<?xml version="1.0" encoding="utf-8"?>
<!DOCTYPE trials [
<!ELEMENT trials (trial+)>

<!ELEMENT trial (main,contacts,countries,criteria,health_condition_code,health_condition_keyword,intervention_code,
          intervention_keyword,primary_outcome,secondary_outcome,secondary_sponsor,secondary_ids,source_support,ethics_reviews)>

<!ELEMENT main (trial_id,utrn?,reg_name,date_registration,primary_sponsor,public_title,acronym?,scientific_title,scientific_acronym?,
          date_enrolment,type_enrolment,target_size,recruitment_status,url?,study_type,study_design,phase,hc_freetext?,i_freetext?,results_actual_enrolment,results_date_completed,results_url_link,results_summary,           results_date_posted,results_date_first_publication,results_baseline_char,results_participant_flow,results_adverse_events,results_outcome_measures,results_url_protocol,results_IPD_plan, results_IPD_description)>
<!ELEMENT trial_id (#PCDATA)>
<!ELEMENT utrn (#PCDATA)>
<!ELEMENT reg_name (#PCDATA)>
<!ELEMENT date_registration (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT primary_sponsor (#PCDATA)>
<!ELEMENT public_title (#PCDATA)>
<!ELEMENT acronym (#PCDATA)>
<!ELEMENT scientific_title (#PCDATA)>
<!ELEMENT scientific_acronym (#PCDATA)>
<!ELEMENT date_enrolment (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT type_enrolment (#PCDATA)>
<!ELEMENT target_size (#PCDATA)>
<!ELEMENT recruitment_status (#PCDATA)><!-- Pending,Recruiting,Suspended,Complete,Other -->
<!ELEMENT url (#PCDATA)>
<!ELEMENT study_type (#PCDATA)><!-- interventional,observational -->
<!ELEMENT study_design (#PCDATA)>
<!ELEMENT phase (#PCDATA)>
<!ELEMENT hc_freetext (#PCDATA)>
<!ELEMENT i_freetext (#PCDATA)>
<!ELEMENT results_actual_enrolment (#PCDATA)>
<!ELEMENT results_date_completed (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_url_link (#PCDATA)>
<!ELEMENT results_summary (#PCDATA)>
<!ELEMENT results_date_posted (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_date_first_publication (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_baseline_char (#PCDATA)>
<!ELEMENT results_participant_flow (#PCDATA)>
<!ELEMENT results_adverse_events (#PCDATA)>
<!ELEMENT results_outcome_measures (#PCDATA)>
<!ELEMENT results_url_protocol (#PCDATA)>
<!ELEMENT results_IPD_plan (#PCDATA)>
<!ELEMENT results_IPD_description (#PCDATA)>


<!ELEMENT contacts (contact+)>
<!ELEMENT contact (type,firstname,middlename,lastname,address,city,country1,zip,telephone,email,affiliation)>
<!ELEMENT type (#PCDATA)><!-- Public,Scientific -->
<!ELEMENT firstname (#PCDATA)>
<!ELEMENT middlename (#PCDATA)>
<!ELEMENT lastname (#PCDATA)>
<!ELEMENT address (#PCDATA)>
<!ELEMENT city (#PCDATA)>
<!ELEMENT country1 (#PCDATA)>
<!ELEMENT zip (#PCDATA)>
<!ELEMENT telephone (#PCDATA)>
<!ELEMENT email (#PCDATA)>
<!ELEMENT affiliation (#PCDATA)>

<!ELEMENT countries (country2+)>
<!ELEMENT country2 (#PCDATA)>

<!ELEMENT criteria (inclusion_criteria,agemin,agemax,gender,exclusion_criteria)>
<!ELEMENT inclusion_criteria (#PCDATA)>
<!ELEMENT agemin (#PCDATA)>
<!ELEMENT agemax (#PCDATA)>
<!ELEMENT gender (#PCDATA)>
<!ELEMENT exclusion_criteria (#PCDATA)>

<!ELEMENT health_condition_code (hc_code+)>
<!ELEMENT hc_code (#PCDATA)>

<!ELEMENT health_condition_keyword (hc_keyword+)>
<!ELEMENT hc_keyword (#PCDATA)>

<!ELEMENT intervention_code (i_code+)>
<!ELEMENT i_code (#PCDATA)>

<!ELEMENT intervention_keyword (i_keyword+)>
<!ELEMENT i_keyword (#PCDATA)>

<!ELEMENT primary_outcome (prim_outcome+)>
<!ELEMENT prim_outcome (#PCDATA)>

<!ELEMENT secondary_outcome (sec_outcome+)>
<!ELEMENT sec_outcome (#PCDATA)>

<!ELEMENT secondary_sponsor (sponsor_name+)>
<!ELEMENT sponsor_name (#PCDATA)>

<!ELEMENT secondary_ids (secondary_id+)>
<!ELEMENT secondary_id (sec_id,issuing_authority)>
<!ELEMENT sec_id (#PCDATA)>
<!ELEMENT issuing_authority (#PCDATA)>

<!ELEMENT source_support (source_name+)>
<!ELEMENT source_name (#PCDATA)>

<!ELEMENT ethics_reviews (ethics_review+)>
<!ELEMENT ethics_review (status,approval_date,contact_name,contact_address,contact_phone,contact_email)>
<!ELEMENT status (#PCDATA)><!-- Not approved,Approved,NA -->
<!ELEMENT approval_date (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT contact_name (#PCDATA)>
<!ELEMENT contact_address (#PCDATA)>
<!ELEMENT contact_phone (#PCDATA)>
<!ELEMENT contact_email (#PCDATA)>
]>
<trials>
  <trial>
    <main>
      <trial_id>IRCT2014070218314N1</trial_id>
      <utrn></utrn>
      <reg_name>IRCT</reg_name>
      <date_registration>2014-10-07</date_registration>
      <primary_sponsor>Department of health, Governement of Sindh</primary_sponsor>
      <public_title>Clinical Trial of a new snake antivenom for the treatment of viper snake bites in Sindh.</public_title>
      <acronym></acronym>
      <scientific_title>Clinical Trials of new bivalent snake antivenom immunoglobulins (IgG) for the treatment of envenoming by medically important vipers in Sindh (Phase II study)</scientific_title>
      <scientific_acronym></scientific_acronym>
      <date_enrolment>2014-10-20</date_enrolment>
      <type_enrolment>anticipated</type_enrolment>
      <target_size>12</target_size>
      <recruitment_status>Complete</recruitment_status>
      <url>https://irct.ir/trial/16643</url>
      <study_type>interventional</study_type>
      <study_design>Randomization: N/A, Blinding: Not blinded, Placebo: Not used, Assignment: Single, Purpose: Treatment, Other design features: Single arm dose finding study.</study_design>
      <phase>2-3</phase>
      <hc_freetext>treatment of envenomation.</hc_freetext>
      <i_freetext>Test drug: Snake antivenom immunoglobulin (IgG).</i_freetext>
      <results_actual_enrolment></results_actual_enrolment>
      <results_date_completed></results_date_completed>
      <results_url_link></results_url_link>
      <results_summary></results_summary>
      <results_date_posted></results_date_posted>
      <results_date_first_publication></results_date_first_publication>
      <results_baseline_char></results_baseline_char>
      <results_participant_flow></results_participant_flow>
      <results_adverse_events></results_adverse_events>
      <results_outcome_measures></results_outcome_measures>
      <results_url_protocol></results_url_protocol>
      <results_IPD_plan></results_IPD_plan>
      <results_IPD_description></results_IPD_description>
    </main>
    <contacts>
      <contact>
        <type>public</type>
        <firstname>Professor Dr. Allah Bux Ghanghro Principal Scientific Consultant</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>Snake antivenom/antirabies serology lab, old DHO office, Sakrand road</address>
        <city>Nawabshah</city>
        <country1>Pakistan</country1>
        <zip>67450</zip>
        <telephone>009224499370250-58</telephone>
        <email>Allah.bux@usindh.edu.pk; dpd_burgri@asvsindh.gos.pk</email>
        <affiliation>Institute of Biochemistry University of Sindh Jamshoro</affiliation>
      </contact>
      <contact>
        <type>scientific</type>
        <firstname>Dr. Naeemul Haque Quraishi, Principal Investigator</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>Snake antivenom/antirabies serology lab, old DHo office, Sakrand road</address>
        <city>Nawabshah</city>
        <country1>Pakistan</country1>
        <zip>67450</zip>
        <telephone>009224499370250-58</telephone>
        <email>pd_naeem@asvsindh.gos.pk; naimquraishi@yahoo.com</email>
        <affiliation>snake antivenom/antirabies serology lab, department of Health, Government of Sindh</affiliation>
      </contact>
    </contacts>
    <countries>
      <country2>Pakistan</country2>
    </countries>
    <criteria>
      <inclusion_criteria>Inclusion Criteris: Patient envenomed by Saw Scaled Viper (Echis carinatus Sochureki/ lundi) and Russell’s viper (Daboia Russelii/Daman/Koriala); Adult male or female (non-pregnant) above 18 years.	Reached hospital within few hours (within 0-7 hours) of snake bite. However the late reaching patients will be treated according to provincial protocol of snakebite management without inclusion in the study; Snake specie is confirmed by identification of dead snake or the clinical observation of incoagulable blood, or when a description of snake is associated with symptoms and signs consistent with systemic envenoming by viper species such as incoagulable blood, spontaneous systemic bleeding, intravascular hemolysis, (pink plasma, anemia, hemoglobinuria), acute renal failure or oliguria; 20WBCT shows incoagulable blood; Patients show no early (anaphylactic) reaction within 10-30 minutes (itching, urticaria, fever, nausea, vomiting, tachycardia, hypotension, bronchospasm) on administration of 0.3ml of test ASV as initial dose; 	Patient or his/her legally acceptable representative able to understand the informed consent and enter into the study with their free will by signing the same.&#13;
Exclusion Criteria: Not willing to accept newly produced ASV as the core remedy; Debilitated patients and those with other chronic or complicating medical conditions, any neuropathy, renal impairment, liver diseases, diabetes mellitus, Hypertension and any CV disease; Subject with known hypersensitivity to horse (equine) or sheep (ovine) serum in the past (for example after treatment with equine anti-tetanus serum, equine anti-rabies serum or equine or ovine anti-venom) and those with a strong history of atopic diseases (especially severe asthma); Patients showing reaction to initial dose of test ASV; Patients with severe condition, acute renal failure, anuria, generalized rhabdomyolysis evident with myoglobinuria and haemoglobinuria; Pregnant women and patients under 18 years of age; not bitten by any medically important vipers of Sindh.</inclusion_criteria>
      <agemin>18 years</agemin>
      <agemax>60 years</agemax>
      <gender>Both</gender>
      <exclusion_criteria></exclusion_criteria>
    </criteria>
    <health_condition_code>
      <hc_code>T63.0</hc_code>
    </health_condition_code>
    <health_condition_keyword>
      <hc_keyword>Toxic effect of snake venom</hc_keyword>
    </health_condition_keyword>
    <intervention_code>
      <i_code>Treatment - Drugs</i_code>
    </intervention_code>
    <intervention_keyword>
      <i_keyword>Test drug: Snake antivenom immunoglobulin (IgG)</i_keyword>
    </intervention_keyword>
    <primary_outcome>
      <prim_outcome>Permenant restoration of blood coagulability. Timepoint: 6, 12, 18 and 24 hours after dosing. Method of measurement: measured through 20 minutes whole blood clotting test.</prim_outcome>
    </primary_outcome>
    <secondary_outcome>
      <sec_outcome>Early and late snake antivenom reactions. Timepoint: after test dose and ful initial dose patients will be monitored for early reaction while patients will be checked on weekly basis for next 24 days after dosing for late serum reaction. Method of measurement: through clinical sign and symptoms and adverse evnt monitoring.</sec_outcome>
    </secondary_outcome>
    <secondary_sponsor>
      <sponsor_name></sponsor_name>
    </secondary_sponsor>
    <secondary_ids>
      <secondary_id>
        <sec_id></sec_id>
        <issuing_authority></issuing_authority>
      </secondary_id>
    </secondary_ids>
    <source_support>
      <source_name>Department of health, Governement of Sindh</source_name>
    </source_support>
    <ethics_reviews>
      <ethics_review>
        <status>Approved</status>
        <approval_date>2014-05-14</approval_date>
        <contact_name>Ethics committe of Peoples University of medical &amp; health sciences for women Shaheed Benazir Abad.</contact_name>
        <contact_address>Peoples University of medical &amp; health sciences for women , Shaheed Benazir Abad, Nawabshah Sindh Pakistan</contact_address>
        <contact_phone></contact_phone>
        <contact_email></contact_email>
      </ethics_review>
    </ethics_reviews>
  </trial>
</trials>
