Archives of Emergency Medicine and Critical Care

Comparison of Intranasal Ketamine and Intranasal Fentanyl as Adjuncts to Intravenous Ketorolac for Pain Relief in Renal Colic: A Randomized Clinical Trial

Research Article | Open Access | Volume 7 | Issue 2

  • 1. Medical doctor, Shahid Sadoughi University of Medical Sciences, Iran
  • 2. Department of Emergency, Shahid Sadoughi University of Medical Sciences, Iran
  • 3. Department of Urology, Shahid Sadoughi University of Medical Sciences, Iran
+ Show More - Show Less
Corresponding Authors
Soheila Azimi Abarghouei, Department of Emergency, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Tel: +989131564725

Background: Pain relief in patients with renal colic is a crucial aspect of emergency department (ED) management. Current analgesic options, such as opioids and nonsteroidal anti-inflammatory drugs (NSAIDs), are associated with various side effects and contraindications. This study aimed to investigate and compare the efficacy of intranasal ketamine/intravenous ketorolac and intranasal fentanyl/intravenous ketorolac combinations with intravenous ketorolac monotherapy in reducing pain among patients with renal colic.

Materials and Methods: This double-blind randomized clinical trial enrolled 120 patients with renal colic who met the inclusion and exclusion criteria. Participants were randomly assigned to three groups: Group A received 1 mg/kg intranasal ketamine and 30 mg intravenous ketorolac, Group B received 1.5 µg/kg intranasal fentanyl and 30 mg intravenous ketorolac, and Group C received only 30 mg intravenous ketorolac and nasal placebo. Vital signs, adverse effects, and pain intensity based on the visual analog scale (VAS) score were recorded at specified intervals.

Results: There were no significant differences in demographic variables and mean initial pain intensity among the groups. Following the intervention, both the ketamine/ketorolac and fentanyl/ketorolac groups exhibited faster pain reduction compared to the ketorolac group. However, there was no significant difference between the two combination drug regimens (P Value = 0.044, 0.906). The ketamine/ketorolac group demonstrated a quicker response to treatment compared to the other two groups (P Value = 0.004). Some side effects were more frequently reported in the combination drug group than in the single drug group.

Conclusion: The combined regimens of ketamine/ketorolac and fentanyl/ketorolac appear to provide faster pain control in patients with renal colic compared to the single-drug regimen of ketorolac, without increasing the risk of serious complications.


• Intranasal administration

• Ketamine

• Ketorolac

• Fentanyl

• Renal colic


Ashkezari FSZ, Jafari M, Ezzabadi AR, Zarehoroki A, Abarghouei SA (2023) Comparison of Intranasal Ketamine and Intranasal Fentanyl as Adjuncts to Intravenous Ketorolac for Pain Relief in Renal Colic: A Randomized Clinical Trial. Arch Emerg Med Crit Care 7(2): 1060.


Renal colic, a common complication of urolithiasis, affects 5_15% of the global population [1], and is responsible for a notable percentage of emergency department visits [2]. Managing the intense pain associated with renal colic is a top priority for healthcare providers. Opioids, such as morphine, and nonsteroidal anti-inflammatory drugs (NSAIDs), like ketorolac, are commonly used analgesics for this purpose. However, opioids can be addictive [4] and have potential adverse effects [3], while NSAIDs may have side effects and contraindications in certain patient populations [5].

Intravenous administration of medication can be challenging in agitated patients, making intranasal administration through Kiesselbach’s plexus an attractive alternative due to its ease and speed [6]. Nonetheless, it remains unclear which intranasal analgesic is most suitable for patients with renal colic. Intranasal fentanyl is a popular choice, known for its high potency and bioavailability for acute pain relief [7-9]. However, like other opioids, it carries the risk of serious complications such as hypotension and bradypnea [10]. On the other hand, ketamine has demonstrated effectiveness in reducing acute pain by inhibiting NMDA receptors and affecting various other receptors involved in pain modulation [11,12]. Although it can cause mild and transient side effects such as dizziness and hallucinations [10].

This study aimed to compare the analgesic effects of intranasal ketamine and intranasal fentanyl, both in conjunction with intravenous ketorolac, for the management of renal colic pain. By evaluating the efficacy and safety of these combinations, we hope to provide evidence to guide clinicians in selecting the most appropriate intranasal analgesic regimen for patients with renal colic.


This study was a double-blind randomized controlled trial conducted on 120 patients who presented with acute renal colic to the emergency departments at Shahid Sadoughi Hospital and Shahid Rahnemoon Hospital (Figure 1).

Consort flow chart.

Figure 1: Consort flow chart.

The study received approval from the ethics committee of Shahid Sadoughi University (ethics code: IR.SSU.MEDICINE.REC.1399.081) and was registered on www.irct.ir with trial number IRCT20201028049179N1. Prior to the commencement of the study, the patients were informed about the study goals, and their consent was obtained. The authors adhered to the principles outlined in the Declaration of Helsinki throughout the study.

Inclusion criteria consisted of patients aged between 15 to 64 years old with a diagnosis of renal colic based on history, physical examination, urinalysis, and imaging studies collected through ultrasound or computed tomography scans. Patients were excluded if they met any of the following criteria: pregnancy, addiction to drugs and opioids, allergy to fentanyl, Ketamine, or Ketorolac, body temperature over 38°C, suspension of pyelonephritis, systolic blood pressure over 180 or less than 90 mmHg, respiratory rate less than 12, heart rate less than 60 or over 140, history of serious liver, kidney or cardiovascular diseases, active peptic ulcer, brain tumor, glaucoma, psychosis, use of analgesics in the past 4 hours, and a Numeric Rating Scale (NRS) score less than 5.

NRS is a pain severity measuring tool that uses a scale from 0 to 10, with 0 indicating no pain and 10 indicating the worst pain imaginable.

Before the administration of medication, all patients were assessed for vital signs, excluding criteria, and NRS scores. They were then monitored for 60 minutes after treatment, during which they received 500 cc of intravenous fluid and nasal oxygen at a flow rate of 3-5 L/min. Participants were assigned to one of three groups based on a predetermined randomization list generated by https://www.random.org/lists/.

For the nasal ketamine spray, ketamine vials manufactured by Sterop Company were used. These vials contained ketamine hydrochloride injection parenteral 50 mg/1mL, 10 mL, and 50 mg of benzalkonium chloride as a preservative. Desmopressin nasal sprays from Raha Company were emptied, sterilized, and filled with the ketamine solution. Each spray puff contained 7 mg of ketamine, and the spray could be used up to one month after opening the vial.

For the fentanyl spray, fentanyl vials manufactured by Caspian Company were used. Each 10-cc vial contained 0.5 mg of fentanyl and 50 mg of benzalkonium chloride as a preservative. Desmopressin nasal sprays from Raha Company, with a volume of 10 cc, were emptied, sterilized, and filled with the prepared fentanyl solution. Each spray puff contained 7 μg of fentanyl, and the sprays could be used up to one month after opening the vial.

Placebo sprays were prepared using 10 cc vials of distilled water manufactured by Sunlife Company, along with 50 mg of benzalkonium chloride as a preservative, similar to the ketamine and fentanyl sprays. Participants were divided into three groups: - Group A received intranasal ketamine at a dose of 1 mg/ kg (maximum 50 mg, each puff containing 7 mg) and 30 mg of intravenous ketorolac. - Group B received intranasal fentanyl at a dose of 1.5 μg/kg (maximum 50 μg, each puff containing 7 μg) and 30 mg of intravenous ketorolac. - Group C received 30 mg of intravenous ketorolac and 6 puffs of placebo spray. The solvents used in all nasal sprays and syringes were identical. In case participants experienced nausea and vomiting, 4 mg of intravenous ondansetron was prescribed. A triage nurse, who was unaware of the medications being administered, prepared and prescribed the medications based on the random list. Neither the patients nor the assessing physicians were aware of the assigned medications. The physician recorded vital signs, pain scores, and side effects at baseline, as well as at 5, 10, 15, 30, and 60 minutes using a checklist. The checklist consisted of two parts: the first part captured demographic information such as age and gender, while the second part included pain scores, time to respond to treatment (with a reduction of 2 scores), time until pain subside (pain score below 5), request for a second dose, request for rescue analgesic, and side effects. Dissociative side effects were assessed using the Side Effects Rating Scale for Dissociative Anesthetics (SERSDA). If the pain score did not decrease by 2 scores after 15 minutes, a second dose (half of the first dose) was prescribed. If the pain intensity remained unbearable after the second dose and 15 minutes, rescue therapy was administered using 0.15 mg/kg of intravenous morphine. In case of serious complications such as hypo/hypertension, apnea, lethal arrhythmia, or loss of consciousness, the investigation was immediately halted, and appropriate treatment was provided. Other side effects, including nausea and vomiting, drowsiness, hallucinations, agitation, hot flashes, bradypnea, itching, dizziness, and chest tightness, were recorded in the checklist. Participant satisfaction was assessed using a rating scale from 1 to 10 (with 1 being the least satisfaction and 10 indicating complete satisfaction). After 60 minutes, participants were discharged if their pain was controlled, they did not experience nausea, had a normal gait, and did not require hospitalization. The secondary outcome measures included the mean reduction in pain scores at different time intervals, frequency of response to treatment and its time, frequency of patients whose pain scores reduced to 4 or less and the time it took, frequency of the need for a second dose and rescue analgesic, and side effects. Finally, the collected data were analyzed using SPSS (version 16).


During the course of the study, a total of 143 patients were initially enrolled. However, 23 patients were subsequently excluded from the analysis due to various reasons: 2 patients had an allergy to ketorolac, 15 patients had used analgesics within the past 4 hours, 1 patient was pregnant, 2 patients were addicted to opioids, and 3 patients declined to participate. As a result, the final analysis included 120 patients who were randomly assigned into three groups of 40 participants each. In Group A, 67.5% of participants were men, while in Group B it was 70%, and in Group C it was 62.5%. The mean age range was comparable across all three groups (Table 1).

The mean ± SD NRS scores at baseline and at the specified time points are presented in Table 2. There was no significant variation in average pain scores among the three groups according to the Kruskal-Wallis test. However, Group C exhibited a slower rate of pain reduction compared to the other two groups, as determined by repeated measures analysis (P value of 0.044). No significant difference in pain reduction was observed between Groups A and B (P value of 0.906) (Figure 2).

The progression of pain intensity in the mentioned minutes within the three groups.

Figure 2: The progression of pain intensity in the mentioned minutes within the three groups.

The study findings revealed no significant differences in the frequency of response to treatment, the need for a second dose, or the use of a rescue analgesic among the groups (Table 3). Additionally, all groups demonstrated a similar number of patients with pain scores reduced to 4 or less. However, Group A exhibited a shorter response time compared to the other groups (P value: 0.004) (Tables 4 and 5).

The mean satisfaction score was 7.65 ± 2.55 in Group A, 8.05 ± 2.35 in Group B, and 7.42 ± 3.02 in Group C, with no significant difference observed between them (P value: 0.848).

No instances of hypotension, bradypnea, apnea, chest discomfort, or loss of consciousness were reported by any of the patients. Nausea was the most common reported side effect, with no significant differences observed among the groups. Other side effects are outlined in Table 5. Dissociative side effects were reported in all groups, but they were all mild and transient.


Pain relief is of utmost importance for patients with renal colic, and analgesics such as opioids and NSAIDs are commonly used, usually administered intravenously [3].

In this study, we aimed to compare intranasal ketamine with intravenous ketorolac versus intranasal fentanyl with intravenous ketorolac for renal colic pain relief. The results show that the combination regimens of ketamine/ketorolac and fentanyl/ketorolac provide faster pain relief compared to ketorolac/placebo. However, these combination regimens also carry a slightly increased risk of minimal adverse effects.

Some studies have demonstrated the synergistic effect of ketorolac and opioids for renal colic pain relief. For instance, Hosseininejad et al., compared the efficacy of combination therapy with ketorolac and morphine to monotherapy with each drug in patients with acute renal colic. The study found that the balanced analgesia group had significantly lower pain intensity compared to the morphine or ketorolac alone groups. After 40 minutes, the mean pain score in the combination group was significantly less than in the other groups [13]. However, in our study, there was no significant difference in pain intensity after 60 minutes, possibly due to the longer follow-up period in our research.

Ketamine is an analgesic that can be administered through various routes and is a good choice for acute pain relief. Ketamine acts by inhibiting NMDA receptors and reducing pain through a different pathway than NSAIDs and opioids [11,12]. Some studies consider it a suitable option for renal colic pain management on its own, while others suggest its use as an additional therapy for controlling severe pain. For example, a study by Mozafari et al., compared the analgesic effect of intravenous fentanyl with intranasal ketamine in 120 renal colic patients. The findings indicated that ketamine is less effective than fentanyl in controlling renal colic pain and is associated with a higher prevalence of side effects. However, ketamine could be effective in combination with other medications for pain control [10]. In our study, we found that ketamine in combination with ketorolac is more effective than ketorolac alone, and the time needed to respond to treatment in the ketamine/ketorolac group was significantly shorter than in the other two groups. Farnia et al., also reported that intranasal ketamine is a good choice for renal colic and has no more adverse effects than intravenous morphine [12]. In a meta-analysis conducted by Dongxu Zhang et al., it was reported that compared with opioids, ketamine has a longer duration of analgesia in renal colic and a better safety profile. There were no significant differences between ketamine and opioids in terms of nausea, vomiting, and dizziness, but the risk of hypotension was significantly lower in the ketamine group [14]. Our study demonstrated that the combination of ketamine/ ketorolac had a faster onset of activity compared to the other groups. Moreover, Miller et al. (n.d.) reported in their study that low-dose intravenous ketamine has similar analgesic effects to intravenous morphine in acute pain management, but with a faster onset [15].

In a study by Abd El Motlb EA. et al., the analgesic effect of intramuscular ketorolac/ketamine and ketorolac/fentanyl was compared in 80 children undergoing bone marrow aspiration and biopsy under general anesthesia. The study concluded that these two regimens were equally effective as analgesics in the pediatric population undergoing the procedure, without adverse effects. The time to first analgesic request, CHOEP scale, emergence-agitation (EA) score, and the need for rescue analgesic did not differ significantly between the two groups (16), which is consistent with our findings.


This study had a couple of limitations. Firstly, we only enrolled patients who presented to the emergency department at the same time as the assessing physician, which may introduce selection bias. It would have been beneficial to include a larger sample size and a more diverse group of patients to enhance the generalizability of the results. Additionally, we were unable to measure the blood levels of the intranasal medications, which could have provided valuable insights into their pharmacokinetics and correlation with pain relief. Furthermore, the patients were discharged after 60 minutes, so we did not collect data on possible delayed complications or pain recurrence. It is recommended that future studies include longer follow-up periods to assess for these outcomes. Lastly, we did not document certain side effects that may have been caused by the nature of the disease, such as nausea and vomiting, prior to medication administration. To capture a more comprehensive understanding of side effects, it is suggested that future studies evaluate these symptoms in longer follow-up periods and record all signs and symptoms before investigation.


In conclusion, our findings suggest that the combined regimens of ketamine/ketorolac and fentanyl/ketorolac are more effective in controlling pain in patients with renal colic compared to the monotherapy regimen of ketorolac alone. These combined regimens provide faster pain relief. However, it is important to note that the possibility of some side effects also increases with the use of these combined regimens. Further research is needed to optimize the dosages and explore the potential long term complications and recurrence of pain associated with these regimens.


The authors gratefully acknowledge the support and cooperation of the staff in the Emergency Departments of Shahid Sadoughi and Shahid Rahnemoon Hospitals in Yazd, Iran.


1. Patti L, Leslie SW. Acute renal colic. 2017.

2. Motov S, Fassassi C, Drapkin J, Butt M, Hossain R, Likourezos A, et al. Comparison of intravenous lidocaine/ketorolac combination to either analgesic alone for suspected renal colic pain in the ED. Am J Emerg Med. 2020; 38: 165-172.

3. Rajaei M, Noorian K, Madineh S. Comparing the efficacy and adverse effects of tramadol and sodum diclofenac with pethedine in the treatment of renal colic. Armaghane danesh. 2013; 18: 1-9.

4. Ketabchi AA, Ebad-Zadeh MR, Parvaresh S, Moshtaghi-Kashanian GR. Opium dependency in recurrent painful renal lithiasis colic. AHJ. 2012; 4: 73.

5. Sen S, Chakraborty R, De B, Ganesh T, Raghavendra H, Debnath S. Analgesic and anti-inflammatory herbs: a potential source of modern medicine. IJPSR. 2010; 1: 32.

6. Sin B, Wiafe J, Ciaramella C, Valdez L, Motov SM. The use of intranasal analgesia for acute pain control in the emergency department: A literature review. Am J Emerg Med. 2018; 36: 310-318.

7. Panagiotou I, Mystakidou K. Intranasal fentanyl: from pharmacokinetics and bioavailability to current treatment applications. Expert Rev. Anticancer Ther. 2010; 10: 1009-1021.

8. Borland ML, Jacobs I, Geelhoed G. Intranasal fentanyl reduces acute pain in children in the emergency department: a safety and efficacy study. Emerg. Med. 2002; 14: 275-280.

9. Belkouch A, Zidouh S, Rafai M, Chouaib N, Sirbou R, Elbouti A, et al. Does intranasal fentanyl provide efficient analgesia for renal colic in adults? Pan Afr. Med. J. 2015; 20.

10. Mozafari J, Verki MM, Motamed H, Sabouhi A, Tirandaz F. Comparing intranasal ketamine with intravenous fentanyl in reducing pain in patients with renal colic: A double-blind randomized clinical trial. The Am J Emer Med. 2020; 38: 549-553.

11. Shrestha R, Pant S, Shrestha A, Batajoo KH, Thapa R, Vaidya S. Intranasal ketamine for the treatment of patients with acute pain in the emergency department. World J Emerg Med. 2016; 7: 19.

12. Farnia MR, Jalali A, Vahidi E, Momeni M, Seyedhosseini J, Saeedi M. Comparison of intranasal ketamine versus IV morphine in reducing pain in patients with renal colic. Am J Emerg Med. 2017; 35: 434-437.

13. Hosseininejad SM, Amini Ahidashti H, Bozorgi F, Goli Khatir I, Montazer SH, Jahanian F, et al. Efficacy and Safety of Combination Therapy with Ketorolac and Morphine in Patient with Acute Renal Colic; A Triple-Blind Randomized Controlled Clinical Trial. Bull Emerg Trauma. 2017; 5: 165-170.

14. Zhang D, Liang P, Xia B, Zhang X, Hu X. Efficacy and Safety of Ketamine Versus Opiates in the Treatment of Patients with Renal Colic: A Systematic Review and Meta-analysis. Pain Ther. 2023: 1-15.

15. Miller JP, Schauer SG, Ganem VJ, Bebarta VS. Low-dose ketamine vs morphine for acute pain in the ED: a randomized controlled trial. Am J Emerg Med. 2015; 33: 402-408.

16. El Motlb EAA. Analgesic efficacy of intramuscular ketamine/ ketorolac versus fentanyl/ketorolac for children undergoing bone marrow biopsy and aspiration. Res Opin Anesth Intensive Care. 2020; 7:135-41

Ashkezari FSZ, Jafari M, Ezzabadi AR, Zarehoroki A, Abarghouei SA (2023) Comparison of Intranasal Ketamine and Intranasal Fentanyl as Adjuncts to Intravenous Ketorolac for Pain Relief in Renal Colic: A Randomized Clinical Trial. Arch Emerg Med Crit Care 7(2): 1060

Received : 07 Nov 2023
Accepted : 06 Dec 2023
Published : 09 Dec 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
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