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Latest review

First review round: 14.4 weeks. Overall rating: 0 (very bad). Outcome: Rejected.

Motivation:
1- You don't have to spend half a year of your life and of the authors' life to reject their work, you sent your comments and reviews 3 different times, which could be done at the same time. The first time you asked me about some clinical details which I have done. The second time you asked to change the title, update references and do some format changes, which I did. The last time: commenting on the abstract and rejecting my work. All of that could have been done the first time, no need to waste your time, as such mine. 2- THE IMPORTANT point is the cause of your rejection: You angrily mentioned that the author is refusing to make changes which is previously suggested about updating the references and the maximum is 4 references more than 5 years. You really look like you didn't review my edited article well, as I sent you the file with only 3 references dated more than 5 years. 3- The last reviewers' comments carry a poor professional manner and bad communication: You could reject my work but still, talk in a nice way using supportive sentences that encourage me to submit another work to your journal later on. You have used a lot of abbreviations and had a quick judgment about the cause that you used to reject my work. 4- I am not sure I am the only one to be treated in such a manner by your journal reviewers. Still, I do suggest carrying out an audit, or a quality improvement project, involving most of the work submitted to your journal and doing a root cause analysis about the outcomes, the reviews, the times of reviewers' comments, and the timeline till the decision. I am sure if you do that, and are dedicated to improving your journal performance, I am sure this will improve your journal H INDEX. 5- Finally, I wish you all the best and look forward to submitting new work with you soon.