Annals of Reproductive Medicine and Treatment

Imaging and Hysteroscopy in Gynecology

Research Article | Open Access | Volume 5 | Issue 1

  • 1. German Medical Center (GMC), Dubai Health Care City (DHCC), Dubai, UAE
  • 2. Department of Obstetrics and Gynecology, University Clinics of Schleswig Holstein, Kiel, Germany
  • 3. Emirates Hospital, Jumeirah, Dubai, UAE
+ Show More - Show Less
Corresponding Authors
Mettler Liselotte, 24105 Kiel, Germany. Düsternbrooker Weg

The establishment of a final diagnosis for intrauterine surgery, inspite of good imaging still requires direct viewing as in hysteroscopy to initiate the appropriate treatment. In many cases, the patient can be treated during the initial hysteroscopy. Advancements in modern imaging techniques such as 2D and 3D ultrasound, magnetic resonance imaging, computer tomography and other radiological procedures have improved the diagnosis of gynecological conditions to a great extent. The paper gives an insite in to 127 imaging attemps compared to hysteroscopic findings.


Mettler L, Ugarte AC, Mettler AD, Sammur W, Alkatout I (2021) Imaging and Hysteroscopy in Gynecology. Ann Reprod Med Treat 5(1): 1024.


One hundred and twenty-seven diagnoses established by transvaginal ultrasound and the corresponding outcomes of hysteroscopy and treatment were evaluated at the German Medical Center in Dubai Health Care City, UAE.

Vaginal ultrasound, Saline infusion sonohysterography and Hysterosalpingo-contrast sonography

We used the Samsung Accuvix A 30 ultrasound device with a 2D vaginal probe with enhanced directional power Doppler imaging (DPD) for the detection of peripheral blood vessels. Ambiguous intracavitary images of polyps, fibroids or adhesions were further clarified by using saline infusion sonohysterography (SIS) or hysterosalpingo-foam sonography (HyFoSy), which is a modification of hysterosalpingo-contrast sonography (HyCoSy). Saline infusion sonohysterography (SIS) is a valuable imaging tool to assess the uterus, the endometrial lining, and the endocervical canal. It is useful for evaluating a wide range of pathologies including polyps, leiomyomata, adhesions, anomalies, and endometrial hyperplasia or cancer [1]. SIS is a simple, inexpensive, and low-risk procedure; its findings complement those of a hysterosalpingogram (HSG), hysterocontrast sonography, or hysteroscopy. A 3D vaginal probe was not always at our disposal at the time.

Diagnostic hysteroscopy, mini-hysteroscopy or office hysteroscopy

Rigid hysteroscopes with an optical angle of 30 degrees (Figure 1) and flexible hysteroscopes (Figure 2)

Rigid diagnostic hysteroscope with an operating channel. • Oval shape • 5mm diameter • 2mm rod lens • 5-French channel • Inner and outer sheath • Semi-rigid instruments.

Figure 1: Rigid diagnostic hysteroscope with an operating channel.

• Oval shape

• 5mm diameter

• 2mm rod lens

• 5-French channel

• Inner and outer sheath

• Semi-rigid instruments.

Flexible hysteroscope. • 3-5mm in diameter • Steerable tip • 5 to 7 French channel • Not ideal for surgical interventions.

Figure 2: Flexible hysteroscope.

• 3-5mm in diameter

• Steerable tip

• 5 to 7 French channel

• Not ideal for surgical interventions.

are available in the market. The published literature does not specify the size limits for mini-hysteroscopes. A mini-hysteroscope with a diameter of less than 5mm can be introduced through the cervical canal without analgesia or dilatation. The majority of studies on mini hysteroscopy are focused on this category of scopes. Some mini-hysteroscopes are oval in cross-section, as is the internal os, and measure only 2.8mm in diameter. A patient with a cervical stenosis or one who experiences severe pain during passage of the cervical canal might need a cervical block. Most mini-hysteroscopes have a working channel of 5-7 French for the insertion of graspers, scissors, polyp snares, or electrodes [2,3]. Valves for distension fluid are available in different shapes; a continuous flow system is recommended. Recent technological advancements favor thinner and smaller resectoscopes. The availability of small loops and a variety of working electrodes has made it possible to perform the mini-hysteroscopic procedure along with resection. Monopolar and bipolar electrodes are available. The bipolar electrode is recommended because the use of pure saline as distension medium is safest and minimizes the risk of water intoxication. Especially endometrial sampling in postmenopausal women with bleeding can be performed with greater sensitivity and specificity when the biopsy is performed under constant viewing. The cervix is entered either directly with the aid of a speculum or is inspected under vision during vaginoscopy. The hysteroscope is inserted in the cervical canal under continuous fluid pressure. Examination of, and any surgical procedures in, the uterine cavity require distension of the cavity by a continuous flow of fluid; the commonly used fluid is sterile saline. An angulated (30 degrees) optical device permits thorough screening of the uterine cavity. The continuous flow of fluid ensures clear vision and flushes away mucus, blood, and tissue debris. The cavity usually distends at a fluid pressure of 50- 80mmHg. The lowest pressure that provides sufficient distension is recommended. Excessively high pressure causes contraction of the uterus (pain) and loss of fluid into the abdominal cavity through the tubes. Sometimes a pressure of 125mmHg is needed for clear vision. A hysteroscopic pump may be used to maintain sufficient pressure when performing an office hysteroscopy. A pressure bag to compress a 1-liter bag of saline is not optimal but may help to perform the diagnostic hysteroscopy and biopsy when no hysteroscopic pump is available. This method requires a nurse to attend to the pressure bag and keep its pressure constant throughout the procedure. Bipolar electrodes for cutting and tissue evaporation require a conductive ion or electrolyte- rich medium to close the circuit between the active and the return electrode.

n patients being treated for infertility, an office hysteroscopy is recommended to rule out intracavitary lesions prior to embryo transfer, and to treat small lesions through the operating channel of the diagnostic hysteroscope. When the investigation reveals a pathology that cannot be eliminated during the diagnostic or office hysteroscopy, or the patient has pain, she should be advised to undergo an operative hysteroscopy. Normally the cervix is not clamped. A slightly filled bladder helps to elevate the uterus into a stretched position. A useful office hysteroscope is ENDOSEE, along with its various modifications [4]; the device is economical and requires very little equipment.

Operative hysteroscopy [5,6]

A. The basic equipment for an operative hysteroscopy consists of the following itemHysteroresectoscope with a matching electrode and a 12- 15° angulated optical device

B. Light source with cable

C. Hysteromat with inflow and outflow tubes

D. Distension medium

E. Video camera

F. High-frequency unit for monopolar and bipolar current

The bipolar technique has extended the scope of operative hys- teroscopy and made the procedure even safer. The decisive advan- tage of a bipolar hysteroscopy is that it can be performed without an electrolyte-free solution (sorbitol-mannitol solution). Instead, Ringer’s or saline solution can be used; this reduces the cost of the distension medium. Bipolar hysteroscopy is currently the method of choice for high-risk situations (such as myomas grade 2/ESGE), because it is associated with a low rate of complications. Bipolar techniques are gaining increasing importance in operative hys- teroscopy. Bipolar techniques in hysteroscopy help to solve some problems in intrauterine surgery and provide greater safety for the patient. Preferred indications for the bipolar surgical technique are myomas grade 2/ESGE and large myomas (>4cm). The main ad- vantages of bipolar myoma resection include avoidance of the TUR syndrome (electrolyte shifts), and second or third surgeries as a result thereof. Fluid overload may occur even with the use of Ring- er’s solution. Care should be taken to ensure that the fluid deficit does not exceed three liters. Even greater caution is advised in an- esthesiological risk groups. Besides using electrosurgery for simple mechanical destruction of tissue in fibroids and polyps, scissors or shavers with mechanical cutting and integrated suction systems are available. The Bigatti shaver (Storz) [7,8] and the Truclear tissue removal system (Medtronic) are widely accepted options.



A. Diagnostic hysteroscopy with a 5mm hysteroscope

B. Dilate the cervical canal to Hegar 7-9 (when using a smaller resectoscope for fertility surgery, only to Hegar 7)

C. Insert the outer sheath with an obturator

D. Replace the obturator with a hysteroresectoscope and matching electrode, and 12° angulated lenses

E. Check the connections

i. Check the correct distension medium (bipolar: Ringer’s solution; monopolar: sorbitol-mannitol solution)

ii. Inflow tube for the distension medium-airless and connected with the Hysteromat (irrigate beforehand!)

iii. Check pressure and flow selection on the Hysteromat

iv. Outlet tube in the collecting container

v. Connect with the electrosurgical unit and check the power level on the high-frequency unit (preselected programs for monopolar and bipolar surgery)

F. Open the inflow tube and perform distension of the uterine cavity. Irrigation is usually needed as the first step because dilatation of the cervix causes bleeding F. Open the inflow tube and perform distension of the uterine cavity. Irrigation is usually needed as the first step because dilatation of the cervix causes bleeding

General and established indications for operative hysteroscopy

A. Infertility and abnormal bleeding

B. Septum dissection

C. Intrauterine adhesiolysis (grades III-IV/ESGE)

D. Myoma resection in one or a few submucous fibroids

E. Polyp resection

F. Endometrial ablation/endometrial resection

G. Resection of residual placenta

H. Opening or coagulation of hematometra in the rudimentary uterine horn

I.Removal of a lost IUD in the uterine cavity

Relative indications for operative hysteroscopy are the following:

A. Septum dissection with primary and secondary infertility

B. Resection of multiple myomas



At the German Medical Center in Dubai Health Care City, in an office setting without the equipment of an operating room, we encountered the following uterine pathologies over a period of two years (2017 to 2019) after performing palpation, vaginal ultrasound examinations, and HyFoSy (Table 1).

Table 1 Summarizes the new augmented reality techniques used to visualize the uterine cavity.

New Augmented Reality Techniques to Explore the Uterine Cavity
  1. Vaginal Ultrasound 2. Diagnostic Hysteroscopy 3. Operative Hysteroscopy
  Saline infusion sonography and hysterosal-pingo contrast sonography Mini hysteroscopy or office hysteroscopy The necessary basic equipment for operative hysteroscopy consists of the following items
and Techniques
Samsung Accuvix A 30 sonographic machine 
with a 2D vaginal probe with enhanced 
Directional power Doppler Imaging (DPD)/ 
Saline Infusion Sonohysterography(SIS)
or by hysterosalpingo foam sonography 
Rigid hysteroscopes withan 
optical angle of 30 degrees 
(Figure 1) and flexible hysteroscopes (Figure

Hysteroresectoscope with matching electrode and 12o-15o angled optic with

Light source with cable

a. Hysteromat with inflow and outflow tube
b. Distending Medium
c. Video camera


One hundred and twenty- seven patients were treated either directly through the operating channel of the diagnostic hysteroscope under conscious sedation or underwent an operative hysteroscopy in general anesthesia.

In 19 patients the thickened endometrium could be treated by performing a biopsy and/or curettage (Figure 3).

Vaginal ultrasound. • Compared to hysteroscopy • In a 49-year-old patient with ?endometrial hyperplasia

Figure 3 Vaginal ultrasound.

• Compared to hysteroscopy

• In a 49-year-old patient with endometrial hyperplasia

In six patients we performed endometrial ablation with a bipolar loop and a roller ball. In 42 patients with endometrial polyps and 35 with submucosal fibroids, the imaging investigation was complemented with saline infusion ultrasonography. The patients then underwent an operative hysteroscopy, during which polyps and fibroids were resected under vision, followed by dilation and curettage. No unexpected malignancy was encountered. In three further patients we suspected an intrauterine malignancy and performed an endometrial biopsy under vision solely for diagnostic purposes. In 18 patients undergoing treatment for infertility, the hysteroscopy was performed together with a laparoscopy; no pathologies were suspected. A uterine septum or a fundal cleft was resected in seven women. Four of these women only had a fundal cleft, but the latter are known to hinder implantation. In four patients, a preoperatively diagnosed septum was divided with the hook electrode during the operative hysteroscopy. The operative procedures performed in the 127 patients are summarized in (Table 2).

Table 2: 127 operative hysteroscopic procedures.

Hysteroscopy with endometrial biopsies n = 19
Hysteroscopy and endometrial ablation Hysteroscopic polypectomies Hysteroscopic n = 6
myomectomies n = 42
Endometrial biopsy for a suspected malignancy n = 35
nfertility treatment with laparoscopy and hysteroscopy, which revealed 7 septa not detected preoperatively n = 3
Primarily diagnosed uterine septa Total n = 18
  n = 4
  n = 127

One hundred and twenty-six operative procedures were performed without complications. One patient underwent submucous bipolar resection of a myoma measuring 4 cm in size and experienced a pulmonary embolism after 24 hours. Regrettably, the patient was not given heparin. She reported respiratory problems on the phone and underwent an immediate control investigation which revealed her condition. The patient was treated accordingly and recovered well.


Barring pregnancies, which are the domain of fetal medicine, the uterine cavity has ceased to be a mystery. Ultrasound imaging in conjunction with SIS and HyFoSy are valuable techniques for diagnostic purposes. They can be used for performing an office hysteroscopy. Minor surgical procedures can also be performed in this setting through the operating channel of the diagnostic hysteroscope. Alternatively, the surgeon may perform an operative hysteroscopy in general anesthesia. All of our patients underwent their preliminary examinations in the office without analgesia or anesthesia. Many lesions were clearly seen on two dimensional ultrasound (Figure 4) conditions such as septa were seen even more clearly on three-dimensional ultrasound (Figure 5a&5b)..

Imaging of the septate uterus. 2D ultrasound with two separate  endometrial echoes in the transverse plane..

Figure 4: Imaging of the septate uterus. 2D ultrasound with two separate endometrial echoes in the transverse plane..

Image of a septate uterus (a)&(b) using three-dimensional  transvaginal ultrasonography (3D).

Figure 5: Image of a septate uterus (a)&(b) using three-dimensional transvaginal ultrasonography (3D).

In our work environment in the UAE, minor surgical procedures for diagnostic purposes as well as operative hysteroscopies are performed in a day-care setting, under conscious sedation or anesthesia. Office hysteroscopies performed for diagnostic purposes may also include extensive work through the operating channel of the hysteroscope by the use of graspers, scissors, or catheters for canalization of the proximal tube. (Figure 6) shows a patient with a suspected septum who underwent a hysteroscopy. (Figure 7) shows the two-dimensional ultrasound image and the corresponding hysteroscopic finding of a submucous fibroid.

A septate uterus on hysteroscopy.

Figure 6: A septate uterus on hysteroscopy.

a. Submucous fibroid seen clearly on 2D ultrasound with saline  infusion b. Compared to its hysteroscopic presentation before enucleation

Figure 7 a. Submucous fibroid seen clearly on 2D ultrasound with saline infusion

b. Compared to its hysteroscopic presentation before enucleation.


The large majority of conditions in the uterus can be detected and treated, provided the patients consult their doctors at the very onset of symptoms and undergo regular annual or biannual gynecological controls with palpation and a vaginal ultrasound examination. On ultrasound, the uterine cavity is visualized better by the transvaginal approach than through the abdomen. Hysteroscopy is one of the many procedures used in minimally invasive surgery (MIS), frequently in the postoperative setting, and has expanded the scope of surgical gynecology. Operative hysteroscopy has become a standard gynecological procedure and should be a part of the surgical repertoire at every hospital. Future developments include new and smaller scopes, possibly the revival of flexible scopes, novel concepts of modular digital hysteroscopy, instruments that provide better vision, and simplified all-in-one instruments. Nanorobotics may pave the way for the creation of the “hysterorobot”.

Mettler L, Ugarte AC, Mettler AD, Sammur W, Alkatout I (2021) Imaging and Hysteroscopy in Gynecology. Ann Reprod Med Treat 5(1): 1024

Received : 27 Apr 2020
Accepted : 25 May 2020
Published : 26 May 2020
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
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
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