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Research Article | DOI: https://doi.org/10.31579/2578-8965/278
1Department of Obstetrics and Gynaecology, Abia State University Teaching Hospital, Aba, Nigeria.
2Department of Biochemistry, Lead City University, Ibadan, Oyo State, Nigeria.
*Corresponding Author: Christian O. Onyemereze, Department of Obstetrics and Gynaecology, Abia State University Teaching Hospital, Aba, Nigeria.
Citation: Edmund O. Ezirim, Emmanuel M. Akwuruoha, Chyke I. Amah, Christian O. Onyemereze and Augustine I. Airaodion, (2025), Evaluation Of the Management of Premature Ovarian Insufficiency in Nigerian Women by Healthcare Professionals, J. Obstetrics Gynecology and Reproductive Sciences, 9(6) DOI:10.31579/2578-8965/278
Copyright: © 2025, Christian O. Onyemereze. 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 August 2025 | Accepted: 22 August 2025 | Published: 29 August 2025
Keywords: premature ovarian insufficiency; hormone replacement therapy; fertility preservation; reproductive endocrinology; healthcare professionals; nigeria; clinical management
Background: Premature ovarian insufficiency (POI) is a significant cause of infertility and long-term health complications in women. Its management in low-resource settings is often constrained by limited awareness, diagnostic capacity, and access to appropriate interventions. This study evaluated the management of POI in Nigerian women by healthcare professionals, focusing on knowledge, clinical practices, attitudes, and institutional challenges.
Materials and Methods: A descriptive cross-sectional study was conducted at the Abia State University Teaching Hospital, Aba, Nigeria, involving 150 healthcare professionals selected through stratified random sampling. Data were collected using a validated, structured questionnaire and analyzed with SPSS version 26. Descriptive statistics summarized sociodemographic data, while Chi-square and logistic regression identified factors associated with good management practices, with statistical significance set at p < 0.05.
Results: Participants had a mean age of 38.7 ± 8.4 years, and 58.67% were female. Overall, 64% demonstrated good knowledge of POI, particularly regarding its definition (74.67%) and hormone replacement therapy (78%). Common management practices included hormonal assays (67.33%) and prescribing HRT (75.33%), while fertility preservation counseling was less frequent (57.33%). Positive attitudes towards POI management were prevalent, though only 38% agreed that institutional resources were adequate. Major challenges included lack of protocols (65.33%), poor patient awareness (68.67%), and limited diagnostic facilities (56%). Knowledge significantly correlated with practice (r = 0.614, p < 0.001), and good practice was associated with being a doctor, having ≥10 years’ experience, and higher knowledge scores (p < 0.05).
Conclusion: While healthcare professionals demonstrated moderate-to-good knowledge and generally positive attitudes toward POI management, gaps remain in fertility preservation, institutional support, and diagnostic capacity. Strengthening training, protocols, and resource allocation is essential to improve outcomes for Nigerian women with POI.
Premature ovarian insufficiency (POI) is a clinical syndrome defined by loss of ovarian follicular activity before the age of 40 years, producing hypergonadotropic hypogonadism with estrogen deficiency and variable menstrual irregularity or amenorrhea [1]. Although historically described as “premature ovarian failure,” the preferred term “insufficiency” better reflects the sometimes intermittent and potentially recoverable ovarian function in a minority of affected women. Estimates of global prevalence have varied by method and population: earlier estimates suggested about 1% of women, while more recent meta-analyses and population studies indicate prevalence may be higher in some regions and socioeconomic strata, with pooled estimates rising into the low single-digit percentages and evidence of greater burden in low- and middle-income settings. The clinical picture of POI ranges from isolated menstrual disturbances to profound impacts on fertility and systemic health, making the condition both a reproductive and long-term medical concern for women of reproductive age [2].
The etiology of POI is heterogeneous and includes genetic causes (such as X-chromosome abnormalities and FMR1 premutation carriage), autoimmune disorders, iatrogenic injury from gonadotoxic therapies or pelvic surgery, infectious and environmental contributors, and a substantial proportion of idiopathic cases for which no clear cause is identified [1]. This multiplicity of possible causes requires clinicians to adopt a broad, systematic approach to evaluation (medical and family history, biochemical confirmation, targeted genetic and autoimmune testing where indicated) because identifying the cause can alter counseling, screening for comorbidities, family planning, and cascade testing of relatives. The diversity of etiologies also contributes to variable clinical trajectories and complicates the development of high-certainty evidence for specific management pathways, a theme emphasized in recent international guideline efforts [3].
Beyond its immediate reproductive consequences, POI confers important long-term health risks related to premature hypoestrogenism. Women with POI are at increased risk of decreased bone mineral density and early osteoporosis, adverse cardiometabolic changes, possible cognitive effects, sexual dysfunction, and psychosocial morbidity including anxiety, depression and impaired quality of life [1]. Because many of these sequelae accrue over years and because POI affects women decades earlier than natural menopause, international recommendations consistently emphasize active long-term monitoring and preventive care (notably bone and cardiometabolic risk screening) in addition to symptomatic management. These chronic health risks also mean that treatment decisions for POI differ in important ways from menopausal care in older women [4].
Therapeutically, the foundation of medical management for most women with POI is physiologic sex-steroid replacement to ameliorate symptom burden and to mitigate long-term consequences of estrogen deficiency. Contemporary evidence-based guidelines from reproductive and endocrine societies recommend hormone replacement (estrogen with appropriate progestogen when the uterus is present) until at least the usual age of natural menopause, unless contraindications exist, and they address nuances such as routes and formulations, the need for individualized counseling, monitoring, and bone health strategies. Fertility preservation and assisted reproduction require distinct approaches, for example, referral for fertility counseling early after diagnosis, discussion of donor-egg options and the limits of spontaneous pregnancy, and require coordination between endocrinologists, gynecologists, and fertility specialists. Importantly, guideline panels also highlight gaps in evidence and the frequent under-utilization or misapplication of hormone therapy in younger women because of misplaced extrapolation from risks observed in older menopausal populations [1,3].
Optimal management of POI depends heavily on the knowledge, attitudes, diagnostic vigilance, and counseling skills of frontline healthcare professionals, including general practitioners, family physicians, obstetrician–gynecologists, endocrinologists, and allied reproductive health staff. International audits and surveys point to heterogeneity in provider awareness, variations in practice (for example, inconsistent use of recommended biochemical and genetic tests, under-prescription of appropriate hormonal replacement, and variable referral patterns for fertility care or psychosocial support), and persistent educational gaps even among specialists. In many settings these clinician-level factors, awareness of condition, comfort with long-term hormone treatment for younger women, and access to referral pathways, are the rate-limiting step to delivering evidence-based POI care [3].
In Nigeria, context-specific factors complicate the translation of international recommendations into routine care. Cultural meanings attached to fertility, variable access to specialist reproductive services, constrained laboratory and imaging resources, and fragmented referral systems can delay diagnosis and limit therapeutic options [1]. There is limited published empirical literature from Nigeria specifically examining the management pathways, clinical decision-making, or guideline adherence for POI; more broadly, studies of menopausal and reproductive health experiences in Nigerian communities highlight how sociocultural norms, local health system capabilities, and provider knowledge shape care-seeking and quality of management for ovarian and menopausal disorders. These structural and sociocultural realities, together with the burden of iatrogenic causes (for example, from cancer therapies where survivorship is improving) and infectious contributors in the region, argue for an empirical assessment of how healthcare professionals in Nigeria recognize, evaluate, counsel and treat women with POI [5].
The clinical importance of early estrogen deprivation, the complexity of etiologies, recent international guideline recommendations, and documented variability in clinician knowledge and practice create a compelling rationale for focused investigation. An evaluative study in Nigeria that documents current diagnostic practices, treatment choices (particularly hormone replacement usage), referral and follow-up patterns, and clinicians’ educational needs would address a clear evidence gap. Such research can identify barriers to guideline-concordant care, uncover context-specific obstacles (diagnostic, logistic, cultural), and inform targeted interventions, provider education, local clinical pathways, or system-level resource allocation, to improve outcomes for Nigerian women affected by POI. This study therefore has the potential to generate actionable insight for clinicians, policy makers, and patient advocates seeking to align practice with contemporary evidence while respecting local realities.
Study Design
A descriptive cross-sectional study was conducted to evaluate the management of premature ovarian insufficiency (POI) in Nigerian women by healthcare professionals. The design was chosen to provide a snapshot of prevailing diagnostic and therapeutic practices, as well as to assess knowledge, attitudes, and challenges faced by healthcare professionals in managing POI.
Study Setting
The study was carried out at the Abia State University Teaching Hospital (ABSUTH), Aba, Abia State, Nigeria. ABSUTH is a tertiary healthcare facility that serves as a referral center for both public and private hospitals in Abia State and neighboring states. The hospital provides specialized obstetrics and gynecology services, including reproductive endocrinology and infertility care, and is staffed by consultants, resident doctors, nurses, and allied health professionals involved in women’s reproductive health.
Study Population
The study population comprised healthcare professionals directly or indirectly involved in the management of women’s reproductive health at ABSUTH. This included: Consultant obstetricians and gynecologists, Resident doctors in obstetrics and gynecology, Family physicians, Endocrinologists, Reproductive health nurses and midwives, Clinical laboratory scientists working in hormonal assay units
Inclusion Criteria:
Exclusion Criteria:
Administrative staff with no clinical duties.
Healthcare professionals on leave or unavailable during the study period.
Sample Size Determination
The sample size was calculated based on Cochran’s formula for cross-sectional studies, following the methodology described by Akwuruoha et al. [6]:
The formula components are defined as follows:
Substituting values:
P = 50% = 0.5
q = 1 – 0.5
= 0.5
n = ((1.96)^2 (0.5 x 0.5))/〖(0.05)〗^2 = 384
Since the total number of eligible healthcare professionals in ABSUTH was less than 10,000, the finite population correction formula was applied:
Where N is the total population of eligible healthcare professionals in the hospital (estimated at 210).
Allowing for a 10% non-response rate, the final sample size was 150 participants.
Sampling Technique
A stratified random sampling technique was employed to ensure proportional representation of different categories of healthcare professionals. The strata were based on professional roles (consultants, residents, nurses/midwives, laboratory scientists). Within each stratum, simple random sampling was used to select participants using the hospital’s duty roster as a sampling frame.
Data Collection Instrument
Data were collected using a structured, self-administered questionnaire developed by the researchers after an extensive literature review and consultation with experts in gynecology and reproductive endocrinology. The instrument was divided into five sections:
1.Socio-demographic characteristics (age, sex, professional cadre, years of experience).
2. Knowledge of POI (definition, etiology, diagnostic criteria, laboratory investigations, and complications).
3. Clinical management practices (hormone replacement therapy, counseling, fertility preservation options, referral patterns).
4. Attitudes towards POI management (perceived importance, willingness to manage, perceived patient barriers).
5. Challenges in management (institutional, patient-related, and resource-related constraints).
Responses were measured using a mix of closed-ended questions, multiple-choice items, and Likert-scale questions (5-point scale ranging from “strongly agree” to “strongly disagree”).
Validity and Reliability of Instrument
The questionnaire was subjected to face and content validity checks by three reproductive health experts and one epidemiologist. A pilot study involving 15 healthcare professionals at another hospital in Abia State (not included in the final study) was conducted to assess clarity, relevance, and comprehensiveness. Reliability was evaluated using Cronbach’s alpha, yielding a coefficient of 0.84, indicating good internal consistency.
Data Collection Procedure
After obtaining institutional ethical approval, data collection was carried out over a 6-week period. The research team approached eligible participants in their respective departments during work hours, explained the study’s objectives, obtained written informed consent, and administered the questionnaire. Completed questionnaires were retrieved immediately or within a maximum of 48 hours to minimize data loss.
Data Management and Analysis
Completed questionnaires were checked for completeness, coded, and entered into the Statistical Package for the Social Sciences (SPSS) version 26 for analysis. Data analysis included:
Descriptive statistics: (frequencies, percentages, means, and standard deviations) for socio-demographic variables, knowledge scores, and practice patterns.
Inferential statistics: Chi-square test was used to determine associations between categorical variables (e.g., knowledge level vs. professional cadre). Logistic regression analysis was performed to identify predictors of good POI management practices. Statistical significance was set at p < 0.05.
Ethical Considerations
Written informed consent was obtained from all participants before data collection. Confidentiality was ensured by anonymizing the questionnaires, and data were stored in password-protected files accessible only to the research team. Participants were informed of their right to withdraw from the study at any time without penalty.
The study involved 150 healthcare professionals, most of whom were aged 30–39 years (32.00%) and female (58.67%) (Table 1). Consultants and resident doctors in obstetrics and gynecology formed the largest professional group (44, 29.33%), while 30.67% had 6–10 years of professional experience.
Knowledge of premature ovarian insufficiency (POI) was generally high, with 74.67% correctly defining the condition and 78.00% identifying hormone replacement therapy (HRT) as the mainstay treatment. Overall, 64.00% had good knowledge, while 10.00% demonstrated poor knowledge (Table 2).
In terms of clinical practice, 75.33% routinely prescribed HRT, 67.33%requested hormonal assays, and 57.33% provided fertility preservation counseling (Table 3). Attitudes were largely positive, with over 88% agreeing that POI management is important for women’s reproductive health, although perceptions of institutional resource adequacy were lower (mean = 2.96 ± 1.24) (Table 4).
Commonly reported challenges included poor patient awareness (68.67%), lack of institutional protocols (65.33%), and high investigation costs (61.33%) (Table 5). The mean age of participants was 38.7 ± 8.4 years, with a mean knowledge score of 68.9 ± 14.5% and practice score of 63.7 ± 15.2% (Table 6).
Correlation analysis showed significant positive relationships between knowledge and practice scores (r = 0.614, p < 0.001), knowledge and years of experience (r = 0.342, p < 0.001), and practice and years of experience (r = 0.297, p = 0.002) (Table 7). Good practice was significantly associated with professional cadre, higher knowledge level, and ≥10 years of experience (p <0.05) (Table 8).
| Variable | Frequency (n = 150) | Percentage (%) |
| Age group (years) | ||
| 20–29 | 31 | 20.67 |
| 30–39 | 48 | 32.00 |
| 40–49 | 46 | 30.67 |
| ≥50 | 25 | 16.67 |
| Sex | ||
| Male | 62 | 41.33 |
| Female | 88 | 58.67 |
| Professional cadre | ||
| Consultant obstetrician/gynecologist | 22 | 14.67 |
| Resident doctor (O&G) | 44 | 29.33 |
| Family physician | 18 | 12.00 |
| Endocrinologist | 10 | 6.67 |
| Reproductive health nurse/midwife | 40 | 26.67 |
| Laboratory scientist | 16 | 10.67 |
| Years of professional experience | ||
| 1–5 | 35 | 23.33 |
| 6–10 | 46 | 30.67 |
| 11–15 | 38 | 25.33 |
| >15 | 31 | 20.67 |
Table 1: Socio-demographic characteristics of participants (n = 150)
| Variable | Frequency (n) | Percentage (%) |
| Correctly defined POI | 112 | 74.67 |
| Identified autoimmune causes | 89 | 59.33 |
| Identified genetic causes | 94 | 62.67 |
| Knew diagnostic criteria (FSH, estradiol) | 103 | 68.67 |
| Identified HRT as mainstay treatment | 117 | 78.00 |
| Knew associated complications (osteoporosis, infertility, cardiovascular risk) | 108 | 72.00 |
| Overall knowledge level | ||
| Good (≥70%) | 96 | 64.00 |
| Fair (50–69%) | 39 | 26.00 |
| Poor (<50%) | 15 | 10.00 |
Table 2: Knowledge of premature ovarian insufficiency (POI) among participants
| Practice item | Frequency (n) | Percentage (%) |
| Routinely requests hormonal assay | 101 | 67.33 |
| Prescribes hormone replacement therapy | 113 | 75.33 |
| Provides fertility preservation counseling | 86 | 57.33 |
| Refers to reproductive endocrinology specialist | 92 | 61.33 |
| Advises bone mineral density screening | 79 | 52.67 |
| Uses multidisciplinary management | 72 | 48.00 |
Table 3: Clinical management practices for POI
| Statement | Strongly agree n (%) | Agree n (%) | Neutral n (%) | Disagree n (%) | Strongly disagree n (%) | Mean ± SD |
| POI management is important for women’s reproductive health | 81 (54.00) | 52 (34.67) | 9 (6.00) | 5 (3.33) | 3 (2.00) | 4.35 ± 0.83 |
| HRT should be offered to most POI patients without contraindications | 74 (49.33) | 56 (37.33) | 11 (7.33) | 6 (4.00) | 3 (2.00) | 4.28 ± 0.87 |
| Fertility preservation is essential in newly diagnosed POI | 69 (46.00) | 55 (36.67) | 13 (8.67) | 8 (5.33) | 5 (3.33) | 4.17 ± 0.97 |
| Institutional resources for POI management are adequate | 22 (14.67) | 35 (23.33) | 31 (20.67) | 39 (26.00) | 23 (15.33) | 2.96 ± 1.24 |
Table 4: Attitudes towards POI management (n = 150)
| Challenge type | Frequency (n) | Percentage (%) |
| Lack of institutional protocol | 98 | 65.33 |
| Limited diagnostic facilities | 84 | 56.00 |
| High cost of investigations | 92 | 61.33 |
| Poor patient awareness | 103 | 68.67 |
| Unavailability of fertility preservation services | 77 | 51.33 |
Table 5: Challenges in management of POI
| Variable | Mean ± SD |
| Age of participants (years) | 38.7 ± 8.4 |
| Years in practice | 10.2 ± 6.1 |
| Knowledge score (%) | 68.9 ± 14.5 |
| Practice score (%) | 63.7 ± 15.2 |
Table 7: Correlation Analysis Between Knowledge, Practice, and Years of Experience
| Variable | Good practice n (%) | Poor practice n (%) | χ² | df | p-value |
| Professional cadre | |||||
| Consultant/Resident doctors | 54 (77.14) | 16 (22.86) | 10.27 | 2 | 0.006 |
| Nurses/Midwives | 21 (52.50) | 19 (47.50) | |||
| Lab scientists/others | 8 (33.33) | 16 (66.67) | |||
| Knowledge level | |||||
| Good | 73 (76.04) | 23 (23.96) | 15.86 | 1 | <0> |
| Fair/Poor | 10 (26.32) | 28 (73.68) | |||
| Years of experience | |||||
| ≥10 years | 46 (76.67) | 14 (23.33) | 7.92 | 1 | 0.005 |
| <10 years | 37 (52.86) | 33 (47.14) |
Table 8: Factors Associated with good Practice in POI Management
The present study, surveying 150 healthcare professionals in Nigeria, ranging from consultants to laboratory scientists, reveals a generally favorable level of knowledge, with 64% demonstrating a “good” overall knowledge of premature ovarian insufficiency (POI), and 74.7% correctly defining the condition. This is comparable to findings in Brazil, where just over half of gynecologists accurately diagnosed POI and around half requested karyotype analysis, though only a minority identified all etiologies [7]. Our results thus underscore a relatively strong knowledge base amongst Nigerian professionals, though significant gaps remain, particularly in identifying etiologic factors (59–63%).
In terms of clinical practice, 67% routinely requested hormonal assays, and 75% prescribed hormone replacement therapy (HRT), indicating alignment with international standards. According to guidelines by ESHRE, ASRM, and Mayo Clinic, diagnosis should be based on elevated FSH (>25–40 IU/L) on two separate occasions alongside estradiol levels, and management should include estrogen and progesterone therapy until the age of natural menopause (approximately 50 years) [8]. That three-quarters of Nigerian clinicians adhere to HRT is encouraging, though specialists in Brazil reported only a 20% prescription rate despite understanding the long-term benefits [7]. The 57% rate of fertility preservation counseling in our survey is particularly noteworthy, given the ESHRE emphasis on early fertility discussions and multidisciplinary management [3].
Yet, our data also reveal concerning deficits: only around half advised bone mineral density screening or used multidisciplinary models. This is important because POI is associated with increased risks of osteoporosis and cardiovascular diseases, highlighted in ESHRE and ACOG guidelines, and multi-specialist involvement (endocrinology, genetics, psychology) is essential for holistic care [9]. In contrast, a 2025 UK Biobank/NHANES study found that menopausal hormone therapy significantly mitigated accelerated biological aging in women with POI [10], confirming the importance of such comprehensive management strategies.
Our participants' attitudes were largely positive: mean agreement scores of over 4.2 out of 5 affirm the perceived importance of POI management, HRT use, and fertility preservation counseling. However, only 38% believed their institutions had adequate resources (mean 2.96 ± 1.24), mirroring the challenges reported in our survey regarding insufficient protocols, diagnostic limitations, cost barriers, patient awareness, and lack of preservation services. These reflect findings in other low-resource settings where institutional constraints hinder full guideline implementation [11].
Correlations between knowledge and practice (r = 0.614, p <.001) and their positive association with years of experience underscore the value of ongoing education and clinical exposure. Similar to other studies in Nigeria, experienced cadres tend to demonstrate more guideline-concordant care; however, even among consultants/residents, gaps remain, 21% still lacked adequate practice [7].
Multivariate analysis showed that professional cadre, knowledge level, and length of service significantly predicted good practice. Consultants and residents were far more likely (77%) to demonstrate proper management than nurses/midwives (52%) or laboratory staff (33%). This underlines the necessity of role-specific training, particularly among midwives and allied professionals, as frontline providers. Our findings resonate strongly with ESHRE’s 2024 recommendations emphasizing early diagnosis, timely initiation of HRT until the age of natural menopause, routine screening for osteoporosis and cardiovascular risks, multidisciplinary care, and fertility preservation discussions [3].
In conclusion, Nigerian healthcare professionals exhibit commendable understanding and attitudes toward POI, surpassing some benchmarks like those in Brazil, yet significant gaps in protocol implementation, resource availability, and multidisciplinary coordination persist. Our results reinforce global recommendations for holistic POI management and underscore the urgent need for structured institutional support, targeted education, and system-wide reforms to optimize care and health outcomes for Nigerian women.
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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
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
