AUCTORES
Globalize your Research
Research Article | DOI: https://doi.org/10.31579/2640-1045/086
*Corresponding Author: Gninkoun Comlan Jules, Service d’Endocrinologie & Diabétologie du CNHU-HKM, Faculté des Sciences de la Santé, Cotonou (Bénin).
Citation: Comlan J GNINKOUN, Finagnon A WANVOEGBE, Joseph S FANOU, Calice S TOFFOHOSSOU, F DJROLO. (2021). Seasonal Variations of Hyperglycemic Crises in Diabetic Patients at a National Hospital Center, Benin: a Cross Sectional Study. Endocrinology and Disorders. 5(6): DOI:10.31579/2640-1045/086
Copyright: © 2021 Gninkoun Comlan Jules, 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: 10 August 2021 | Accepted: 03 September 2021 | Published: 10 September 2021
Keywords: diabetes ; complications; hyperglycemic crises; infections ; climate
Aim : To study the seasonal characteristics of hyperglycemic decompensations in the endocrinology department of the CNHU-HKM of Cotonou.
Materials and methods :It was a cross-sectional, descriptive, and study of diabetic patients hospitalized from January 1, 2010 to December 31, 2019. Diabetic patients hospitalized for ketosis decompensation and/or hyperglycemic hyperosmolar syndrome were included in this study. The meteorological data used were obtained from the climate observation network of the Direction de la Météorologie Nationale (DMN) du Bénin. We have considered the means of rainfall and temperature per month and per year.
Results : A total of 613 patients were included during the study period. The mean age of the patients was 46.77±15.84 years. The frequency of hyperglycemic hyperosmolar syndrome and ketoacidosis was 14.7% and 69.5% respectively. Hyperglycemic crises were more frequent during the rainy season and periods of low temperature. The main precipitating factors were infections and non-adherence to treatment. The main infectious sites involved in hyperglycemic crises were pulmonary (19%), urogenital (21.3%) and malaria (26.8%). The frequency of these different infections was higher during the rainy season with a statistically significant difference (p=0.02) for malaria.
Conclusion : The frequency of hyperglycemic crises was high and had a seasonal distribution. The most frequent precipitating factors were infections and non-adherence to treatment. Those factors were more frequent in the rainy season.
Diabetes mellitus is a public health problem that concerns every continent. According to the International Diabetes Federation (IDF), the number of people living with diabetes will rise from 19 million in 2019 to 47 million by 2045 [1] in Africa region. Its course can lead to complications such as hyperglycemic crises including diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome [2]. In West Africa, the prevalence of ketoacidosis is high and ranges from 28.99% to 59.1
This study was carried out in the endocrinology and metabolism department of the Hubert Koutoukou Maga National University Hospital Center (CNHU) in Cotonou. It was a cross-sectional, descriptive study of diabetic patients hospitalized from January 1, 2010 to December 31, 2019. Diabetic patients hospitalized for ketosis decompensation and/or hyperglycemic hyperosmolar syndrome were included in this study.
Study population was constitued by patients with diabetes of both genders hospitalized in the endocrinology and metabolism department of the Hubert Koutoukou Maga National University Hospital Center (CNHU) in Cotonou. Data were collected using a questionnaire established for the needs of the study Inclusion criteria All diabetic patient who has been hospitalized during the study period was included. Exclusion criteriaPatients with an incomplete medical records were not includedSample size We have done a complete recruitment of all cases of ketosis decompensation and Hyperosmolar hyperglycemic syndrome during the study period.
The ketosis decompensation of diabetes mellitus was defined by a glycemia ≥ 250 mg/dL and a ketonuria ≥ two crosses with positive glycosuria [14].
Hyperosmolar hyperglycemic syndrome was defined by an hyperglycemia greater than or equal to 600 mg/dL and an osmolarity greater than 320 mOsmol/L [15].
When the patient presented with both ketotic decompensation and hyperosmolar hyperglycemic syndrome, we retained a combined decompensation.
The following variables were collected: age, gender, profession, duration of diabetes, type of diabetes, decompensation factors, blood glucose, glycosuria, ketonuria, test for malaria, bacteriological analysis of urine, chest X-ray, blood culture.
Infectious sites were classified as follows
Pneumonia was considered when there were clinical symptoms suggestive such as fever, chest pain, sputum cough, and pulmonary condensation syndrome, systematized opacities, non-retractile with or without a bronchogram on the chest X-ray
The urinary tract site was retained in the presence of mictional burning, pollakiuria, dysuria, or hypogastric pain, with a bacteriological analysis of urine showing ≥104 leukocyturia and ≥105 bacteriuria [16].
The genital site was retained in a woman with symptoms such as vulvar pruritus, leukorrhea.
The meteorological data used were obtained from the climate observation network of the Direction de la Météorologie Nationale (DMN) du Bénin. The climatological parameters considered were temperature (in °C) and the rainfall (in mm). The average monthly values of these parameters for each year has been considered. Cotonou is characterized by two rainy seasons and two dry seasons: a long rainy season from mid-March to mid-July; a short dry season which begins in mid-July and ends at the end of August; a short rainy season that starting in September and ends in mid-November; and a long dry season that runs from mid-November to mid-March [17].
The source of data was the records of hospitalized diabetic patients and the hospitalization register, and for the climatological data, the climate observation network of the National Meteorological Department (DMN) was used. We checked the consistency of the data and outliers and duplicates were removed. Data management and analysis were performed using SPSS software version 21 and R software version 3.6.1. The qualitative variables had been described as proportions and the quantitative variables as position parameters. Comparisons of means were made using the t-test and comparisons of proportions were done using the Chi-square test or Fisher's test as required. A p value <0>
Study population characteristics
A total of 613 patients were included during the study period. The mean age of the patients was 46.77±15.84 years, and there was a slit predominance of women The other general characteristics of the study population are shown in Table 1.
Hyperglycemic crises and seasons
The frequency of hyperglycemic crises was high during the rainy seasons (Figure 1 and 2). Moreover, the number of cases of hyperglycemic crises was positively correlated with rainfall and low temperatures (August) (figure 3).
Precipitating factors of hyperglycemic crises and seasons
The main precipitating factors for hyperglycemic crises were infections (59.32%), non-adherence to treatment (19.32%) and malaria was the most frequent infection (26.8%). (Table 2)
The frequency of malaria, urogenital infections and pneumonia was higher during the rainy season and respectively represented 60.19%, 62.20% and 58.90% of cases with a statistically significant difference for malaria. (Table 3)
We have determined from retrospective hospital data over a decade the prevalence and the precipitating factors of hyperglycemic crises according to the different seasons of the year in a tropical region among diabetic patients. The current study found that the prevalence of hyperglycemic crises was higher during rainy seasons and periods of cold weather. Another important finding was the high prevalence of infections, in particular malaria, in diabetic patients during rainy seasons.
Indeed, 57.19% of the cases of hyperglycemic crises had been diagnosed during the rainy season versus 42.81% of them during the dry season. When considering the climatological data of rain and temperature, the number of cases of decompensation was positively linked to the precipitation (Figure 5). These results are in agreement with Lontchi-Yimagou et al [13] findings in Cameroon which showed a high incidence of hyperglycemic crises during October, a month of heavy rainfall in their study. This high number of cases during periods of heavy rainfall could be related to the increased frequency of the most important precipitating factors such as infections (59.32%). A possible explanation for this might be that infections induce hyperglycemia by a considerable increase in the global metabolism and turnover of glucose, while its oxidation is barely increased [18]. Another possible explanation for this is that other seasonal conditions may contribute to hyperglycemia. Indeed, these conditions may include eating habits and lifestyle changes. In the rainy season, there is a decrease in physical activity due to frequent rainfall and a proneness to consumption of high-calorie meals that could contribute to hyperglycemia [13].
Low temperatures (July-August-September), especially in August, were also associated with a higher number of cases of hyperglycemic crises whereas precipitation decreased (Figure 5). These findings are in agreement with those obtained by other authors such as Butalia et al [19] and Chin-Li Lu et al [20]. Butalia et al. [19] reported an increase in the incidence of cases of ketoacidosis in type 1 diabetics during the winter, and especially during the month of December. Chin-Li Lu et al. [20]. noted a higher incidence of hyperglycemic crises in the winter compared to the summer. However, there are studies that report an increase in the incidence of ketoacidosis in equatorial countries. These authors suggest that the high temperature in equatorial countries results in more rapid dehydration and acute hyperglycemia, more particularly in young children [21, 22].
The main infectious sites involved in hyperglycemic crises were pulmonary (19%), urogenital (21.3%) and malaria (26.8%). These results are in keeping with previous observational studies [8,22]. This also accords with our recent and earlier observations, which showed similar prevalences of pulmonary and urogenital sites (18.04% and 23.3% respectively) [2]. Moreover, in the same study, malaria was the most frequent infection (32.33%). The frequency of infections, especially malaria, was higher during the rainy season. Seasonality of infections is well known and described in the literature. These variations seem to be related to environmental conditions, including temperature, precipitation, humidity, insolation, pH and salinity [24]. In the United States, the prevalence of bacterial pneumonia is higher during the mid-winter period [25]. Seasonal variations of malaria are well known in Africa and climate being the main factor influencing the development of malaria. Malaria is a disease closely linked to the availability of liquid water in the environment and to favorable temperatures for the development of Anopheles mosquitoes which are malaria transmitters [26]. The rainy season seems to provide the necessary conditions for the development of these mosquitoes, resulting in high malaria transmission during this period. The metabolic impact in the diabetic patient is hyperglycemia, which may lead to hyperglycemic crises.
This is the first study that has documented the seasonalty of hyperglycemic crises and their precipitating factors in Benin. The frequency of hyperglycemic crises was high and seasonally related. The incidence of hyperglycemic crises was higher during the rainy season. The most frequent precipitating factors were malaria and non-adherence to treatment. Educating diabetic patients about mosquito control and the use of insecticide treated bed nets could contribute to reducing the frequency of decompensation, especially during the rainy season.
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.
