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Trial registered on ANZCTR
Registration number
ACTRN12616000556448
Ethics application status
Approved
Date submitted
7/12/2015
Date registered
29/04/2016
Date last updated
29/04/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Protective effect of insulin against inhalation anesthesia induced apoptosis in laporoscopic cholecystectomy patients
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Scientific title
The Protective Effect of Insulin against Isoflurane or Sevoflurane Induced Hepatocellular Apoptosis in Laparoscopic Cholecystectomy Patients
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Secondary ID [1]
288083
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Nil known
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Universal Trial Number (UTN)
Nil known
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
apoptosis in laporoscopic cholecystectomy
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Condition category
Condition code
Anaesthesiology
297193
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0
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Anaesthetics
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Oral and Gastrointestinal
297572
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
80 patients undergoing laporoscopic cholecystectomy will be divide into 2 groups. After induction of general anesthesia with propofol 1mg kg-1 , fentanyl 2 microg kg-1 and atracurium 0.5 mg kg-1 then anesthesia will be maintained by: Arm 1 will receive isoflurane inhalational anesthetic by the dose 1.2% (1MAC) and Arm 2 sevoflurane inhalational anesthetic by the dose 2% (1MAC) after induction for maintenance of general anesthesia till the end of surgery. The type of surgery is laporoscopic cholecystectomy which lasts about one hour in our institute. Both inhalational anesthetic drugs will be monitored with infrared gas spectrophotometry to adjust the targeted end tidal concentration. Both arms will be subdivided into control subgroup which will receive 500 ml ringer acetate intravenous infusion 1 hour before surgery, and insulin subgroup which will receive glucose insulin potassium (GIK) intravenous infusion to study its protective effect against apoptosis. GIK is composed of 500 ml of 10% dextrose, 10 mEq of potassium and 10 IU of regular insulin. All fluids will be infused over 30 minutes and will be finished before starting the operation.
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Intervention code [1]
293394
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Treatment: Drugs
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Comparator / control treatment
Patients undergoing laporoscopic cholecystectomy will be divided into 2 control groups. Arm 1 will recieve isoflurane inhalational anesthetic and Arm 2 sevoflurane inhalational anesthetic for maintenance of general anesthesia. Both groups will receive regular intravenous fluids solution (ringer acetate) with no drugs at a rate of 3ml kg-1h-1 and will be finished before starting the operation.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Apoptosis assessed by liver biopsy taken for immunohistochemical evaluation of hepatocyte apoptotic biomarkers (Bcl-xl, Akt, Fas, Fas-L, caspase-3,-7and-9) activity.
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Assessment method [1]
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Timepoint [1]
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At the end of surgery before the umbilical port closure for all patients.
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Primary outcome [2]
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apoptosis assessed by the following apoptotic biomarkers (Bcl-xl, Akt, Fas, FasL, annexinV, caspase-3,-7 and -9) in the blood.
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Assessment method [2]
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Timepoint [2]
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3 ml of venous blood were collected two hours preoperatively (T0), at the end of surgery (T1) and one day after surgery (T24)
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Secondary outcome [1]
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liver function tests (ALT, AST, albumin, bilirubin (Total)), kidney function tests (blood urea and creatinine)
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Assessment method [1]
319379
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Timepoint [1]
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2 ml of venous blood were collected 2 hrs before surgery (T0) and 24 Hrs postoperatively (T24)
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Eligibility
Key inclusion criteria
Elective laporscopic cholecystectomy.
Age: 25-55 years.
Gender: Both male and female.
BMI: 20-30 kg/m2 (Normal weight).
ASA Class: I.
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Minimum age
25
Years
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Maximum age
55
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Pregnancy and lactation.
Fever or sepsis.
Addicts and drug abusers.
Acute cholecystitis.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
14/02/2013
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Date of last participant enrolment
Anticipated
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Actual
2/02/2014
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
80
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Accrual to date
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Final
80
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Recruitment outside Australia
Country [1]
7396
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Egypt
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State/province [1]
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Giza
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Theodor Bilharz Research Institute
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Address [1]
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El-Nile St., Warrak El-Hader, Imbaba Giza , Egypt P.O.BOX : 30 Imbaba
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Country [1]
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Egypt
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Primary sponsor type
Hospital
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Name
Theodor Bilharz Research Institute
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Address
El-Nile St., Warrak El-Hader, Imbaba Giza , Egypt P.O.BOX : 30 Imbaba
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Country
Egypt
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Secondary sponsor category [1]
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Government body
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Name [1]
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Academy of scientific research and technology
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Address [1]
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101 Kasr El Ainy St. Kasr El Ainy
Cairo 11516
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Country [1]
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Egypt
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Institutional Review Board of Theodor Bilharz Research Institute (TBRI - IRB)
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Ethics committee address [1]
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Theodor Bilharz Research Institute El Nile St. Warrak ElHadar P.O. Box 30 Imbaba Giza, 12411 Egypt
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Ethics committee country [1]
293988
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Egypt
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Date submitted for ethics approval [1]
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02/01/2013
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Approval date [1]
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11/02/2013
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Ethics approval number [1]
293988
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FWA00010609
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Summary
Brief summary
The hypothesis to be studied is that the commonly used inhaled anesthetics isoflurane and sevoflurane may induce apoptosis in liver and insulin can guard against their apoptotic effect. This study has two objectives: The first one is to compare the apoptotic effect of isoflurane and sevoflurane on human hepatocytes and the second objective is to figure out the rule of insulin infusion as antiapoptoic agent in modulation of such effect evidenced by immunohistochemical study of liver biopsy and blood markers. Pre and postoperative liver and kidney function tests will be measured to help correlating the apoptotic changes with biochemical changes if present.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
663
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/AnzctrAttachments/369737-Ethical committe approval.pdf
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Contacts
Principal investigator
Name
62006
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Prof Khalda Galal Radwan
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Address
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Theodor Bilharz Research Institute El Nile St. Warrak ElHadar P.O. Box 30 Imbaba Giza, 12411 Egypt
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Country
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Egypt
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Phone
62006
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+201220411852
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Fax
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Email
62006
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[email protected]
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Contact person for public queries
Name
62007
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Mohamed A. Maher
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Address
62007
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Theodor Bilharz Research Institute El Nile St. Warrak ElHadar P.O. Box 30 Imbaba Giza, 12411 Egypt
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Country
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Egypt
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Phone
62007
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+201005097625
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Fax
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Email
62007
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[email protected]
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Contact person for scientific queries
Name
62008
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Mohamed A.Maher
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Address
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Theodor Bilharz Research Institute El Nile St. Warrak ElHadar P.O. Box 30 Imbaba Giza, 12411 Egypt
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Country
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Egypt
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Phone
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+201005097625
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Fax
62008
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Email
62008
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
THE PROTECTIVE EFFECT OF INSULIN AGAINST ISOFLURANE AND SEVOFLURANE INDUCED HEPATOCELLULAR APOPTOSIS
2018
https://doi.org/10.21608/jesp.2018.77476
N.B. These documents automatically identified may not have been verified by the study sponsor.
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