling and guidance and have the responsibilities to teach among infertile overweight women lifestyle modification, as it offers a great challenge in today’s world.
Hyper-androgenism, often exacerbated by obesity, is the primary cause of poly cystic ovary syndrome (PCOS), characterized by excessive androgen synthesis and overexpressed luteinizing hormone receptors (Zeng et al., 2020). Hyperandrogenemia, a clinical sign of PCOS, occurs when estrogen's negative feedback to the brain decreases, leading to increased frequency of the LH puls (Morshed et al., 2021). Approximately 60% and 100% of PCOS patients have hyperandrogenism, which manifests both clinically (as in the case of hirsutism, alopecia, and acne) and biochemically (Ashraf et al., 2019). Biochemical hyperandrogenism, defined as testosterone, androstenedione, and/or DHEA-S levels above the top 95th percentile in 98 healthy, non-hirsute eumenorrheic women, is challenging to assess due to lack of consensus on detection methods (Kanbour et al., 2022).
Clinical signs of high levels of androgen in females are hirsutism, acne, and female pattern hair loss (formerly known as androgenic alopecia). Hirsutism, or excessive terminal hair growth with a masculine pattern distribution, affects 60%–70% of PCOS patients (Kamenov & Gateva, 2020). Adolescent females often experience comedonal acne, but moderate or severe cases during early puberty or mild inflammatory acne during perimenarcheal years are rare (5% frequency) (Carmina et al., 2022). Although biochemical hyperandrogenism and acne are linked, the prognostic significance of acne alone is uncertain (DiVall, 2023). Female androgenetic alopecia (FAGA) is a common non-scarring alopecia in women, causing generalized hair loss in the center scalp, with the frontal hairline typically preserved (Kamenov & Gateva, 2020). Lifestyle modification is the first-line treatment for hyper-androgenic symptoms, which have been found to restore ovulation and increase pregnancy rates in overweight or obese anovulatory patients (Gu et al., 2022; Sheha et al., 2018; Mohamed et al., 2024; Hassan et al., 2019; Hassan & Farag, 2019; Hassan et al., 2025). Nurses can positively impact women with hyper-androgenic symptoms through counseling, education, and support. They can help patients with low self-esteem, educate them about risk factors, encourage healthier habits, and suggest support groups (Wright et al., 2020; Hassan et al., 2015; Mostafa et al., 2018; Nady Fet al., 2018; Mohammed et al., 2018).
Significance Of the Study
Hyperandrogenism's stigmatizing clinical features like hirsutism, acne, alopica, and infertility may contribute to anxiety and emotional discomfort (Wang & Li, 2021, Hassan & Farag, 2019). In Upper Egypt, infertility is a significant social burden for women, leading to childlessness and social stigma, causing feelings of incompleteness, blame, pressure, and threats to marriage (Hassan, 2016; Gamel et al., 2019; Hassan et al., 1015). Researchers suggest diet, exercise, and weight loss as the first line of treatment for PCOS girls, prior to pharmacological treatment (Afefy et al., 2019). Medical professionals can help PCOS-affected girls adjust their lifestyles, as even a 5% weight loss can improve hyperinsulinemia, decrease testosterone levels, and restore menstrual periods (Mani et al., 2018). Obese women with hyperandrogenism benefit from dietary changes and exercise, as even small lifestyle changes can significantly improve insulin sensitivity and reestablish ovulation (Yesiladali et al., 2022). So, this study will be conducted to evaluate the effect of lifestyle modification on hyper-androgenic symptoms among infertile obese and overweight women, and therefore, enhance fertility and alleviate infertility.
Operational definitions:
Lifestyle Modification Interventions
Lifestyle modification interventions are behavioral strategies aimed at altering various lifestyle health behaviors.
Hyper-Androgenism
In this study discusses a condition where the ovaries produce abnormal amounts of androgens, typically present in women in small amounts.
Aim of the study:
This study aims to evaluate the impact of lifestyle modification on hyper-androgenic symptoms in infertile obese and overweight women, aiming to improve fertility and alleviate infertility.
Study hypotheses:
Hyper-Androgenic infertile overweight and obese women who will receive lifestyle modification interventions will experience an improvement and decrease hyper-androgenic symptoms, that in turn will that improve their fertility than those who don’t attend.
Research design:
A quasi-experimental design (Study-Control) was utilized to fulfill the purpose of this study.
Study setting
The study was conducted at gynecological and infertility outpatient and inpatient clinics and specialized medical center for the treatment of infertility and delayed childbearing affiliated with Beni-Suef University Hospital.
Sample
Sample type and size:
A purposive sample of hyper-androgenic infertile overweight and obese women will be selected, meeting specific criteria for hyper-androgenism, reproductive age (18-40 years), and body mass index >25kg/m2.
Sample size calculation
The equation for calculating sample is size adopted from Kadam & Bhalerao (2010) at power of 80%, confidence level of 95% and margin of error of 5%. The sample size was estimated to be 115 women (Study-control). Using the following equation:
The variables in this formula are: n & n' are sample size, z is the z score which is 1.96, ε is the margin of error which is 0.05, N is the population size which is 163, p̂ is the population, proportion which is 50 % or 0.5
Sampling procedure:
The study aims to compare lifestyle modification for women with hyper-androgenism, with 116 women divided into two groups: the experimental group, receiving lifestyle modification, and the control group, taking routine care. Patients will be interviewed twice before and after interventions.
Tools of data collection: two main tools were utilized in collecting data:
Tool (1): Arabic Structured interviewing questionnaire adapted from Mostafa et al., (2012) divided into two parts:
Part I. The data includes basic demographic information such as telephone number, age, residence, marital status, employment, length in centimeters, and weight in kilograms, waist circumference, and thigh circumference.
Part II. Features of hyper-androgenism included questions about hirsutism, acne, and androgen-related alopecia.
Scoring system: The Ludwig scale assesses androgenic alopecia severity, ranging from Stage I, which begins with head thinning, to Stage II, where the scalp shows, and Stage III, where hair loss occurs.
Tool (2): Lifestyle and habits characteristics that divided into:
Part I: The study collected data on women's nutrition habits, including food and soft drinks, using a five-point scale and assessing their total score using sub-scores (0=daily, 1=4-5 per week, 2= 2-3 times a week, 3=once, and 4=rarely). Poor habits are those with scores below 60% of total scores, ranging from 0-21.5, and good habits are those with scores are 21.6-36.
Part II: The Block Adult Physical Activity Screener is a tool used to predict physical activity levels in adults. It assesses job-related, daily life, and leisure activities, using data from a large US sample. The tool measures responses on nine items, with sub-scores ranging from mild to vigorous. (Sternfeld et al., 2009). The total score was assessed by summation of sub-scores different levels of physical activity, ranging from moderate to vigorous, based on the total score; Mild physical activity (sedentary life) if score is < 25>
Validity of Tools:
Five qualified experts reviewed and modified an instrument for content accuracy, internal validity, completeness, and clarity, incorporating suggestions and incorporating suggestions into the instrument for overall validity.
Reliability of Tools:
The instrument's reliability was computed by the researcher to test its internal consistency. The researcher used test-retest reliability. It was accomplished by giving the same instrument to the same subjects in comparable circumstances two or more times. Scores from repeated testing were compared to the consistency of the results over time. All dimensions of the instrument were internally reliable, with Cronbach’s α scores ranging from 0.70 to 0.97 for tool (I) and 0.80 to 0.95 for tool (II).
The researcher tested the instrument's internal consistency using test-retest reliability, administering it to participants under similar conditions on multiple occasions. Results showed internal reliability, with Cronbach's α scores ranging from 0.70 to 0.97 for tool (I) and 0.80 to 0.95 for tool (II).
Administrative approvals:
An official letter was taken from the Dean of the Faculty of Nursing, Menoufia University contain the title and objectives of the study and was submitted to the director of Beni-Suef university hospital to obtain the official agreement to conduct the study. An official permission was obtained to carry out the study from the directors of the above-mentioned settings.
Ethical Considerations:
The study received official approval from ethical and research counsels at Menoufia University, and informed oral consent from all women after explaining the study's nature and purpose.
Pilot study:
A pilot study was conducted on 10% of the study sample (10 women) to assess applicability, efficiency, tool clarity, and feasibility of fieldwork, identifying potential obstacles.
Field Work:
The study, which spanned six months, began in October 2023 and concluded in March 2024, involving preparatory, interviewing, data gathering, planning, implementation, follow-up, and evaluation phases.
Phase I (preparatory phase):
The researcher conducted a literature review, developed data collection tools, and tested their validity through a jury of experts to ensure content, knowledge, accuracy, and relevance of the tools.
Phase (1I): Interviewing and data gathering phase:
Researchers conducted a pre-test phase for hyper-androgenic infertile overweight and obese women, assessing socio-demographic characteristics, lifestyle habits, and baseline measures related to hyper-androgenism. Oral consent was obtained, and full anthropometric measurements were performed.
Phase III (Planning phase):
The researcher surveyed women at gynecological and infertility outpatient clinics and specialized medical centers for treatment of infertility and delayed childbearing, based on assessment data and literature review.
Phase IV (the intervention phase) (program implementation for the study group only)
The study implemented a lifestyle modification intervention for women aiming for 5-10% weight loss or a BMI below 29 kg/m2 within six months. The study participants were provided with a lifestyle change program through three educational sessions with duration of approximately 60 minutes for each session. Hyper-androgenism definition, symptoms, and complications, in addition to the importance of weight reduction, were discussed during the 1st session, while the 2nd and 3rd sessions were concerned with instructing the women about energy-restricted diet, eating behaviors, and physical activity.
Supportive material (Arabic Booklet): The researcher created a handout booklet in Arabic, detailing the definition, symptoms, risk factors, diagnosis, medical treatment, and lifestyle modification for polycystic ovary syndrome, including exercise and diet.
Phase V: Evaluation phase (Follow-up Schedule and Outcomes Evaluation)
Arabic card was constructed by the researcher to assess the outcome measures. Follow-up card examination documented assessment signs of hyperandrogenism (Hirsutism, Acne, and Androgenic alopecia). The study followed up with monthly interviews, SMS or phone calls, regular appointments, and weekly logs to track diet and exercise patterns. After 6 months, researchers evaluated anthropometry, menstrual cycle, hirsutism, and acne grade. The evaluation (posttest) was carried out two weeks to one month after the completion of the program for both the control and study groups. The control group received only routine care during the intervention period, and they were given the educational booklet after the posttest for ethical aspects.
Statistical Analysis: -
The data was analyzed using SPSS (version 25), Excel, and chi-square (χ2) test, and presented in frequency distribution tables, numbers, and percentages. The significance level was set at a P value of <0>
Figure 1 shows the total hirsutism levels among the studied women. It reveals that 45% of the study group had moderate hirsutism, before the intervention, compared to 23
Figure 1 shows the total hirsutism levels among the studied women. It reveals that 45% of the study group had moderate hirsutism, before the intervention, compared to 23
The current study findings revealed that nearly half and more than one-third of the study and control groups had moderate hirsutism before the intervention, respectively. After the intervention, about two-thirds of the study group had no terminal hair visible. Meanwhile, there were no statistically significant differences between study and control groups, neither before nor after the intervention. These findings came in agreement with Niranjani et al. (2022). Their study found that the non-interventional group showed no improvement in the Modified Ferriman Gallwey scale (Hirsutism) score during Pre-test through Post-test 2, while group A and group B showed a 1 score decrease. However, the study contradicts Pramod et al.'s (2023) findings, which found less than 25% of overweight and obese women with PCOS had dark hair growth, possibly due to different populations. Regarding acne vulgaris levels, the study found an improvement in acne vulgaris levels after an intervention, with most participants experiencing milder acne, but no significant differences were found between the study and control groups. This was in concordance with Niranjani et al. (2022), who revealed that in the global acne grading scale (acne), during pre-test through post-test 2, the non-interventional group showed no improvement in score, whereas group A and group B showed a 2 score decrease. This may be explained by the fact that the majority of girls had a wish to have a have a good body image and conceive in the future and, therefore, had a greater incentive to adhere to the change in their lifestyle. The study contradicts Smith et al.'s (2007) findings, which found no acne-fighting effect of chocolate compared to a placebo bar. The study's findings differences may be due to differences in overweight and obese women with PCOS. Regarding androgenic alopecia levels among the studied hyper-androgenic infertile overweight and obese women, the current study findings revealed that there is an improvement in alopecia levels after the intervention for the study group. Two-fifths of the study group suffered from stage II (hair loss with visible scalp) androgen alopecia before the intervention, which was reduced to one-quarter. Moreover, more than two-thirds of them were having stage I (minor thinning not noticeable) after the intervention. Meanwhile, there were statistically significant differences between study and control groups after the intervention.
These findings came in agreement with Niranjani et al. (2022), and supported by Roya et al. (2021), who studied "study of prevalence, phenotypic features, and lifestyle modifications of polycystic ovarian syndrome patients". They revealed that Lifestyle modification (LSM) can improve hyperandrogenism symptoms and PCOS severity by promoting an active lifestyle and healthy dietary habits, which reduce weight, insulin resistance, free testosterone, and hair loss. Regarding pregnancy rate, the current study findings revealed that there were significant improvements in fertility and ovulation after the lifestyle modification intervention; about more than one-third of the study had positive pregnancy tests after intervention. The current results are supported by Alwahab et al. (2018), who studied “A ketogenic diet may restore fertility in women with polycystic ovary syndrome” and revealed that half of the study group had a positive pregnancy test after intervention. On the contrary, these findings were incongruous with those of Hamadi (2018), who studied “Public Health Nutrition Intervention to Enhance Healthy Eating and Lifestyle Modification among Lebanese Women with Polycystic Ovarian Syndrome", who showed that nearly three-quarters of the study group had a positive pregnancy test after lifestyle intervention. These differences might be attributed to populations’ cultural differences and lifestyles between Egyptian and Lebanese women.
The study shows improvement in lifestyle and daily habits among hyper-androgenic infertile overweight and obese women, with most exhibiting improved habits post-intervention, while less than one-third of the control group showed improvement. These results came in agreement with Eleftheriadou et al. (2015), who study “Dietary Habits in Adolescent Girls with Polycystic Ovarian Syndrome" and found that adolescent PCOS patients' poor eating habits may lead to obesity in later life, requiring early lifestyle interventions to address long-term health risks. Furthermore, George (2021) found that poor lifestyle dietary habits among participants contribute to increased body weight and long-term health risks, requiring early lifestyle interventions. Regarding total physical activity levels among the studied hyper-androgenic infertile overweight and obese women. The current study findings revealed that there is an improvement in total physical activity. Most of the study and control groups had mild physical activity (sedentary lifestyle) before the intervention, compared to two-thirds of the study group after the intervention having moderate physical activity. There is a statistically significant difference between the study and control groups after the intervention.
These results came in agreement with Wang et al. (2021), who studied “Effectiveness of a 6-month lifestyle intervention on diet, physical activity, quality of life, and markers of cardio-metabolic health in women with PCOS and obesity and non-PCOS obese controls” and showed that A 6-month lifestyle intervention led to a decrease in high-calorie snacks and increased moderate to vigorous physical activity among women, benefiting health, reduced morbidity, and improved mood, and predicting long-term weight maintenance. Moreover et al., (2023) revealed significant improvements in hyperandrogenism and dyslipidemia can be achieved with lifestyle changes (diet and exercise) that result in a small to moderate weight loss of about 5%-10%. However, Zhang et al. (2018) found no significant differences in physical activity between the PCOS and control groups, contradicting the current study. Also, Mutsaerts et al. (2013) found that women with PCOS did not exhibit a significant change in lifestyle or physical activity compared to non-PCOS obese controls. This disagreement may be attributed to the type and intensity of physical activity.
The current study findings revealed that there is a statistically significant association between of hyper-androgenic feature (Hirsutism, Acne, Alopecia) improvement and lifestyle habits in the study group of hyper-androgenic infertile overweight and obese women. Abdolahian et al.'s 2020 meta-analysis supports the findings, indicating that dietary and physical activity modification can enhance hirsutism. Patnode et al. (2017) and Fathey et al. (2022) conducted meta-analyses, revealing that exercise intervention did not positively affect androgenic traits. The disagreement may stem from differences in interventions and populations studied, but low-calorie diets may improve reproductive system dysfunctions, menstrual irregularities, and fertility in women (Mani et al., 2018). But was not similar to the meta-analysis of 14 studies involving 617 adult women achieved by Benham et al. (20180), who studied “Role of exercise training in polycystic ovary syndrome" and found out the impact of exercise interventions on reproductive function remained unclear. This disagreement could be due to differences in the type and duration of interventions and populations studied.
Lifestyle modification interventions have a significant positive effect on androgenic alopecia, acne vulgaris, and hirsutism levels for infertile overweight and obese women, which in turn improve women’s fecundity-related decline hyper-androgenism.
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.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
