JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Association between Gynecological Cancers and Female Infertility: Insights from
Bidirectional Mendelian Randomization Analysis
Version: 3 Date: 22 Feb 2025
Reviewer's report:
1. The summary should provide OR and confidence intervals, not just P-values.
2. While the conclusions mention the need for preventive measures and clinical management
strategies, the specific application of these findings should lead to recommendations for
reproductive protection for breast cancer survivors.
3. Breast cancer (BC) showed a significant association in reverse MR (P=0.043), close to the
significance threshold (P<0.05), and the risk of false positives should be vigilant. No association
was found for other cancers (OC, EC, CC), possibly resulting in Class II errors due to insufficient
sample size.
Title: Association between Gynecological Cancers and Female Infertility: Insights from
Bidirectional Mendelian Randomization Analysis
Version: 3 Date: 22 Feb 2025
Reviewer's report:
This study employed two-sample MR to investigate the associations between female infertility
(FI) and risk of four gynecologic cancers from a genetic perspective. Personally, the biggest
concern is the use of publicly available database. The biggest concern is the reliance on publicly
available databases. Although the authors sourced data from the IEU OpenGWAS database,
the lack of peer-reviewed validation introduces uncertainties. Conducting GWAS for cancers,
particularly those with limited sample sizes such as ovarian and cervical cancer in this study,
requires careful consideration. Inadequate adjustment for confounding variables may result in
biased findings. Generally, this study has generally done a good job in the methodology part.
Further points for consideration include:
1. The manuscript still requires significant improvements in language to enhance clarity and
readability.
2. I totally agree with previous reviewers' suggestions to apply Bonferroni correction for multiple
testing. Given the analysis of four cancers, the significance threshold should be adjusted to
0.05/4. Based on this threshold, it appears there are no significant findings in the study. However,
the authors could still discuss the marginal association between breast cancer and FI, but this
should be done with much greater caution.
3. Is it feasible for the authors to conduct a validation analysis using cancer GWAS summary
statistics from the UK Biobank (UKB)? This would provide additional robustness to the findings,
particularly for endometrial, ovarian, and cervical cancers. Data for ovarian cancer, for instance,
can be easily accessed via the UKB website (e.g., https://pan-ukb-us-east-1.s3.amazonaws.com/
sumstats_flat_files/phecode-184.11-females.tsv.bgz).
4. The authors may consider using multivariable MR to control for potential confounding factors
such as BMI and diabetes, which may influence both female infertility and cancer risk.
5. The current “significant” result between BC and FI is OR = 1.05 (0.98, 1.11), P = 0.043. This
is weird to me since the 95%CI cross 1 and the p value should not be less than 0.05. Any typos
here? Same issue for the RAPS result between OC and FI [OR = 1.04 (1.02, 1.07), P = 0.059].
Title: Association between Gynecological Cancers and Female Infertility: Insights from
Bidirectional Mendelian Randomization Analysis
Version: 4 Date: 18 Mar 2025
Reviewer's report:
Good Work! Just two more simple questions:
1. What is the total R2 of the instrument variables for different exposures?
2. How do the authors interpret the different results between those MR methods?
Title: Association between Gynecological Cancers and Female Infertility: Insights from
Bidirectional Mendelian Randomization Analysis
Version: 5 Date: 29 Mar 2025
Reviewer's report:
The authors have addressed all concerns raised in my initial review thoroughly and
professionally. Their revisions significantly improve the clarity, methodological rigour, and
interpretation of the result.Based on the revised manuscript and the authors’ satisfactory
engagement with the review process, I recommend acceptance of the paper in its current form.
No further revisions are required from my perspective.
Title: Combined pharmacological and surgical treatments for recurrent chemical peritonitis due
to rupture of a bilateral mature cystic teratoma: A case report
Version: 0 Date: 23 Jan 2025
Reviewer:  Wisam Akram
Reviewer's report:
Dear colleagues
Thank you very much indeed for diverting this very nice article to me for peer reviewing!
Actually, this article explains in the eyes of other researchers why I always reject doing
laparoscopic resection of TERATOMa by laparoscopy. In fact I am still using open laparotomy
for its removal!
The reason for this is that the contents of dermoid benign cyst are always so diverse like sebum
or teeth and always there will be spillage of their contents into the peritoneal cavity which
are extremely difficult to remove thereafter even with multiple washing and inspection of the
peritoneal cavity. Needless to say it needs longer time to remove!
However, Science is science and I can not reject newer approaches based on personal views only.
And, that is why I agree with the author conclusions reached in his paper. It is really Ironic to
reach a conclusion based on contradiction, sometimes!?
My decision; Accept!
Good work and good luck
Sincerely yours
Wisam Akram
Title: Combined pharmacological and surgical treatments for recurrent chemical peritonitis due
to rupture of a bilateral mature cystic teratoma: A case report
Version: 0 Date: 23 Jan 2025
Reviewer:  Zeena Raad Helmi
Reviewer's report:
Dear Author,
Thank you for the opportunity to review the manuscript entitled “Combined pharmacological
and surgical treatments for recurrent chemical peritonitis due to rupture of a bilateral mature
cystic teratoma A case report”
Comments:
Very interesting case
Please add the histopathology report and picture of the slides
Title: Combined pharmacological and surgical treatments for recurrent chemical peritonitis due
to rupture of a bilateral mature cystic teratoma: A case report
Version: 0 Date: 12 Feb 2025
Reviewer:  Habibah Abdul Hamid
Reviewer's report:
Combined pharmacological and surgical treatments for recurrent chemical peritonitis due to
rupture of a bilateral mature cystic teratoma: A case report
Dear authors.
Here are my comments.
Abstract:
1. The case presentation appears somewhat misleading, as the patient was preoperatively
diagnosed with spontaneous rupture, which differs from the presentation in the main text.
2. The differential diagnosis of ovarian accidents includes torsion, infection, and rupture.
However, internal bleeding within the cyst is also a possibility. Including the hemoglobin (Hb)
level would help clarify this.
3. Was the patient given antibiotics during the first presentation? If so, specifying the type of
antibiotics and duration of treatment would enhance the report.
Main Text:
4. The concerns from the abstract apply here as well.
5. The intraoperative findings describe bilateral ovarian tumors with ‘hiats’ in each tumor (Fig. 4,
5). However, the term ‘hiats’ is unclear and should be revised or defined for better understanding.
Discussion:
6. Consider emphasizing the role of medical management, particularly the use of steroids and
antibiotics, in treating chemical peritonitis.
7. Further discussion on the indications for oophorectomy in this case would be beneficial,
particularly in the context of recurrence and future fertility considerations.
Thanks.
Title: Combined pharmacological and surgical treatments for recurrent chemical peritonitis due
to rupture of a bilateral mature cystic teratoma: A case report
Version: 0 Date: 04 Mar 2025
Reviewer:  Manal Madany Abdel Qader
Reviewer's report:
I first appreciate the author for this interesting subject and find the title clear and directed to it
Regarding the abstract , i found it summarize the case informatively  starting from introducing
the case till all the management as detail history , clinical examination , investigations needed
in the form of WBC , CRP , CT scan ending with  pre and post operative  findings details all
documented
The case presentation is well-organized, detailing:
The chemical irritation caused by the ruptured teratomas due to the fatty component related to
it clearly described in the intraoperative findings
The postoperative course was well-managed and put in our mind the delay drain removal may
play role in a case like this
Follow up of the patient postoperatively nicely  written in details with the end use of anti-
inflammatory medications for management of chemical peritonitis
Discussion and Conclusion
It was clear , informative and discussed the important points related to the case report in the
form of discussing the clinical course of chemical peritonitis as it is rare , but when occurs it
will be ended with sever complications with the benefit of steroids  in resolving it
The article nicely pointed on the benefits of laparoscopic procedures in fertility preservations as
an effective, minimally invasive approach to achieve this goal.
Regarding the references it was nicely written , but need more updated references
Title: Combined pharmacological and surgical treatments for recurrent chemical peritonitis due
to rupture of a bilateral mature cystic teratoma: A case report
Version: 1 Date: 20 Mar 2025
Reviewer:  Zeena Raad Helmi
Reviewer's report:
Dear Author,
Thank you for the opportunity to review the manuscript entitled “Combined pharmacological
and surgical treatments for recurrent chemical peritonitis due to rupture of a bilateral mature
cystic teratoma A case report”
Comments:
The manuscript titled “Combined pharmacological and surgical treatments for recurrent
chemical peritonitis due to rupture of a bilateral mature cystic teratoma A case report”,has
successfully undergone the required revisions and is now ready for acceptance and publication
Title: Combined pharmacological and surgical treatments for recurrent chemical peritonitis due
to rupture of a bilateral mature cystic teratoma: A case report
Version: 1 Date: 21 Mar 2025
Reviewer:  Zina Abdullah Hussein
Reviewer's report:
Dear Authors,
I would like to express my sincere appreciation for your valuable contribution to your work .It
was a pleasure to review your work, and I commend the effort, thoroughness, and insight you put
into your study. Your research adds significant value to the field, and I look forward to seeing
its continued impact
Best regards
Title: Combined pharmacological and surgical treatments for recurrent chemical peritonitis due
to rupture of a bilateral mature cystic teratoma: A case report
Version: 1 Date: 22 Mar 2025
Reviewer:  Manal Madany Abdel Qader
Reviewer's report:
Regarding the title , I found it clear and directed to the case report
Regarding the abstract , I found it summarize the case  , informatively  starting from introduction
till all the management as detail history , clinical examination , investigations
The case presentation is well-organized with informative details
The postoperative course was well-managed and put in our mind the delay drain removal may
play role in a case like this
Follow up of the patient postoperatively nicely  written in details with the end use of anti-
inflammatory medications for management of chemical peritonitis
Discussion and Conclusion
It was clear , informative and discussed the important points related to the case report in the
form of discussing the clinical course of chemical peritonitis as it is rare , but when occurs it
will be ended with sever complications with the benefit of steroids  in resolving it
The article nicely pointed on the benefits of laparoscopic procedures in fertility preservations as
an effective, minimally invasive approach to achieve this goal.
Title: Transcriptomics and proteomics reveal associations between myometrium and
intrauterine adhesions
Version: 3 Date: 09 Dec 2024
Reviewer:  Ragini Mehrotra
Reviewer's report:
The study is novel in its subject and has been done meticulously studying and describing all
aspects and "Omics" well within the perview of the subject. Still the small sample size and
nonavailability of the comparative data with the normal controles limits the inferences drawn.
Title: Investigating the relationship between MIND diet and postpartum depressive symptoms
Version: 2 Date: 03 Aug 2024
Reviewer:  Leyla Kaya
Reviewer's report:
The article titled “Investigating the relationship between the MIND diet and postpartum
depression” represents a very different article about the relationship between the MIND diet and
the presence of depressive symptoms in the postpartum period. The article is publishable and I
believe it will be of interest to readers.
Title: Good long-term results of sacral neuromodulation for endometriosis related chronic pelvic
pain
Version: 2 Date: 30 Oct 2024
Reviewer's report:
This small  retrospective case series describes the long-term outcomes of SNM in the treatment
of refractory pain associated with endometriosis in patients who have failed standard medical
and aggressive surgical management within the Finnish medical system registry.   The study
was performed with telephone administered questionnaire assessing the patient’s pain score and
whether the device was still on and functional. The average duration of follow-up was 73 months
with 14 of 16 patients  undergoing IPG implant and 10 of 14 patients experiencing a significant
decrease in likert pain scores (-4.9) across the study timeframe.  These results were further
analyzed in the context of the type of endometriosis, preceding surgery, and functional electrodes
finding no difference in the group with successful vs unsuccessful implant.  Although SNM
is  not FDA approved for CPP , these results appear to support previous studies documenting
effectiveness of SNM in the long – term treatment of CPP secondary to endometriosis.
Critique:
1. Authors are using a very simple no validated  tool to assess pain and pain is a very difficult
patient complaint to categorize and rate.  Most studies utilize multiple different pain rating tools
and questionnaires to assess the effectiveness of an intervention. To improve their study, the
authors should better elucidate  how pain is assessed. Is this pain value assessing immediate pain
or pain across the past 24 hours or past week?
2. The authors should comment on how they are programming the SNM for CPP ?  Are they
using standard programs.
3. Results: Median values  ( 7.4 vs 2.25) have different significant digits.  Please correct.
4. Figure 1.  Complication with testing shows 3 patients with pain. Were they implanted?
5. Figure 1 Following IPG implant you document 1 patient with pain and then 1 explant for
sciatic pain. Is this the same patient?
6. Table 1 – Please categorize light vs strong opiodes
7. Table 2 – include pretest NRS
8. Table 3 – I assume the authors when stating number of electrodes are specifying the number
of electrodes they are referring to the number of functional electrodes. Please  clarify
9. Table 3 – should also include column of S3/S4 implants to assess if location of lead is
potentially a factor in success/failure in their series of patients.
10. Figure 2.  Specify number of patients in each of the groups in the forest plot. This also affects
your statistical calculation.
11.  Further elucidation of how these patients with successful long- term results were treated
would be helpful. Were the programs changed? If so.  how often? Did sensory thresholds increase
over time?
Title: Endometrial Histological Patterns and Associated Factors of Abnormal Uterine Bleeding
among Women seeking Gynecological Services from Referral hospitals in Western Uganda: A
Cross-sectional Study
Version: 2 Date: 20 May 2024
Reviewer's report:
ABSTRACT: There are grammatical errors, wrong use of capital letter and tenses that need to
be corrected (see text). The last sentences is not clear, does this recommendation include women
of all ages eg adolescents?
INTRODUCTION: This section is rather long and can be abridged. There are several sentences
that need to be referenced, paragraphing is poor and there are also grammatical errors and wrong
use of tenses. The aim of the study should be clearly stated at the end and the authors should
explain the significance of the study explicitly as well as its justification.
METHODS: This section should be much more detailed. Under sampling techniques (page 6),
the authors should state clearly who enrolled the participants and how they were identified. They
should also explain in detail how they selected the participants. Under endometrial sampling
procedure, did the study have only one researcher who was the only person who took samples
from all the women? The authors should state where the endometrial biopsies were performed,
how those with abnormal uterine bleeding were detected and how relevant information was
obtained from the participants, managed and stored. They should also state who analyzed the
samples since their center did not have a histopathologist / histopathology laboratory as stated.
There should be a statement on ethical considerations for this kind of study in the methods, were
written informed consents obtained from all participants prior to commencement of the study,
if so when exactly?
RSULTS: There are several wrong use of tenses and paragraphing is poor. The authors should
explain how all the information about the patients in table were obtained, how the 54 patients
with AUB were detected and how their BMI was estimated.  Figure 1 can be deleted and the
information put in the text. In page 8, were fibroids also one of the findings from the histological
assessment as stated, if so it should be explained in the discussion.
DISCUSSION; There are several statements that need clarification, several also that need to be
corrected. These are noted on the text. The 1st recommendation in page 14 is not clear, does this
apply to all patients eg adolescents? The authors should in the methods section state the current
practice as it pertains to abnormal uterine bleeding and endometrial biopsy in their center for
clarity.
REFERENCES: The following are not well written—3,8, 19,21,25, 26, and 28.
Title: Endometrial Histological Patterns and Associated Factors of Abnormal Uterine Bleeding
among Women seeking Gynecological Services from Referral hospitals in Western Uganda: A
Cross-sectional Study
Version: 2 Date: 03 Jun 2024
Reviewer's report:
Title of Manuscript: Endometrial Histological Patterns and Associated Factors of Abnormal
Uterine Bleeding among Women seeking Gynecological Services from Referral hospitals in
Western Uganda: A Cross-sectional Study
Authors: Joan Logose1, Marie Pascaline Sabine Ishimwe2, Moses Kabali4, Emmanuel Okurut1,
Emmanuel Eliu3, Adam Ddamulira1, Theoneste Hakizimana1*
This manuscript investigates the prevalence, histological patterns, and determinants of abnormal
uterine bleeding (AUB) in Ugandan women. The research questions are clearly outlined, and
the writing is generally good. The findings could be valuable for clinicians managing AUB,
especially in resource-limited settings.
However, some revisions would strengthen the manuscript for publication.
Areas for improvement:
• Introduction:
o Clearly state the purpose of the introduction (e.g., to introduce the research question and its
significance).
o Consider streamlining some information, such as detailed percentages from each cited study.
Ensure proper citation formatting according to a specific style guide.
• Methods:
o Include details about participant recruitment, informed consent procedures, and ethical
considerations.
o Statistical analysis tests validity may need further assessment because it out of my field of
competence
• Discussion:
o Streamline the discussion by focusing on key results and their connection to existing literature.
o Explain the significance of specific findings
o Discuss the limitations of the study and outline future research directions.
• Conclusions:
o Revise the second paragraph to ensure consistency with the research findings.
Overall, this study has potential for publication in a peer-reviewed journal with some revisions.
Title: Endometrial Histological Patterns and Associated Factors of Abnormal Uterine Bleeding
among Women seeking Gynecological Services from Referral hospitals in Western Uganda: A
Cross-sectional Study
Version: 4 Date: 02 Jan 2025
Reviewer's report:
I congratulate the authors for a detailed study, however few queries needs to be taken care of-
1. How was the sample size determined, as the study mentioned in the reference no. 3 does
not include pathology types of endometrial reports ?[https://pmc.ncbi.nlm.nih.gov/articles/
PMC8855377/]
2. contraceptive history is not mentioned in the care record proforma nor is it included in the
results. IUCD, progesterone containing devices and injections are known to cause abnormal
uterine bleeding. How was this excluded?
3. Why was MVA used for endometrial biopsy when an OPD based aspiration devices [ Pipelle,
Vabra aspirator etc.] could have been used? A smaller size cannula of < 3 mm generally does
not require and anesthesia , was a bigger sizes suction cannula used with MVA?
4. As the procedure was done in 30 minutes of coming to OPD , was sensitivity test for local
anaesthesia done? Were there any side effects/ complications due to Local anaesthesia?
5. How was the normality of data checked?
6. The CI  for OR is very wide , hence a bigger sample size would be justified!
7. How was the diagnosis of Leiomyoma made was it only clinical? as there is no mention of
USG for the diagnosis of leiomyoma, it might be under-reported.
I wish best of luck to the authors
Title: Endometrial Histological Patterns and Associated Factors of Abnormal Uterine Bleeding
among Women seeking Gynecological Services from Referral hospitals in Western Uganda: A
Cross-sectional Study
Version: 7 Date: 14 Mar 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
No - there are issues with the statistics in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The manuscript is improved in quality but further revision is needed
REQUESTED REVISIONS:
The authors need to conduct model fitting statistics for their final multivariable model. Saying
this will be addressed in the future is not enough. In addition, the authors need to add their
responses on multicollinearity testing and the version of the SPSS software used to the data
analysis section.