Mugla Merkez

Researchers are evaluating AZD0780, an oral PCSK9 inhibitor, in a phase 3, randomized, placebo-controlled study. This trial focuses on patients with established atherosclerotic cardiovascular disease ASCVD or those at high risk for a first ASCVD event. The study aims to assess how AZD0780 compares to placebo in reducing the risk of major adverse cardiovascular events, also known as MACE-PLUS, over the course of the trial. Participants are randomly assigned to receive either oral AZD0780 once daily or a matching placebo once daily. The study continues until a primary analysis censoring date, which may be up to approximately 54 months from randomization. After this, a study closure visit will be conducted as the final visit for each participant. During the study, participants will be regularly monitored for cardiovascular events including heart attacks, strokes, urgent coronary revascularizations, and other related outcomes. Researchers will track the time to first occurrence of these events as the primary outcome. Safety and other secondary outcomes like all-cause mortality will also be assessed. The total participation time can last up to about 54 months, with ongoing evaluations throughout this period.

Elderly patients undergoing transurethral resection face a higher risk of developing postoperative cognitive dysfunction POCD and delirium, which can lead to longer hospital stays, more complications, and a lower quality of life. This observational study aims to find perioperative factors linked to POCD and delirium in patients aged 65 and older and to create a risk prediction model to help identify those at greater risk. Cognitive function and delirium are measured using the Montreal Cognitive Assessment MoCA and the Confusion Assessment Method CAM. Participants aged 65 years and above scheduled for transurethral resection will be followed before, during, and after surgery. Baseline information such as demographics, frailty, comorbidities, and cognitive status will be collected. During surgery, details about anesthesia, procedure length, and intraoperative events will be recorded. After surgery, cognitive function and delirium will be assessed on postoperative days 1, 2, and 3 using MoCA and CAM to monitor changes. Throughout the study, participants will undergo repeated cognitive and delirium assessments to identify factors independently associated with POCD and delirium. The research team will develop and evaluate a predictive risk model using statistical methods. The study may help clinicians recognize vulnerable patients earlier and support more personalized perioperative care. The total study duration spans from baseline assessment before surgery through postoperative day 3, with final analysis expected by November 2026.

Researchers are investigating the possible link between hemorrhoids and coughing by studying patients who visit a general surgery outpatient clinic with symptoms such as bleeding, pain, itching, fecal leakage, prolapse, and mucus discharge. The study aims to determine if coughing is a contributing factor to hemorrhoids by assessing cough symptoms, including their presence, duration, and frequency, in patients diagnosed with hemorrhoidal disease. This prospective, observational study will gather detailed information on cough severity, comorbid chest diseases, and smoking history among these patients. Patients diagnosed with hemorrhoidal disease will be examined and graded based on mucosal prolapse according to the Goligher classification. Evaluations will include physical exams, height and weight measurements, and questionnaires such as the Leicester Cough Questionnaire and the Cough Visual Analog Scale. Cough duration will be categorized as acute or chronic, and additional data will be collected on chest diseases and smoking status. Patients with cough will be referred for further chest disease evaluation. Participants will provide demographic and clinical information, including cough and hemorrhoid symptoms, comorbidities, and lifestyle factors. The study will measure the relationship between hemorrhoid severity and cough characteristics, along with chest disease presence and smoking history. Data will be collected between March and June 2025, and the primary outcome will focus on cough severity as measured by the Leicester Cough Questionnaire.

Researchers are investigating postoperative pain management in women undergoing vNOTES Vaginal Natural Orifice Transluminal Endoscopic Surgery hysterectomy, a minimally invasive gynecologic surgery that combines endoscopic visualization with a scarless vaginal approach. Although vNOTES uses lower pressure pneumoperitoneum than traditional laparoscopy and offers benefits like less pain and faster recovery, post-laparoscopic pain syndrome PLPS remains a challenge. This trial aims to assess whether adding an intraperitoneal saline washout to low-pressure vNOTES further reduces pain and analgesic use after surgery. The study compares two groups of women scheduled for elective total hysterectomy using low-pressure vNOTES at 8 mmHg pneumoperitoneum. One group receives only the low-pressure vNOTES procedure, while the other group also receives a warm saline washout 25 mLkg at 370C at the end of surgery to wash out residual carbon dioxide and acidic metabolites. Additional surgeries like salpingectomy or oophorectomy may be performed as needed during the procedure. Participants will be followed to measure pain levels using the Visual Analogue Scale VAS 24 hours after surgery as the primary outcome. Researchers will monitor analgesic consumption and recovery progress, with all participants providing informed consent and able to complete pain and recovery questionnaires. The study uses a randomized, triple-masked design to compare outcomes and is sponsored by Erzincan Military Hospital.

Researchers are studying the effects of Reiki and self-acupressure on functionality and quality of life in people with multiple sclerosis. Reiki is a complementary energy practice involving gentle hand placement on key body areas to promote energy flow, which has been shown to help with symptoms like pain, depression, insomnia, and fatigue. This randomized controlled trial aims to compare Reiki, self-acupressure, and no intervention groups to understand their impact on multiple sclerosis symptoms and daily functioning. Participants will be divided into three groups one receiving Reiki treatments, one practicing self-acupressure, and a control group with no intervention. Reiki treatments involve the practitioner holding their hands on various body points for 3-5 minutes, possibly extended to 10-20 minutes for problematic areas, with sessions lasting 30-90 minutes. Self-acupressure is a self-administered technique, while the control group does not receive any specific treatment. During the study, participants will be assessed over four weeks using tools measuring quality of life and functional abilities related to multiple sclerosis. Researchers will monitor changes in symptoms and overall well-being. The trial includes safety monitoring and excludes those with certain health conditions or recent treatments that could affect results. The total participation period is at least four weeks, during which participants will be observed and evaluated regularly.

Researchers are evaluating the use of a pain diary to assess early postoperative pain in patients undergoing elective laparoscopic cholecystectomy. This randomized controlled trial compares a pain diary group to a control group receiving routine pain assessment using the Visual Analog Scale VAS. The study aims to improve patient involvement in pain evaluation without adding new pain medications. Patients are randomly assigned to one of two groups. The intervention group uses a patient-completed pain diary introduced before surgery to record pain intensity at rest and during movement at specific times after surgery. The control group receives standard care with pain assessed by nurses and researchers using VAS at the same postoperative times. Both groups follow a pain management protocol tailored for laparoscopic cholecystectomy and are cared for in separate hospital rooms to prevent mix-up. Participants will have their pain intensity measured at nine time points within the first 48 hours after surgery 2, 4, 6, 12, 16, 20, 24, 32, and 48 hours. Additional pain assessments are done during this period. The study includes evaluations of pain intensity using standardized tools, and outcomes compare the pain diary with routine assessment methods. Safety and study adherence will be monitored throughout the hospital stay, which is expected to be at least 24 hours after surgery.

Researchers are evaluating the effect of remote ischemic preconditioning RIPC on protecting the heart muscle during coronary artery bypass graft CABG surgery in patients with type 2 diabetes mellitus. This clinical trial addresses the concern of heart muscle injury during CABG, which is especially significant in high-risk diabetic patients. RIPC is a low-cost, non-invasive method that may help reduce heart damage by increasing tolerance to reduced blood flow through brief, repeated cycles of limb blood flow restriction. Participants will be randomly assigned to one of two groups one group will receive RIPC before the surgery, which involves inflating a blood pressure cuff on the upper arm to 200 mmHg for 5 minutes followed by 5 minutes of deflation, repeated five times before the chest is opened. The other group will receive standard care without RIPC. This procedure is done under general anesthesia and is designed to keep participants unaware of their group assignment. During the study, researchers will monitor heart injury by measuring high-sensitivity troponin T levels at 24, 48, and 72 hours after surgery. They will also assess other outcomes such as acute kidney injury within 72 hours, the maximum dose of heart support medications used during the first 72 hours, and the length of stay in the intensive care unit and hospital up to 60 days. Participants will be closely observed through these assessments to understand the potential heart-protective role of RIPC in diabetic patients undergoing cardiac surgery.

Researchers are investigating whether Alpha-1 Antitrypsin Deficiency AATD, a genetic condition that reduces a protective protein in the lungs, is more common in people who experience shortness of breath and show airway obstruction on breathing tests. This condition can lead to lung diseases like emphysema, especially in smokers. The study aims to better detect AATD in patients with breathing difficulties to improve diagnosis and treatment options. This is a prospective, case-control study involving patients visiting a pulmonary outpatient clinic for shortness of breath who undergo routine spirometry. Participants are divided into two groups based on lung function results those with airway obstruction and those without. Blood samples are collected to measure AAT protein levels and test for common genetic mutations linked to AATD. Laboratory staff analyzing these samples will not know the participants group assignments. Participants will have their breathing assessed by spirometry and their symptom severity recorded using a standardized scale. Smoking history is collected as well. Blood samples for AAT levels come from routine blood draws, while genetic testing uses a finger-prick sample. Data will be carefully recorded and analyzed to explore the relationship between AATD, airway obstruction, and symptoms. The study continues until early 2026, with results expected to help identify undiagnosed cases and guide future care.

Researchers are evaluating the effects of balcinrenone combined with dapagliflozin compared to dapagliflozin alone in patients who have chronic heart failure, impaired kidney function, and have recently experienced a heart failure event. This Phase III study is conducted internationally across about 700 sites and aims to assess how these treatments impact cardiovascular death and heart failure events. Participants will be randomly assigned to one of three groups balcinrenonedapagliflozin 15 mg10 mg plus placebo, balcinrenonedapagliflozin 40 mg10 mg plus placebo, or dapagliflozin 10 mg plus placebo. Each participant will take one capsule and one tablet daily. The study duration averages 22 months, including screening, about 20 months of blinded treatment, and a one-month follow-up with open-label dapagliflozin. During the study, participants will undergo assessments for heart failure events, hospitalizations, and cardiovascular death. Researchers will monitor these outcomes over about 38 months, including symptom scores and other health measures. Safety and treatment effects will be followed during the treatment and the one-month post-treatment period.

Researchers are studying patients diagnosed with subacromial impingement syndrome, a common cause of shoulder pain. The study focuses on understanding how shoulder functional tests relate to ultrasound measurements. Patients are selected based on clinical evaluations like Neers test, Hawkins Kennedy, and supraspinatus palpation test, with age limits between 18 and 70 years. The study is observational and conducted at a Physical Medicine and Rehabilitation outpatient clinic. Participants will undergo diagnostic evaluations where demographic data is collected, and shoulder function is assessed using DASH and Constant Murley scores. A radiologist with four years of musculoskeletal ultrasound experience will measure subacromial bursa thickness, supraspinatus tendon thickness, acromiohumeral distance, and the ratio of tendon thickness to acromiohumeral distance using a Siemens V8 ultrasound device in a specific arm position. During the study visit, patients will have their demographic information recorded and complete the functional scores. Ultrasound measurements will be taken to assess shoulder structures. Researchers will analyze these data to evaluate the relationship between functional test results and ultrasound parameters. The main outcomes measured on the study day include subacromial bursa thickness, supraspinatus tendon thickness, and acromiohumeral distance.