WoS İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6
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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 Investigation of the Susceptibility Rates to Ceftazidime-Avibactam and Colistin, Clonal Relationships, and Clinical Data of Patients with Carbapenem-Resistant Klebsiella Pneumoniae Isolates Detected in the ICUs of a Hospital in İstanbul(K Faisal Special Hospital Research Centre, 2026) Akkaya, Yuksel; Aydin, Irfan; Harmankaya, Sebile; Karakul, Mehmet; Aydin, Mehtap; Erdin, Begum Nalca; Kilic, Ibrahim Halil; Karakuş, MehmetBACKGROUND: The increase in carbapenem-resistant K. pneumoniae (CR-Kp) in intensive care units (ICUs) causes treatment difficulties and increases risk in mortality. OBJECTIVES: The aim of this study was to investigate the susceptibility rates of CR-Kp isolates obtained from ICUs to ceftazidime-avibactam (CAZ-AVI) and colistin, carbapenem resistance genes, clonal relationships and clinical characteristics of the patients. DESIGN: Retrospective cohort SETTING: Single-center, University of Health Sciences, & Uuml;mraniye Training and Research Hospital MATERIALS AND METHODS: This study was conducted between June 2023 and December 2024. Isolates were identified using VITEK MS v.3.2, and antibiotic susceptibility testing was performed using the VITEK 2 Compact system. CAZ-AVI susceptibility was determined using disk diffusion, and colistin susceptibility was determined using broth microdilution to determine minimum inhibitory concentration (MIC) values. Carbapenem resistance genes were determined using multiplex real-time polymerase chain reaction (RT-PCR) and clonal relationship arbitrarily primed-polymerase chain reaction (AP-PCR). MAIN OUTCOME MEASURES: Resistance genes of CR-Kp isolates, clonal relationships, CAZ-AVI and colistin resistance, and clinical characteristics of patients SAMPLE SIZE: Ninety-seven isolates from 76 patients RESULTS: Among patients with CR-Kp isolates, central venous catheter use was detected in 59 cases (78%), ventilator-associated pneumonia in 44 cases (58%), and bacteremia in 39 cases (51%), respectively. It was determined that 53 of the patients (70%) died. Using the AP-PCR method, 60 different genotypes were identified among 97 isolates, and clustering was determined in 42 of the isolates (46%). It was determined that 36 (37%) of the isolates were resistant to colistin and 42 (45%) were resistant to CAZ-AVI. NDM+OXA-48, OXA-48, KPC, KPC+NDM, and NDM genes were detected in 40 (43%), 32 (35%), 10 (11%), 2 (2%), and 3 (3%) isolates, respectively. It was determined that 30 (75%) of the isolates with NDM+OXA-48 and only 4 (12%) of the isolates with OXA-48 were resistant to CAZ-AVI. CONCLUSION: In addition to OXA-48, an increase in the frequency of CR-Kp isolates containing the NDM, NDM+OXA-48, KPC+NDM, and OXA-48+KPC genes were also detected. It was also determined that resistance to colistin and CAZ-AVI is increasing. The AP-PCR method can also be used to investigate infections. LIMITATIONS: Single center,Pulsed Field Gel Electrophoresis (PFGE) could not be performed together with AP-PCRArticle Does Localization Change Management in Complicated Right and Left-Sided Diverticulitis(Baishideng Publishing Group Inc, 2025) Acar, Turan; Sur, Yunus; Acar, Nihan; Tekindal, Mustafa Agah; Dilek, Osman NuriBACKGROUND Distribution of the colonic diverticula differs in different populations, and right-sided colon diverticulitis (RCD) and left-sided colon diverticulitis (LCD) manifest distinct clinical features. Complicated diverticulitis (CD) mostly requires hospitalization and can be treated within a spectrum from observation to surgery. Treatment choice is formed depending on the patient's general condition, the presence of diffuse peritonitis, the localization of diverticulitis, Hinchey stage, and responsiveness to the prior treatment. Clinical disparities regarding right and LCD also led to the differences in the incidences of both emergency surgery and future elective surgery. AIM To evaluate the clinical features of CD, display the differences according to colonic localizations, and present treatment approaches. METHODS This was a retrospective study from a single centre analysing data from a prospective database. The 253 patients with history of hospitalization for CD were included and divided into two groups: RCD and LCD. To compare the differences between the two groups, the Student's t-test was used when the parametric test prerequisites were fulfilled, and the Mann-Whitney U test was used when such requirements were not fulfilled. RESULTS The 208 (82.2%) patients were found to have LCD, and 45 (17.8%) had RCD. The majority of the patients had Hinchey 1A diverticulitis (49.8%). Male gender was significantly more common in patients who underwent surgery for LCD. While persistent abdominal pain was the main prior finding in the conservative treatment of both localizations, surgery was most performed due to abscess in RCD and perforation in LCD. The presence of an accompanying malignancy during colonoscopy was significantly more common in LCD cases who underwent surgery. Hartmann's procedure was the most performed technique in emergency settings (56.3%), while laparoscopic colectomy with anastomosis was in elective settings (53.9%). In addition, surgery was found to prolong the mean length of hospital stay in LCD patients. CONCLUSION Although diverticulitis is a benign condition, the need for an individualized and evidence-based approach makes management challenging. Localization of the disease has an important role in determining the appropriate treatment.Article 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 Citation - WoS: 1Safety and Efficacy of Depatuxizumab Mafodotin Monotherapy or in Combination With Temozolomide in Patients With/Without EGFR-Amplified Recurrent Glioblastoma: A Systematic Review(Lippincott Williams & Wilkins, 2025) Moghib, Khaled; Hassan, Malak A.; Eljadid, Ghaith Y.; Salomon, Izere; Algazar, Mansour A.; Abu Arafeh, Muhannad Wael; Ibrahim, Ismail A.This study aimed to assess the safety and efficacy of depatuxizumab mafodotin as a monotherapy or in combination with temozolomide in patients with recurrent epidermal growth factor receptor (EGFR)-amplified glioblastoma multiforme, focusing on overall survival (OS) and progression-free survival (PFS). A comprehensive literature search was conducted across PubMed, Cochrane Library, Web of Science, and Scopus databases up to August 2024. Randomized controlled trials (RCTs) and observational studies were included, comparing depatuxizumab mafodotin alone or with temozolomide in patients with and without EGFR amplification. Data extraction encompassed participant demographics, treatment regimens, and clinical outcomes. Of 102 screened publications, 10 RCTs and cohort studies involving 1431 patients met the inclusion criteria. The included studies examined depatuxizumab mafodotin as a standalone therapy and in combination with other agents, revealing OS ranging from 5 to 14 months and considerable variability in PFS. While depatuxizumab mafodotin shows the potential to improve survival outcomes, the heterogeneity in results highlights the need for further research. Future studies should refine patient selection criteria and explore alternative therapeutic combinations, such as depatuxizumab mafodotin with gemcitabine or cisplatin, to optimize treatment strategies.Article Ultrasound Measurements of Pelvic Floor and Diaphragm Muscles in Chronic Obstructive Pulmonary Disease Patients With Urinary Incontinence(Springer London Ltd, 2025) Balaban, Mehtap; Dusgun, Elif Sena; Nur, Hifziye Pervin; Lalecan, Nida; Sertcelik, Umran Ozden; Celenay, Seyda Toprak; Ozden Sertcelik, Umran; Toprak Celenay, SeydaBackgroundThe precise manner in which morphological properties of pelvic floor muscles (PFMs) and diaphragm muscle in Chronic Obstructive Pulmonary Disease (COPD) patients with Urinary Incontinence (UI) are affected remains unclear.AimThis study aimed to compare the ultrasound measurements of PFMs and diaphragm muscle in COPD patients with and without UI.MethodsThirty COPD patients with UI [UI group, age: 61.00 (42.00-70.00) years, body mass index: 27.86 (20.20-54.69) kg/m2] and thirty COPD patients without UI [N-UI group, age: 64.00 (47.00-70.00) years, body mass index: 27.11 (20.30-35.94) kg/m2] were included. The PFMs contaction assessment and diaphragm muscle morphological properties were evaluated using the Logiq S7/Expert ultrasound device. The percentage of change in thickness of diaphragm muscle, known as the diaphragm thickening fraction index (DTFI), was also calculated.ResultsIt was found that the PFMs contraction (p = 0.018) and DTFI (p = 0.016) values were significantly lower in the UI group compared to the N-UI group. No significant differences were observed in the diaphragm thickness score during the inspiration (p = 0.973) and expiration (p = 0.233) between the groups.ConclusionsPatients with COPD and UI exhibited diminished the PFMs contaction severity and DTFI compared to those with COPD but no UI. It should be considered that UI comorbidity in COPD may negatively affect PFMs contaction severity and diaphragm muscle morphological properties.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.