<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT01670955</url>
  </required_header>
  <id_info>
    <org_study_id>LASUTH/08/2012</org_study_id>
    <nct_id>NCT01670955</nct_id>
  </id_info>
  <brief_title>The Safety and Effectiveness of Jobelyn in Pre-operative Management of Anaemia in Gynaecological Patients</brief_title>
  <official_title>A Prospective Phase II/III Randomized, Blinded Study to Demonstrate the Safety and Effectiveness of Jobelyn ( a Herbal Preparation ) in Pre-operative Management of Anaemia in Gynaecological Patients</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Lagos State University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Health Forever Product Limited. Lagos, Nigeria</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>Lagos State University</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      PROTOCOL FOR THE STUDY OF THE SAFETY AND EFFICACY OF JOBELYN, IN THE PREOPERATIVE MANAGEMENT&#xD;
      OF ANAEMIA IN GYNAECOLOGICAL PATIENTS&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      It has long been known that anaemia increases the risk of death and complications in patients&#xD;
      who have cardiovascular surgery, but results of a recent study show that these risks are&#xD;
      increased in patients with anaemia who undergo various types of surgery, including&#xD;
      gynaecological procedures.&#xD;
&#xD;
      Compared with patients without anaemia, the risk of death within 30 days after surgery was&#xD;
      42% higher among patients with anaemia. In addition, patients with anemia were 35% more&#xD;
      likely to experience cardiac, respiratory, urinary, and wound complications as well as sepsis&#xD;
      and blood clots.&#xD;
&#xD;
      Because even mild anaemia increases the risk of postoperative morbidity in patients&#xD;
      undergoing major non-cardiac surgery, doctors need to consider preoperative treatment of&#xD;
      anaemia when possible. More research is needed to establish the efficacy, safety and&#xD;
      cost-effectiveness of pre-operative anaemia management.&#xD;
&#xD;
      One of the major clinical issues in many gynaecological patients in Nigeria is that of&#xD;
      optimizing the packed cell volume before surgery. Anaemia could be traced to multiple factors&#xD;
      notable of which are high prevalence of infection, worm infestation and malnutrition (R). In&#xD;
      other to reduce the waiting time and reduce morbidity and mortality associated with surgery,&#xD;
      it is important to correct the packed cell volume adequately before surgery.&#xD;
&#xD;
      The traditional method of correcting PCV involves the use of 'routine' haematinics such as&#xD;
      Ferrous sulphate, Folic acid and Multivitamin. This is in addition to dietary advice. While&#xD;
      the efficacy of these drugs has been well acknowledged in clinical practice, there is dearth&#xD;
      of literatures on their specific influence on haematological parameters. Majority of&#xD;
      Nigerians are gradually having a change of perception about traditional medicines with&#xD;
      gradual shift towards their use. It is believed that traditional drugs act faster and more&#xD;
      effective than other orthodox drugs in conventional use. One of such area is in the&#xD;
      correction of anaemia.&#xD;
&#xD;
      Sorghum bicolor, a grain long used in Africa for its high nutritional value also exhibits&#xD;
      strong antioxidant properties and antiinflammatory effects. The traditional preparation of&#xD;
      Sorghum bicolor has an oxygen radical absorbance capacity (ORAC) OF 37,622 micro mole TE/g.&#xD;
      This is much higher than other botanical preparations. Complementing the antioxidant&#xD;
      properties, Sorghum bicolor also exhibits anti inflammatory effects and demonstrated&#xD;
      selective COX-2 inhibition, providing effective reduction in inflammation without residual&#xD;
      side effects.&#xD;
&#xD;
      Sorghum bicolor extract has been shown to increase the haematocrit and haemoglobin level and&#xD;
      reduce the white cell count in trypanosome brucei brucei induced anaemia in experimental&#xD;
      rabbits. These effects were conclusive within 49 days of experimentation. Animals sacrificed&#xD;
      after the administration of lethal dose Jobelyn were shown to have congestion of the liver,&#xD;
      kidneys and lungs. This might be as a result of direct effect on these organs or a sign of&#xD;
      cardiotoxicity. However there is a wide therapeutic range.&#xD;
&#xD;
      Sorghum bicolor is the proprietary name for the product intended to treat sickle cell&#xD;
      disease. It is exactly the same as jobelyn which is currently marketed as a nutritional&#xD;
      supplement. Jobelyn is marketed in 250mg capsules of sorghum bicolor leaf extract. The&#xD;
      product is widely marketed in the United States and in Nigeria. Many pregnant women have been&#xD;
      using it regularly for a long time without any report of adverse effect.&#xD;
&#xD;
      The sorghum bicolor extract is expected to increase the haematocrit of' pregnant women within&#xD;
      a short time.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date>December 2012</start_date>
  <completion_date type="Actual">December 2013</completion_date>
  <primary_completion_date type="Actual">June 2013</primary_completion_date>
  <phase>Phase 2</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Single Group Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Single (Participant)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Anaemia</measure>
    <time_frame>3 months</time_frame>
    <description>Change in haematological parameters</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>morbidity</measure>
    <time_frame>3 months</time_frame>
    <description>Reduced postoperative morbidity</description>
  </secondary_outcome>
  <other_outcome>
    <measure>Hospital Stay</measure>
    <time_frame>3 months</time_frame>
    <description>Duration of hospital stay</description>
  </other_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">73</enrollment>
  <condition>Anemia</condition>
  <arm_group>
    <arm_group_label>Jobelyn + Ferrous Sulphate + Folic Acid</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Caps Jobelyn 250mg, 12 hourly + Ferrous Sulphate 600mg thrice daily + Folic Acid 5mg daily</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Ferrous Sulphate + Folic Acid</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Ferrous Sulphate 600mg, thrice daily + Folic Acid, 5mg daily</description>
  </arm_group>
  <intervention>
    <intervention_type>Dietary Supplement</intervention_type>
    <intervention_name>Jobelyn</intervention_name>
    <description>Jobelyn is a sorghum bicolor extract marketed as dietary supplement</description>
    <arm_group_label>Jobelyn + Ferrous Sulphate + Folic Acid</arm_group_label>
    <other_name>Sorghum bicolor extract</other_name>
  </intervention>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Ferrous Sulphate + Folic Acid</intervention_name>
    <description>Ferrous Sulphate 600mg, thrice daily + Folic Acid, 5mg daily</description>
    <arm_group_label>Ferrous Sulphate + Folic Acid</arm_group_label>
    <arm_group_label>Jobelyn + Ferrous Sulphate + Folic Acid</arm_group_label>
    <other_name>Iron Tablets</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Mild to moderate anaemia&#xD;
&#xD;
          -  Asymptomatic severe anaemia&#xD;
&#xD;
          -  Non life threatening gynaecological condition&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Failure to give informed consent&#xD;
&#xD;
          -  Symptomatic severe anaemia&#xD;
&#xD;
          -  Pregnancy&#xD;
&#xD;
          -  Malignancies and Chronic inflammatory disease&#xD;
      </textblock>
    </criteria>
    <gender>Female</gender>
    <minimum_age>N/A</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Adetokunbo O Tayo, M.D.</last_name>
    <role>Principal Investigator</role>
    <affiliation>Lagos State University</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Lagos State University Teaching Hospital</name>
      <address>
        <city>Ikeja</city>
        <state>Lagos</state>
        <zip>100001</zip>
        <country>Nigeria</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Nigeria</country>
  </location_countries>
  <reference>
    <citation>Brohan M, Jerkovic V, Collin S. Potentiality of red sorghum for producing stilbenoid-enriched beers with high antioxidant activity. J Agric Food Chem. 2011 Apr 27;59(8):4088-94. doi: 10.1021/jf1047755. Epub 2011 Mar 7.</citation>
    <PMID>21381750</PMID>
  </reference>
  <reference>
    <citation>Geera B, Ojwang LO, Awika JM. New highly stable dimeric 3-deoxyanthocyanidin pigments from sorghum bicolor leaf sheath. J Food Sci. 2012 May;77(5):C566-72. doi: 10.1111/j.1750-3841.2012.02668.x. Epub 2012 Apr 10.</citation>
    <PMID>22489620</PMID>
  </reference>
  <reference>
    <citation>Kayode AP, Nout MJ, Linnemann AR, Hounhouigan JD, Berghofer E, Siebenhandl-Ehn S. Uncommonly high levels of 3-deoxyanthocyanidins and antioxidant capacity in the leaf sheaths of dye sorghum. J Agric Food Chem. 2011 Feb 23;59(4):1178-84. doi: 10.1021/jf103963t. Epub 2011 Jan 25.</citation>
    <PMID>21322653</PMID>
  </reference>
  <reference>
    <citation>Yang L, Browning JD, Awika JM. Sorghum 3-deoxyanthocyanins possess strong phase II enzyme inducer activity and cancer cell growth inhibition properties. J Agric Food Chem. 2009 Mar 11;57(5):1797-804. doi: 10.1021/jf8035066.</citation>
    <PMID>19256554</PMID>
  </reference>
  <reference>
    <citation>Shih CH, Siu SO, Ng R, Wong E, Chiu LC, Chu IK, Lo C. Quantitative analysis of anticancer 3-deoxyanthocyanidins in infected sorghum seedlings. J Agric Food Chem. 2007 Jan 24;55(2):254-9. doi: 10.1021/jf062516t.</citation>
    <PMID>17227050</PMID>
  </reference>
  <reference>
    <citation>Camargo Filho I, Cortez DA, Ueda-Nakamura T, Nakamura CV, Dias Filho BP. Antiviral activity and mode of action of a peptide isolated from Sorghum bicolor. Phytomedicine. 2008 Mar;15(3):202-8. doi: 10.1016/j.phymed.2007.07.059. Epub 2007 Sep 24.</citation>
    <PMID>17890069</PMID>
  </reference>
  <reference>
    <citation>Burdette A, Garner PL, Mayer EP, Hargrove JL, Hartle DK, Greenspan P. Anti-inflammatory activity of select sorghum (Sorghum bicolor) brans. J Med Food. 2010 Aug;13(4):879-87. doi: 10.1089/jmf.2009.0147.</citation>
    <PMID>20673059</PMID>
  </reference>
  <reference>
    <citation>Park JH, Darvin P, Lim EJ, Joung YH, Hong DY, Park EU, Park SH, Choi SK, Moon ES, Cho BW, Park KD, Lee HK, Kim MJ, Park DS, Chung IM, Yang YM. Hwanggeumchal sorghum induces cell cycle arrest, and suppresses tumor growth and metastasis through Jak2/STAT pathways in breast cancer xenografts. PLoS One. 2012;7(7):e40531. doi: 10.1371/journal.pone.0040531. Epub 2012 Jul 6.</citation>
    <PMID>22792362</PMID>
  </reference>
  <reference>
    <citation>Wu L, Huang Z, Qin P, Yao Y, Meng X, Zou J, Zhu K, Ren G. Chemical characterization of a procyanidin-rich extract from sorghum bran and its effect on oxidative stress and tumor inhibition in vivo. J Agric Food Chem. 2011 Aug 24;59(16):8609-15. doi: 10.1021/jf2015528. Epub 2011 Jul 29.</citation>
    <PMID>21780844</PMID>
  </reference>
  <reference>
    <citation>Devi PS, Kumar MS, Das SM. Evaluation of antiproliferative activity of red sorghum bran anthocyanin on a human breast cancer cell line (mcf-7). Int J Breast Cancer. 2011;2011:891481. doi: 10.4061/2011/891481. Epub 2011 Oct 16.</citation>
    <PMID>22312562</PMID>
  </reference>
  <reference>
    <citation>Awika JM, McDonough CM, Rooney LW. Decorticating sorghum to concentrate healthy phytochemicals. J Agric Food Chem. 2005 Aug 10;53(16):6230-4. doi: 10.1021/jf0510384.</citation>
    <PMID>16076098</PMID>
  </reference>
  <verification_date>May 2016</verification_date>
  <study_first_submitted>August 18, 2012</study_first_submitted>
  <study_first_submitted_qc>August 22, 2012</study_first_submitted_qc>
  <study_first_posted type="Estimate">August 23, 2012</study_first_posted>
  <last_update_submitted>May 17, 2016</last_update_submitted>
  <last_update_submitted_qc>May 17, 2016</last_update_submitted_qc>
  <last_update_posted type="Estimate">May 18, 2016</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Lagos State University</investigator_affiliation>
    <investigator_full_name>Dr. A. Tayo</investigator_full_name>
    <investigator_title>CONSULTANT IN THE DEPARTMENT OF GYNAECOLOGY AND OBSTETRICS, LASUTH</investigator_title>
  </responsible_party>
  <keyword>Anemia</keyword>
  <keyword>preoperative</keyword>
  <keyword>gynecological patients</keyword>
  <keyword>Sorghum bicolor</keyword>
  <keyword>Packed Cells Volume</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Anemia</mesh_term>
  </condition_browse>
  <intervention_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Folic Acid</mesh_term>
  </intervention_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT01670955
org study id: LASUTH/08/2012
nct id: NCT01670955
lead sponsor: 
collaborator: 
has dmc: Yes
PROTOCOL FOR THE STUDY OF THE SAFETY AND EFFICACY OF JOBELYN, IN THE PREOPERATIVE MANAGEMENT
      OF ANAEMIA IN GYNAECOLOGICAL PATIENTS
It has long been known that anaemia increases the risk of death and complications in patients
      who have cardiovascular surgery, but results of a recent study show that these risks are
      increased in patients with anaemia who undergo various types of surgery, including
      gynaecological procedures.

      Compared with patients without anaemia, the risk of death within 30 days after surgery was
      42% higher among patients with anaemia. In addition, patients with anemia were 35% more
      likely to experience cardiac, respiratory, urinary, and wound complications as well as sepsis
      and blood clots.

      Because even mild anaemia increases the risk of postoperative morbidity in patients
      undergoing major non-cardiac surgery, doctors need to consider preoperative treatment of
      anaemia when possible. More research is needed to establish the efficacy, safety and
      cost-effectiveness of pre-operative anaemia management.

      One of the major clinical issues in many gynaecological patients in Nigeria is that of
      optimizing the packed cell volume before surgery. Anaemia could be traced to multiple factors
      notable of which are high prevalence of infection, worm infestation and malnutrition (R). In
      other to reduce the waiting time and reduce morbidity and mortality associated with surgery,
      it is important to correct the packed cell volume adequately before surgery.

      The traditional method of correcting PCV involves the use of 'routine' haematinics such as
      Ferrous sulphate, Folic acid and Multivitamin. This is in addition to dietary advice. While
      the efficacy of these drugs has been well acknowledged in clinical practice, there is dearth
      of literatures on their specific influence on haematological parameters. Majority of
      Nigerians are gradually having a change of perception about traditional medicines with
      gradual shift towards their use. It is believed that traditional drugs act faster and more
      effective than other orthodox drugs in conventional use. One of such area is in the
      correction of anaemia.

      Sorghum bicolor, a grain long used in Africa for its high nutritional value also exhibits
      strong antioxidant properties and antiinflammatory effects. The traditional preparation of
      Sorghum bicolor has an oxygen radical absorbance capacity (ORAC) OF 37,622 micro mole TE/g.
      This is much higher than other botanical preparations. Complementing the antioxidant
      properties, Sorghum bicolor also exhibits anti inflammatory effects and demonstrated
      selective COX-2 inhibition, providing effective reduction in inflammation without residual
      side effects.

      Sorghum bicolor extract has been shown to increase the haematocrit and haemoglobin level and
      reduce the white cell count in trypanosome brucei brucei induced anaemia in experimental
      rabbits. These effects were conclusive within 49 days of experimentation. Animals sacrificed
      after the administration of lethal dose Jobelyn were shown to have congestion of the liver,
      kidneys and lungs. This might be as a result of direct effect on these organs or a sign of
      cardiotoxicity. However there is a wide therapeutic range.

      Sorghum bicolor is the proprietary name for the product intended to treat sickle cell
      disease. It is exactly the same as jobelyn which is currently marketed as a nutritional
      supplement. Jobelyn is marketed in 250mg capsules of sorghum bicolor leaf extract. The
      product is widely marketed in the United States and in Nigeria. Many pregnant women have been
      using it regularly for a long time without any report of adverse effect.

      The sorghum bicolor extract is expected to increase the haematocrit of' pregnant women within
      a short time.
allocation: Randomized
intervention model: Single Group Assignment
primary purpose: Treatment
masking: Single (Participant)
measure: Anaemia
time frame: 3 months
description: Change in haematological parameters
measure: morbidity
time frame: 3 months
description: Reduced postoperative morbidity
measure: Hospital Stay
time frame: 3 months
description: Duration of hospital stay
arm group label: Jobelyn + Ferrous Sulphate + Folic Acid
arm group type: Active Comparator
description: Caps Jobelyn 250mg, 12 hourly + Ferrous Sulphate 600mg thrice daily + Folic Acid 5mg daily
arm group label: Ferrous Sulphate + Folic Acid
arm group type: Active Comparator
description: Ferrous Sulphate 600mg, thrice daily + Folic Acid, 5mg daily
intervention type: Dietary Supplement
intervention name: Jobelyn
description: Jobelyn is a sorghum bicolor extract marketed as dietary supplement
arm group label: Jobelyn + Ferrous Sulphate + Folic Acid
other name: Sorghum bicolor extract
intervention type: Drug
intervention name: Ferrous Sulphate + Folic Acid
description: Ferrous Sulphate 600mg, thrice daily + Folic Acid, 5mg daily
arm group label: Ferrous Sulphate + Folic Acid
arm group label: Jobelyn + Ferrous Sulphate + Folic Acid
other name: Iron Tablets
criteria: 
gender: Female
minimum age: N/A
maximum age: N/A
healthy volunteers: Accepts Healthy Volunteers
last name: Adetokunbo O Tayo, M.D.
role: Principal Investigator
affiliation: Lagos State University
facility: 
country: Nigeria
citation: Brohan M, Jerkovic V, Collin S. Potentiality of red sorghum for producing stilbenoid-enriched beers with high antioxidant activity. J Agric Food Chem. 2011 Apr 27;59(8):4088-94. doi: 10.1021/jf1047755. Epub 2011 Mar 7.
PMID: 21381750
citation: Geera B, Ojwang LO, Awika JM. New highly stable dimeric 3-deoxyanthocyanidin pigments from sorghum bicolor leaf sheath. J Food Sci. 2012 May;77(5):C566-72. doi: 10.1111/j.1750-3841.2012.02668.x. Epub 2012 Apr 10.
PMID: 22489620
citation: Kayode AP, Nout MJ, Linnemann AR, Hounhouigan JD, Berghofer E, Siebenhandl-Ehn S. Uncommonly high levels of 3-deoxyanthocyanidins and antioxidant capacity in the leaf sheaths of dye sorghum. J Agric Food Chem. 2011 Feb 23;59(4):1178-84. doi: 10.1021/jf103963t. Epub 2011 Jan 25.
PMID: 21322653
citation: Yang L, Browning JD, Awika JM. Sorghum 3-deoxyanthocyanins possess strong phase II enzyme inducer activity and cancer cell growth inhibition properties. J Agric Food Chem. 2009 Mar 11;57(5):1797-804. doi: 10.1021/jf8035066.
PMID: 19256554
citation: Shih CH, Siu SO, Ng R, Wong E, Chiu LC, Chu IK, Lo C. Quantitative analysis of anticancer 3-deoxyanthocyanidins in infected sorghum seedlings. J Agric Food Chem. 2007 Jan 24;55(2):254-9. doi: 10.1021/jf062516t.
PMID: 17227050
citation: Camargo Filho I, Cortez DA, Ueda-Nakamura T, Nakamura CV, Dias Filho BP. Antiviral activity and mode of action of a peptide isolated from Sorghum bicolor. Phytomedicine. 2008 Mar;15(3):202-8. doi: 10.1016/j.phymed.2007.07.059. Epub 2007 Sep 24.
PMID: 17890069
citation: Burdette A, Garner PL, Mayer EP, Hargrove JL, Hartle DK, Greenspan P. Anti-inflammatory activity of select sorghum (Sorghum bicolor) brans. J Med Food. 2010 Aug;13(4):879-87. doi: 10.1089/jmf.2009.0147.
PMID: 20673059
citation: Park JH, Darvin P, Lim EJ, Joung YH, Hong DY, Park EU, Park SH, Choi SK, Moon ES, Cho BW, Park KD, Lee HK, Kim MJ, Park DS, Chung IM, Yang YM. Hwanggeumchal sorghum induces cell cycle arrest, and suppresses tumor growth and metastasis through Jak2/STAT pathways in breast cancer xenografts. PLoS One. 2012;7(7):e40531. doi: 10.1371/journal.pone.0040531. Epub 2012 Jul 6.
PMID: 22792362
citation: Wu L, Huang Z, Qin P, Yao Y, Meng X, Zou J, Zhu K, Ren G. Chemical characterization of a procyanidin-rich extract from sorghum bran and its effect on oxidative stress and tumor inhibition in vivo. J Agric Food Chem. 2011 Aug 24;59(16):8609-15. doi: 10.1021/jf2015528. Epub 2011 Jul 29.
PMID: 21780844
citation: Devi PS, Kumar MS, Das SM. Evaluation of antiproliferative activity of red sorghum bran anthocyanin on a human breast cancer cell line (mcf-7). Int J Breast Cancer. 2011;2011:891481. doi: 10.4061/2011/891481. Epub 2011 Oct 16.
PMID: 22312562
citation: Awika JM, McDonough CM, Rooney LW. Decorticating sorghum to concentrate healthy phytochemicals. J Agric Food Chem. 2005 Aug 10;53(16):6230-4. doi: 10.1021/jf0510384.
PMID: 16076098
responsible party type: Principal Investigator
investigator affiliation: Lagos State University
investigator full name: Dr. A. Tayo
investigator title: CONSULTANT IN THE DEPARTMENT OF GYNAECOLOGY AND OBSTETRICS, LASUTH
mesh term: Anemia
mesh term: Folic Acid
sharing ipd: No