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Trial registered on ANZCTR
Registration number
ACTRN12617000482369
Ethics application status
Approved
Date submitted
7/01/2017
Date registered
3/04/2017
Date last updated
3/04/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Ultrasound measurements of anterior soft tissue thickness to predict difficult laryngoscopy in women undergoing elective cesarean section under general anesthesia.
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Scientific title
Ultrasound measurements of anterior soft tissue thickness to predict difficult laryngoscopy in women undergoing elective cesarean section under general anesthesia.
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Secondary ID [1]
290786
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nil known
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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:
difficult laryngoscopy
301417
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Condition category
Condition code
Anaesthesiology
301146
301146
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0
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Other anaesthesiology
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Prospective, observational study included 140 pregnant women (18-45 years old, ASA I-II) who underwent elective cesarean section under general anesthesia. A written informed consent was obtained from each patient. Patients with difficult airway anamnesis, history of neck surgery were not included in the study.
In addition, very urgent cases such as acute fetal distress and ablatio placenta were excluded from the study. Mallampati test, mouth opening, sternomental distance, thyromental distance, upper lip bite test, neck circumference were recorded one day before operation. The distance from the skin to the anterior aspect of the trachea was measured at five different levels: hyoid bone (zone 1), tirohyoid membrane (zone 2), vocal cords (zone 3), thyroid isthmus (zone 4) and suprasternal notch (zone 5). An anaesthesiologist who were unaware of the clinical screening variables and ultrasonography results performed laryngoscopy.
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Intervention code [1]
296726
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Early Detection / Screening
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Comparator / control treatment
no control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
300554
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Primary outcome: The determining ultrasound measurements of 5 different levels (Hyoid bone, Thyrohyoid membrane, Vocal cords, Thyroid isthmus, Suprasternal notch) of anterior neck soft tissue:
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Assessment method [1]
300554
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Timepoint [1]
300554
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24 hours prior to general anesthesia
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Secondary outcome [1]
330295
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Secondary Outcome: clinical screening test for detecting of difficult laryngoscopy:
Mouth openning (cm),assessed using a caliper.
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Assessment method [1]
330295
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Timepoint [1]
330295
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once at 24 hours prior to general anesthesia
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Secondary outcome [2]
333134
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Modified Mallampati Score assessed as a visiual parameter
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Assessment method [2]
333134
0
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Timepoint [2]
333134
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once at 24 hours prior to general anesthesia
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Secondary outcome [3]
333135
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Thyromental distance (cm),assessed using a caliper.
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Assessment method [3]
333135
0
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Timepoint [3]
333135
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once at 24 hours prior to general anesthesia
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Secondary outcome [4]
333136
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Sternomental distance (cm),assessed using a caliper.
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Assessment method [4]
333136
0
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Timepoint [4]
333136
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once at 24 hours prior to general anesthesia
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Secondary outcome [5]
333137
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Cormack&Lehane Classification, assessed using Macintosh No:3 blade
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Assessment method [5]
333137
0
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Timepoint [5]
333137
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at the moment of laryngoscopy
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Secondary outcome [6]
333138
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protruding upper teeth
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Assessment method [6]
333138
0
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Timepoint [6]
333138
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once at 24 hours prior to general anesthesia
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Secondary outcome [7]
333139
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Wilson risk sum score
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Assessment method [7]
333139
0
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Timepoint [7]
333139
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once at 24 hours prior to general anesthesia
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Secondary outcome [8]
333140
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Neck circumference measured at the thyroid cartilage,assessed using a caliper.
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Assessment method [8]
333140
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Timepoint [8]
333140
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once at 24 hours prior to general anesthesia
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Secondary outcome [9]
333141
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Intubation Difficulty Scale (IDS, )assessed using Macintosh No:3 blade
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Assessment method [9]
333141
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Timepoint [9]
333141
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15 mins after endotracheal intubation
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Eligibility
Key inclusion criteria
18-45 years old
ASA (American Society of Anesthesiologists) II
elective cesarean section surgery
general anesthesia
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Minimum age
18
Years
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Maximum age
45
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
difficult airway anamnesis
history of neck surgery
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Study design
Purpose
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Duration
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Selection
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Timing
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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
7/04/2014
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Date of last participant enrolment
Anticipated
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Actual
8/04/2016
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Date of last data collection
Anticipated
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Actual
8/04/2016
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Sample size
Target
140
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Accrual to date
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Final
140
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Recruitment outside Australia
Country [1]
8515
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Turkey
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State/province [1]
8515
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Bursa
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Funding & Sponsors
Funding source category [1]
295205
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Hospital
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Name [1]
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Health Sciences University Bursa Yuksek Ihtisas Training and Education Hospital
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Address [1]
295205
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Health Sciences University Bursa Yuksek Ihtisas Training and Education Hospital Mimar Sinan Neighbohood/Emniyet Street/ 16310 Yildirim/Bursa
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Country [1]
295205
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Turkey
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Primary sponsor type
Individual
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Name
Canan Yilmaz
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Address
Health Sciences University Bursa Yuksek Ihtisas Training and Education Hospital Clinic of Anesthesiology And Reanimation Mimar Sinan Neighbohood/Emniyet Street/ 16310 Yildirim/Bursa
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Country
Turkey
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Secondary sponsor category [1]
294038
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Individual
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Name [1]
294038
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Derya Karasu
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Address [1]
294038
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Health Sciences University Bursa Yuksek Ihtisas Training and Education Hospital Clinic of Anesthesiology And Reanimation Mimar Sinan Neighbohood/Emniyet Street/ 16310 Yildirim/Bursa
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Country [1]
294038
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Turkey
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296556
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Health Sciences University Bursa Yuksek Ihtisas Training and Education Hospital Clinical Research Ethics Committee
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Ethics committee address [1]
296556
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Health Sciences University Bursa Yuksek Ihtisas Training and Education Hospital Mimar Sinan Neighborhood /Emniyet Street/16310 / Yildirim /Bursa
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Ethics committee country [1]
296556
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Turkey
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Date submitted for ethics approval [1]
296556
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27/03/2014
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Approval date [1]
296556
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02/04/2014
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Ethics approval number [1]
296556
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2014/08/01
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Summary
Brief summary
Obstetric patient airway management is becoming important, because of anatomical and physiological changes in the airway related to the pregnancy. The aim of our study was to compare the ultrasound (USG) measurements of 5 different levels of anterior neck soft tissue and other clinical screening tests for determination of difficult laryngoscopy in patients who underwent cesarean section operation with general anesthesia.. Materials and Methods: Prospective, observational study included 140 pregnant women (18-45 years old, ASA I-II) who underwent elective cesarean section under general anesthesia. A written informed consent was obtained from each patient. The study protocol was approved by the local Ethics Committee. Patients with difficult airway anamnesis, history of neck surgery were not included in the study. In addition, very urgent cases such as acute fetal distress and ablatio placenta were excluded from the study. Mallampati test, mouth opening, sternomental distance, thyromental distance, upper lip bite test, neck circumference were recorded. The distance from the skin to the anterior aspect of the trachea was measured at five different levels: hyoid bone (zone 1), tirohyoidmembrane (zone 2), vocal cords (zone 3), thyroid isthmus (zone 4) and suprasternal notch (zone 5). An anaesthesiologist who were unaware of the clinical screening variables and USG results performed laryngoscopy. When second attempt for intubation was failed, to use of other difficult intubation equipments were planned. Results: 120 patients were evaluated statistically. According to Cormack and Lehane’s scale, patients were divided into two groups: a grade 1 or 2 was accepted easy laryngoscopy, whereas a grade 3 or 4 was considered difficult laryngoscopy. 30 patients were classified as having difficult laryngoscopy (25 %). All of the patients were entubated succesfully. Amoung the other clinical screening tests for difficult laryngoscopy: limited mouth opening (<3cm), high Wilson's Risk Score (> 2), large neck circumference (> 40 cm), unable to bite the upper lip, and high mallampati score (III-IV) were found higher in the difficult laryngoscopy group (p<0.05). Also, BURP maneuver, useage of gum elastic bougie, high intubation difficulty score (IDS =5), three more intubation attempts, airway difficulty rate were significantly higher in the difficult laryngoscopy group (p<0.05). Conclusion(s): We thought that USG measurement of anterior neck soft tissue has no influence on determination of difficult laryngoscopy in pregnant patients.
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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
71282
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Dr Hilal Erdem Solak
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Address
71282
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Health Sciences University Bursa Yuksek Ihtisas Training and Education Hospital Clinic of Anesthesiology ve Reanimation Mimar Sinan Neighborhood/Emniyet Street/16310 Yildirim /Bursa
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Country
71282
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Turkey
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Phone
71282
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+905057163727
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Fax
71282
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Email
71282
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[email protected]
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Contact person for public queries
Name
71283
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Canan Yilmaz
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Address
71283
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Health Sciences University Bursa Yuksek Ihtisas Training and Education Hospital Clinic of Anesthesiology ve Reanimation Mimar Sinan Neighborhood/Emniyet Street/16310 Yildirim /Bursa
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Country
71283
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Turkey
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Phone
71283
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+905059045989
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Fax
71283
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Email
71283
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[email protected]
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Contact person for scientific queries
Name
71284
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Derya Karasu
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Address
71284
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Health Sciences University Bursa Yuksek Ihtisas Training and Education Hospital Clinic of Anesthesiology ve Reanimation Mimar Sinan Neighborhood/Emniyet Street/16310 Yildirim /Bursa
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Country
71284
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Turkey
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Phone
71284
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+905057281175
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Fax
71284
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Email
71284
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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
No additional documents have been identified.
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