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Trial registered on ANZCTR
Registration number
ACTRN12620000044921
Ethics application status
Approved
Date submitted
9/01/2020
Date registered
21/01/2020
Date last updated
21/12/2021
Date data sharing statement initially provided
21/01/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
A comparison of 2 different medicated ointments with placebo for pain relief after banding of haemorrhoids.
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Scientific title
A 3-arm Randomised, Double-blind, Placebo-controlled Trial of Lignocaine vs Lignocaine+Diltiazem vs Placebo Topical Ointments to Reduce Post-Procedural Pain in Patients Undergoing Haemorrhoidal Banding
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Secondary ID [1]
300214
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None
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Universal Trial Number (UTN)
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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:
haemorrhoids
315775
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Condition category
Condition code
Oral and Gastrointestinal
314060
314060
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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
The interventions consist of 3 different ointments:
-lignocaine 2% in polyethylene glycol (PEG) base or
-lignocaine 2% and diltiazem 2% in polyethylene glycol (PEG) base
A 2cm length of ointment will be digitally applied to the anal area 3 times per day for 5 days from the procedure. Each participant will record in a written diary that the ointment has been applied.
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Intervention code [1]
316487
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Treatment: Drugs
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Comparator / control treatment
Ointment consisting of polyethylene glycol (PEG) base
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Pain scores between the 3 arms will be assessed using a standardised 10-point patient reported continuous visual analogue scale (zero represented no pain at all, and ten represented the severest pain imaginable)
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Assessment method [1]
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Timepoint [1]
322455
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• 30 minutes
• 1 hour
• 6 hours
• 12 hours
• 24 hours
• 48 hours
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Secondary outcome [1]
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Total opioid analgesic usage as reported by the patient in oral morphine milli-equivalents.
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Assessment method [1]
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Timepoint [1]
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Day of procedure and days 1,2 and 3 post-procedure
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Secondary outcome [2]
378590
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Time off work in days
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Assessment method [2]
378590
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Timepoint [2]
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Up to day 30 post-procedure as reported by the participant at 30 day phone follow-up.
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Secondary outcome [3]
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Patients not requiring opiates
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Assessment method [3]
378591
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Timepoint [3]
378591
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Recorded at days 1,2 and 3 and 4 post-procedure by a self-completed diary.
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Secondary outcome [4]
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Post-operative surgical complications graded by the Clavien-Dindo Classification of Surgical Complications up to day 30 post-procedure as reported by the participant at day 30 follow-up and/or from the medical record if admitted for any reason poast-procedure
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Assessment method [4]
378592
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Timepoint [4]
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Up to day 30 post-procedure as reported by the participant at day 30 follow-up and/or from the medical record if admitted for any reason post-procedure
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Secondary outcome [5]
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Incidence of repeat procedure
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Assessment method [5]
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Timepoint [5]
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Within 30 days of index procedure will be compared between groups based on medical record review.
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Secondary outcome [6]
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Proportion of patients developing urinary retention requiring catheterization between groups as recorded in medical record or reported by the patient.
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Assessment method [6]
378594
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Timepoint [6]
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By day 30 post-procedure
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Secondary outcome [7]
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Patient reported satisfaction with analgesia after discharge (Likert scale and percent satisfaction)
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Assessment method [7]
378595
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Timepoint [7]
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At day 5.
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Secondary outcome [8]
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Proportion of participants that would recommend the procedure to friends or family if they required it
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Assessment method [8]
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Timepoint [8]
378596
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Assessed at day 30 post-procedure at phone follow-up.
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Eligibility
Key inclusion criteria
Patients aged 18 years and over who present to the colorectal outpatient clinic or the private rooms of participating surgeons with symptomatic haemorrhoids suitable for banding will be considered for inclusion and offered study information.
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Minimum age
18
Years
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Maximum age
No limit
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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
A person will be excluded if they have the following:
• Coexisting anorectal disease such as anal fissure, fistula in ano, perianal abscess, thrombosed haemorrhoids, or colorectal malignancy
• A current medical history of uncontrolled ischemic heart disease, heart block, pregnancy or currently breastfeeding, severe hypertension (systolic blood pressure greater than 180mmHg), or orthostatic hypotension
• Poor general condition (i.e ASA classification 4 or 5)
• Allergy or sensitivity to diltiazem, lignocaine or polyethylene glycol (PEG) USP ointment base
• Current calcium channel blocker use
• Known side effects from previous calcium channel blocker use
• Refuse or are unable to give written informed consent to participate in the study.
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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)
Central computer based randmisation
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
Efficacy
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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
15/12/2020
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Actual
3/03/2021
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Date of last participant enrolment
Anticipated
15/12/2022
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Actual
8/10/2021
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Date of last data collection
Anticipated
31/01/2023
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Actual
9/12/2021
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Sample size
Target
100
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Accrual to date
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Final
99
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
15584
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John Hunter Hospital - New Lambton
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Recruitment hospital [2]
15585
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Belmont Hospital - Belmont
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Recruitment hospital [3]
15586
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Newcastle Private Hospital - New Lambton Heights
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Recruitment hospital [4]
15791
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Newcastle Endoscopy Centre - Charlestown
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Recruitment postcode(s) [1]
28981
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2305 - New Lambton
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Recruitment postcode(s) [2]
28982
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2280 - Belmont
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Recruitment postcode(s) [3]
28983
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2305 - New Lambton Heights
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Recruitment postcode(s) [4]
28984
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2290 - Charlestown
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Funding & Sponsors
Funding source category [1]
304646
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Hospital
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Name [1]
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John Hunter Hospital
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Address [1]
304646
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Lookout Road
New Lambton Heights
NSW 2305
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Country [1]
304646
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Australia
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Primary sponsor type
Government body
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Name
Hunter New England Local Health District
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Address
Lookout Road
New Lambton Heights
NSW 2305
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
304949
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Country [1]
304949
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Hunter New England human Research Ethics Committee
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Ethics committee address [1]
305067
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Locked bag 1 New Lambton NSW 2305
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Ethics committee country [1]
305067
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Australia
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Date submitted for ethics approval [1]
305067
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31/01/2020
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Approval date [1]
305067
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20/04/2020
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Ethics approval number [1]
305067
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Summary
Brief summary
Haemorrhoidal symptoms are among the commonest complaints of mankind, it can occur in up to 80% of the population, involving any age and affecting both males and females equally. Surgical haemorrhoidectomy is most commonly used for 3rd or 4th degree haemorrhoids. However, surgery is associated with severe postoperative pain that is a source of such anxiety that some patients decide not to undergo the operation. Due to this, another non-surgical method can be used such as rubber band ligation, however this still requires pain relief. Research has suggested that current forms of pain relief are short term, caused more pain. Therefore, topical local anaesthetic agents are the next appealing option although have not been as successful as anticipated. Lignocaine in combination with Diltiazem are options that have not been used in this area and could potentially be more effective in relieving pain. This trial will examine the role of diltiazem and lignocaine in reducing post-procedure pain.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Stephen Smith
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Address
99154
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Surgical Services
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre
NSW 2310
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Country
99154
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Australia
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Phone
99154
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+61 2 4923 6397
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Fax
99154
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Email
99154
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[email protected]
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Contact person for public queries
Name
99155
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Rosemary Carroll
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Address
99155
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Surgical Services
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre
NSW 2310
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Country
99155
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Australia
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Phone
99155
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+61 2 4923 6397
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Fax
99155
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Email
99155
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[email protected]
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Contact person for scientific queries
Name
99156
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Stephen Smith
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Address
99156
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Surgical Services
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre
NSW 2310
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Country
99156
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Australia
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Phone
99156
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+61 2 4923 6397
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Fax
99156
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Email
99156
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Undecided
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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
Embase
Topical Lidocaine or Lidocaine/Diltiazem Ointment Following Rubber Band Ligation of Hemorrhoids: A Prospective 3-Armed Randomized Controlled Trial.
2023
https://dx.doi.org/10.1097/DCR.0000000000002774
N.B. These documents automatically identified may not have been verified by the study sponsor.
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