PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/8
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Article Effects of Combined Triflow, Deep Breathing and Coughing Exercises on Postoperative Pulmonary Function After Mitral Valve Replacement: A Randomized Controlled Trial(BMC, 2026) Akinci, Naile; Eren, EsraBackground Postoperative pulmonary complications remain a major cause of morbidity after cardiac valve surgery. Although incentive spirometry (Triflow) is routinely used in postoperative care, evidence regarding the additional benefits of combining Triflow with deep breathing and coughing exercises remains limited. This study aimed to evaluate the effects of combined Triflow, deep breathing, and coughing exercises on postoperative pulmonary function in adult patients undergoing mitral valve replacement. Methods This randomized controlled, single-blind trial was conducted between May and August 2025 in a private hospital in Istanbul. A total of 60 adult patients undergoing mitral valve replacement were randomly allocated to an experimental group (n = 30) or a control group (n = 30) using simple randomization. The experimental group performed Triflow combined with deep breathing and coughing exercises, while the control group performed Triflow alone. Results Postoperative SpO(2) levels were significantly higher in the experimental group at T1 (p = 0.009; 95% CI: 0.46-3.14), T2 (p < 0.001; 95% CI: 1.57-3.43), and T3 (p < 0.001; 95% CI: 2.72-4.54). The FEV1/FVC ratio increased significantly in the experimental group compared with the control group at discharge (p < 0.001; 95% CI: 4.46-6.41). Respiratory rate was significantly higher in the experimental group at T1 (p < 0.001; 95% CI: 1.68-4.45), T2 (p < 0.001; 95% CI: 3.34-6.26), and T3 (p < 0.001; 95% CI: 5.23-8.37). Hematocrit levels were significantly lower in the experimental group at T1 (p = 0.039; 95% CI: -8.32 to - 0.24), T2 (p = 0.007; 95% CI: -8.29 to - 1.40), and T3 (p = 0.034; 95% CI: -6.54 to - 0.28). Pain scores were significantly lower in the experimental group at T1 (p < 0.001; 95% CI: -2.82 to - 1.71) and T2 (p < 0.001; 95% CI: -1.98 to - 1.08). Time to first mobilization was significantly shorter in the experimental group (p < 0.001; 95% CI: -2.94 to - 1.26). No postoperative pulmonary complications were observed in either group. Conclusion The combined application of Triflow, deep breathing, and coughing exercises was associated with significant improvements in postoperative pulmonary function, oxygen saturation, pain reduction, and earlier mobilization compared with Triflow alone in patients undergoing mitral valve replacement. These findings suggest that a structured, combined respiratory exercise protocol may provide additional clinical benefits in the early postoperative period.Article Ramadan Fasting and Seizure Activity in Adults with Epilepsy: A Systematic Review and Meta-Analysis(Academic Press Inc Elsevier Science, 2026) Ibrahim, Ismail A.; Shaaban, Sally; Elewa, Mandy; Rahman, Muhammad Samir Haziq Bin Abd; Mohamed, Lobna Ahmed; Talaia, Ahmed M.; Khoo, Ching Soong; Haziq bin Abd Rahman, Muhammad SamirPurpose: Ramadan fasting in Muslims entails abstaining from food and fluids from dawn to sunset, which can influence sleep patterns, medication timing, and food intake. Building on evidence that ketogenic diets and intermittent fasting may improve seizure control, we aim to analyze the link between intermittent Ramadan fasting in adults with epilepsy and seizure activity. Method: We systematically searched PubMed, Scopus, Web of Science, Cochrane Library, and Embase between 2000 and January 2025 for articles that appeared between these dates. The terms used for searching included fasting in Ramadan with epilepsy or seizures. The seizure frequency and seizure status of the participants are the outcomes that we analyzed. Two reviewers independently screened and extracted data, with a third resolving any differences that arose between them. Meta-analysis was done using the random-effects model with statistical heterogeneity using the I2 statistic. Results: Of the 1485 articles, only eight were found to be relevant, and 4 of these included 564 patients who met the inclusion criteria. The analysis of the pooled data demonstrated that 61.1% of patients remained seizure-free throughout Ramadan (95% CI: 38.8%-83.4%), with considerable heterogeneity (I2 = 87.7%). Seizure risk was higher in patients on polytherapy with poor baseline seizure control, increased fasting times, or high potassium levels. In contrast, extended seizure-free intervals and increased sleep duration pre-Ramadan were good predictors of safe fasting, and each seizure-free week increased the chance of remaining seizure-free by 10%, as did each extra hour of sleep by 30%. Seizure frequency increases were caused by interruption of daily rhythms, psychological tension, tiredness, and extended fasting. Conclusion: While many patients remained seizure-free during Ramadan, high study variability highlights the need for standardized research. With proper medical supervision, fasting may be safely practiced for selected epilepsy patients.Correction Diagnostic Utility of Smartphone-Integrated Gait Analysis in the Assessment of BPPV (Vol 16 , 1728659 , 2025)(Frontiers Media S.A., 2026) Durmus, Kasim; Bora, Adem; Sapci, Baris; Al-Hazzar, Marwan Khaled; Akti, Kerem; Sapci, Melek Kekul; Altuntas, Emine ElifArticle Effects of Left and Bilateral Transcutaneous Auricular Vagus Nerve Stimulation on Pain, Mood, and Autonomic Nervous System in Female Patients With Fibromyalgia: a Randomized Controlled Trial(Taylor & Francis Inc, 2025) Akkurt, Mustafa Ferit; Ozden, Ali Veysel; Akkurt, Halil Ekrem; Akkurt, Burcu; Bildik, CelaleddinIntroduction: Fibromyalgia Syndrome (FMS) is a complex disease characterized by widespread pain, fatigue, emotional disturbances, and autonomic dysfunction. Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) has emerged as a potential noninvasive approach to modulate FMS-related symptoms. Purpose: To compare the effects of left and bilateral taVNS on pain, mood, functionality, and autonomic nervous system (ANS) activity in individuals with FMS. Methods: Forty female individuals with FMS were assigned to either a left (n = 20) or a bilateral (n = 20) taVNS group. Both received 11 sessions of taVNS targeting the tragus and concha regions (30 minutes each, 25 Hz, 300 mu s) over nonconsecutive days, excluding weekends and menstrual periods. Visual Analog Scale (VAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Fibromyalgia Impact Questionnaire (FIQ) were assessed. ANS activity was evaluated via heart rate variability (HRV). After 11 sessions of taVNS, a 2-week follow-up was performed. Results: No significant differences were observed between groups except for FIQ and BAI on day 28 (p = .002-0.008). Both groups showed significant within-group improvements in VAS (r = 0.87-0.94; p < .001), BDI (r = 0.46-0.71; p < .001), FIQ (r = 0.95-0.99; p < .001), and BAI (r = 0.69-0.94; p < .001) scores. Parasympathetic Nervous System (PNS) (p = .365-0.776) and Sympathetic Nervous System (SNS) (p = .598-0.880) indices, which are the subparameters of HRV, showed no significant between-group differences, with small effect sizes (r < 0.15). Conclusion: Both stimulation protocols effectively reduced pain and improved mood and functionality in fibromyalgia, indicating a safe, noninvasive adjunctive treatment option. Clinicaltrials.gov: (Identifier: NCT06871306).Article Unraveling the Potential of Stem Cell Therapy in Motor Neuron Disease: A Narrative Review(Bentham Science Publ, 2025) Essa, Syed Muhammad; Khosa, Noor Ahmed; Kakar, Amanullah; Ozturk, Basar; Ibrahim, Ismail A.; Haq, NomanMotor neuron disorders (MNDs), including ALS, are deadly neurodegenerative conditions that cause progressive motor neuron degeneration. With neuroprotection and the potential for neuron regeneration employing MSCs, ESCs, iPSCs, and NSCs, stem cell treatment presents a viable alternative to current medicines, which only control a limited number of symptoms. Following PRISMA criteria, this narrative review methodically screened 1248 records from the Cochrane, Web of Science, PubMed, and Scopus databases. Following a thorough screening process, 22 studies, including preclinical models and 19 clinical trials, were analysed to assess the therapeutic mechanisms, safety, and efficacy of stem cell therapies for MNDs. Mesenchymal stem cell (MSC) therapy has shown a promising safety profile and possible therapeutic efficacy in ALS, with no substantial transplant-related toxicity noted. ALS functional rating scale-revised (ALSFRS-R) scores and forced vital capacity (FVC) assessments from clinical trials, such as those evaluating autologous bone marrow-derived MSCs, demonstrated stabilisation in ALS development. Studies have also emphasised as to how immunomodulation and neurotrophic factors play a part in MSC-based therapies. Recent data indicate that repeated intrathecal MSC injection could extend the duration of therapeutic advantages. Clinical trials have shown safety and early efficacy signals for motor neurons produced from embryonic stem cells (ESCs), especially using AstroRx (R). This suggests that ESCs could be a viable option for regenerative medicine. Nonetheless, issues, like host integration and differentiation optimisation, still exist. Although clinical translation is still in its early stages, induced pluripotent stem cells (iPSCs) and their derivatives provide disease modelling and patient-specific therapeutic applications. Stem cell therapy holds promise for treating MND, with MSCs leading the way in current trials. It is necessary to enhance ESC- and iPSC-based techniques to tackle integration issues. To ensure long-term safety and efficacy, therapies must be developed using standardised protocols, patient stratification, optimised delivery, and large-scale studies.Article The Therapeutic Role of Ginseng in Promoting Hippocampal Neurogenesis and Ameliorating Cognitive Function Following Whole Brain Radiotherapy in Rats(Springer/Plenum Publishers, 2025) Sahin, Sevim; Bayindir, Nihan; Ertas, Busra; Ceylan, Cemile; Elibol, Birsen; Ozkan, Alper; Sener, GokselWhole-brain radiotherapy (WBRT) is a prevalent technique for managing multiple intracranial metastases, however, the cognitive damage in long-term survivors due to WBTR is a critical concern that impacts patients' quality of life. Panax ginseng, a bioactive compound recognized for its neuroprotective benefits, also enhances cognitive functions, including memory and learning. This study aims to examine the potential protective effects of Panax ginseng supplementation on cognitive dysfunction and the levels of neurogenesis-related proteins in the hippocampus of rats that underwent WBRT, which was delivered as 3 fractions of 6 Gy (total dose 18 Gy) using a linear accelerator. Thirty-six male Sprague-Dawley rats were divided into three groups: radiation, ginseng treatment, and control. After 60 days of Panax ginseng administration (100 mg/kg), behavior tests (Morris water maze and novel object recognition) were performed, followed by western blot analysis of the hippocampus. Results indicated that Panax ginseng supplementation ameliorated radiation-induced cognitive impairments. Additionally, western blot analyses revealed that Panax ginseng promoted neuronal recovery and neuroplasticity processes in the hippocampus, simultaneously exhibiting a neuroprotective mechanism by reducing apoptosis and neurotoxicity markers. Panax ginseng ameliorates cognitive dysfunction after WBRT by enhancing neurogenesis and diminishing cell death in the hippocampus.Article Effects of an Adapted Dance Exercise Program on Trunk Control, Balance and Functional Mobility in Children and Adolescents with Cerebral Palsy: Randomized Controlled Study(Taylor & Francis inc, 2025) Yekdaneh, Asena; Arman, NilayAims: The study aimed to investigate whether an 8-week adapted dance exercise program (ADEP), delivered in addition to conventional physiotherapy, would improve trunk control, balance, functional mobility, and quality of life (QoL) in children and adolescents with cerebral palsy (CP) compared with conventional physiotherapy alone. Methods: Thirty participants with CP (Gross Motor Function Classification System Level I - II) were randomly assigned to the ADEP group (n = 15) or the control group (n = 15). Both groups received conventional physiotherapy, while the ADEP group additionally performed physiotherapist-choreographed dance exercises accompanied by music, twice a week for 8 weeks. Outcomes included the Trunk Control Measurement Scale (TCMS) for trunk control, the Pediatric Balance Scale (PBS) for balance, the Timed Up and Go (TUG) for functional mobility, and the Pediatric Outcomes Data Collection Instrument (PODCI) for QoL. Results: The ADEP group showed significantly greater improvements than the control group in TCMS-Total (Delta = 10.53 vs 3.50, p < .001), TCMS-selective motor control (Delta = 6.00 vs 1.42, p < .001), TCMS-dynamic sitting balance (Delta = 7.53 vs 2.28, p < .001), and PODCI-Global scores (Delta = 4.61 vs -1.71, p < .001). Both groups improved in PBS and TUG, but between-group differences were not significant. Effect sizes indicated large improvements in trunk control in favor of the ADEP group. Conclusions: An 8-week ADEP program, when combined with conventional physiotherapy, produced clinically meaningful gains in trunk control and QoL in children and adolescents with CP. These findings support the use of dance-based rehabilitation as a feasible and engaging adjunct to physiotherapy.Article Citation - Scopus: 1Detection of Candida (Candidozyma) Auris by Molecular Methods and Investigation of Clinical Symptoms of Patients in a Tertiary Hospital in Istanbul(K Faisal Spec Hosp Res Centre, 2025) Akkaya, Yuksel; Erdin, Begum Nalca; Aydin, Irfan; Ozel, Ayse Serra; Yilmaz, Ahmet Munir; Cilkiz, Mustafa; Toraman, Zulal AsciBACKGROUND: Candidozyma auris is resistant to many antifungals, spreads rapidly and causes deaths in patient groups with comorbid factors. OBJECTIVES: The aim of this study was to determine the virulence of C. auris, antifungal resistance genes and clinical characteristics of the patients. DESIGN: Retrospective cohort SETTING: Single-center MATERIAL AND METHODS: This study was conducted between August 2022 and December 2023 at & Uuml;mraniye Training and Research Hospital. ITS1-5.8S-ITS2 and ITS1-ITS4 gene regions of the rDNA gene of C. auris isolates identified by VITEK MS v.3.2 were amplified by polymerase chain reaction (PCR) method. These regions were partially sequenced using the Sanger method. The presence of C. aurisspecific CDR1, ERG11, MDR1, ACT1, SAP5, HYR3, ALS5, IFF4, FUR1, PLB3, PGA26 and PGA52 gene regions were determined by PCR. Antifungal susceptibility testing of C. auris was performed with VITEK 2 Compact AST YS08 and SYO. MAIN OUTCOME MEASURES: Variations in C. auris isolates, antifungal resistance and clinical characteristics of patients SAMPLE SIZE: Forty-four isolates from 31 patients RESULTS: According to gene regions, nine different variations were identified in our hospital, with VAR-1 being the most common. Twenty-five (80.6%) of the patients died and isolation of the causative agent was between days 1-30 in 13 (41.9%) patients. Antibiotic use, ICU admission rate, and central venous catheter use in patients were 29 (93.6%), 28 (90.3%), and 21 (67.7%), respectively. Hypertension, diabetes mellitus (DM) and septic shock were found in 14 (45.2%), 13 (41.9%) and 10 (32.3%) patients, respectively. Antifungal resistance rates of the isolates were determined as 97.7% and 84.1% for amphotericin B and fluconazole, respectively. No resistance to micafungin and caspofungin was detected. The survival rate with echinocandin use was 22% (4 patients). CONCLUSION: Identification of gene regions is valuable in determining the pathogenicity of C. auris. . Due to the presence of comorbidi- ties in patients with C. auris, , it is not possible to determine the exact proportion of deaths attributable to C. auris alone. LIMITATIONS: Single center setting; gene regions could not be ex- pressed.Article Protective Effect of Artichoke (Cynara scolymus L.) Leaf and Receptaculum Extracts Against Hepatic Encephalopathy in Bile Duct Ligated Rats(Springer/Plenum Publishers, 2025) Kam, Ozkan; Bebitoglu, Berna Terzioglu; Sener, Goksel; Oguz, Elif; Erdogan, Nurettin Fatih; Kilickap, Andac; Hatiboglu, NebileHepatic encephalopathy (HE), complication of liver dysfunction, leads to neurocognitive impairments. Artichoke (Cynara scolymus L.) has been traditionally used for its antioxidant, anti-inflammatory and hepatoprotective properties. This study evaluates artichoke leaf and receptaculum extracts in cholestasis and HE in a rat model. Wistar rats were divided into 6 groups: sham-control, bile duct ligation (BDL), and BDL with low/high-dose leaf or receptaculum extracts. After BDL, physiological saline and extracts (250/500 mg/kg) were administered orally for 28 days. Cognitive activity was evaluated using Morris water maze and novel object recognition tests on day 28. Artichoke extract regulated liver enzymes and bilirubin at high-doses and significantly increased antioxidant enzyme activities reduced by BDL. Elevated 8-Hydroxyguanosine (8-OHdG) levels decreased in liver and brain tissues. Similarly, artichoke extracts reduced cytokine and hydroxyproline (HP) levels elevated by cholestasis. Following BDL, Na+/K+-ATPase levels in brain and liver tissues decreased, while artichoke extract reversed this. Artichoke, particularly high-dose receptaculum, improved impaired performance and increased time in the target quadrant after BDL. Both artichoke leaf and receptaculum extracts improved recognition. Artichoke treatments, especially high-dose receptaculum, reduced hepatic and neuronal damage and improved histological appearance. These findings highlight the therapeutic potential of artichoke extracts for liver fibrosis and related neurocognitive disorders.Article Effect of Progressive Muscle Relaxation on Postoperative Pain in Laparoscopic Living Kidney Donors: A Randomized Controlled Trial(BMC, 2025) Akinci, NaileAim This study aimed to evaluate the effect of progressive muscle relaxation on postoperative pain in laparoscopic living kidney donors. Design This was a randomized controlled, single-blind trial. This study was conducted in accordance with the CONSORT statement. Methods This study was conducted between January and September 2023 and included 62 patients (study group = 31, control group = 31) who met the inclusion criteria and underwent laparoscopic living donor nephrectomy in the transplant service of a private hospital in Istanbul province. A power analysis was performed to calculate the sample size and the power of the study (G*Power 3.1). Study data were collected using a patient information form, a postoperative patient follow-up and evaluation form to record the total number of bolus requests and administrations via of boluses with the PCA device and additional analgesic needs, and the Visual Analog Scale (VAS). The data obtained in the study were analyzed on the SPSS 22.0 statistical software. Results Additional analgesic requirements did not differ significantly between groups where progressive muscle relaxation exercises were applied and the VAS score and bolus requirement were significantly lower than in the control group (p < 0.05). Anxiety levels were also significantly reduced in the experimental group compared to both their pre-test scores and the control group (p < 0.05). Although the time to resume oral intake did not differ significantly between the groups (X-2 = 5.020; p = 0.170 > 0.05), the time to start mobilization was significantly earlier in the experimental group (X-2 = 8.808; p = 0.012 < 0.05). As a result of the study, it was found that progressive muscle relaxation exercises reduced postoperative pain, bolus requirements, and anxiety in patients undergoing living donor nephrectomy. Additionally, these exercises facilitated earlier mobilization following surgery.