Reviewer ’s report  
 
Title: Lead Poisoning; a Neglected Potential Diagnosis in Abdominal Pain  
 
Version: 0 Date: 03 Jan 2020  
 
Reviewer: Ozgur Karcioglu  
 
Reviewer's report:  
 
The conclusion sentence o f the article is: "Lead toxicity should be considered in the potential 
differential diagnosis of severe and resistant abdominal pain in patients referring to general EDs 
or GI clinics if a positive history of opium abuse exists." Thus the authors should ha ve analyzed 
all admissions due to a chief complaint of abdominal pain to detect patients with lead poisoning 
and/or opiate abuse.  Otherwise the authors should use certain selection criteria to enroll patients 
to this prospective study.  
The study used the  eligibility criteria as: "Patients evaluated in the emergency and GI outpatient 
clinic with the chief complaint of abdominal pain of unknown origin or resistant to routine 
antacid treatment were enrolled into the study." Then how many patients were diagno sed with 
acute appendicitis or other surgical entities? In brief, "abdominal pain of unknown origin" needs 
to be clarified before a reader can comprehend the scope of the article. Otherwise, the research 
would be limited to confines of a case series of lea d poisoning -related abdominal pain.  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specif y what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently a pplying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is y es to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publicat ion, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/ 4.0/). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Lead Poisoning; a Neglected Potential Diagnosis in Abdominal Pain  
 
Version: 0 Date: 03 Jan 2020  
 
Reviewer: Ozgur Karcioglu  
 
Reviewer's report:  
 
The conclusion sentence o f the article is: "Lead toxicity should be considered in the potential 
differential diagnosis of severe and resistant abdominal pain in patients referring to general EDs 
or GI clinics if a positive history of opium abuse exists." Thus the authors should ha ve analyzed 
all admissions due to a chief complaint of abdominal pain to detect patients with lead poisoning 
and/or opiate abuse.  Otherwise the authors should use certain selection criteria to enroll patients 
to this prospective study.  
The study used the  eligibility criteria as: "Patients evaluated in the emergency and GI outpatient 
clinic with the chief complaint of abdominal pain of unknown origin or resistant to routine 
antacid treatment were enrolled into the study." Then how many patients were diagno sed with 
acute appendicitis or other surgical entities? In brief, "abdominal pain of unknown origin" needs 
to be clarified before a reader can comprehend the scope of the article. Otherwise, the research 
would be limited to confines of a case series of lea d poisoning -related abdominal pain.  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specif y what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently a pplying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is y es to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publicat ion, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/ 4.0/). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Lead Poisoning; a Neglected Potential Diagnosis in Abdominal Pain  
 
Version: 0 Date: 03 Jan 2020  
 
Reviewer: Ozgur Karcioglu  
 
Reviewer's report:  
 
The conclusion sentence o f the article is: "Lead toxicity should be considered in the potential 
differential diagnosis of severe and resistant abdominal pain in patients referring to general EDs 
or GI clinics if a positive history of opium abuse exists." Thus the authors should ha ve analyzed 
all admissions due to a chief complaint of abdominal pain to detect patients with lead poisoning 
and/or opiate abuse.  Otherwise the authors should use certain selection criteria to enroll patients 
to this prospective study.  
The study used the  eligibility criteria as: "Patients evaluated in the emergency and GI outpatient 
clinic with the chief complaint of abdominal pain of unknown origin or resistant to routine 
antacid treatment were enrolled into the study." Then how many patients were diagno sed with 
acute appendicitis or other surgical entities? In brief, "abdominal pain of unknown origin" needs 
to be clarified before a reader can comprehend the scope of the article. Otherwise, the research 
would be limited to confines of a case series of lea d poisoning -related abdominal pain.  
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specif y what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently a pplying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is y es to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publicat ion, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/ 4.0/). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant