Journal of Cancer Biology and Research

Patient Reported Outcomes, Oral Health, Taste and Dietary Impact During and Following Head and Neck Cancer Therapy

Research Article | Open Access Volume 8 | Issue 1 |

  • 1. Cedars-Sinai Medical Center, USA
  • 2. Cedars-Sinai Medical Center, USA
  • 3. Private Practice, USA
  • 4. Department of Biology, Temple University, USA
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Corresponding Authors
Joel B. Epstein, Private Practice, Beverly Hills, CA 90048, Cedars-Sinai Medical Center, Los Angeles, City of Hope Comprehensive Cancer Center, Duarte

Objective: The purpose of this paper is to present patient reported outcomes (PRO) of oral function and toxicity in head and neck cancer (HNC) patients and the clinical oral conditions affecting diet and maintenance of body weight during and following cancer therapy.

Study design: Patients with HNC were evaluated during and following cancer therapy. Oral conditions affecting taste and oral diet, including taste and smell function were assessed.

Results: The participating patients reported appetite decline and taste loss in 50% of patients during and in 62.5% following treatment. Decreased food intake and altered food choice were reported as severe by 50% of patients. Throat and mouth pain affected 67% of acute and 42% of post-treatment patients. The spicy perception of capsaicin was reported to have severe impact for 80% of acute and 70% of post-treatment patients. Bitter taste perception affected oral diet either often or all the time in 33% of acute and in 83% of post-treatment patients. Weight loss occurred in 5% during treatment and in 12% post-treatment.

Conclusions: This is the first report of clinical oral function including taste and smell testing, saliva production and patient reported outcomes. Oral complications including mucositis and saliva affect taste change throughout cancer treatment and in the first two years of survivorship. This study provides initial suggestions that may guide diet and food intake and in product development for HNC patients


Epstein JB, Dana Villines MA, Geena L. Epstein RN, Smutzer G (2020) Patient Reported Outcomes, Oral Health, Taste and Dietary Impact During and Following Head and Neck Cancer Therapy. J Cancer Biol Res 8(1): 1128


CT: Chemotherapy; HNC: Head and Neck Cancer; MDASI-HN: MD Anderson Inventory-Head and Neck; PRO: Patient Reported Outcomes; RT: Radiation Therapy; STTA: Scale of Subjective Total Taste Acuity; VHNSS: Vanderbilt Head and Neck Symptom Survey; WIRB: Western Institutional Review Board


Oral intake is impaired during treatment for head and neck cancer (HNC), as oral and oropharyngeal function in patients is negatively affected. Oropharyngeal pain, decreased saliva production, taste and smell changes, and general symptoms of fatigue and nausea influence appetite [1,2]. Flavor is a multidimensional symptom that requires saliva production and is impacted by taste, touch, temperature, and smell. Taken together, these factors affect appetite. Taste qualities include salt, sweet, sour (acid), bitter, savory (umami), fat taste and possibly water taste [3,4]. Spicy foods and foods that cause a cooling sensation also affect the flavor of food [5], by activating receptors of trigeminal neurons. Eating, while a nutrition related activity, also affects social and cultural interactions [3,4].

Dysgeusia may be caused by local injury to mucosa that includes damage to taste or olfactory function, saliva change (quantity and quality), oral infection, and systemic conditions [4,6-9]. Dysgeusia is common in HNC patients [1,4,10,11]. Radiation therapy (RT) has local/regional effects on taste function and chemotherapy (CT) may effect taste and smell [12]. CT may have effects upon taste and smell and has general effects such as fatigue and nausea [4,13].

Changes in taste impacts the quality of life, contributing to morbidity and potentially mortality [9,12,15]. Taste changes and nutritional compromise have been associated with impaired immune function [15,16]. Patient reported outcomes (PRO), using the MD Anderson Inventory-Head and Neck (MDASI-HN), survey in HNC survivors post-RT with or without CT showed that less than one-third of these patients reported maintaining a normal diet. This study reported that dysphagia and dental problems were associated with diet modifications. Further studies have documented that the experience of eating is altered following HNC therapy, and negative social impact [9,19].

In this prospective study, we examined HNC patients during and following cancer therapy, and assessed PRO, oral examination findings and taste and smell. This report focuses on PRO and correlation with oral examination findings, along with taste/smell testing previously reported [20].


Ten patients were evaluated 4-6 weeks after starting HNC therapy (acute treatment group, N = 6), and following treatment (post-treatment group, N = 8). Patients enrolled were adults with HNC, scheduled to receive intensity-modulated RT with/without platinum-based CT and/or HNC patients up to 2 years following cancer treatment. Exclusion criteria included prior treatment for HNC, induction CT and tumor involving more than 50% of the oral tongue.

To assess patient report of treatment toxicities, the Vanderbilt Head and Neck Symptom Survey (VHNSS), and the Scale of Subjective Total Taste Acuity (STTA), were completed by the patients. The VHNSS v 2.0 evaluates oropharyngeal treatment related toxicities. This data is presented in the results section as a score of 1-2 for the item indicates that the toxicity was present while a score ≥ 4 indicates the toxicity was present and severe [21]. The STTA assesses the overall perception of changes in taste with zero representing no change and four representing almost complete loss of taste function [4]. Taste testing used rapidly dissolving pullulan-based edible films that included a taste or trigeminal stimulus in the film as previously reported [20,22]. Taste intensity was measured on a 7-point Likert category scale (none – strong). Olfactory function was measured with the Smell Identification Test (Sensonics, Haddonfield, NJ).

Descriptive analysis was performed for all variables and are presented as counts with percentages for dichotomous and categorical variables. Age is presented as mean ± standard deviation. Western Institutional Review Board (WIRB, Puyallup, WA; IRB # 20172768), approved the study and all patients provided written informed consent to participate.


Patient’s demographics and clinical characteristics are summarized in Table 1. Tobacco use, defined as >15pack/year history, was reported by three patients and half of the patients reported social alcohol use, defined as 2-4 drinks/week. Average weight loss of 5% during treatment and 12% at follow-up was seen.

Most patients reported that appetite declined during treatment and at follow-up (Figure 1A). All patients reported very good appetite at the start of treatment, during treatment, 16.7% reported poor or very poor appetite, and following treatment 50% reported poor or very poor appetite.Food and beverage textures consumed (e.g.: thin liquid, thick liquid, semisolid, soft, firm, hard, abrasive) were reported in the acute and post groups, respectively: all food textures 66.7% and 62.5%; all textures to thick liquids 30% and 60%; and consuming all kinds of liquid/beverage 100% and 60%. Completion of a meal was impacted during treatment and in follow-up. More than half of patients reported eating a whole meal or more to feel full in both groups: 66.7% in the acute group and 62.5% in the post treatment group (Figure 1B). Most patients needed longer or a much longer time to consume a meal: 50% in the acute group and 62.5% in the post group. Pleasure and enjoyment associated with eating prior to cancer treatment, was rated as very pleasant or pleasant by all the patients, while 66% reported unpleasant or very unpleasant eating due to no taste, pain or difficulty swallowing in the acute group and 28.6% in the post treatment group.

Oral symptoms that may affect food consumption during and following HNC treatment are shown. During treatment, throat and mouth/tougue pain due to mucositis was repored by 67% of patients. Following treatment, throat and mouth pain was reported to impact eating in 54% of the early post-treatment visits and by 42% of the post-treatment group. Taste loss was reported by 50% of patients during treatment, and 62.5% of patients following treatment.

Oral symptoms impacting function are shown in Table 2. Dry mouth was rated as severe by 80%, and mild by 20% of patients during treatment and severe by 86% and mild by 14% of posttreatment patients. Thick mucus in the oral cavity had severe effect for 60% and 28% of patients during treatment and posttreatment, respectively. Food sticking in the mouth was repored at follow up to be severe by 72% of patients. In contrast, food sticking in the oral cavity was reported as severe for 40% of patients during treatment.

Taste change during treatment was reported as severe by 67% of patients and mild by 33% and similar report of decreased amount of food consumumption was noted in patients during therapy. Altered food choice was reported as severe by 50% of patients and minor by 33%. Following treatment, taste change was report by 88% of patients with 50% reporting severe effects resulting in decreased food intake and altered food choice 50% of patients.

Taste changes also had an impact on food choices (Table 3). In this cohort, spicy sensation and sour taste were the most problematic during and after treatment. The spicy perception of capsaicin was reported to have severe impact by 80% of patients during treatment and 70% following treatment. Bitter taste affected oral diet often or all the time in 33% of patients during treatment, and in 83% following treatment. The following tastes impacts were expereinced by 50-60% during treatment but reduced to between 0-28% in post treatment: bland, umami (savory), sweet, metallic and fat taste. Smell identification was similar during treatment (x = 28.33 ± 6.71) and post-treatment (x = 31.00 ± 7.69).

Table 1: Demographics of study participants.

Patient Number   10 %
Gender Male 7 70
  Female 3 30
Mean Age (y)   59.9 + 7.0 N/A
Ethnicity Caucasian 8 80
  Hispanic 1 10
  Asian 1 10
Cancer Location SCC* Tonsil p16 positive 6 60
  Base of Tongue p16 positive 3 30
  Oral Tongue p16 positive 1 10
*SCC refers to oral squamous cell carcinoma.

Table 2: Percentage of Patients Reporting Oral Symptoms that Impacted Diet

  Acute Group (n = 5) Post Group (n = 7)
  ≥ 1 ≥ 4 ≥ 1 ≥ 4
Xerostomia 20 80 14 86
Excess mucus        
Thick mucus/phlegm 40 60 28 28
Swallowing difficult 40 40 28 56
Mucosal sensitivity        
Sensitive to spicy, hot, or acidic foods 20 80 28 72
Range of motion        
Limitations in jaw movement 20 40 72 14
Swallowing/eating foods        
Food gets stuck in mouth 20 40 14 72
Food gets stuck in throat 60 0 42 42
Choke/strangle on liquids 0 0 58 0
Dental health        
Difficulty chewing due to teeth/dentures 20 0 14 0
Table 2 note: Symptoms can range from 0 (no symptom present) to 10 (most severe report of the symptom), and are categorized as 1-3 for ‘symptom is present’ and ≥ 4 for ‘severe symptom is present’. Within group totals may be less than 100% if a patient(s) reported ‘0’(no symptom present) for the indicated symptom.



Acute oropharyngeal complications of HNC therapy include mucositis, pain, saliva change, secondary oral infection, taste change, dysphagia, odynophagia, aspiration, fatigue, nausea, limited jaw opening and tongue movement. Acute complications result in social and psychological effects and are associated with fatigue, depression and isolation [18]. As acute oral complications resolve following treatment, chronic toxicities continue to impact oral and oropharyngeal function. The impact of RT upon taste is multifactorial and is compounded when combined with CT [1,4,17,19].

A recent survey of HNC survivors reported the most impactful symptoms following treatment include dry mouth, difficulty swallowing, mucus secretion, taste change and choking/coughing while eating [17]. Dysphagia and problems with teeth/gums were associated with maintaining a normal diet [17].

The current study showed that symptoms that affect food consumption differed during and following cancer treatment. During treatment acute toxicities causing mouth and throat pain due to mucositis affected two-thirds of patients and although following cancer treatment, pain was less impactful. Dry mouth was reported in 50% of patients following treatment and was correlated with whole resting saliva (r = -0.96, p < 0.01) as well as unstimulated saliva in the post treatment group (r = -0.98, p < 0.01; see [20]. Half of patients reported their eating ability was affected due to food texture in the post-treatment group. Although these changes were not statistically significant, differences throughout the treatment trajectory and following treatment may assist in predicting patient food preferences. These findings suggest that evaluation and management of the oral conditions and modifications of diet and food product development are required to address the trajectory of oral function during and following therapy.

Hyposalivation may limit saliva food-coating and decreased food particle delivery to taste receptors [23]. Hyposalivation and viscous secretions impact oral comfort, taste function, speech and swallowing. Oropharyngeal infection (e.g., candidiasis), affects taste and oral comfort. As previously reported, more viscous (mucus), secretion impact taste function that was found in the current study [9]. Therefore, saliva quantity and quality should be assessed in HNC patients and managed when possible. Other studies state that saliva change caused by cancer therapy may lead to decreased taste function [9,17,23,24].

Taste change during radiation therapy, typically occurs concurrently with mucosal damage, which suggesting direct damage to taste receptors, while persisting change in taste following treatment may reflect decreased turnover rates of taste receptor cells, and/or neuronal damage [2,17,24,25]. Taste recovery is unpredictable with some patients reporting improvement in a few months to a year after cancer therapy, while others may not fully recover [9,26-28].

In the current study, taste change was reported by all patients during treatment and by 87.5% of participants post-treatment with follow-up continuing up to two years. The changes in taste were associated with decreased amount of food eaten and altered food choices. In addition, taste change impacts diet choice, social aspects of food consumption, and sociocultural influence in people with traditionally spicy diets. These changes appear to represent painful mucositis during treatment and may reflect mucosal toxicity and neuropathy (C-fiber activation), posttreatment. In the post-treatment group, 50% of patients reported their eating ability was affected by food texture but was less common (16.7%), in the acute group. Although these changes were not statistically significant between the two groups, these differences may promote understanding in order to anticipate patient food and meal preferences.

Most patients were challenged in completing a meal and required a longer time to consume a meal. These findings require patient accommodations due to impact upon diet and nutrition and social interaction around meals and support recommendations for smaller portions, snacking and more frequent meals.

As reported in our prior companion paper [20], taste intensity and pleasantness (hedonics), testing with edible taste strips followed a similar pattern as the tastes that impacted food choices, as reported separately for this cohort. Spicy/pungent responses with capsaicin as the stimulus showed the highest (strongest), intensity and most strongly disliked stimulus during treatment and follow up. Fat taste (linoleic acid), and sweet taste (sucralose), were most frequently reported as producing strong intensity during treatment. At follow-up, the most frequently reported intensity for fat taste was moderate, and sweet was vairable from weak to strong intensity. Sweet was the only primary taste quality to receive a positive pleasantness (hedonic), rating as the most frequent response. Salt taste stimuli yielded strong intensities during and following HNC treatment, and was most frequently reported as extremely disliked in the follow-up group. These findings inform diet recommendations and product development for people during and following HNC therapy.

Olfactory function may be affected in HNC therapy when RT includes the nasopharynx and the olfactory bulb along with CT [1,16]. Changes in olfactory function have been reported with CT that included cisplatin and methotrexate [16]. However, in our report, only three HNC patients (33%), reported smell disturbance. Of the patients that reported change in smell identification, two were seen approximately 3 to 4 months after treatment with combined RT/CT.

In the current study, all HNC patients in a prior report had moderate to severe taste disturbance and dry mouth as previously reported [9]. Other studies report that 75% to 100% of HNC patients who received RT experience taste change depending on the radiation dose and treatment fields [4,28].

In a prior study, variable changes of reduced or abnormal taste perception occurred in two-thirds of patients, and increased intensity occurred in one third of patients [9]. In addition, taste studies with electrogustometry show taste qualities are affected. HNC patients had a high number of reported “no taste” or “abnormal taste” and a correlation between decreased sweet and increased sour taste [9,29], comparable to findings in the current study. In a recent study, Epstein et al. [9], found that bitter taste function was alterred in most HNC, which was reported in the current study particularly post-treatment. As reported in the current cohort [20], sensitivity to spicy and acidic (sour) foods was highly impactful during and following treatment. In prior studies, umami taste was the most affected sensation [9,29], which may have an effect upon appetite and oral intake, and decrease in quality of life [30]. In the current study, umami taste was reported impactful by 60% of patients during treatment, with fewer reporting impact post-treatment (28%), suggesting some recovery may occur in umami taste post-treatment. Fat taste change was reported by 83% during treatment and in 28% following treatment. The potential recovery in umami and fat taste over time, reported in this study, may affect dietary  guidance and product development considerations in order to consume high energy foods and maintain enjoyment of eating. Some studies have shown improvement by 8 weeks following HNC treatment [29,31]. However, other studies found that taste changes may persist indefinitely in some HNC patients [1,30]. In the current study, continuing taste changes were observed up to two years post-treatment and likely will continue indefinitely in some patients.

The eating experience is altered leading to patients accommodating with modifications including maladaptation affecting diet and impacting social interactions that influence general well-being and quality of life [18]. In the current study, HNC treatment was associated with patient weight during treatment (less 5% weight loss) and continued during follow up with a mean of 12% loss from pretreatment weight. HNC treatment reduced the pleasure of eating; 66.7% of patients reported unpleasant or very unpleasant taste perception, pain or difficulty swallowing in acute group and in 28.6% of patients with unpleasant or very unpleasant eating in the post treatment group. Therefore, the impact of treatment toxicities affecting diet and nutrition must be assessed during and following HNC treatment. Patients reported reduced ability to eat a full meal, which clearly challenges calorie and nutrient intake. In addition, the time required to consume a meal was increased which has significant implications in the social setting. Appetite decline has significant implications in survivorship and is both understudied and underappreciated. Our results show a considerable and continuing impact of treatment upon appetite during treatment and greater impact following treatment.

A post-treatment survey following HNC treatment found only 28% reported a normal full diet [17]. They identified clinical correlations with T stage, location of primary tumor, combined RT/CT were associated with poor oral intake [17]. Symptoms of dry mouth, difficulty swallowing, mucus secretion, taste and choking/coughing with eating were most impactful [17]. This study, focused on survivors, and likely underestimates the frequency, severity and impact of oropharyngeal function in the broader HNC population. Our study reports similar findings and further evaluated components of oral health and taste and olfaction in addition to general PRO. In addition, our report emphasizes the differences between acute and chronic complications during the cancer journey of HNC patients. Our study shows that oropharyngeal function, taste, flavor, and appetite are complex and multidisciplinary constructs. Diet and nutrition affect health and social well-being and require evaluation across the continuum of oncology care from treatment and throughout survivorship.Taste perception may have profound impact on health and requires attention of the health care team. While current approaches to nutrition and diet management have emphasized nutritional supplementation, little attention has been paid to oropharyngeal factors that influence comfort, taste and dietary choices and appetite [9]. The current study shows changes in the oral conditions throughout the HNC treatment continuum require management. We assessed saliva function, oral hygiene, gingivitis and mucosal change that may impact oral function and affect diet. Dental status was reported by Kamal et al. [17], may  impact quality of life and oral function. Taste management should include addressing oral status including acute mucosal damage (mucositis), pain management, oral hygiene, and addressing dental/oral disease and saliva management. Current guidance for medical intervention in taste change is based on preliminary studies. [9,32].

Our findings suggest that attention to diet and nutrition must include management of oral conditions and modifications of diet recommendations and food product development. These factors should be considered in diet and nutritional advice and products, seeking high calorie, protein and nutrient content in meals, meal replacements and supplements. Future studies should examine and manage oral health, taste and examine flavor in HNC patients in order to improve patient dietary needs and nutrition.

Table 3: Percentage of Patients Reporting Taste Changes Affecting Food Choices

Taste Frequency of impact upon Diet
  None Seldom Half time Often All the time
Umami Pleasant          
Acute   40   20 40
Post 28 42   14 14
Acute 40 20     40
Post   17   51 34
Acute   40   40 20
Post 42 42   14  
Acute 20   20 20 40
Post 42   14 14 28
Acute 20 20   20 40
Post 42   42   14
Acute 60 20   20 20
Post 42 28 14   14
Acute 40     20 40
Post 100        
Acute   20   20 60
Post 57 14   14 14
Table 3 note: Acute group n = 5, post group n = 7 except for “bitter” n = 6



We gratefully acknowledge funding provided by the Cancer Nutrition Consortium, and Hormel Foods Inc. We acknowledge assistance in data entry by Dr. Sifira Marques de Andrade e Silva, Clion CAM Group, Salvadior BA, Brazil, visiting dentist, Beverly Hills, CA


Ethics approval and consent to participate: Western Institutional Review Board (WIRB, Puyallup, WA; IRB # 20172768) approved the study and all patients provided written informed consent to participate.

Consent for publication: All authors consent to publication.

Availability of data and material: Data is not publicly available

Competing interests: The authors report no conflict of interest/competing interests.

Funding: We gratefully acknowledge funding provided by the Cancer Nutrition Consortium, and Hormel Inc.

Authors’ contributions:

JE: made substantial contributions to the conception and design of the work; responsible for the acquisition, and interpretation of data; have drafted the work or substantively revised it

DV: made substantial contributions to the design of the work; responsible for the analysis and interpretation of data; have drafted the work or substantively revised it

GE: responsible for the acquisition; have drafted the work or substantively revised it

GS: made substantial contributions to the conception and design of the work; have drafted the work or substantively revised it

All authors have approved the submitted version and have agreed both to be personally accountable for the author’s own contributions and to ensure that questions related to the accuracy or integrity of any part of the work.


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Received : 27 Aug 2020
Accepted : 09 Sep 2020
Published : 11 Sep 2020
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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 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
TEST Journal of Dentistry
ISSN : 1234-5678
Launched : 2014
Annals of Nursing and Practice
ISSN : 2379-9501
Launched : 2014
JSM Dentistry
ISSN : 2333-7133
Launched : 2013
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