Annals of Clinical Cytology and Pathology

First Report of Autochthonous Visceral Leishmaniosis in Humans in foz Do Iguaçu, Paraná State, Southern Brazil

Case Report | Open Access

  • 1. Hospital Ministro Costa Cavalcanti
  • 2. Prefeitura do Município de Foz do Iguaçu - Centro de Controle de Zoonoses
  • 3. Acadêmico do Curso de Medicina da Universidade Federal de Santa Catarina;
  • 4. Prefeitura do Município de Foz do Iguaçu - Vigilância Epidemiológica é o que consta no site da prefeitura
  • 5. Secretaria de Saúde do Estado do Paraná
  • 6. 6 Programa de Pós-Graduação em Engenharia de Bioprocessos e Biotecnologia, Universidade Federal do Paraná, Curitiba, Paraná, Brasil
  • 7. Universidade Federal da Integração Latino Americana, Foz do Iguaçu, Paraná, Brasil UNILA
+ Show More - Show Less
Corresponding Authors
Vanete Thomaz Soccol, Programa de Pós-Graduação em Engenharia de Bioprocessos e Biotecnologia, Universidade Federal do Paraná, Curitiba, Paraná Brazil

This is the first report of autochthonous visceral leishmaniosis in humans in Foz do Iguaçu city, Parana, Brazil, bordering Argentina and Paraguay. During his physical examination, a 28-year-old man from Foz do Iguaçu, showed good general health, a slightly bleached, discrete bilateral cervical lymphadenopathy, 38°C fever, confirmation of weight loss and no other symptoms About 15 days after the first visit, he presented with discrete hepatomegaly and splenomegaly palpation of the abdomen. Amyelogram, stained by May-Grunwald-Giemsa, showed normocellular bone marrow for age and presence of Leishmania amastigotes in macrophages and extracellularly. The parasite was isolated by bone marrow aspiration and cultured in Novy, Mac Neal-Nicolle medium. Serological exams by enzyme-linked immunosorbent assay and DPP were positive. Polymerase chain reaction (PCR) with primers RV1/RV2 was performed on DNA extracted from bone marrow aspirate and showed an identical pattern to the Leishmania infantum reference strain.The species of the parasite, isolated in culture, was confirmed by PCR using primers for the ITS-1 region followed by restriction fragment length polymorphism (RFLP) pattern analysis and sequencing. RFLP verified the parasite showed a very similar pattern to L. infantum and the forward and reverse sequences presented 99% identity with L. infantum. An epidemiological survey in dogs, in the house of the patient’s home and neighborhood showed 13.3% positivity. Lutzomyia longipalpis was present in the perdomestic environment of the patient’s home.


Pina Trench FJ, Ritt AG, Gewehr TA, de Souza Leandro A, Chiyo L, et al. (2016) First Report of Autochthonous Visceral Leishmaniosis in Humans in foz Do Iguaçu, Paraná State, Southern Brazil. Ann Clin Cytol Pathol 2(6): 1041.


•    Visceral leishmaniosis
•    Human
•    Parana state
•    Southern brazil


Visceral leishmaniosis (VL) is responsible for over 50,000 deaths per year, with an estimated average of half a million new cases annually [1]. In Brazil, VL has an effect of close to 3000 cases and approximately 200 deaths per year [2]. Over the past 20 years, there has been a transition in the epidemiological profile of VL, with an increase in the proportion of cases in the south west region and movement from rural to urban areas. In the Southern Cone, the triple borders of Argentina, Brazil and Paraguay, work has been conducted under the coordination of the Pan American Health Organization for research vectors and reservoirs of visceral leishmaniosis since 2012. In 2012 Lutzomyia longipalpis was confirmed in Foz do Iguaçu [3], and from 2012-2013, Thomaz-Soccol et al., [4] showed dog samples positive by serological tests and the parasites isolated were identified as L. infantum [5].

Here we report the first case of a patient diagnosed with visceral leishmaniosis with autochthonous transmission in Foz do Iguaçu city, Paraná State, in southern Brazil.

First Report of Vl in a man from Foz Do Iguaçu

The first report of VL in Foz do Iguaçu, Paraná, Brazil 25°32‘49“S, 54°35’18”W was a 28-year-old, brown man who worked for the military police. He attended outpatient consultation with a complaint of 30 days of daily fever of 38-39ºC and night sweats accompanied by weight loss of 3 kg. He denied travelling to any other locations in the preceding 12 months and reported that he had been tested for tuberculosis two years previously, and the results were negative after extensive research with a pulmonologist.

A physical examination showed good general health, a slightly bleached, discrete bilateral cervical lymphadenopathy, and fever of 38° C, the confirmation of weight loss, and no other signs or symptoms. An initial blood examination showed data compatible with acute infection or inflammatory disease (Table 1). The patient showed negative blood and urine cultures, an X-ray chest indicated injury, with a scar on the right apex, and an abdominal ultrasound was normal. About 15 days after the first visit, he presented discrete hepatomegaly and splenomegaly palpation of the abdomen, which were absent in the initial physical examination. The patient was referred to a hematologist to assess hematologic disease in the bone marrow. The results of samples stained by the May-Grunwald-Giemsa method and data are shown in Table (1). The myelogram showed normocellular bone marrow for the patient’s age. The myeloid series showed elements at all stages of maturation. The erythroid component presented numerous hyperplasic cells (42%) without gross changes in shape. The megakaryocytic component presented amastigotes of leishmania sp. in the macrophages and extracellularly (Table 1, Figure 1). ELISA and DPP® serology using L. infantum antigen were reactive. The parasite was isolated by bone marrow aspiration and was cultured in Novy, Mac Neal-Nicolle medium. Species identification was performed by PCR using primers RV1 and RV2 [5]. In addition, amplification of the internal transcribed spacer 1 (ITS-1) was performed, followed by RFLP, as proposed by Schönian et al. (2003) [6]. RFLP showed an identical pattern to the reference strain of L. infantum (Figure 1). The forward and reverse sequences showed 99% identity with L. infantum (MHOM/BR/74/PP75; Gene Bank access number AF103739).

The patient was treated with deoxycholate of amphotericin B at a dose of 50 mg daily for a total period of 15 days, nonsequentially. He became asymptomatic, and blood count recovery was achieved after the seventh dose of medication. He presented complications of lung disease four days after the use of amphotericin, but showed excellent clinical response with the use of trimethoprim-sulfamethoxazole. After being attended at our service for six months, he has undergone complete clinical and blood count recovery. No marrow aspiration was performed for control of cure.

Here, we report the first patient with clinical and laboratorial confirmation of VL; in the Foz do Iguaçu city, Paraná State.

Epidemiological Research in the Address of the Patient

Serological evaluation in dogs: A serological study was performed, using TR-DPP® as screening and the ELISA test for confirmation, on 165 dogs in the patient’s house and the surrounding neighborhood. Twenty-two of these samples were positive (13.3%), 142 were negative (85%) and one had an indeterminate ELISA result (1.6%). The two dogs owned by the patient had negative results. Among the positive animals, 18 were euthanatized with the owner’s consent. Four owners, who did not agree to the removal of their positive dogs, signed a term of responsibility for rejecting the euthanasia of a positive dog.

Investigating the presence of Phlebotominae: Sand flies were captured with automatic CDC light traps, used for sampling the Phlebotominae in peridomestic environments and inside the patient’s home. The traps were active from approximately 6:30 p.m. to 7:30 a.m., for three consecutive rainless nights. They were placed 1.5 m above the ground. The study was conducted from July 16th to 18th 2015. One female of Lu. longipalpis was found in the patient’s residence. Two males of the same species were captured at another residential address in the vicinity.

Using the same methodology, 12 traps were installed where the patient worked, from August 3rd o 5th 2015. In this environment, one female Lutzomyia sp. was captured.

Table 1: Results of Hematological Parameters.

First Exam Hemogram    
  Hemoglobin (g/dL ) 10.9    
  Hematocrit (%) 34.9    
  Leukopenia (cells/mcL) 2,600    
  Platelets/mcL 107,000    
  Enzymes AST and ALT (U/L of serum) 50.6 and 71.5    
  LDH -283    
  PCR 13* Shows acute disease or inflammatory syndrome
Second Exam Hemogram Myelogram  
  Hemoglobin (g/dL) -11.8 Myeloid Erythroid Megakaryocytic
  Hematocrit (%) - 36.1 4% -promyelocytes Present and numerous hyperplastic cells (42%) without gross changes 7%- lymphocytes
  RBCs (/mm³) - 4.62 16% - myelocytes   1% - monocytes
  Mean corpuscular volume - 78.1 fl 20% - metamyelocytes   4% - blasts
  WBC (/mm³) - 2,400 4% - segmented rods   2% - plasma cells
  43% neutrophils/
8% lymphocytes 
(1% eosinophils/
8% monocytes)
  Platelets(/mm³)- 109,000      



The southern regions of Brazil were not considered an important area for VL until the beginning of 2008, when a dog was diagnosed with the disease in São Borja County, in the State of Rio Grande do Sul. In the same year, Lu. longipalpis were captured and autochthonous canine cases were confirmed [7,8] followed by the first human case registered in 2009 [9]. In Santa Catarina, Steindel et al., (2013) [10] described an outbreak of autochthonous canine VL (CVL), and in 2014, Maziero et al., [11] reported dogs with serology positive for VL in São Miguel do Oeste. Neighbouring countries Paraguay and Argentina have also recorded VL in recent years [12,13]. This prompted further research and the vector Lu. longipalpis was confirmed in areas of Foz do Iguaçu near Argentina [3]. However, the real distribution of the vector, in Foz do Iguaçu city remains unknown. Autochthonous transmission of L. infantum in dogs has been verified in regions near Argentina and Paraguay [14]. Again, the real CVL distribution in Foz do Iguaçu city (is not known) has yet to be determined. These data suggest a time sequence in the establishment of the disease in a given geographic area. Thus, the stage is set for the development of the disease in humans. In anticipation of diagnosing human cases, anyone who has had a fever for over a week or who reports rapid weight loss is being including in the differential diagnosis of VL.

With this first case of human VL, it was essential to determine whether this case was autochthonous or imported, because nowadays people travel within and to different regions very quickly and easily. The serological survey showed sero reactive dogs and the presence of the vector confirmed local transmission.

From a clinical perspective, this case was a typical manifestation of visceral leishmaniosis in the initial phase. We chose to prescribe amphotericin B, using a cumulative dose for a total period of 15 non-sequential days. The increased creatinine levels and hypokalemia were controlled during hospitalization. At the end of the therapy, the patient’s splenomegaly was reduced by approximately 60%, the fever had ceased, and the pancytopenia was completely reversed.

Diagnostic tests for VL have certain limitations, for example, the serological tests can remain positive for a long time after patient treatment, thus they do not allow health professionals to evaluate the effect of the therapy and they have been known to cross-react with other diseases. Since subclinical infections occur, a positive test does not necessarily indicate active disease. Clinicians and epidemiologists always request serological tests to confirm the diagnoses, because parasitological methods are invasive. They expect the results to be reliable, with high specificity and sensitivity and as fast as possible, to enable them to treat preventable disease. However, no method provides 100% of sensitivity and the clinical features of this disease render the diagnosis difficult and complex. It is therefore important that the different specialties talk to each other and the laboratory to make decisions on patient referrals.

From now on, in Paraná state, physicians need consider a potential diagnosis of visceral leishmaniosis when a patient has fever for more than 10 days, and people traveling to Foz do Iguaçu need to know that this region is now endemic for visceral leishmaniosis.


We acknowledge Prof. Philip Sidney Pacheco Badiz for English correction.


1. Organización Mundial de La Salud. Control de lasleishmaniasis: informe de una reunióndel Comité de Expertos de la OMS sobre El Control e lasLeishmaniasis. Ginebra 22 a 26 de marzo de. 2010.

2. Brasil. Ministério da Saúde . Óbitos de Leishmaniose Visceral, Brasil, Grandes Regiões e Unidades Federadas (1990 a 2013). 2014.

3. Santos DR, Ferreira AC, Bisetto-Jr A. The first record of Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae: Phlebotominae) in the State of Paraná, Brazil. Rev Soc Bras Med Trop. 2012; 45: 643-645.

4. Thomaz-Soccol V. Cutaneous and Visceral leishmaniasis in the Parana state, Brazil border with Argentina and Paraguay. FIFTH WORLD CONGRESS ON LEISHMANIASIS - WORLDLEISH 5-13th to May 17th, at the Convention Center ENOTEL RESORTS, Porto de Galinhas, PE, Brazil. 2013.

5. Lachaud L, Marchergui-Hammami S, Chabbert E, Dereure J, Dedet JP, Bastien P. Comparison of six PCR methods using peripheral blood for detection of canine visceral leishmaniasis. J Clin Microbiol. 2002; 40: 210-215

6. Schönian G, Nasereddin A, Dinse N, Schweynoch C, Schallig HD, Presber W, et. al. PCR diagnosis and characterization of Leishmania in local and imported clinical samples. Diagn Microbiol Infect Dis. 2003; 47: 349-358.

7. Brasil, Ministério da Saúde. Nota técnica conjunta da Secretaria de Vigilância em Saúde do Ministério da Saúde e da Secretaria de Estado da Saúde Pública do Rio Grande do Sul sobre a situação da Leishmaniose Visceral na fronteira do Estado do Rio Grande do Sul com a Argentina. 2010.

8. Deboni SC, Barbosa M, Ramos RR 2011. Leishmaniose Visceral no Rio Grande do Sul: Vigilância Epidemiológica de casos humanos. Bol Epidemiol-Centro Estadual de Vigilância em Saúde. 2011; 13:3.

9. Souza GD, Santos E, Andrade Filho JD 2009. The first report of the main vector of visceral leishmaniasis in America, Lutzomyia longipalpis (Lutz & Neiva) (Diptera: Psychodidae: Phlebotominae), in the state of Rio Grande do Sul, Brazil. Mem Inst Oswaldo Cruz. 104: 1181-1182.

10. Steindel M, Menin A, Evangelista T, Stoco PH, Marlow MA, Fleith RC, et al. Outbreak of autochthonous canine visceral leishmaniasis in Santa Catarina, Brazil. Pesq Vet Bras. 2013; 33: 490-496.

11. Maziero N, Thomaz-Soccol V, Steindel M, Link JS, Rossini D, Alban SM, et al. Rural-urban focus of canine visceral leishmaniosis in the far western region of Santa Catarina State, Brazil. Vet Parasitol. 2014; 205: 92-95.

12. Salomon OD, Sinagra A, Nevot MC, Barberian G, Paulin P, Estevez J, et al . First visceral leishmaniasis focus in Argentina. Mem Inst Oswaldo Cruz. 2008; 103: 109-111.

13. Canese A. Leishmaniosis visceral canina em elarea metropolitana de la “Gran Asunción”, Paraguay. Medicina (Buenos Aires) 60 (Supl. III). 2000; 65.

14. Bisetto-JR A, Thomaz-Soccol V, Navarro IT. Leishmaniose Visceral no Estado do Paraná. 5ª. Revista do Conselho Regional de Medicina Veterinária do Paraná. 2014; 41: 6-7.

Received : 09 Aug 2016
Accepted : 15 Sep 2016
Published : 11 Oct 2016
Annals of Otolaryngology and Rhinology
ISSN : 2379-948X
Launched : 2014
JSM Schizophrenia
Launched : 2016
Journal of Nausea
Launched : 2020
JSM Internal Medicine
Launched : 2016
JSM Hepatitis
Launched : 2016
JSM Oro Facial Surgeries
ISSN : 2578-3211
Launched : 2016
Journal of Human Nutrition and Food Science
ISSN : 2333-6706
Launched : 2013
JSM Regenerative Medicine and Bioengineering
ISSN : 2379-0490
Launched : 2013
JSM Spine
ISSN : 2578-3181
Launched : 2016
Archives of Palliative Care
ISSN : 2573-1165
Launched : 2016
JSM Nutritional Disorders
ISSN : 2578-3203
Launched : 2017
Annals of Neurodegenerative Disorders
ISSN : 2476-2032
Launched : 2016
Journal of Fever
ISSN : 2641-7782
Launched : 2017
JSM Bone Marrow Research
ISSN : 2578-3351
Launched : 2016
JSM Mathematics and Statistics
ISSN : 2578-3173
Launched : 2014
Journal of Autoimmunity and Research
ISSN : 2573-1173
Launched : 2014
JSM Arthritis
ISSN : 2475-9155
Launched : 2016
JSM Head and Neck Cancer-Cases and Reviews
ISSN : 2573-1610
Launched : 2016
JSM General Surgery Cases and Images
ISSN : 2573-1564
Launched : 2016
JSM Anatomy and Physiology
ISSN : 2573-1262
Launched : 2016
JSM Dental Surgery
ISSN : 2573-1548
Launched : 2016
Annals of Emergency Surgery
ISSN : 2573-1017
Launched : 2016
Annals of Mens Health and Wellness
ISSN : 2641-7707
Launched : 2017
Journal of Preventive Medicine and Health Care
ISSN : 2576-0084
Launched : 2018
Journal of Chronic Diseases and Management
ISSN : 2573-1300
Launched : 2016
Annals of Vaccines and Immunization
ISSN : 2378-9379
Launched : 2014
JSM Heart Surgery Cases and Images
ISSN : 2578-3157
Launched : 2016
Annals of Reproductive Medicine and Treatment
ISSN : 2573-1092
Launched : 2016
JSM Brain Science
ISSN : 2573-1289
Launched : 2016
JSM Biomarkers
ISSN : 2578-3815
Launched : 2014
JSM Biology
ISSN : 2475-9392
Launched : 2016
Archives of Stem Cell and Research
ISSN : 2578-3580
Launched : 2014
Annals of Clinical and Medical Microbiology
ISSN : 2578-3629
Launched : 2014
JSM Pediatric Surgery
ISSN : 2578-3149
Launched : 2017
Journal of Memory Disorder and Rehabilitation
ISSN : 2578-319X
Launched : 2016
JSM Tropical Medicine and Research
ISSN : 2578-3165
Launched : 2016
JSM Head and Face Medicine
ISSN : 2578-3793
Launched : 2016
JSM Cardiothoracic Surgery
ISSN : 2573-1297
Launched : 2016
JSM Bone and Joint Diseases
ISSN : 2578-3351
Launched : 2017
JSM Bioavailability and Bioequivalence
ISSN : 2641-7812
Launched : 2017
JSM Atherosclerosis
ISSN : 2573-1270
Launched : 2016
Journal of Genitourinary Disorders
ISSN : 2641-7790
Launched : 2017
Journal of Fractures and Sprains
ISSN : 2578-3831
Launched : 2016
Journal of Autism and Epilepsy
ISSN : 2641-7774
Launched : 2016
Annals of Marine Biology and Research
ISSN : 2573-105X
Launched : 2014
JSM Health Education & Primary Health Care
ISSN : 2578-3777
Launched : 2016
JSM Communication Disorders
ISSN : 2578-3807
Launched : 2016
Annals of Musculoskeletal Disorders
ISSN : 2578-3599
Launched : 2016
Annals of Virology and Research
ISSN : 2573-1122
Launched : 2014
JSM Renal Medicine
ISSN : 2573-1637
Launched : 2016
Journal of Muscle Health
ISSN : 2578-3823
Launched : 2016
JSM Genetics and Genomics
ISSN : 2334-1823
Launched : 2013
JSM Anxiety and Depression
ISSN : 2475-9139
Launched : 2016
Clinical Journal of Heart Diseases
ISSN : 2641-7766
Launched : 2016
Annals of Medicinal Chemistry and Research
ISSN : 2378-9336
Launched : 2014
JSM Pain and Management
ISSN : 2578-3378
Launched : 2016
JSM Women's Health
ISSN : 2578-3696
Launched : 2016
Clinical Research in HIV or AIDS
ISSN : 2374-0094
Launched : 2013
Journal of Endocrinology, Diabetes and Obesity
ISSN : 2333-6692
Launched : 2013
Journal of Substance Abuse and Alcoholism
ISSN : 2373-9363
Launched : 2013
JSM Neurosurgery and Spine
ISSN : 2373-9479
Launched : 2013
Journal of Liver and Clinical Research
ISSN : 2379-0830
Launched : 2014
Journal of Drug Design and Research
ISSN : 2379-089X
Launched : 2014
JSM Clinical Oncology and Research
ISSN : 2373-938X
Launched : 2013
JSM Bioinformatics, Genomics and Proteomics
ISSN : 2576-1102
Launched : 2014
JSM Chemistry
ISSN : 2334-1831
Launched : 2013
Journal of Trauma and Care
ISSN : 2573-1246
Launched : 2014
JSM Surgical Oncology and Research
ISSN : 2578-3688
Launched : 2016
Annals of Food Processing and Preservation
ISSN : 2573-1033
Launched : 2016
Journal of Radiology and Radiation Therapy
ISSN : 2333-7095
Launched : 2013
JSM Physical Medicine and Rehabilitation
ISSN : 2578-3572
Launched : 2016
Annals of Clinical Pathology
ISSN : 2373-9282
Launched : 2013
Annals of Cardiovascular Diseases
ISSN : 2641-7731
Launched : 2016
Journal of Behavior
ISSN : 2576-0076
Launched : 2016
Annals of Clinical and Experimental Metabolism
ISSN : 2572-2492
Launched : 2016
Clinical Research in Infectious Diseases
ISSN : 2379-0636
Launched : 2013
JSM Microbiology
ISSN : 2333-6455
Launched : 2013
Journal of Urology and Research
ISSN : 2379-951X
Launched : 2014
Journal of Family Medicine and Community Health
ISSN : 2379-0547
Launched : 2013
Annals of Pregnancy and Care
ISSN : 2578-336X
Launched : 2017
JSM Cell and Developmental Biology
ISSN : 2379-061X
Launched : 2013
Annals of Aquaculture and Research
ISSN : 2379-0881
Launched : 2014
Clinical Research in Pulmonology
ISSN : 2333-6625
Launched : 2013
Journal of Immunology and Clinical Research
ISSN : 2333-6714
Launched : 2013
Annals of Forensic Research and Analysis
ISSN : 2378-9476
Launched : 2014
JSM Biochemistry and Molecular Biology
ISSN : 2333-7109
Launched : 2013
Annals of Breast Cancer Research
ISSN : 2641-7685
Launched : 2016
Annals of Gerontology and Geriatric Research
ISSN : 2378-9409
Launched : 2014
Journal of Sleep Medicine and Disorders
ISSN : 2379-0822
Launched : 2014
JSM Burns and Trauma
ISSN : 2475-9406
Launched : 2016
Chemical Engineering and Process Techniques
ISSN : 2333-6633
Launched : 2013
JSM Allergy and Asthma
ISSN : 2573-1254
Launched : 2016
Journal of Neurological Disorders and Stroke
ISSN : 2334-2307
Launched : 2013
Annals of Sports Medicine and Research
ISSN : 2379-0571
Launched : 2014
JSM Sexual Medicine
ISSN : 2578-3718
Launched : 2016
Annals of Vascular Medicine and Research
ISSN : 2378-9344
Launched : 2014
JSM Biotechnology and Biomedical Engineering
ISSN : 2333-7117
Launched : 2013
Journal of Hematology and Transfusion
ISSN : 2333-6684
Launched : 2013
JSM Environmental Science and Ecology
ISSN : 2333-7141
Launched : 2013
Journal of Cardiology and Clinical Research
ISSN : 2333-6676
Launched : 2013
JSM Nanotechnology and Nanomedicine
ISSN : 2334-1815
Launched : 2013
Journal of Ear, Nose and Throat Disorders
ISSN : 2475-9473
Launched : 2016
JSM Ophthalmology
ISSN : 2333-6447
Launched : 2013
Journal of Pharmacology and Clinical Toxicology
ISSN : 2333-7079
Launched : 2013
Annals of Psychiatry and Mental Health
ISSN : 2374-0124
Launched : 2013
Medical Journal of Obstetrics and Gynecology
ISSN : 2333-6439
Launched : 2013
Annals of Pediatrics and Child Health
ISSN : 2373-9312
Launched : 2013
JSM Clinical Pharmaceutics
ISSN : 2379-9498
Launched : 2014
JSM Foot and Ankle
ISSN : 2475-9112
Launched : 2016
JSM Alzheimer's Disease and Related Dementia
ISSN : 2378-9565
Launched : 2014
Journal of Addiction Medicine and Therapy
ISSN : 2333-665X
Launched : 2013
Journal of Veterinary Medicine and Research
ISSN : 2378-931X
Launched : 2013
Annals of Public Health and Research
ISSN : 2378-9328
Launched : 2014
Annals of Orthopedics and Rheumatology
ISSN : 2373-9290
Launched : 2013
Journal of Clinical Nephrology and Research
ISSN : 2379-0652
Launched : 2014
Annals of Community Medicine and Practice
ISSN : 2475-9465
Launched : 2014
Annals of Biometrics and Biostatistics
ISSN : 2374-0116
Launched : 2013
JSM Clinical Case Reports
ISSN : 2373-9819
Launched : 2013
Journal of Cancer Biology and Research
ISSN : 2373-9436
Launched : 2013
Journal of Surgery and Transplantation Science
ISSN : 2379-0911
Launched : 2013
Journal of Dermatology and Clinical Research
ISSN : 2373-9371
Launched : 2013
JSM Gastroenterology and Hepatology
ISSN : 2373-9487
Launched : 2013
Annals of Nursing and Practice
ISSN : 2379-9501
Launched : 2014
JSM Dentistry
ISSN : 2333-7133
Launched : 2013
Author Information X