<?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>IRCT20201023049119N1</trial_id>
      <utrn></utrn>
      <reg_name>IRCT</reg_name>
      <date_registration>2021-04-10</date_registration>
      <primary_sponsor>Bojnourd University of Medical Sciences</primary_sponsor>
      <public_title>The effect of using Salvadora Persica toothbrush on elderly constipation intensity</public_title>
      <acronym></acronym>
      <scientific_title>The effect of using Salvadora Persica toothbrush on the intensity of constipation in the elderly referred to specialized gastroenterology clinic.</scientific_title>
      <scientific_acronym></scientific_acronym>
      <date_enrolment>2021-03-05</date_enrolment>
      <type_enrolment>anticipated</type_enrolment>
      <target_size>60</target_size>
      <recruitment_status>Complete</recruitment_status>
      <url>https://irct.ir/trial/51844</url>
      <study_type>interventional</study_type>
      <study_design>Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive, Other design features: In this trial, participants in control group will use a regular plastic toothbrush, and in intervention group will use Salvadora Persica toothbrush 3 times a day, at morning, noon, and night, 5 minutes each time, for 6 weeks. Participants will receive information on how to use toothbrushes, Randomization description: First, a purposive sampling will be done; then eligible subjects will be randomly allocated into two groups, using permutation blocks randomization approach and the codes generated by the relevant software. Subjects will be randomized individually.</study_design>
      <phase>N/A</phase>
      <hc_freetext>Constipation.</hc_freetext>
      <i_freetext>Intervention 1: Control group: participants in this group will use their regular plastic toothbrush 3 times a day, at morning after breakfast, noon after lunch, and night after dinner, 5 minutes each time, for 6 weeks. Participants will receive necessary instruction on appropriate use of the toothbrush . Intervention 2: Intervention group: participants in this group will use Salvadora Persica wood as toothbrush. Participants and their caregivers will receive instructions on how to prepare, use, and maintain this toothbrush by description and showing video. Participants will use the toothbrush 3 times a day, at morning after breakfast, noon after lunch, and evening after dinner, 5 minutes each time, perpendicular to teeth and gums with rotating movements. Before using, the toothbrush is placed in tepid water to soften the fibers, and then about 1 cm of the stem skin is peeled and the fibers inside are unbraided using a hammer or with teeth. The toothbrush is held like a pen in hand, rubbed on teeth and the gums. After finishing, the used part is cut and disposed. The toothbrush is washed and dried after each use to prevent contaminants.  This protocol will be done for 6 weeks.</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>Undecided - It is not yet known if there will be a plan to make this available</results_IPD_plan>
      <results_IPD_description>Justification or reason for indecision in sharing IPD is No more information is available for now.</results_IPD_description>
    </main>
    <contacts>
      <contact>
        <type>public</type>
        <firstname>Raheleh Yousefzadeh</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>Plaque12. Alley 30. South Danesh</address>
        <city>Gonbad-e Qabus</city>
        <country1>Iran (Islamic Republic of)</country1>
        <zip>4971889711</zip>
        <telephone>+98 17 2238 6734</telephone>
        <email>susfzd76@gmail.com</email>
        <affiliation>Bojnourd University of Medical Sciences</affiliation>
      </contact>
      <contact>
        <type>scientific</type>
        <firstname>Raheleh Yousefzadeh</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>Plaque12. Alley 30. South Danesh</address>
        <city>Gonbad-e Qabus</city>
        <country1>Iran (Islamic Republic of)</country1>
        <zip>4971889711</zip>
        <telephone>+98 17 2238 6734</telephone>
        <email>susfzd76@gmail.com</email>
        <affiliation>Bojnourd University of Medical Sciences</affiliation>
      </contact>
    </contacts>
    <countries>
      <country2>Iran (Islamic Republic of)</country2>
    </countries>
    <criteria>
      <inclusion_criteria>Being over 60 years old.
Being fully conscious and teachable.
Having natural teeth.
Having degrees of constipation (too mild to severe).
Being a city resident.
Being able to perform the intervention protocol independently or with the help of their caregiver.
Being able to do activities of daily living.
Using C-Lax pill for their constipation.</inclusion_criteria>
      <agemin>60 years</agemin>
      <agemax>no limit</agemax>
      <gender>Both</gender>
      <exclusion_criteria>Being on treatment for heart disease, hypertension, respiratory diseases and gastrointestinal ulcers.
Being addicted to drugs.
Use of medications causing constipation.</exclusion_criteria>
    </criteria>
    <health_condition_code>
      <hc_code>K59.00</hc_code>
    </health_condition_code>
    <health_condition_keyword>
      <hc_keyword>Constipation, unspecified</hc_keyword>
    </health_condition_keyword>
    <intervention_code>
      <i_code>Treatment - Drugs</i_code>
      <i_code>Treatment - Devices</i_code>
    </intervention_code>
    <intervention_keyword>
      <i_keyword>Control group: participants in this group will use their regular plastic toothbrush 3 times a day, at morning after breakfast, noon after lunch, and night after dinner, 5 minutes each time, for 6 weeks. Participants will receive necessary instruction on appropriate use of the toothbrush .</i_keyword>
      <i_keyword>Intervention group: participants in this group will use Salvadora Persica wood as toothbrush. Participants and their caregivers will receive instructions on how to prepare, use, and maintain this toothbrush by description and showing video. Participants will use the toothbrush 3 times a day, at morning after breakfast, noon after lunch, and evening after dinner, 5 minutes each time, perpendicular to teeth and gums with rotating movements. Before using, the toothbrush is placed in tepid water to soften the fibers, and then about 1 cm of the stem skin is peeled and the fibers inside are unbraided using a hammer or with teeth. The toothbrush is held like a pen in hand, rubbed on teeth and the gums. After finishing, the used part is cut and disposed. The toothbrush is washed and dried after each use to prevent contaminants.  This protocol will be done for 6 weeks.</i_keyword>
    </intervention_keyword>
    <primary_outcome>
      <prim_outcome>Constipation intensity based on the score of Constipation Assessment Scale (CAS). Timepoint: Study onset (before starting the intervention), week 3, and week 6 after starting the intervention. Method of measurement: Using of Constipation Assessment Scale: This questionnaire was published by McMillan in 2001 and contains 8 questions; each question has three answer options with scores from zero to 2; Total score ranges from zero to 16, with the higher score denotes more severe constipation.</prim_outcome>
    </primary_outcome>
    <secondary_outcome>
      <sec_outcome></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>Bojnourd University of Medical Sciences</source_name>
    </source_support>
    <ethics_reviews>
      <ethics_review>
        <status>Approved</status>
        <approval_date>2021-02-01</approval_date>
        <contact_name>Ethics committee of North Khorasan University of Medical Sciences</contact_name>
        <contact_address>Central Library. School of Medicine. south side of the hospital. Shahriar St. Bojnourd. Bojnurd North Khorasan Iran (Islamic Republic of)</contact_address>
        <contact_phone></contact_phone>
        <contact_email></contact_email>
      </ethics_review>
    </ethics_reviews>
  </trial>
</trials>
