Annals of Pediatrics and Child Health

Efficacy of Calcium-Rich Foods Consumption on Urinary Fluoride Excretion in Children: A Pilot Trial in Halaba, Southern Ethiopia

Research Article | Open Access | Volume 11 | Issue 1

  • 1. School of Nutrition, Food Science and Technology, Hawassa University, Ethiopia
  • 2. Faculty of Biosystems and Water Resources Engineering, Institute of Technology, Hawassa University, Ethiopia
  • 3. College of Pharmacy and Nutrition, University of Saskatchewan, Canada
+ Show More - Show Less
Corresponding Authors
Bergene Boshe Boricha, School of Nutrition, Food Science and Technology, Academic Center of Excellence for Human Nutrition, Hawassa University, P.O.BOX 05, Hawassa, Ethiopia, Tel: 251916127061/+251954727909

Fluorosis is a public health problem in the Rift Valley areas of Ethiopia. While defluoridation of water is best solution, consumption of calcium-rich foods may mitigate development of adverse symptoms. The aim of the study was to determine whether calcium-rich foods would decrease fluoride absorption in children using urinary fluoride concentration as an indirect measure. Randomly selected children from a larger study were assigned to four groups of 10 participants each: two groups had a daily calcium-rich food as the intervention, one as a solid food (millet porridge) and one as a beverage (cup of milk); and two groups acted as calcium-poor controls also using a solid food (maize porridge) or a beverage (cup of soft drink). Morning urine was collected at baseline and at end line after 7 days. After the seven days, mean (SD) urinary fluoride concentration in the combined calcium-rich intervention groups was significantly (p=0.006) reduced from 6.8 (2.5) to 4.1 (2.4) mg/L. No significant (p>0.05) change was seen for the combined calcium-poor controls. Children in areas having high fluoride water would benefit from calcium-rich foods to prevent fluoride absorption causing dental and skeletal fluorosis.


• Fluorosis

• Fluoride

• Calcium-rich

• Calcium-poor

• Ethiopia


Bantero TG, Mulualem D, Desta DT, Worancha GW, Boricha BB, et al (2023) Efficacy of Calcium-Rich Foods Consumption on Urinary Fluoride Excretion in Children: A Pilot Trial in Halaba, Southern Ethiopia. Ann Pediatr Child Health 2023; 11(1): 1299.


F: Fluoride; Ca: Calcium


Fluoride (F) occurs in high concentrations in ground water in many parts of the world [1]. Topically applied F has a protective effect against dental caries [2] and as such is an essential micromineral with an Adequate Intake (AI) recommended for children ages 4-8 years of 1 mg/day [3]. However, F in doses over 0.1 mg F/kg body weight/day can weaken the skeleton and teeth as well as cause non-skeletal problems such as gastrointestinal upset, and pain [4,5]. The Upper-Tolerable Intake Level (UL) is set to prevent excess intake, and the UL value for children ages 4-8 y is 2.2 mg/day, showing a very narrow safe range of intake between AI and UL [6]. In areas where drinking water with F concentrations exceed the World Health Organization (WHO) guideline of a “desirable” upper limit of 1.5 mg/L [7], severe health effects of dental fluorosis (DF) and skeletal fluorosis (SF) are seen in those populations [4, 8, 9]. In the Ethiopian Rift Valley, the mean level of fluoride in ground water is 6.03 mg/L and which is 4-fold higher than the WHO upper limit, indicating high risk for fluorosis by those who depend on this water source [10].

much as 80% of ingested fluoride from dietary sources (water, prepared food and beverages) is absorbed in the stomach [3]. Plasma distributes F to hard tissues, and plasma F levels reflect what has been absorbed. Urinary excretion of F rises when F intake is high and is an indirect indictor of F absorption [8, 11,12]. When ingested F absorption is limited by the co-ingestion of divalent cations such as calcium and magnesium, urinary F levels do not increase, indicating that F ingestion has been blocked. However, there are only a limited number of studies in animal models [12], and adults [13], demonstrating this.

Recently, a study of school-age children in Southern Ethiopia showed that they had low calcium intakes, and that greater severity of dental fluorosis was associated with this low calcium intake in an area where water F was over 10 mg/L [5]. This study revealed that fluorosis remains a significant community health problem in Ethiopia and that there is excess intake of fluoride and low consumption of dietary calcium in Halaba. In adults, a 6-month study was conducted [13], whereby supplemental intake of 1000 mg calcium per day reduced urinary F excretion in women by approximately 60%.

As children are prone to dental fluorosis, it is important to determine whether providing additional calcium to children could impair F absorption and thus be a possible mitigating factor in preventing fluorosis. To our knowledge only one study in older children has measured a fall in urinary F concentration after increasing dietary calcium intake [14]. We aimed to determine whether urinary F excretion would be reduced using food sources of calcium in young children. We tested two common sources of calcium food for children in Ethiopia: milk and millet, and paired each with a control food that was similar in energy intake and food type, i.e., soft drink and maize, respectively. Our hypothesis was that those children given the calcium rich food would have a lower urinary F excretion than control children who received the low-calcium rich food.


Study area

Halaba zone is located 315 km south of Addis Ababa and is geographically located at 7017’ N latitude and 38006’ E longitude. The altitude of the study area ranges from 1554 to 2149 m with most of the area being about 1800 m. Rainfall has been a major limiting factor, thus creating a reliance on ground water as a source of water. The study area was selected because it was known to have high water fluoride [11]. Two kebeles (Kobochobare and Andegna Ansha) were chosen for a larger study of the area, as previously described [15]. In brief, a list of households with children 3-8 years were identified, and 127 study participants (parent-child pairs) were selected using simple random method from each kebele. From this larger group, a total of four groups of 10 children each were randomly selected from Kobochobare kebele (Figure 1).

Figure 1: Flowchart showing sampling and treatments.

In households where there was more than one eligible child, the index child was selected by tossing a random number. The study was conducted from November to December, 2016.

Fluoride and calcium intakes

At the time of the larger study, water and staple foods were selected from each area to determine fluoride intakes as well as calcium sources in the community. Water samples from the source, urine sample and staple foods were collected from the study participants, households, and community shopping centers. The collected samples were kept in polyethylene bags on ice until transported to laboratory [15].

Intervention, measurement, and data collection procedures

The 40 children were selected from Kobochobare kebele by the random selection and assigned randomly into two arms of the study (Figure 1). Baseline urine samples were collected before the feeding trial began.

In the first arm, one group was given a daily intake of 250 mL of milk (calcium-rich) and the other group was given a daily intake of 250 mL of soft drink (calcium-poor). In the second arm of the study one group was given 100 grams of millet porridge (calcium-rich) and the other group consumed 100 grams maize porridge (calcium-poor). Beverages and food ingredients were purchased locally and distributed daily, by the researchers, at the nearest health post. Before cooking porridges, millet and maize grains were washed, dried and milled. To make 100 g millet porridge, the following ingredients were mixed and cooked: 35 g of millet flour, 123 g of water, 0.54 g of iodized salt and 5.4 g of vegetable oil. To make 100 g maize porridge, the following ingredients were mixed and cooked: 31 g of maize flour, 108 g of water, 0.5 g of iodized salt, and 4.7 g of vegetable oil. All the ingredients used for the preparation of porridges were purchased from local market of the kebele, and cooking was carried out at the health post.


Each child was given 100 g of porridge at the health post, which they ate completely. For beverages, exact amounts of milk or soft drink were provided to each child. Leftover foods from cooked porridge or beverages were given to the family for other children. The study participants’ caregivers were instructed to have children eat their usual amounts of food, beverages, and water in addition to the provided food or beverage provided.

Foods were provided for seven days. In the morning of the eighth day, the child’s first-morning urine was collected in a coded plastic tube at the health post. Urine samples were quickly stored in icebox cooled with ice packs until brought to the Academic Center of Excellence for Human Nutrition laboratory of School of Nutrition, Food Sciences and Technology at Hawassa University.

Laboratory analysis

The fluoride levels of urine were analyzed at the Ethiopian Public Health Institute (EPHI) laboratory, by using an ion analyzer Orion Research Specific Ion meter, as described elsewhere [15]. Then urinary fluoride, food, and water samples were analyzed by using Perfect IONTM combination fluoride ion-selective electrode (Mettler Toledo, Germany) coupled with bench top dual-channel ion-meter (Jenway, model 3345, England) and pH/ISE meter (Orion Model, EA 940 Expandable Ion Analyzer) equipped with combination fluoride-ion selective electrode (Orion Model 96-09). The calcium contents of water and food samples were determined by using atomic absorption spectrophotometer by using the AOAC method (2000). The staple food and water sample F levels were analyzed, and the result described in mg/ kg or ml/L.

The amounts of calcium and fluoride were calculated manually using two stages [16]. In the first stage, the nutrient intake data were recorded separately for each respondent. Portion sizes and quantities were converted into weight equivalents. In the second stage, for each respondent, the weight equivalent was computed manually using the Ethiopian Food Composition table for calcium and laboratory analysis results for fluoride.

Data management and analysis

All data were entered, cleaned, and analyzed using statistical package for social science software (SPSS) [17]. Using fluoride and calcium values for foods and beverages, mean intake, percent of recommended daily allowance, and upper tolerable intake, and descriptive statistics (mean ±SD), frequency and percentage) were calculated as previously described [15]. The trial data was calculated for comparison of mean and significant difference between two treatment groups and controls using independent two samples t-test. P-value of less than 0.05 was taken as statistically significant.

Ethical considerations

The study approval was obtained from the Institutional Review Board of the College of medicine and health science at Hawassa University. Informed written consent was taken from the study participants’ mothers.


The study subjects in this study consisted of 40 children, 22 were males and 18 were females. The mean age of children was 4.32 ± 0.92 years, ranging in from 3 to 6 years. Details of these children were provided previously [15]. The intervention provided approximately 140 mg additional calcium per day when children were fed millet porridge compared to those given maize porridge, and approximately 200 mg additional calcium when the control children were provided with cow’s milk as opposed to soft drink (Table 1).

Table 1: Mean (±SD) urinary fluoride level of children assigned in different groups during the seven days intervention period in Halaba, Ethiopia


Extra Calcium#

Urinary Fluoride (mg/L)

Mean (SD)


N = 10 per group


Baseline                          Endline

Calcium-rich food

Millet porridge 100 g




6.1 (2.5)



Calcium-poor food

Maize porridge 100 g




6.5 (2.3)


7.5 (4.6)

Calcium-rich beverage

Cow milk 250 mL




7.6 (2.3)


4.5 (2.3)

Calcium-poor beverage

Soft drink 250 mL




4.9 (2.1)


5.0 (1.9)

# Estimation of calcium content was made using Ethiopian Food Composition and United Stated Department of Agriculture Food Composition Tables.

In Table 1, urinary fluoride concentrations are shown for all four groups. The concentration of fluoride changed from 6.1±2.5 to 3.8±2.6, 6.5±2.3 to 7.5±4.6, 7.6±2.3 to 4.5±2.3 and 4.9±2.1 to 5.0±1.9 for millet, maize, cow milk group and soft drink groups, respectively, from baseline to endline. There was an apparent decrease in the calcium-rich groups (with that for milk being significant) while values in the calcium-poor groups did not change. In Table 2,

Table 2: Independent Sample t-test of urinary fluoride level of among children who consumed calcium-rich and calcium-poor foods during the 7 days intervention period in Halaba, Ethiopia



Calcium- rich foods (n =20)

Calcium-poor foods (n=20)


t (df)




95% CI


6.8 (2.5)

5.7 (2.3)

1.52 (38)


-0.40, 2.68


4.1 (2.4)

6.9 (3.5)

-2.95 (38)


-4.75, -0.89

#Statistically significant (P<0.05) difference observed using Independent Sample t-test Abbreviations: CI; confidence interval; df: degrees of freedom. P: probability

data from the results of combining data for feeding calcium-rich foods versus calcium-poor food are shown. When children were given the calcium-rich treatments for 7 days, there was a significant decrease in urinary fluoride excretion at endline compared to baseline. In contrast, when children were given a calcium-poor food or beverage, no change in fluoride excretion was observed.

It was found that urinary F excretion was significantly reduced when children were given a calcium-rich food (millet porridge) or beverage (milk) every day for 7 days. In contrast,

in children given the calcium-poor foods maize porridge or soft drink as a control food, urinary F excretion remained the same. Daily estimated amount of calcium intake without the intervention foods was approximately 360 mg, as we previously reported [15], while adding a serving of a calcium-rich food increased intake to an average of 500 – 580 mg/day. This would result in more children meeting their RDA of 1000 mg per day for children 4 to 8 years [18]. A study of older children in Halaba, age 6 to 8 years of age, found dietary calcium to be 544 ± 203 mg [5]. This is comparable as older children have higher energy demands and consume more food as a result.

At baseline urinary F excretion for the four groups averaged 6.2mg/L per day, which was indicative of the high level of fluoride these children were exposed to. After seven days of feeding the intervention or control foods, urinary fluoride excretion decreased in the children given the calcium-rich foods (millet porridge or cow’s milk) and rose in children given the calciumpoor foods (maize porridge or soft drink). When data were analyzed by combining both calcium-rich groups and calcium poor groups (Table 2). So that the number of subjects was 20 in each group, thus increasing power, there was a significant decrease in urinary F excretion with calcium-rich foods compared to no change with calcium-poor foods.

The current study showed that children living in a high fluoride water environment had a high excretion of urinary fluoride. Similar findings were seen in Ethiopian children living in Halaba by [11], who showed 24-hour takes of F being 12.9 ± 3.8 mg, which would result in similarly high excretion rate of F. Halaba is not the only region in Ethiopia with high F intakes. As shown by Demelash et al. [10], throughout the Ethiopian Rift Valley, the pooled mean level of fluoride in ground water was 6.03 mg/L. Kebede et al. [11], had also reported high F intakes in several sites in Ethiopia.

We found that when examined as pooled intake, those children given the calcium-rich foods, either millet porridge or cow’s milk, had significantly less urinary F than children given the low calcium-poor food of maize porridge or soft drink, respectively. Previous studies support that fluorosis can be mitigated by increasing calcium intake by a therapeutic regimen including calcium [19]. We have shown in adults living in Ethiopia a calcium supplement (which was eggshell powder) decreased urinary fluoride excretion and reduced signs and symptoms of fluorosis [13]. A study in children showed that a low dietary calcium intake was associated with greater risk of dental fluorosis and signs of skeletal fluorosis [5]. Our current study has shown that even over a short time period (seven days consumption) of calcium-rich food, there can be a reduction in the concentration of urinary fluoride which is an indirect measure of a reduction in fluoride absorption [8].

The mechanism for calcium’s mitigation of F absorption is thought to be binding of the F- anion with the Ca++ cation producing an insoluble compound that cannot be absorbed [20]. In an animal study, excretion of fecal F increased and urinary F decreased when rats were fed high F diets, which supports this mechanism [12].

Calcium is not the only nutritional supplement that protects against fluoride absorption. In a study done on 30 adolescent dental patients, one group received 250 mg calcium with a vitamin D3 supplement compared to 500 mg ascorbic acid also with vitamin D, for three months. Similar to our results, urinary F excretion was reduced with calcium, and its effect was greater than that of vitamin C [21]. However, in our study, the foods provided were locally available and acceptable, in contrast to supplemental nutrients such as vitamin C.

Calcium intakes in Ethiopia are low, as shown by [22], for children and by [23], for adult women. In our larger study [15], we found that the community had low level of understanding on the prevention of fluorosis and were not aware of the benefit of calcium rich foods on the fluorosis prevention. Like as many of Ethiopian community, this community uses cereals like maize, and other cereals and root and tubers for complementary food preparation and for household consumption. These foods contain low amount of calcium. Therefore, providing nutrition education, accessing foods which contain good amount of calcium like milk and finger millet is important to prevent the problem in the sustainable manner. As recently shown [24], finger millet is one of the most calcium-dense foods, with three times the level of calcium than milk, and the only cereal that contains high calcium content which is consistent across different varieties. Thus, it and other high calcium foods that are locally available should be promoted in high fluoride areas of Ethiopia [15].

The limitations of this study include that the effect of calcium on body fluoride was measured using urinary fluoride excretion which is an indirect measure of F absorption. Further, dietary calcium intake of children was estimated from a week-long frequencies of calcium-rich food consumption which might not have accurately estimated the usual calcium intake of children beyond that week. Finally, the randomization was done without blinding. Nevertheless, our study provide support for improving calcium intakes of young children, especially in areas where water fluoride levels are high.


Dietary intakes of calcium were low in this area of Ethiopia which experienced high levels of fluoride in water and foods. Subsequently the children were at risk for dental and skeletal fluorosis in previous reports from this area. In testing whether a calcium-rich food added daily would reduce the burden of excess fluoride absorption leading to fluorosis, we found one cup of milk (approximately 250 mL) reduced urinary F excretion which indirectly demonstrated reduced fluoride absorption. In general adding calcium-rich foods such as millet may also be as effective.


Funding for this study was provided by the University of Saskatchewan to the first author as a short-term graduate stipend and cost of materials and supplies. The contribution of the Ethiopian Public Health Institute in conducting fluoride analysis is appreciated.

  1. Dace O, Wiatrowsky E, Samachson J, Spencer H. Fluoride analysis of the human diet and of biological samples. Clin Chim Acta. 2002; 51: 211-216.
  2. Scientific Committee on Health and Environmental Risks (SCHER). Opinion of critical review of any new evidence on the hazard profile, health effects, and human exposure to fluoride and the fluoridating agents of drinking water. Brussels, Belgium: Directorate General for Health and Consumers, European Commission. 2011; 16: 2-4.
  3. Institute of Medicine (IOM). Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride, Institute of Medicine, National Academy Press, Washington D.C. 1997.
  4. Bailey K, Chilton J, Dahi E, Fewtrell L, Magara Y. Fluoride in drinking- water. Geneva: World Health Organization with IWA publishing. 2006; 1-144.
  5. Tefera N, Mulualem D, Baye K, Tessema M, Woldeyohannes M, Yehualashet A, et al. Association between dietary fluoride and calcium intake of school-age children with symptoms of dental and skeletal fluorosis in Halaba, Southern Ethiopia. Front Oral Health. 2022; 3: 853719.
  6. European Food Safety Authority (EFSA). Opinion of the Scientific Panel on Dietetic Products, Nutrition and Allergies (NDA) on the tolerable upper intake level of fluoride, EFSA J. 2005; 192: 1-65.
  7. WHO. Guidelines for drinking-water quality: Third Edition Incorporating the First and Second Agenda. Volume 1 Recommendations. Geneva, Switzerland: World Health Organization (WHO). 2008.
  8. Rango T, Vengosh A, Jeuland M, Tekle-Haimanot R, Weinthal E, Kravchenko J, et al. Fluoride exposure from groundwater as reflected by urinary fluoride and children’s dental fluorosis in the Main Ethiopian Rift Valley. Sci Total Environ. 2014; 496: 188-197.
  9. Tekle-Haimanot R. Study of fluoride and fluorosis in Ethiopia with recommendations on appropriate defluoridation technologies: a UNICEF sponsored consultancy [unpublished manuscript]. Addis Ababa, Ethiopia: Addis Ababa University. 2005.
  10. Demelash H, Beyene A, Abebe Z, Melese A. Fluoride concentrationin ground water and prevalence of dental fluorosis in Ethiopian Rift Valley: systematic review and meta-analysis, BMC Public Health. 2019; 19: 1298.
  11. Kebede A, Retta N, Abuye C, Whiting SJ, Kassaw M, Zeru T, et al. Dietary fluoride intake and associated skeletal and dental fluorosis in school age children in rural Ethiopian Rift Valley. Int J Environ Res Publ Health. 2016: 13: 756.
  12. Kebede A, Retta N Abuye C, Whiting SJ, Kassaw M, Zeru T, et al. Minimizing Bioavailability of fluoride through addition of calcium- magnesium citrate or a calcium and magnesium-containing vegetable to the diets of growing rats. Int J Biochem Res Rev. 2016; 10: 1-8.
  13. Mulualem D, Hailu D, Tessema M, Whiting SJ. Efficacy of calcium- containing eggshell powder supplementation on urinary fluoride and fluorosis symptoms in women in the Ethiopian Rift Valley. Nutrients. 2021; 13: 1052.
  14. Mehta DN, Shah J. Reversal of dental fluorosis: A clinical study. J Nat Sci Biol Med. 2013; 4: 138-144.
  15. Bantero T, Mulualem D, Desta D, Worancha G, Boricha BB, Whiting SJ. Potential for dietary calcium to prevent fluoride uptake in children in Halaba special district, southern Ethiopia: knowledge, attitudes, and practices of mothers. Juniper Open J Publ Hlth. 2022; 6.
  16. Gibson RS, Ferguson EL. An interactive 24-hour recall for assessing the adequacy of iron and zinc intakes in developing countries. HarvestPlus Technical Monograph 8. Washington, DC and Cali: International Food Policy Research Institute (IFPRI) and International Center for Tropical Agriculture (CIAT), 2008.
  17. Melaku Z, Assefa G, Enqusilassie F, Bjorvatn K, Tekle-Haimanot R. Epidemiology of skeletal fluorosis in Wonji Shoa Sugar Estate, Wonji, Ethiopia: a community-based survey. Ethiop Med J. 2012; 50: 307- 313.
  18. Institute of Medicine (IOM). Dietary Reference Intakes for Calcium and Vitamin D, Institute of Medicine, National Academy Press, Washington D.C. 2011.
  19. Gupta SK, Gupta RC, Seth AK, Gupta A. Reversal of fluorosis in children. Indian Pediatr. 1994; 31: 439-443.
  20. Cerklewski FL. Fluoride bioavailability nutritional and clinical aspects. Nutr Res. 1997; 17: 907-927.
  21. Andezhath S, Bhatnagar M. Reversal of fluoride induced cell injury through elimination of fluoride and consumption of diet rich in essential nutrients and antioxidants. Molec Cell Biochem. 2002; 234- 235.
  22. Tezera F, Whiting SJ, Gebremedhin S. Dietary calcium intake and sunlight exposure among children aged 6-23 months in Dale woreda, southern Ethiopia. Afr J Food Agr Nutr Dev. 2017; 17: 12451-12464.
  23. Tesfaye B, Sinclair K, Wuehler S, Moges T, De-Regil L, Dickin K. Applying international guidelines   for   calcium   supplementation to prevent pre-eclampsia: Simulation of recommended dosages suggests risk of excess intake in Ethiopia. Publ Health Nutr. 2019; 22: 531-541.
  24. Anitha S, Givens DI, Botha R, Kane-Potaka J, Sulaiman NLB, Tsusaka, TW, et al. Calcium from finger millet—a systematic review and meta-analysis on calcium retention, bone resorption, and in vitro bioavailability. Sustainability, 2021; 13: 8677.

Bantero TG, Mulualem D, Desta DT, Worancha GW, Boricha BB, et al (2023) Efficacy of Calcium-Rich Foods Consumption on Urinary Fluoride Excretion in Children: A Pilot Trial in Halaba, Southern Ethiopia. Ann Pediatr Child Health 2023; 11(1): 1299.

Received : 27 Feb 2023
Accepted : 19 Mar 2023
Published : 23 Mar 2023
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
Annals of Clinical Cytology and Pathology
ISSN : 2475-9430
Launched : 2014
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
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