JerMa88/BMC_Womens_Health_Peer_Reviews huggingface dataset:
Title: Alterations in Menstrual Characteristics and Associated Factors in Chinese Women Post
SARS-CoV-2 Infection: A Cross-Sectional Study
Version: 0 Date: 31 Dec 2024
Reviewer:  Rajani Dube
Reviewer's report:
• The article explores the menstrual abnormalities associated with SARS-CoV-2 infection
through a cross-sectional survey including a large sample size. It will be of interest to those
interested in the field.
• Abstract is structured and is representative of the study. It includes appropriate keywords.
• The title is appropriate and the introduction adequately provides an overview of existing
literature, identifies the gap, and states the goals of the study.
• Methodology is elaborate, well-described, and clear. A detailed explanation of the procedure,
outcome measures, and statistical analyses are given so that it can be replicated if required.
• The tables are appropriately used and are representative of the data. They are clearly
understandable without much repetition of the (data in the) text.  However, the tables need
improvement in formatting and spelling check.
• The discussion includes an in-depth analysis of the result, compares the findings to other
research in the literature, and appropriately highlights the similarities and contrasts. It is
suggested to highlight the strengths and limitations of the study or what it adds to existing
literature.
• The conclusion is consistent with the results and interpretation.
• Minor modifications- Needs language and grammar correction at places
o Expand terms like HPO, BMI, and ACE-2 at its first mention in the text. Subsequently, the
abbreviation can be used throughout the manuscript.
o Line-58- It will be more appropriate to write- Certain viral……function of the female
reproductive system.
o Line-70, please correct the referencing.
o Line 83- Add reference for Wenjuanxing platform.
o Line-89- Please correct AUB referrers to abnormalities in …
o Line 102- please clarify whether participants stopped answering questions voluntarily or the
rest of the questions were automatically not available to them.
o Line 105- Clarify whether a description of the disorders (specifically POI, PCOS) was provided
to the participant during the self-reported survey.
o Specify the data on the type of vaccine received by the participants
o Line 230, 244- Menstrual cycle (not cycling)
o Line 232- ie system???
• The references are appropriate and well-cited. However, there are inconsistencies in the style,
especially the use of et al after certain numbers of author names. It can be modified to a uniform
style according to the journal guidelines.
Title: The Application of Progesterone-Primed Ovarian Stimulation Protocol in Patients with
Ovarian Endometriosis Combined with Diminished Ovarian Reserve
Version: 0 Date: 17 Jan 2025
Reviewer:  Irene Iavarone
Reviewer's report:
I read with great interest the present Manuscript which falls within the aim of the Journal. In my
honest opinion, the topic is interesting enough to attract the readers’ attention. Methodology is
accurate and conclusions are supported by the data analysis. Nevertheless, authors should clarify
some points and improve the discussion citing relevant and novel key articles about the topic.
For all those reasons, I suggested performing the minor revisions.
- Inclusion and exclusion criteria should be clarified in the Materials and Methods section: in
particular, specify whether patients were intaking any concomitant treatment;
- Line 89: please clarify which are the uterine anomalies (mullerian congenital etc.), as well as
endometrial diseases (endometritis, polyps etc.);
- Authors may evaluate the impact of additional factors in OS. Please consider: "Iavarone I,
Mele D, Caprio F, et al. Obesity may impair response to ovarian stimulation. A retrospective
observational study on oocyte quality. Front Cell Dev Biol. 2024;12:1461132. Published 2024
Sep 30. doi:10.3389/fcell.2024.1461132";
- Authors have not adequately highlighted the strength and limitations of the study. I suggest
better specifying those points.
Title: Efficacy and Safety of Vaginal Suppositories Containing Combination of Natamycin and
Lactulose in Treatment of Vulvovaginal Candidiasis: International, Randomized, Controlled,
Superiority Clinical Trial (Combination of Natamycin and Lactulose for Treatment of
Vulvovaginal Candidiasis)
Version: 0 Date: 07 Sep 2024
Reviewer:  Mohammed abu El-Hamd
Reviewer's report:
The discussion and results should be more organized.
Major corrections to the language are essential.
Title: Efficacy and Safety of Vaginal Suppositories Containing Combination of Natamycin and
Lactulose in Treatment of Vulvovaginal Candidiasis: International, Randomized, Controlled,
Superiority Clinical Trial (Combination of Natamycin and Lactulose for Treatment of
Vulvovaginal Candidiasis)
Version: 0 Date: 12 Sep 2024
Reviewer's report:
Dear colleagues, thank you for inviting me to review your research. You've done a great job,
congratulations. It's a very interesting idea to use lactulose to treat vaginal infections. You’ve
done it and was the pioneer who showed the benefits and adverse events of lactulose for vagina,
not only the well-known effects in the intestine. But your manuscript should be revised.
My comments:
1. You compared the effectiveness of VVC treatment with natamycin and natamycin + lactulose.
I have never come across such a low efficacy of natamycin before. Natamycin, like Nystatin,
practically have no resistance to any type of Candida and therefore are the drugs of choice even
in cases of complicated VVC. At the same time, you showed a high recovery rate in the lactulose-
taking group, which is also not typical for Candida infection.  It means that you didn’t exclude
other causes of vulvovaginal symptoms and had a place of overdiagnosis VVC.
2. You used for diagnosis of VVC: clinical symptoms, microscopic test and pH #4,5. You did
not provide data on yeast culture before and during treatment (the gold standard for confirming
diagnosis for VVC in the studies) or nucleic acid amplifications tests.
The symptoms and signs of VVC can be relatively nonspecific and have many other potential
causes, including vaginal infections, vulvar dermatoses and GUMS (age of your patients was
18-60).
Your analysis of microscopic tests didn’t include leucocytes and epithelial cells , that could be
helping to exclude aerobic vaginitis, cytolytic vaginosis and vulvovaginal atrophy.
Poor effectiveness of natamycin in the study can be explained by it. And other side, the presence
of other causes of vulvovaginal complaints in women may explain to more benefits of natamycin
+lactulose and benefits of lactulose alone in some patients.
3. Many patients had a lack of lactobacilli count in your study. It is not typical for Candida
infection too. This is an additional argument that other vulvovaginal diseases have not been
excluded. Lactobacilli count is not the criteria of resolve of VVC.
4. You have not provided tables with the dynamics of clinical symptoms and laboratory
parameters, pH test during the treatment.
In conclusion:
The authors should more correctly state the criteria for inclusion in the study or expand the list
of diseases for the treatment.
Title: Efficacy and Safety of Vaginal Suppositories Containing Combination of Natamycin and
Lactulose in Treatment of Vulvovaginal Candidiasis: International, Randomized, Controlled,
Superiority Clinical Trial (Combination of Natamycin and Lactulose for Treatment of
Vulvovaginal Candidiasis)
Version: 1 Date: 03 Oct 2024
Reviewer's report:
Dear authors, thank you for such a detailed 7-page response, containing many quotes from
various publications. But I did not find answers to my questions in it at all. And you haven't
changed anything in the manuscript according to my recommendations. Graphic materials,
including new tables, require serious improvement.
My opinion of the results of the study: I can assume that all the treated women had VV
candidiasis, but you did not provide convincing data that would exclude other concomitant
causes of vulvovaginal complaints. You received such low efficacy in the Pimafucin group
(62%) and unexpectedly high (43%) - in the Lactulose group, which clearly indicates that
candidiasis was not the only vulvovaginal disease in these women, or even was absent. That's
why you can't  conclude that natamycin+lactulose is more effective in treating VV candidiasis,
then Pimafucin.
You should take this into account and revise the manuscript completely.
Title: Efficacy and Safety of Vaginal Suppositories Containing Combination of Natamycin and
Lactulose in Treatment of Vulvovaginal Candidiasis: International, Randomized, Controlled,
Superiority Clinical Trial (Combination of Natamycin and Lactulose for Treatment of
Vulvovaginal Candidiasis)
Version: 1 Date: 05 Oct 2024
Reviewer:  Mohammed abu El-Hamd
Reviewer's report:
Good work
Title: Efficacy and Safety of Vaginal Suppositories Containing Combination of Natamycin and
Lactulose in Treatment of Vulvovaginal Candidiasis: International, Randomized, Controlled,
Superiority Clinical Trial (Combination of Natamycin and Lactulose for Treatment of
Vulvovaginal Candidiasis)
Version: 2 Date: 06 Nov 2024
Reviewer:  Mohammed abu El-Hamd
Reviewer's report:
Good article.
Title: Efficacy and Safety of Vaginal Suppositories Containing Combination of Natamycin and
Lactulose in Treatment of Vulvovaginal Candidiasis: International, Randomized, Controlled,
Superiority Clinical Trial (Combination of Natamycin and Lactulose for Treatment of
Vulvovaginal Candidiasis)
Version: 2 Date: 13 Nov 2024
Reviewer's report:
No comment
Title: Efficacy and Safety of Vaginal Suppositories Containing Combination of Natamycin and
Lactulose in Treatment of Vulvovaginal Candidiasis: International, Randomized, Controlled,
Superiority Clinical Trial (Combination of Natamycin and Lactulose for Treatment of
Vulvovaginal Candidiasis)
Version: 3 Date: 07 Jan 2025
Reviewer:  Mohammed abu El-Hamd
Reviewer's report:
good article
Title: Efficacy and Safety of Vaginal Suppositories Containing Combination of Natamycin and
Lactulose in Treatment of Vulvovaginal Candidiasis: International, Randomized, Controlled,
Superiority Clinical Trial (Combination of Natamycin and Lactulose for Treatment of
Vulvovaginal Candidiasis)
Version: 3 Date: 14 Jan 2025
Reviewer's report:
PAPER:The patient completed a questionnaire in the presence of the investigating
physician .The questionnaire contained closed-ended responses ranging from 1 point (no clinical
symptoms) to 5 points (severe clinical symptoms) (Additional file 3).
Additional file 3:   Table S2. Assessment of the severity of the symptom of vulvovaginal
candidiasis on a 4-point scale#0-3 point#
11 symptoms are listed in Table S2, and 5 are analyzed in the paper. Please review Table S2 again
The author needs to carefully check the scoring table, which is the foundation of the research.
Discussion is not a restatement of research results, it requires analysis of the results.
Title: Efficacy and Safety of Vaginal Suppositories Containing Combination of Natamycin and
Lactulose in Treatment of Vulvovaginal Candidiasis: International, Randomized, Controlled,
Superiority Clinical Trial (Combination of Natamycin and Lactulose for Treatment of
Vulvovaginal Candidiasis)
Version: 4 Date: 06 Feb 2025
Reviewer's report:
line 249#a 5-point scale should be a 4-point scale
line 421# a 5-point scale should be a 4-point scale
line 479#SAE should be AE
Title: Efficacy and Safety of Vaginal Suppositories Containing Combination of Natamycin and
Lactulose in Treatment of Vulvovaginal Candidiasis: International, Randomized, Controlled,
Superiority Clinical Trial (Combination of Natamycin and Lactulose for Treatment of
Vulvovaginal Candidiasis)
Version: 5 Date: 10 Feb 2025
Reviewer's report:
No further modification is required at present
Title: Case Report: Postoperative Pulmonary Edema and Pulmonary Hemorrhage Following
Hysteroscopy
Version: 0 Date: 23 Oct 2024
Reviewer's report:
The manuscript provides an insightful and detailed account of a rare complication following
hysteroscopy—pulmonary edema and pulmonary hemorrhage associated with the use of normal
saline as the uterine distension medium. While the case presentation is thorough, several recent
studies could provide valuable context and help position the findings within the broader field
of hysteroscopic interventions.
Overall, the language needs to be checked and edited by a native English speaker-
I suggest adding the following discussion topics and citations to enhance the discussion:
-Current and improved multipurpose role of hysteroscopic surgery (PMID: 33246040; PMID:
34648934; PMID: 32330671) : This reference could be included in the introduction to help
provide a broader understanding of the role of hysteroscopy in the management of gynecological
issues, particularly concerning diagnostic accuracy and the complications that may arise during
these procedures.
-Hysteroscopic treatment of fibroids: when, why, and how? (PMID: 32410475; PMID:
33942886): This could be mentioned in the discussion when addressing indications for
hysteroscopy and associated complications. It may help emphasize the importance of patient
selection criteria for hysteroscopy and address potential risks related to uterine fibroids.
-Pain management for hysteroscopic surgery (PMID: 37917158 ; PMID: 33166706): This
topic could be integrated into the discussion on anesthesia and airway management during
hysteroscopy. It highlights the importance of effective pain management strategies, which might
contribute to preventing intraoperative complications, such as airway obstruction, that could
lead to adverse outcomes like pulmonary edema.
Title: Case Report: Postoperative Pulmonary Edema and Pulmonary Hemorrhage Following
Hysteroscopy
Version: 0 Date: 14 Nov 2024
Reviewer's report:
Dear authors,
This is an overall well constructed and reported case.
However, mire details and information should be mentioned regarding the indication of the
hysteroscopy, its occurrence: complicated or not, with some extra details.
please do mention whether there was uterine perforation or not and elaborate on this point in the
discussion, because it is a main factor in causing excessive fluid absorption.
Title: Case Report: Postoperative Pulmonary Edema and Pulmonary Hemorrhage Following
Hysteroscopy
Version: 0 Date: 14 Dec 2024
Reviewer:  Atar Singh Kushwah
Reviewer's report:
1. The abstract does not quantify or discuss the broader clinical relevance (e.g., potential
incidence, estimated risk). It omits detailed mention of the diagnostic process, which is critical
for contextualizing the findings.
2. Spelling error in “Backgroud” should be corrected to “Background.” The abstract briefly
mentions the follow-up duration to underscore long-term safety.
3. The introduction does not sufficiently highlight the novelty of the simultaneous occurrence of
upper airway obstruction and pulmonary hemorrhage in this context. Limited exploration of why
low-viscosity saline is traditionally considered safer. No definition or reference for the safety
threshold of irrigation pressure (150 mmHg) in context with systemic risks.
4. The intraoperative oxygen saturation drop and response lack detailed physiological reasoning;
this could be crucial for understanding pathophysiology. There is no quantitative explanation
of how much saline absorption may have occurred under elevated intrauterine pressure. This
estimation is crucial for generalizability.
5. Inconsistent units in describing irrigation pressure (alternating between “mmHg” and “cm
above the table”). Lack of visual support or table summarizing critical perioperative parameters
(e.g., vital signs, fluid balance).
6. Speculative conclusions about fluid absorption and pulmonary capillary pressure are not
directly validated by intraoperative or postoperative measurements (e.g., no pulmonary wedge
pressure or volume overload studies). The lack of pathological data weakens the causal
link between hypothesized mechanisms and observed outcomes. The authors should clearly
acknowledge this limitation and explore alternatives.
7. CT scans lack detailed annotations or legends that fully explain key observations for non-
specialist readers. No quantitative data (e.g., radiographic scores or descriptive statistics)
accompany the visual findings. Formatting inconsistency in figure captions (e.g., placement of
labels like "Figure 1" vs. embedded text).
8. Conclusions do not discuss the long-term relevance of these findings for clinical guidelines
or training programs. The novelty of the findings is undermined by the lack of quantitative
evidence. Overemphasis on a single case's implications without sufficiently qualifying the
conclusions as tentative.
Title: Case Report: Postoperative Pulmonary Edema and Pulmonary Hemorrhage Following
Hysteroscopy
Version: 0 Date: 23 Dec 2024
Reviewer:  Michael Odida
Reviewer's report:
An interesting case report. Some issues to address. The names of authors cites in the introduction
should be without their initials. Also in the introduction, thirty  two percent should be written
in figures.
Title: Case Report: Postoperative Pulmonary Edema and Pulmonary Hemorrhage Following
Hysteroscopy
Version: 0 Date: 27 Dec 2024
Reviewer:  Hawraa Hussein Ghafel
Reviewer's report:
Dear author, I hope you are well. I have reviewed your case report  and i really enjoyed when
i read it , I commend your efforts . I have left you some comments to help you make the report
perfect. I hope to see your report  published soon.
Regards
Title: Case Report: Postoperative Pulmonary Edema and Pulmonary Hemorrhage Following
Hysteroscopy
Version: 1 Date: 23 Jan 2025
Reviewer:  Hawraa Hussein Ghafel
Reviewer's report:
Dear author (s), I hope you are well. I have reviewed the revision and the study is now in its
best version. I hope to see the article published soon
Regards
Professor Hawraa Hussein Ghafel
Title: Diagnostic Value of Multimodal Hysterosalpingo-Contrast Sonography Combined with
Negative Intrauterine Contrast-Enhanced Ultrasound in Female Infertility
Version: 2 Date: 21 Aug 2024
Reviewer's report:
Thank you for giving me the opportunity to review this interesting study "Diagnostic Value of
Multimodal Transvaginal Contrast-Enhanced Ultrasound Combined with Negative Intrauterine
Contrast-Enhanced Ultrasound in Female Infertility".
However, I have some comments and recommendations:
Comments:
Title: - Is appropriate for the content of the article.
Abstract:- Represents a suitable summary of the work.
Article content:- The methods and results have been well explained.
Conclusions:- Are justified on the basis of the study.
Recommendations:
Discussion:- Mention the strength of the study.
References:- Stick to the format of the journal.
General:- Revise language, grammar and syntax.
Title: Diagnostic Value of Multimodal Hysterosalpingo-Contrast Sonography Combined with
Negative Intrauterine Contrast-Enhanced Ultrasound in Female Infertility
Version: 2 Date: 28 Dec 2024
Reviewer:  Yigit Cakiroglu
Reviewer's report:
General comments:
The manuscript has aimed to explore the diagnostic efficiency of different modes of contrastation
combined with different modes for tubal patency. The authors have analyzed in total 310 infertile
patients in this study.
Abstract:
The abstract should be rewritten in a structured format.
Introduction:
Information about infertility and the roles of tubes and uterus have been given in the introduction
section.
More information should be given about tubal patency evaluation techniques, and multimodal
TV contrast US.
Aim has been defined in this section.
Material and Methods
-“Patients with abnormal hysteroscopy were offered hysteroscopy” should be clarified.
-Infertility reasons should be defined for the inclusion criteria.
-“All the angiography data….” Angiography should be clarified.
Results
-“The 15 bilateral obstruction cases (Figure 5) were confirmed by laparoscopic surgery.” Were
the accuracy of unilateral obstructed cases evaluated without LS?
- Would the authors explain “mediastinal uterus”?
Discussion
The discussion section states the importance and significance of the findings.
- “Grassroots hospitals” should be clarified.
References:
The reference section contains appropriate and number of references, but more upto-date
references should be cited.
Tables:
Tables are well-designed and well-organized.
Figures:
Figures are so demonstrative.
Title: Diagnostic Value of Multimodal Hysterosalpingo-Contrast Sonography Combined with
Negative Intrauterine Contrast-Enhanced Ultrasound in Female Infertility
Version: 2 Date: 28 Dec 2024
Reviewer's report:
Dear colleagues
Thank you very much for diverting this very nice article to me for peer reviewing.
As a mater of fact, The author compared with advanced techniques of vaginal ultrasound
with various contrast methods and agent and found that the 4 D type with one method of
contrast enhanced imaging is superior to the others with regard to uterine polyp, uterine shape
abnormality as well as tubal obstruction.
I don't have so far any serious or objections to to the methodology used by the author.
So far, The author has proved his point of view in table 2 and 4.
Maybe, it is remarkable to mention that there exist a superior or a specific statistical test for
this kind of papers as far as diagnostic efficiency of new method is investigated compared to
the standard one.
The test is called INTER RATER OBSERVATION TEST with calculation of the coefficient
of Kappa Cohen.
I really wonder why the author didn't use this method in addition to the already done statistics
used in this paper. I shall be very happy if you ask the author why he didn't imply calculation of
Kappa Cohen coefficient as a supplementary and highly enrichment test supporting the results
obtained by author shown in his results.
I hope that his answer will be satisfactory to the Journal Board rather to me as my point of view
is just an opinion rather than objection to his paper.
Thank you very much
Sincerely Yours
Wisam Akram
Title: Diagnostic Value of Multimodal Hysterosalpingo-Contrast Sonography Combined with
Negative Intrauterine Contrast-Enhanced Ultrasound in Female Infertility
Version: 3 Date: 30 Jan 2025
Reviewer's report:
Dear colleagues
Thank you very much for re submitting this article for reviewing the author answer.
I have read my point of view, and read very carefully the cleaver and comprehensive answer
by the author.
Apparently the author is methodologically and statistically is a competent one. He understood
the significance of Kappa Cohen uses and referred that when he used it in table 2, Virtually
they were all close to 1; ( Its range from 0 to 1). The value near 1 indicates excellent agreement
between two diagnostic methods. Also he referred clearly to the table that should we have applied
to, namely number 2, and he is correct! To me, That is more than enough to be comprehensive
with all his future readers.
So, my decision; Accept
Thank  you very much
Sincerely yours
Wisam Akram
Title: Diagnostic Value of Multimodal Hysterosalpingo-Contrast Sonography Combined with
Negative Intrauterine Contrast-Enhanced Ultrasound in Female Infertility
Version: 3 Date: 31 Jan 2025
Reviewer's report:
Thank you for giving me the opportunity to review this interesting study "Diagnostic Value
of Multimodal Hysterosalpingo-Contrast Sonography Combined with Negative Intrauterine
Contrast-Enhanced Ultrasound in Female Infertility".
Almost all reviewer’s comments and recommendations were considered.