
2School of Allied Health and Communicative Disorders, Northern Illinois University, USA
3Owner and Laboratory Manager, Norman Clinical Laboratory, Inc. USA
The number of Americans aged 45-64 has increased by 24% over the last decade [1]. It is projected that by 2030, older adults will comprise 20% of the U.S. population [1]. The aging population often suffers from at least one chronic condition or possibly multiple co-morbidities including gastrointestinal issues. More specifically, 6-17% of the U.S. elderly population is suffering from gastroesophageal reflux disease (GERD) [2]. Older adults seem more prone to GERD due to malabsorption and higher prevalence of chronic atrophic gastritis [3-4].
GERD is a digestive disorder in which stomach contents reflux back into the lower esophagus, causing erosion of the esophageal lining and often times causing emesis or chest pain [5-7]. If GERD is left untreated, continuous exposure of the esophageal lining to stomach acid can cause a condition called “Barrett’s esophagus” in which pre-cancerous cells develop [5].
Absorption, Metabolism and Storage of Vitamin B12
Vitamin B12 absorption begins in the stomach where food-bound or enzyme-bound cobalamin is released from proteins by gastric hydrochloric acid (HCl-) and the gastric proteolytic enzyme, pepsin [4,10-13]. After release of cobalamin, the free vitamin B12 is bound to an R protein (haptocorrin or transcobalamin I) from saliva, and is transported to the duodenum [4]. This R protein is thought to provide protection to vitamin B12 from use by intestinal bacteria [4].
The most common causes of vitamin B12 deficiency in humans are associated with acquired malabsorption. A number of studies have shown that elderly individuals with an average age over 80 taking PPIs had lower serum vitamin B12 levels [14-18] and higher serum methylmalonic acid levels [15,16], but whether this is true for 50-70 year olds who are taking PPIs is unknown. It appears that chronic use of PPIs can induce achlorhydria, which leads to malabsorption of vitamin B12, as gastric acid is required to release vitamin B12 from food [16,17]. This can occur across the age spectrum, but seems to have the most impact on elderly individuals and those with low vitamin B12 stores in the body.
Although the sMMA and uMMA respond similarly to vitamin B12 supplementation [20], uMMA, due to its increased specificity for vitamin B12, is superior to that of sMMA. Unlike uMMA, sMMA levels may be falsely elevated due to renal insufficiency [21]. However, creatinine should be utilized, when interpreting uMMA, to account for possible kidney function impairment [10]. The test for uMMA, which is 40 times more concentrated than the levels of sMMA, is non-invasive, only requires 1 mL of urine, and is stable when frozen for months [21,22]. However, false positives have not been reported with uMMA measurements [22]. Both serum and urinary MMA biomarkers have higher sensitivity and specificity than serum vitamin B12 [12]. A potential drawback is the need for implementation of a quality assurance system regarding the uMMA measurements. Researchers from the Hospital of the University of Munich, Germany found a deviation of > 20% from the mean concentration of uMMA samples in a large proportion of samples submitted by ten European clinical laboratories [23]. This variable can be easily controlled by having all samples evaluated by one laboratory.
A quasi-experimental design was used for this study. Thirty men and women were recruited from January to April, 2015 using informational flyers posted at the campus of Northern Illinois University (NIU), at local assisted care living facilities and other community locations. Prior to participating in this study, subjects signed a consent form. All study procedures were approved by the Institutional Review Board at NIU. On the day of their scheduled appointment, subjects brought a completed 3-day food record with them, completed a brief informational survey, had their anthropometrics assessed, and then provided a urine sample for the uMMA assay.
Survey: Each subject completed a survey designed to collect details about their demographics, lifestyle behaviors, use of vitamin supplements, and use and name of PPIs. In addition, participants were queried about their use of vitamin B12, vitamin B6, and folic acid supplements.
Due to the small sample size and the matched pairs design, this study used the non-parametric related-samples Wilcoxon signed rank test to determine differences in key variables between subjects in the PPI group and subjects in the non-PPI group. This test was also used to test the hypothesis to determine if the subjects in the PPI group would have higher uMMA levels than their age- and gender-matched controls in the non-PPI group.
Thirty subjects (n = 10 males; n = 20 females) aged 50-68 years participated in this study (Table 1). Most participants (93.3%) were Caucasian, two were African American (6.7%). The PPI group reported that they had been taking PPIs for a range of 1.5-15 years (M ± SD = 7 ± 3.9 years) and 67% of the PPI group had been on PPIs for at least 5 years (n = 10).
Dietary intake data was not available for one non-PPI group participant. Therefore, the data presented for dietary intake reflects the related-samples Wilcoxon signed rank test for 14 pairs. Dietary intake descriptive values were calculated with 29 participants. Equivalence of groups in regard to dietary intake was analyzed using 14 instead of 15 pairs. Tests for equivalency of groups indicated no significant differences between average daily caloric intake (kcal/kg) (Z = 0.09, p = 0.93), carbohydrates as percentage of caloric intake (Z = 0.03, p = 0.98), protein as percentage of caloric intake (Z = -1.41, p = 0.16), fat as percentage of caloric intake (Z = 1.73, p = 0.08), dietary vitamin B12 (μg) (Z = -1.15, p = 0.25), dietary vitamin B6 (mg) (Z = -1.29, p = 0.20), and dietary folate (μg) (Z = -0.66, p = 0.51) (Table 1).
PPI Group (n = 15) | Non-PPI Group (n = 15) | |||||
Anthropometrics | Mean ± SD | Median | Mean ± SD | Median | Z Score | P Value |
Age | 56.6 ± 5.5 | 56.0 | 56.5 ± 5.2 | 54.0 | - 0.11 | 0.91 |
BMI (kg/m2 ) | 33.2 ± 6.6 | 30.9 | 28.3 ± 4.4 | 27.3 | - 2.33 | 0.02 |
Body Fat Percent (%) | 40.4 ± 8.2 | 39.8 | 35.1 ± 8.0 | 35.6 | - 2.36 | 0.02 |
Body Fat Mass (kg) | 38.3 ± 14.3 | 33.1 | 28.6 ± 9.6 | 26.3 | - 2.33 | 0.02 |
Lean Body Mass (kg) | 54.7 ± 10.3 | 53.0 | 52.0 ± 10.5 | 51.7 | - 0.91 | 0.36 |
Dietary/Supplement Intake | ||||||
Average Daily Caloric Intake (kcal/kg) | 19.3 ± 6.7 | 18.1 | 20.0 ± 4.7 | 20.4 | 0.09 | 0.93 |
Carbohydrate as % of Caloric Intake | 40.9 ± 6.3 | 39.7 | 41.2 ± 5.5 | 40.8 | 0.03 | 0.98 |
Protein as % of Caloric Intake | 20.6 ± 4.2 | 19.5 | 18.2 ± 3.3 | 18.0 | - 1.41 | 0.16 |
Fat as % of Caloric Intake | 36.7 ± 4.7 | 36.3 | 38.8 ± 4.8 | 38.2 | 1.73 | 0.08 |
Dietary Vitamin B12 (µg) | 3.8 ± 3.1 | 2.9 | 2.7 ± 1.8 | 2.0 | - 1.15 | 0.25 |
Dietary Vitamin B6 (mg) | 1.1 ± 0.7 | 0.8 | 1.1 ± 0.8 | 0.8 | - 1.29 | 0.20 |
Dietary Folate (µg) | 262.0 ± 195.3 | 185.2 | 178.0 ± 105.3 | 173.2 | - 0.66 | 0.51 |
Supplemental Vitamin B12 (µg) | 25.8 ± 35.3 | 15.0 | 64.13 ± 204.1 | 0.0 | - 0.23 | 0.82 |
Supplemental Vitamin B6 (mg) | 3.0 ± 2.8 | 3.0 | 3.7 ± 6.5 | 0.0 | - 0.09 | 0.93 |
Supplemental Folic Acid (µg) | 246.7 ± 216.7 | 400.0 | 293.3 ± 439.91 | 0.0 | 0.00 | 1.00 |
uMMA Levels (µg uMMA/mg creatinine) | 1.6 ± 0.6 | 1.6 | 2.0 ± 0.6 | 1.8 | 1.54 | 0.12 |
Note: P values resulted from related -samples Wilcoxon signed ranks tests. Total of percentages for carbohydrates, protein, and fat may not equal 100% due to rounding. Only 14 pairs were available for analysis of dietary intake.
SD = Standard deviation.
Tests for equivalency of groups regarding supplemental intake indicated no significant difference between supplemental vitamin B12 (μg) (Z = -0.23, p = 0.82), supplemental vitamin B6 (mg) (Z = -0.09, p = 0.93), and supplemental folic acid (μg) (Z = 0.00, p = 1.00).
Urinary methylmalonic acid levels ranged from 0.90 to 2.80 μg/mg creatinine in the PPI group and 1.20 to 3.30 μg/mg creatinine in the non-PPI group. The hypothesis that the PPI group would have higher uMMA levels than the non-PPI group was not confirmed (Z = 1.54, p = 0.12).
The PPI group and non-PPI group were significantly different regarding BMI, body fat percent, and body fat mass with the PPI group displaying a higher BMI, body fat percent, and body fat mass than the non-PPI group. The BMI of the PPI group (M ± SD = 33.2 ± 6.6; Mdn = 30.9), indicated obesity, while the BMI of non-PPI group (M ± SD = 28.3 ± 4.4; Mdn = 27.3), indicated they were overweight [27]. Because there is an association between BMI and GERD, obesity commonly is seen as a risk factor that contributes to the development of GERD [28,29]. Research has indicated that obesity is associated with a 1.5 to 2 times increase in risk of GERD symptom development [30,31], and this association has been confirmed utilizing multichannel intraluminal impedance-pH monitoring [32]. The mechanism of this relationship is largely unknown; however, one study suggested that an increase in obesity is associated with a postprandial transient lower esophageal sphincter relaxation with subsequent acid reflux [29]. Subjects with a higher BMI in the aforementioned study were more likely to have acid reflux, and therefore, had a greater reliance on PPI’s.
The PPI group and non-PPI group were not significantly different regarding dietary or supplemental intake of B vitamins. When dietary and supplemental intakes were combined, the daily reference intake for vitamin B12, vitamin B6 and folic acid was met. The only vitamin that would affect uMMA levels is vitamin B12, and all subjects were ingesting a sufficient amount of vitamin B12 based on the established daily reference intake values. As such, there is no reason to suggest that dietary intake or supplementation had any effect on uMMA results.
The only other study using uMMA to measure vitamin B12 status was conducted by Lukaszuk., et al. which investigated the effect of PPI use on vitamin B12 status in 22-50 year olds. That study and the current study both found that uMMA levels were not significantly different between subjects in the PPI group and subjects in the non-PPI group [24]. The use of uMMA, as a biomarker of vitamin B12, has been confirmed by various studies [20-22]. No participants approached an abnormal uMMA level of > 3.8 μg MMA/mg creatinine or > 3.6 mmol/mol creatinine which would have indicated tissue store depletion of vitamin B12 [24].
- Administration on Aging. “Profile of Older Americans: 2014”. US Department of Health & Human Services, 2014.
- Achem S and Kenneth D. “Gastroesophageal Reflux Disease and the Elderly”. Gastroenterology Clinics of North America 43.1 (2014): 147-160.
- Masclee G., et al. “A Benefit-Risk Assessment of the Use of Proton Pump Inhibitors in the Elderly”. Drugs & Aging 31.4 (2014): 263-282.
- Wolters M., et al. “ A Critical Vitamin in the Elderly”. Preventive Medicine 39.6 (2004): 1256-1266.
- El Serag Hashem. “Time Trends of Gastroesophageal Reflux Disease: A Systemic Review”. Clinical Gastroenterology and Hepatology 5.1 (2007): 17-26.
- Kahrilas P., et al. “American Gastroenterological Association Medical Position Statement on the Management of Gastroesophageal Reflux Disease”. Gastroenterology 135.4 (2008): 1383-1391.
- Vakil N., et al. “The Montreal Definition and Classification of Gastroesophageal Reflux Disease: A Global Evidence Based Consensus”. American Journal of Gastroenterology 101.8 (2006): 1900-1920.
- Rohof W., et al. “Pathophysiology and Management of Gastroesophageal Reflux Disease”. Minerva Gastroenterology and Dietology 55.3 (2009): 289-300.
- Yang Yu-Xiao and David M. “Safety of Proton Pump Inhibitor Exposure”. Gastroenterology 139.4 (2010): 1115-1127.
- Grober UK., et al. “Neuroenhancement with Vitamin B12 – Underestimated Neurological Significance”. Nutrients 5.12 (2013): 5031-5045.
- Solomon L. “Diabetes as a Cause of Clinically Significant Functional Cobalamin Deficiency”. Diabetes Care 35.5 (2011): 1077-1080.
- Chatthanawaree W. “Biomarkers of Cobalamin Deficiency (Vitamin B12) Deficiency and its Application”. Journal of Nutrition, Health & Aging 15.3 (2011): 227-231.
- Howden C. “Vitamin B12 Levels During Prolonged Treatment with Proton Pump Inhibitors”. Journal of Clinical Gastroenterology 30.1 (2000): 29-33.
- Dhamarajhan TS., et al. “Do Acid-Lowering Agents Affect Vitamin B12 Status in Older Adults?” Journal of American Medical Directors Association 9.3 (2008): 162-167.
- Hirschowitz BI., et al. “Vitamin B12 Deficiency in Hypersecretors During Long-Term Acid Suppression with Proton Pump Inhibitors”. Alimentary Pharmacology & Therapeutics 27.11 (2008): 1110-1121.
- Rozogny N., et al. “Vitamin B12 Deficiency is Linked with Long-Term Use of Proton Pump Inhibitors in Institutionalized Older Adults: Could a Cyanocobalamin Nasal Spray be Beneficial?” Journal of Nutrition for the Elderly 29.1 (2010): 87-99.
- Termanini B., et al. “Effect of Long-Term Gastric Acid Suppressive Therapy on Serum Vitamin B12 Levels in Patients with Zollinger-Ellison Syndrome”. American Journal of Medicine 104.5 (1998): 422-430.
- Valuck R and Mark JR. “A Case-Control on Adverse Effects: H2 Blocker or Proton Pump Inhibitor Use and Risk of Vitamin B12 Deficiency in Older Adults”. Journal of Clinical Epidemiology 57.4 (2004): 422-428.
- Matchar D., et al. “Isotope-Dilution Assay for Urinary Methylmalonic Acid in the Diagnosis of Vitamin B12 Deficiency”. Annals of Internal Medicine 106.5 (1987): 707-710.
- Hill M., et al. “A vitamin B-12 Supplement of 500 µg/d for Eight Weeks Does Not Normalize Urinary Methylmalonic Acid or Other Biomarkers of Vitamin B-12 Status In Elderly People with Moderately Poor Vitamin B-12 Status”. Journal of Nutrition 143.2 (2013): 142-147.
- Norman E. “Urinary Methylmalonic Acid Test May Have Greater Value than the Total Homocysteine Assay for Screening Elderly Individuals for Cobalamin Deficiency”. Clinical Chemistry 50.8 (2004): 1482-1483.
- Gultepe M., et al. “Urine Methylmalonic Acid Measurements for the Assessment of Cobalamin Deficiency Related to Neuropsychiatric Disorders”. Clinical Biochemistry 36.4 (2003): 275-282.
- Vogeser M., et al. “External Quality Assessment of Urinary Methylmalonic Acid Quantification – Results of a Pilot Study”. Clinical Chemistry and Laboratory Medicine 45.5 (2007): 695-696.
- Lukaszuk J., et al. “Methylmalonic Acid Levels in Non-Elderly Adult Chronic PPI Users”. Journal of Human Nutrition Food Science 1: 1004 (2013).
- Den EWPJ., et al. “Long-Term Use of Proton Pump Inhibitors and Vitamin B12 Status in Elderly Individuals”. Alimentary Pharmacology & Therapeutics 27.6 (2008): 491-497.
- Ruscin JM., et al. “Vitamin B12 Deficiency Associated with Histamine2-Receptor Antagonists and a Proton Pump Inhibitor”. Annals of Pharmacotherapy 36. (2002): 812-816.
- Charney P and Ainsley M. “ADA Pocket Guide to Nutrition Assessment. Chicago, IL”. Academy of Nutrition and Dietetics 2009 Print.
- Corley D and Ai K. “Body Mass Index and Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis”. American Journal of Gastroenterology 10.11 (2006): 2619-2628.
- Wu JCY., et al. “Obesity is Associated with Increased Transient Lower Esophageal Sphincter Relaxation”. Gastroenterology 132.3 (2007): 883-889.
- El Serag H., et al. “Obesity is an Independent Risk Factor for GERD Symptoms and Erosive Esophagitis”. American Journal of Gastroenterology 100.6 (2005): 1243-1250.
- El Serag H. “The Association between Obesity and GERD: A Review of the Epidemiological Evidence”. Digestive Disease and Sciences 53.9 (2008): 2307-2312.
- Hajar N., et al. “Impedance pH Confirms the Relationship between GERD and BMI”. Digestive Diseases and Sciences 57.7 (2012): 1875-1879.
Journal Menu
PubMed Indexed Article
EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.
PMID: 31143884 [PubMed]
PMCID: PMC6536005
EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.
PMID: 31565701 [PubMed]
PMCID: PMC6764777
EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.
PMID: 27747317 [PubMed]
PMCID: PMC5065347
EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?
PMID: 31460519 [PubMed]
PMCID: PMC6711478
EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?
PMID: 30215059 [PubMed]
PMCID: PMC6133253
EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.
PMID: 30417173 [PubMed]
PMCID: PMC6226033
EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.
PMID: 30264037 [PubMed]
PMCID: PMC6155992
EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.
PMID: 30198026 [PubMed]
PMCID: PMC6124505
EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.
PMID: 30294723 [PubMed]
PMCID: PMC6169793
EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs
PMID: 29285526 [PubMed]
PMCID: PMC5743211
EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique
PMID: 29911204 [PubMed]
PMCID: PMC5999047
EC Microbiology
Macrophages and the Viral Dissemination Super Highway
PMID: 26949751 [PubMed]
PMCID: PMC4774560
EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.
PMID: 27390782 [PubMed]
PMCID: PMC4933318
EC Microbiology
Reactive Oxygen Species in HIV Infection
PMID: 28580453 [PubMed]
PMCID: PMC5450819
EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population
PMID: 26280024 [PubMed]
PMCID: PMC4533840
EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis
PMID: 28066845 [PubMed]
PMCID: PMC5214344
EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology
PMID: 28936490 [PubMed]
PMCID: PMC5604476
EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia
PMID: 28713879 [PubMed]
PMCID: PMC5510658
EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature
PMID: 28133641 [PubMed]
PMCID: PMC5267489
EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling
PMID: 29333536 [PubMed]
PMCID: PMC5766278
EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.
PMID: 31032493 [PubMed]
PMCID: PMC6483108
EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.
PMID: 30957099 [PubMed]
PMCID: PMC6448571
EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.
PMID: 30101228 [PubMed]
PMCID: PMC6086333
EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.
PMID: 31080964 [PubMed]
PMCID: PMC6508883
EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.
PMID: 31093608 [PubMed]
PMCID: PMC6513001
EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.
PMID: 31552397 [PubMed]
PMCID: PMC6758937
EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.
PMID: 31681909 [PubMed]
PMCID: PMC6824723
EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.
PMID: 31681910 [PubMed]
PMCID: PMC6824726
EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.
PMID: 31528859 [PubMed]
PMCID: PMC6746603
EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?
PMID: 31276119 [PubMed]
PMCID: PMC6604646
EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.
PMID: 31406965 [PubMed]
PMCID: PMC6690616
EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.
PMID: 31517314 [PubMed]
PMCID: PMC6741290
EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.
PMID: 31633124 [PubMed]
PMCID: PMC6800226
EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.
PMID: 29662969 [PubMed]
PMCID: PMC5898812
EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.
PMID: 30215058 [PubMed]
PMCID: PMC6133268
News and Events
March Issue Release
We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the March issue of respective journals and can be viewed in the current issue pages.
Submission Deadline for April Issue
Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the April issue of respective journals. Submissions are accepted on/before March 22, 2021.
Certificate of Publication
Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.
Best Article of the Issue
Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.
Certifying for Review
Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.
Latest Articles
The latest articles will be updated immediately on the articles in press page of the respective journals.
Immediate Assistance
The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to editor@ecronicon.uk