AUCTORES
Globalize your Research
Review ariticle | DOI: https://doi.org/10.31579/2690-4861/483
1Neonatal intensive care unit, Mother-Child Hospital, Mohammed VI University Hospital, Marrakech.
2Childhood, Health and Development Research Laboratory, FMPM, Cadi Ayya University, Marrakech, Morocco.
3Department of Microbiology, CHU Mohamed VI, Marrakech, Morocco.
*Corresponding Author: O.Assem, Neonatal intensive care unit, Mother-Child Hospital, Mohammed VI University Hospital, Marrakech
Citation: O.Assem, F.Bennaoui , F.Tahiri, A.Lalaoui, K.Abi Alalaa, et al, (2024), The characteristics and therapeutic management of nosocomial neonatal meningitis in Serratia Marcescens in a Moroccan neonatal unit, International Journal of Clinical Case Reports and Reviews, 18(4); DOI:10.31579/2690-4861/483
Copyright: © 2024, O.Assem. 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: 15 May 2024 | Accepted: 24 May 2024 | Published: 02 August 2024
Keywords: Serratia marcescens, meningitis, epidemics and newborns
Introduction : Meningitis in Serratia marcescens (S. marcescens) are rare but potentially serious, especially in newborns. They require rapid identification, adequate management combined with rigorous aseptic rules.
Objective: Report the experience of our department in the management of neonatal meningitis due to S. marcescens.
Material and methods: Retrospective study of 4 cases of neonatal nosocomial meningitis due to S. marcescens hospitalized in the neonatal intensive care unit at Marrakech University Hospital during an epidemic between January and March 2023.
Results :Of 32 patients who developed a nosocomial S infection. marcescens12.5% presented meningitis with the same organism. The average term was 35.2 weeks of amenorrhea. The average age of admission was 2.6 days. The average time between hospitalization and development of meningitis was 4.5 days. Clinically: 3 patients presented a fever, 2 developed hypotonia with refusal to breastfeed and one presented generalized convulsions, a bulging fontanelle with an increase in head circumference. Pleocytosis, hyperproteinorachia and hypoglycorachia were constant in all our patients. We noted resistance to all antibiotics in all cases. All of our patients had at least onepositive blood culture S. marcescens. Transfontanellar ultrasound revealed ventriculitis in a newborn. All of our patients benefited from geographic isolation and were treated with Meropenem and Amikacin. The evolution was favorable in 3 newborns and we noted the death of only one case (low weight).
Conclusion: Early identification of patients with this type of meningitis and rapid implementation of control measures are essential to curb the spread of this severe infection.
THENosocomial infections represent a serious health problem in neonatal intensive care units due to the morbidity and mortality they cause as well as the difficulty of their management. S. marcescens is an omnipresent opportunistic pathogen from the Enterobacteriaceae family which belongs to the Gram-negative bacilli (GNB) and whose eradication from the environment is very difficult [1]. Nosocomial S. Marcescens infections are rare in newborns and often described as epidemics [1,2]. The infection can occur in the form of pneumonia, bacteremia, conjunctivitis, urinary tract infections and even gastroenteritis and exceptionally meningitis, hence the interest of our work which illustrates a series of 4 cases. Meningitis caused by this germ is serious because of its high morbidity and mortality, the neurosensory aftereffects that can be caused and the immune fragility of the newborn, hence the importance of initiating, as soon as this germ is diagnosed, appropriate measures. control before its spread which can be spectacular.
This is a retrospective descriptive study of 4 cases of neonatal nosocomial S marcescens meningitis, carried out at the neonatal intensive care unit (NICU) of the Mohammed VI University Hospital, Marrakech, Morocco. During the fourth epidemic of this germ, between January and March 2023. Our study population included newborns hospitalized in the NICU, whose postnatal age ranged from 0 to 28 days. The diagnosis of nosocomial meningitis due to S. marcescens was made based on the lumbar puncture culture. Data collection is done from an individual file. The literature review was carried out on Pub-Med using the following key words: Serratia marcescens, meningitis, NICU, epidemics and newborns.
Of 32 patients who developed a nosocomial S infectionmarcescens, 4 patients or 12.5% presented meningitis with the same germ, including 3 boys and one girl. The average term of our patients was 35.2 weeks of amenorrhea. The average age of admission was 2.6 days with extremes ranging from1 to 4 days. The average time between hospitalization and the development of S. meningitis. Marcescens was 4.5 days[3 and 6].Concerning the clinical signs: 3 patients presented a fever, 2 developed hypotonia with refusal to breastfeed and one presented generalized convulsions, a bulging fontanelle with an increase in head circumference. On a biological level, Pleocytosis and hypoglycorachia were constant in all our patients and the average proteinorachia in our series was 2.7g/l.[1,6 and 8].We noted Resistance to all antibiotics in the 4 cases. CRP above 40 mg/l and neutropenia were constant in all patients. All of our patients had at least onepositive blood culture with the same germ. Transfontanellar ultrasound was normal in 3 patients and revealed ventriculitis in one newborn. On the therapeutic level, all our patients benefited from geographical isolation with the application of barrier measures and they were all treated by the combination of Meropenem and Amikacin, Ciprofloxacin was used in the patient presenting with ventriculitis, this same patient benefited from an external ventricular bypass. The average duration of treatment was 6 weeks. The seizures were treated with phenobarbital. Control lumbar puncture was performed in 2 patients and they were sterile with an interval of 8 days. The evolution was favorable in 3 newborns and we noted the death of a single case in the context of septic shock (low weight). The 3 surviving patients benefit from regular check-ups during development consultations in order to monitor their progress.
Appearance of ventriculitis on trans-fontanellar ultrasound
S. marcescens is a pathogen capable of colonizing the hospital environment, particularly intensive care units, with considerable capacity to develop intrinsic resistance against different families of antibiotics, hence the difficulty of its therapeutic management [3,4]. Until the end of the 20th century, S. marcescens was considered a non-pathogenic saprophytic organism, the first known outbreak of this bacteria was noted in 1951. Since then, infections with this organism have been reported with increasing frequency [ 5.6]. In the history of our service we have
experienced 4 epidemics of this kind [7,8], the last and most important was between January and March 2023 with 32 cases including 4 cases of meningitis. Contaminated hands represent the major vector of its transmission. Others Sources of contamination have been reported in the literature: catheters, dialysis machines, Propofol and liquid soap [9-10]. Although this microorganism has relatively low virulence, it causes serious nosocomial infections in immunocompromised or critically ill patients, particularly in neonatal units [11,12]. S. marcescens infection an be located in several organs (keratitis, conjunctivitis, urinary and respiratory tract, surgical wounds and gastrointestinal tract), systemic location is the most common while meningeal waiting remains rare[13]. Recently several cases of cerebro-meningeal complications caused by S. marcescens have been reported, namely meningitis, brain abscesses and empyema. It is recommended to systematically perform brain imaging and more particularly transfontanellar ultrasound even in the absence of neurological signs [14]. The statistically significant risk factors for this infection reported in the literature are: low birth weight (less than 1,500 g), gestational age greater than 37 weeks and mechanical ventilation [4]. Other risk factors common to all nosocomial infections were illustrated: the length of hospitalization, the prescription of broad-spectrum antibiotics and the use of invasive therapeutic methods (umbilical catheter, intubation, bladder catheterization and parenteral nutrition). [15]. In our population all newborns were premature and 75% were artificially ventilated, the average weight recovered was 1750 g and 50% of newborns had an umbilical venous catheter. Therapeutically, preventive measures are essential for controlling the spread of this infection [16, 17]. For this, a certain number of measures were taken, in our department, from the diagnosis of the first case, in particular the raising awareness among medical and paramedical staff of the importance of hand hygiene, the use of double protection with gloves, the technical and geographical isolation of infected patients, and the disinfection of any surface or material likely to be contaminated. S. marcescens often presents high resistance to cephalosporins [18, 19]. the rate of resistance to cephalosporins was 100% in our series. The choice of antibiotic therapy differs depending on the results of the antibiogram; meropenem in combination with Amikacin started early gave satisfactory results in our unit. Ciprofloxacin was started in a patient who presented radiological signs of ventriculitis. Corticosteroids have no indication in neonatal meningitis because they do not modify mortality or neurological sequelae [20]. Phenobarbital has been used in the treatment of neonatal meningitis accompanied by seizures. In the study by Chemsi et al, it was used in 51% of cases with an average duration of 7 days [21]. Neonatal nosocomial meningitis has a terrible prognosis, despite the great progress made in diagnostic and treatment methods. The mortality rate of this infection varies from 14.3% to 62.5% of cases [7]. It is currently estimated between 6.6 and 13% in industrialized countries, compared to 20 to 30% in the 1990s [8]. In developing countries, this rate remains high, ranging from 27 to 58% [14, 15]. The high mortality of neonatal meningitis is explained by a certain number of factors which determine the prognosis: the diagnostic delay, the virulence of the germ, the gestational age and the precocity of the meningitis. Other prognostic factors must be taken into account such as vulnerability of the neonatal nervous system, immuno-incompetence, hypotrophy and neonatal distress [22,23]. The need for repeat lumbar puncture during treatment in a newborn with this type of meningitis has been debated. Some experts recommend a 2nd lumbar puncture routinely 48 hours after the start of treatment, while others suggest performing a 2nd lumbar puncture if clinical conditions have not improved after 24 to 72 hours of treatment. A multicenter retrospective study by Greenberg et al showed no significant difference in the mortality rate between two groups of newborns with confirmed bacterial meningitis, the first of whom received a single lumbar puncture while the second had two or more lumbar punctures [24]. In our patient Radiological monitoring was carried out in our patient every 15 days and a hearing screening was negative. We did not note any clinical or para-clinical abnormalities after 6 months of follow-up.
Nosocomial S. Marcescens infections are beginning to become widespread in neonatal intensive care, often in epidemic form. We have experienced 4 episodes of this kind in our department. Meningitis caused by this germ is responsible for significant morbidity and mortality and poses a real problem of acquiring resistance to antibiotics. Early identification of patients with this type of meningitis and rapid implementation of control measures are essential to curb the spread of this severe infection. Short to medium and long term monitoring is necessary to detect neurosensory sequelae.
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.
