NCT03890016

Brief Summary

20 minute Whole Blood Clotting Test(20'WBCT) recommended by World Health Organisation guidelines is probably the most routinely employed bed side screening tool in the country. The Modified Lee and White (MLW) method gives a value which when performed serially gives a trend in clotting time which the investigators hypothesise to be a better tool in serially assessing the victim compared to the 20'WBCT. The investigators propose that delayed reading of both MLW and 20'WBCT to check for clot stability at 30 minutes also provides added information in management of snake bite victims.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
230

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started May 2019

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 22, 2019

Completed
4 days until next milestone

First Posted

Study publicly available on registry

March 26, 2019

Completed
1 month until next milestone

Study Start

First participant enrolled

May 1, 2019

Completed
1.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 31, 2020

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2020

Completed
Last Updated

August 17, 2020

Status Verified

August 1, 2020

Enrollment Period

1.1 years

First QC Date

March 22, 2019

Last Update Submit

August 14, 2020

Conditions

Keywords

Modified Lee and White Method20'WBCTWhole Blood Clotting Test

Outcome Measures

Primary Outcomes (2)

  • Sensitivity and specificity of serial Modified Lee White Method(MLW) in comparison with twenty minute Whole Blood Clotting Test in detecting coagulopathy in snakebite victims.

    48 hours of snakebite

  • Sensitivity and Specificity of admission Modified Lee White Method(MLW) and twenty minute Whole Blood Clotting Test in detecting coagulopathy in snakebite victims.

    Comparing MLW and 20'WBCT to gold standard tests like Prothrombin Time (PT) and activated partial thromboplastin time (aPTT)

    48 hours

Secondary Outcomes (4)

  • Sensitivity of admission 20'WBCT and MLW to diagnose Russells viper (Daboia ruselli) envenomation

    48hours

  • Sensitivity of admission 20'WBCT and MLW to diagnose Hump-nosed pit viper (Hypnale hypnale) envenomation

    48hours

  • Time to detection of hematotoxic envenomation in MLW and 20'WBCT

    48 hours

  • Sensitivity and specificity of delayed reading of clotting time and clotting test at 30 minutes in detecting coagulopathy

    48 hours

Study Arms (1)

snakebite victims

Victims of snakebite presenting to the Emergency Department of Jubilee Mission Medical College and Research Institute

Diagnostic Test: 20'Whole Blood ClottingTest (WBCT)Diagnostic Test: Modified Lee and White (MLW) Method Clotting Time

Interventions

1ml of blood drawn from snake bite victims in clean glass test tubes of 1 cm diameter Kept undisturbed for a period of 20 minutes (measured by a stop watch). At the end of 20 minutes the tube is tilted to see if the blood has clotted or not. If a well formed clot is not formed, the test is recorded as 'abnormal'. If the clot seems well formed, it is further observed for a period of 30 minutes to look for dissolution of the formed clot and would be termed "clot lysis". Clot lysis indicates an unstable clot.

Also known as: 20'WBCT
snakebite victims

The blood collected in three additional test tubes would be utilised for MLW. The three test tubes would be kept on a rack at ambient temperature. The blood sample would be drawn in a 5cc syringe and 1 ml would be added in the three test tubes consecutively. The test tube would be left undisturbed for 5 minutes, after that the first tube would be tilted approximately to check for clot formation every 30 seconds while the other tubes are left undisturbed. After the blood in the first tube has clotted, the time would be noted and the second tube would be tilted every 30 seconds and examined. Following its clotting, the third tube would be examined. The time at which the third tube is recorded as the CT value. Once clotted, then the sample in the all three test tube would be assessed at 20 minute and 30 min to look for breakup or lysis of the clot.

snakebite victims

Eligibility Criteria

Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)
Sampling MethodProbability Sample
Study Population

All snake bite victims presenting to the emergency department of Jubilee mission medical college and research institute.

You may qualify if:

  • All victims of snake bite presenting to the emergency department AND
  • Consenting to be part of the study

You may not qualify if:

  • Those not providing a written informed consent OR
  • Those on anticoagulants or antiplatelets OR
  • With a known hematological disorder OR
  • A known history of chronic liver disease OR
  • Received antivenom or blood products following snakebite at another centre

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Jubilee Mission Medical College and Research Institute

Thrissur, Kerala, 680005, India

Location

MeSH Terms

Conditions

Hemostatic DisordersSnake Bites

Condition Hierarchy (Ancestors)

Vascular DiseasesCardiovascular DiseasesHemorrhagic DisordersHematologic DiseasesHemic and Lymphatic DiseasesBites and StingsPoisoningChemically-Induced DisordersWounds and Injuries

Study Officials

  • Siju Varghese Abraham, M.D

    Jubilee Mission Medical College and Research Institute

    STUDY DIRECTOR

Study Design

Study Type
observational
Observational Model
OTHER
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Assistant Professor

Study Record Dates

First Submitted

March 22, 2019

First Posted

March 26, 2019

Study Start

May 1, 2019

Primary Completion

May 31, 2020

Study Completion

June 30, 2020

Last Updated

August 17, 2020

Record last verified: 2020-08

Locations