This manuscript is work in progress rather than a final report. The major drawback is the small study population and lack of ethical approval, which is vaguely justified by a short statement at the end of page 11. Further, the manuscript contains figure legends but no figures.

The small study population compromises the reliability of the study outcome. The lack of ethical approval presents a major concern, a researcher cannot determine a waiver of the informed consent; such a decision must be granted by the IRB committee. The Tables heading “ figure legends” can be deleted from the manuscript.