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Research Article | DOI: https://doi.org/10.31579/2690-4861/948
1Assistant Professor from Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
2Associate Professor from Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
3Assistant Professor, Department of Nursing, TeMS.C., Islamic Azad University, Tehran, Iran.
*Corresponding Author: Fatemeh Sadat Seyed Nematollah Roshan, Assistant Professor, Department of Nursing, TeMS.C., Islamic Azad University, Tehran, Iran.
Citation: Hasan Navipor, Fatemeh Alhani, Nematollah Roshan FSS, (2025), Effect of Empowerment Program on the Blood Indicators of iron Deficiency Anemia in Teenage Girls, International Journal of Clinical Case Reports and Reviews, 31(2); DOI:10.31579/2690-4861/948
Copyright: © 2025, Fatemeh Sadat Seyed Nematollah Roshan. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 14 October 2025 | Accepted: 30 October 2025 | Published: 07 November 2025
Keywords: teenagers; girls; empowerment; iron deficiency; anemia
Background: More than 30% of the world's population are suffering from anemia, most of which are of iron deficiency type. Anemia as a chronic disease requires behavioral and lifestyle adjustments. Since the school environment is the best and most prepared place to improve the level of public health and considering the importance of this disease in teenage girls as future mothers, the present research was conducted with the aim of investigating the effect of empowerment program on the blood indicators of iron deficiency anemia in teenage girls.
Methods: Teenage girls between 15-18 years of age with similar socioeconomic background were recruited from two high schools in Teharn/Iran for the study. They were all screened and categorized into two groups depending on their hematological indicators of iron deficiency anemia. The intervention group participated in 8 group empowerment sessions for 2 months, while the control group did not attend.
Results: Before the intervention, there was no significant difference in the mean score of hematological indicators in teenagers between the test and control groups (P>0.005). Except for Hb, HCT, MCHC, the mean scores of serum ferritin, TIBC, MCV, and MCH in teenagers of the experimental group before and after the intervention had a significant difference (P<0.005) while in the control group, there was no change in any of these indicators.
Conclusions: The lifestyle change program with nutritional modification should be adopted with the participation of parents and integrated into comprehensive empowerment programs to target iron deficiency anemia among adolescents at different levels in Iran.
Anemia is a decrease in the volume or concentration of hemoglobin(Hb) below the level that exists in healthy people according to gender (<120g>
One of the most common causes of ID is acute blood loss, such as that which occurs in gastrointestinal (GI) bleeding, trauma, surgery, and postpartum bleeding(6). Other causes include malnutrition, decreased iron absorption, celiac disease, use of erythropoietin-stimulating agents (ESAs), chronic illness, gastric bypass surgery, and congenital ID, parasitic diseases, and heavy menstrual bleeding(5, 7). The prevalence of IDA in girls increases after puberty due to monthly bleeding and a growth spurt. These girls suffer from severe ID after marriage and after pregnancy(8). Inadequate iron reserves before pregnancy are the main cause of ID during pregnancy, and even in mild stages, it leads to increased infant and maternal mortality, intrauterine growth retardation, risk of low birth weight (>2500 grams), and premature birth in pregnant women(9). Obviously, in the severe stages of deficiency, anemia appears as a serious problem in sufferers(10).Thus, the health of this age group is at risk.
Currently, in some countries, screening programs for early detection of ID and the resulting anemia are carried out in at-risk populations such as children and women(11, 12). Research shows that consumption of foods containing iron, following a proper nutritional pattern along with the administration of iron supplements, can reduce the occurrence of anemia in children and women(11, 13). Therefore, considering the high prevalence of iron deficiency anemia in society and its importance, especially in women of childbearing age, interventions to empower this group of society in order to improve nutrition-oriented health behaviors seem necessary.
Empowerment is a simple and positive concept that refers to the possibilities and abilities of people and their surroundings, in order to identify problems, inadequacies, and interventions(14). Empowerment is one of the accessible goals in terms of public health, where people try to improve their health by actively participating and making decisions(15). Since the disease is very common in teenage girls as future mothers and causes severe complications, the present study was conducted with the aim of investigating the effect of the empowerment program on the blood indicators of iron deficiency anemia in teenage girls.
This research is a semi-experimental study. Using Pocak's formula and Gigi's table, and the results of the same article, with 95% confidence and 80% test power, and considering the attrition rate, the required number of samples was determined to be 60 samples in two groups(16).
The criteria for entering the study were: teenage girls between 15-18 years, having hemoglobin less than 12 grams per deciliter (g/dl( and serum ferritin less than 15 mg per deciliter (mg/dl((17), not suffering from infectious and parasitic diseases, not under medication or special diet, desire to participate in the research, have a specific address and phone number for follow-up.
The exclusion criteria were: getting sick during the intervention, not attending training sessions.
First, the project was approved by the research council and medical ethics committee of Tarbiat Modares University. Then, the researcher, with a letter of introduction, went to two girls' high schools in Tehran, which were randomly assigned to two control and test groups.
After the necessary coordination with high school officials, an introductory meeting was held to explain the goals of the plan to the girls and their parents. The intervention method, the right to enter and exit the study, and the confidentiality of the data were explained, and written consent was obtained from all participants.
Students who had symptoms of IDA or were sure of having it were asked to go to a laboratory center where the accuracy of its devices had been checked for a blood test.
On a certain day, 5 cc of blood was taken from each sample, fasting at a specific time (8-10 am). Cell counting was done by the Colter T890 machine, and iron and transferrin saturation index (TSAT) were measured by the calorimetric method using Pars Azmoun kits and biochemistry RA-1000 autoanalyzer, and the ELISA method and antibody kit were used to measure ferritin.
After the blood test, in both schools, 30 students with the necessary indicators of anemia (Hb less than 12 g/dL and SF less than 15 μg/dL, transferrin saturation index (TSAT) or transferrin saturation percentage less than 10% and TIBC more than 400 (μg/dL) were randomly included in the study.
After that, the students in the test group were divided into 5 groups of 6 people. 8 educational sessions were held with the aim of empowering teenagers (increasing knowledge, self-efficacy, self-control, self-esteem) in the form of group discussions, about ways to prevent anemia, such as choosing a diet rich in iron and vitamin C, how to properly cook and prepare food, how washing hands properly, and how to clean vegetables.
At the end of each training session, the teenagers were given educational content in the form of educational cards and they were asked to teach all the content to their mothers. Considering that there is a possibility that the mothers were not empowered through the education of the teenager and studying the educational card, they were invited to the school to discuss the contents that the teenager taught them and what they learned from the educational card during 1-2 sessions. In this way, the researcher found out how successful the students were in transferring educational materials. Finally, 3 months after the start of the intervention, blood tests were taken from the students in the same laboratory.
Data analysis was done using SPSS16 statistical software using descriptive and analytical statistics, paired t-test, and independent t-test.
The comparison of the mean indicators of IDA before the intervention between the test and control groups with the independent t-test did not show any significant difference(P>0.05), and the two groups were the same. However, the comparison of the mean indicators of iron deficiency anemia, except for Hb, HCT, and MCHC, after the intervention in the test and control groups showed a significant difference(P≤0.05).
Also, the comparison of the mean indices of Hb, HCT, and MCHC in adolescents under the study before and after the intervention in the experimental and control groups did not show a significant difference with the paired t-test. The comparison of the mean indicators of IDA in adolescents before and after the intervention in the test group shows a significant difference with the paired t-test, and the changes were positive and significant(P≤0.05). But there was no significant difference in any of the Iron deficiency hematological indicators in the control group(P>0.05) (Table 1). It should be noted that although Hb, HCT, and MCHC indicators increased in the test group after the intervention, these changes are not significant.
Since many diseases in children, such as obesity, iron deficiency anemia, constipation, diabetes, etc., are caused by unhealthy family lifestyles, parents' cooperation plays a very important role in controlling and preventing them(18, 19). For this reason, in this study, it was tried to have parents accompany the teenager in the empowerment sessions so that the change in the lifestyle pattern in nutrition happens in the whole family. As the results of this study showed, the comparison of values of mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) before and after the intervention was significant. Also, according to the statistical test comparing the average values of serum iron (SI), serum ferritin (SF), and total iron binding capacity (TIBC), the percentage of transferrin saturation (TSAT) before and after the intervention was significant, while there was no significant difference in any of the indicators in the control group. not seen. As a result, it can be concluded that the educational intervention during 8 two-month sessions was able to influence the specific blood indicators of iron deficiency by empowering the adolescent and an active member of the family by modifying the diet and health principles, and we saw an increase in body iron reserves in the test group.
In a study, Prentice et al, (2017) showed that changing dietary habits and using foods rich in iron is a suitable solution for improving indicators in people with anemia(20). In a study on elementary school girls in Zahedan city, Irandegani et al, (2019) showed that educational intervention based on nutrition during 2 months can have a positive and significant effect on Hb, HCT, and SF(21). Although Hb and HCT did not change in the present study, other specific indicators of IDA improved. Maybe the reason is the age of the students. In other words, the girls in the present study were at the age of menarche, which may be the reason for the unchanged hemoglobin and hematocrit.
Gosdin et al,.(2022) showed in a study that taking iron tablets for 37 weeks causes significant changes in the hemoglobin and hematocrit status of teenage girls(22). Although no changes were seen in Hb and HCT in the current study, instead of using pills, we used a change in the diet rich in iron and vitamin C, and maybe that's why only the change in iron and ferritin storage was achieved. The results of the study by Skolmowska et al, (2022) also showed that nutrition education for female students, although due to the short duration, did not have a significant effect on the reduction of anemia, but it had a positive effect on the amount of total iron and homogenized iron(23) which is in line with the findings of the present study.
In line with the results of the present study, Ahmadpour et al,.(2017) and Parvin et al,.(2021) showed that face-to-face training had an effect on the knowledge, attitude, and performance of female students regarding the prevention of iron deficiency anemia(24, 25). In the present study, by conducting group discussions and practical exercises, it was made to increase the awareness of teenagers about iron deficiency anemia. Empowerment sessions were such that the students could practically prepare a diet rich in iron and vitamins according to their needs. Based on the positive changes made in specific blood indicators of iron deficiency, it can be said that after 8 sessions of empowerment, the knowledge and performance of teenagers regarding anemia has increased. Therefore, it can be hoped that by improving the performance, an important step will be taken in the direction of preventing anemia caused by iron deficiency and improving the health of female students who are future mothers.
According to the improvement of the iron deficiency blood indicators of the studied subjects, it can be concluded that the family-oriented empowerment model has a favorable effect by increasing the ability of students and mothers to modify the dietary pattern in the third level prevention. It is suggested that this study be carried out on different age and gender groups that are exposed to iron deficiency and with a larger number of participants and over a longer period of time. Among the limitations of the current research, we can point out the difference in personal characteristics and mental and psychological conditions of adolescents in response to the intervention and its effect, the effect of environmental and individual factors on their understanding of the family-centered empowerment model.
Competing interests
There is no conflict of interest between the authors of this article.
Ethics approval and consent to participate
This research was conducted in accordance with the Declaration of Helsinki in 1995 (as revised in Brazil in 2013). The code of ethics was obtained from the Biological Committee of the Ministry of Health and the necessary permits were obtained from the officials (number 52/3528). Before starting the research, the researcher introduced herself to the teenagers and mothers and explained how to conduct the research. Regarding the confidentiality of their personal information and the right to withdraw freely from the study at any time, they were assured. An informed consent form was obtained from all teenagers and mothers. The researcher emphasized that no financial burden will be imposed on the participants. Also, in terms of respecting the ethical issues of the research, after the completion of the intervention, all educational issues about iron deficiency anemia were taught to teenagers and their mothers in the control group. An educational booklet was given to them.
Acknowledgment
We sincerely appreciate and thank all the respected education officials, managers, teachers, students and mothers who helped us in this research
%= percentage
ESAs: erythropoietin stimulating agents
Fl:femtoliters
g/dl: grams per deciliter
g/l: grams per liter
Hb: hemoglobin
HCT: hematocrit
ID: iron deficiency
IDA: Iron deficiency anemia
MCH: mean corpuscular hemoglobin
MCHC: mean corpuscular hemoglobin concentration
MCHC: mean corpuscular hemoglobin concentration
MCV: mean corpuscular volume
mg/dl: miligrams per deciliter
ng/mL: Nanograms per millilitre
P= Pvalue
Pg: picograms
Ret: reticulocytes
SF: serum ferritin
SI: serum iron
TIBC: total iron binding capacity
TSAT: transferrin saturation
TSAT: transferrin saturation index
Data availability statement:
The data sets analyzed in this study are not publicly available because the privacy of the samples may be compromised. But they are available from the corresponding author (FSSNR) upon reasonable request.
Funding sources:
Financial support for conducting this research was provided by the Faculty of Medical Sciences of Tarbiat Modares University, but the author(s) did not receive any financial support for the publication of this article.
Conflict of interests:
There is no conflict of interest between the authors of this article.
Ethical approval:
This article is a part of the nursing master's thesis with approval number 52/3528 of the Faculty of Medical Sciences of Tarbiat Modares University.
Patient consent statement:
Verbal and written consent was obtained from teenagers and their mothers.
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I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
