AUCTORES
Globalize your Research
Review Article | DOI: https://doi.org/10.31579/2578-8949/142
Independent Researcher, Croatia.
*Corresponding Author: Siniša Franjić, Independent Researcher, Croatia.
Citation: Siniša Franjić, (2024), Independent Researcher, Croatia, Dermatology and Dermatitis, 9(1); DOI:10.31579/2578-8949/142
Copyright: © 2024, Siniša Franjić. 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: 29 November 2023 | Accepted: 14 December 2023 | Published: 10 January 2024
Keywords: botulism; etiology; toxin; symptoms; health
Botulism is a rare but serious disease caused by the anaerobic bacterium Clostridium botulinum, which produces spores and a toxin. It is very widespread in nature, in the ground and in the digestion of mice, rats and cats. The toxin is often created in rotten food, and the most common sources of infection for humans are canned goods and dried meat products. It is also possible to get the disease if an injured spot on the skin comes into contact with the causative agent of the disease. The disease is not contagious, but occurs suddenly and attacks the nerves.
Botulism is a paralytic disease caused by Clostridium botulinum; an anaerobic, gram-positive, spore-forming bacillus ordinarily found in soil [1]. The living being produces an amazingly powerful neurotoxin. Of the seven sorts of poison (A–G), sorts A, B, and E cause most human illnesses. The poison, a polypeptide, is so strong that 0.1 mg is deadly for people.
Food-borne botulism ordinarily comes about from ingestion of toxin-containing nourishment. Preformed poison is retained from the intestine and produces loss of motion by anticipating acetylcholine discharge from cholinergic filaments at neuromuscular intersections. Essentially any nourishment will back the development of C botulinum spores into vegetative toxin-producing bacilli on the off chance that an anaerobic, nonacid environment is given. The nourishment may not show up or taste ruined. The poison is heat-labile, but the spores are heat-resistant. Lacking warming amid processing (temperature < 115>
Newborn child botulism happens in infants less than 12 months of age. The poison is produced by ingested C botulinum spores which grow and create poison within the gastrointestinal tract.
Annually, 10–15 cases of wound botulism are detailed. Most cases happen in medicate abusers with disease in intravenous or intramuscular injection sites.
Botulism toxins are expansive proteins [2]. In food-borne botulism, ingested preformed toxin is retained within the stomach and upper little digestive tract. Toxins are diminished in estimate by proteolytic chemicals, but their action remains unaltered. Pancreatic trypsin really may improve the harmfulness of a few toxin strains. In expansion to disgracefully home-canned nourishments, episodes of botulism have been followed to noncanned nourishments such as eviscerated dried angle, yogurt flavored with hazelnut preserve, a garlic-in-oil item, custom made salsa, cheese sauce, prepared potatoes fixed in aluminum foil, and sautéed onions put away beneath a layer of butter.
Botulism toxin has potential as a weapon of bioterrorism, both from ingestion and by inward breath. Clinical discoveries would be indistinguishable, but conceivable highlights would incorporate a expansive outbreak with common natural presentation, an unordinary toxin sort, or different concurrent outbreaks.
Botulism is delivered by the neurotoxin from the, anaerobic Gram-positive bacillus, Clostridium botulinum, which pieces acetylcholine discharge at fringe nerve endings [3].
The utilize of botulinum toxin in hemifacial spasm and other disarranges of dystonia (i.e. automatic and maintained muscle withdrawal, or spasticity) is an curiously, and profitable clinical application of this something else undesirable poison. Not suddenly, this helpful application has gotten to be broadly embraced for facial and other cosmesis since it got to be accessible for this reason in 1989. The measurements utilized in such restorative or cosmetic applications is distant as well little to cause systemic side effects, in spite of the fact that periodic poisonous quality (rarely serious) has been detailed due to dose or organization errors.
Etiology
C. botulinum, a species including a heterogeneous group of anaerobic gram-positive life forms that frame subterminal spores, is found in soil and marine situations all through the world and expounds the foremost strong bacterial toxin known [4]. Organisms of types A through G have been recognized by the antigenic specificities of their toxins; a classification framework based on physiologic characteristics has also been depicted. Uncommon strains of other clostridial species—C. butyricum and C. baratii—have moreover been found to create toxin. C. botulinum strains with proteolytic movement can process nourishment and create a ruined appearance; nonproteolytic sorts take off the appearance of nourishment unaltered.
Of the eight particular poison sorts portrayed (A, B, C1, C2, D, E, F, and G), all but C2 are neurotoxins; C2 could be a cytotoxin of obscure clinical noteworthiness. Botulinum neurotoxin, whether ingested, breathed in, or created within the digestive system or a wound, enters the vascular framework and is transported to fringe cholinergic nerve terminals, counting neuromuscular intersections, postganglionic parasympathetic nerve endings, and fringe ganglia. The central apprehensive framework isn't included. Dynamic neurotoxin (150 kDa) is composed of a overwhelming chain (a 100-kDa part mindful for neurospecific authoritative and translocation within the nerve cell) and a light chain (a 50-kDa part capable for intracellular catalytic movement). The steps included in neurotoxin movement incorporate (1) particular authoritative to presynaptic nerve cells at the myoneural intersection, (2) internalization of the toxin inside the nerve cell in endocytic vesicles, (3) translocation of the toxin into the cytosol, and (4) proteolysis by toxin (a zinc endopeptidase) of components of the neuroexocytosis device diminishing discharge of the neurotransmitter acetylcholine. Remedy takes after growing of modern nerve terminals.
Toxin is heat-labile, but spores are profoundly heat-resistant; both can be inactivated beneath suitable conditions. Within the gastrointestinal tract, toxin is complexed with nontoxin proteins and stands up to debasement. Toxin sorts A, B, E, and (rarely) F cause human illness; sort G (from C. argentinense) has been related with sudden passing, but not with neuroparalytic ailment, in some patients in Switzerland; and sorts C and D cause creature malady.
Toxin
In spite of the fact that the toxin is labile, the spores are heat-stable and may in this way deliver unused toxin in the event that cooked nourishment is cleared out at room temperature for more than 16 hr [3]. Most commonly, botulism emerges from the ingestion of ineffectively handled domestic nourishments (generally some of the time called ptomaine harming), in spite of the fact that it every so often happens as a wound contamination. Cases have been detailed taking after the ingestion of angle intestine. The brooding period ranges from 6 hr to 8 days, in spite of the fact that it ordinarily 18–36 hr.
The understanding encounters diplopia, ptosis, dysphagia, dysarthria and plummeting loss of motion. The mouth is dry and there are ordinarily gastrointestinal indications. There's no fever.
Sources
Clinical syndrome caused by ingestion of exotoxins (botulinum toxins) delivered by the anaerobic gram-positive bacillus Clostridium botulinum [5]. Exotoxin binds irreversibly to cholinergic nerve endings, anticipating acetylcholine discharge. Influences the neuromuscular intersection, autonomic ganglia and parasympathetic postganglionic filaments. Classified concurring to the source of contamination:
◗ food-borne botulism: caused by ingestion of Clostridium spores or exotoxin delivered beneath anaerobic conditions (e.g. home canning).
◗ wound botulism: due to defilement of surgical or other wounds. Also seen in medicate abusers infusing ‘black-tar’ heroin subcutaneously (‘skin-popping’).
◗ infant botulism: due to retention of exotoxin created inside the GIT, classically after eating sullied nectar.
◗ adult irresistible botulism: comparable to the newborn child shape but takes after GIT surgery.
◗ inadvertent botulism: takes after coincidental overdose of botulinum poison given for treatment of development clutters (e.g. dystonia).
Features happen inside 12–72 h:
◗ nausea, vomiting and abdominal pain.
◗ symmetrical slipping loss of motion at first influencing cranial nerves, with diplopia, settled expanded understudies, facial weakness, dysphagia, dysarthria, appendage weakness and respiratory trouble.
◗ autonomic unsettling influence: ileus, lethargic understudies, dry mouth, urinary maintenance.
◗ sensory deficit, mental unsettling influence and fever don't happen.
Symptoms
Signs and Symptoms in Patients with Botulism Intoxication [6]
The incubation period for food-borne botulism is 8–36 hours [1]. The introductory indications are lethargy and headache. These are taken after by twofold vision, widened understudies, ptosis, and, inside many hours, trouble with gulping and discourse. The mucous films regularly are exceptionally dry. Plummeting skeletal muscle loss of motion may be seen. Death more often than not comes about from respiratory failure.
Botulism patients show with a “classic triad”: (1) afebrile; (2) symmetrical, flaccid, descending loss of motion with conspicuous bulbar palsies; and (3) clear sensorium. Acknowledgment of this set of three is imperative in making the clinical determination. Botulism is caused by a poison, in this way there's no fever unless secondary infection (eg, aspiration pneumonia) happens. Common bulbar palsies seen incorporate dysphonia, dysphagia, dysarthria, and diplopia (four “Ds”).
Infant botulism is seen in infants more youthful than age 12 months (top onset 2–8 months). Infants more youthful than age 2 weeks once in a while create botulism. The starting side effects are more often than not obstruction and dynamic, frequently extreme, hypotonia. Clinical discoveries incorporate misfortune of facial expression, stoppage, powerless suck and cry, pooled verbal emissions, cranial nerve shortages, generalized weakness, and, on event, apnea.
Diagnosis
Botulism may be a clinical diagnosis that ought to be suspectedin any grown-up with an intense onset of cranial nerve, gastrointestinal and autonomic brokenness, and a history consistent with botulism presentation [6]. Treatment ought to be started quickly, with societies and poison measures utilized to afterward affirm the diagnosis. Appropriate administration of patients with botulism includes early determination, convenient antitoxin organization, cautious checking for respiratory compromise, and steady care counting mechanical ventilation in case essential. Respiratory failure is the essential cause of passing in patients with botulism. Serial examination of oropharyngeal tone and visit checking of spirometry can recognize patients in require of mechanical ventilation some time recently respiratory collapse is up and coming. Patients with wound botulism require early and authoritative surgical mediation. All suspected cases of botulism ought to be detailed to open health specialists quickly. Incite epidemiologic examination makes a difference avoid extra cases and can recognize unused hazard variables for inebriation.
The determination is clinical, and the differential determination incorporates [3]
Botulism as a disease is well known to neurologists, creating an acute, slipping loss of motion that starts within the bulbar musculature [7]. The toxin acts by means of cleavage of the N-ethylmaleimidesensitive figure connection protein receptor (Snare protein), which anticipates combination of the acetylcholine-containing vesicles with the presynaptic layer at the neuromuscular intersection. This produces a paucity of acetylcholine within the synaptic cleft and comes about in clinical weakness. There are seven known sorts of botulinum toxin, all with comparative clinical impacts.
The illness introduction is comparative in any case of the sort of poison or the way in which it is contracted. An intense plummeting loss of motion, starting within the cranial nerves, goes before systemic weakness counting respiratory musculature.
Children
Botulism is a neuroparalytic disease caused by a neurotoxin expounded by Clostridium botulinum, a Gram-positive, spore-forming, commit anaerobe whose normal habitat is the soil [8]. Botulinum toxin is tasteless, odorless, and greatly harmful. It acts by irreversibly blocking the discharge of acetylcholine in fringe substantial and autonomic neural connections as well as at the engine end plates.
Infants lack the Clostridium inhibiting bile acids and defensive bacterial greenery found within the typical adult intestinal tract, so botulism spores can sprout within the intestinal tract. There are around 100 cases of infant botulism every year within the United States, with a top rate between 2–4 months of age. Nectar utilization and parental business at development destinations are noteworthy hazard components.
In differentiate, in more seasoned children, botulism more often than not happens after the ingestion of preformed toxin in ruined nourishment. Crude, domestic canned, or insufficiently arranged nourishments may be sullied with the poison, which is warm labile. Warming nourishment to the boiling point annihilates the poison, but the bacterial spores are safe to warm and may survive the home-canning handle. Canned fish, vegetables, and potatoes have been embroiled in outbreaks of botulism.
In wound botulism, C. botulinum develops within the harmed tissue and produces poison. Most cases of wound botulism within the United States happen either in intravenous sedate clients or children with compound limit breaks.
Treatment
Patients with suspected botulism ought to be hospitalized and observed closely for signs of looming respiratory failure and failure to manage secretions [1]. Early treatment of botulism with antitoxin is useful. The sort of antitoxin treatment prescribed varies depending on the sort of botulism. Treatment ought to begin as before long as the clinical conclusion is suspected (earlier to microbiologic or poison affirmation).
Botulism can be affirmed by the nearness of poison (either within the patient’s serum or stool, or in sullied nourishment) in approximately twothirds of cases [9]. Contact following, within the case of foodborne botulism, is of extraordinary significance.
Treatment is primarily steady, with aviation route assurance and mechanical ventilation when required. Cruel length of mechanical ventilation, when required, is 7 weeks. Clearance of poison from the bowel with bowel purges and cathartics has been pushed. Guanidine hydrochloride, which upgrades the discharge of ACh from nerve terminals, has been detailed to make strides muscle quality, particularly in visual muscles, and may be valuable in milder cases. Antibiotics have not been clearly appeared to be valuable. Equine antitoxins are available, but side impacts are common and their adequacy is constrained. A human¬derived antitoxin has been appeared to be compelling in puerile botulism, and the United States Defense Department has a pentavalent antitoxin, which isn't accessible for open utilize. Antitoxin must be given some time recently the onset of loss of motion in arrange to be successful. In wound botulism, antibiotics (penicillin or metronidazole) and forceful debridement are prescribed.
Most patients start to make strides after a week or so, but hospitalization is usually required for 1-3 months. The mortality is low (5%–8%) with great steady care, counting mechanical ventilation. Mild weakness and stoppage may continue for numerous months.
Botulism is not a widely known term because it is a rare disease, but given that it is a very dangerous disease, it is necessary to learn as much as possible about it and learn how to prevent poisoning by the bacteria that causes it. Botulism is a disease that occurs when the bacterium Clostridium botulinum enters the human body, where it begins to release its poison in the form of neurotoxins, which are considered one of the strongest poisons known. These neurotoxins act on the nervous system and muscles in a very aggressive way, and even a small amount of toxins can be fatal in some cases. Given that there is no vaccine for botulism, nor can immunity be acquired by getting over the disease, it is considered very dangerous, so prevention and protection against infection are key to its eradication.
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.
