Sirnak Merkez

Researchers are studying the impact of manual therapy combined with pelvic floor exercises on pelvic floor muscles in women aged 18 to 55 who experience constipation. The study aims to determine whether adding manual therapy to pelvic floor exercises affects constipation symptoms compared to pelvic floor exercises alone. The condition being studied includes constipation-related issues such as colonic inertia and dyschezia. Participants will be assigned to one of two groups. The first group will perform pelvic floor exercises including diaphragmatic breathing training, bridge exercises, 3-dimensional diaphragm exercises, and other movements aimed at improving intestinal motility and pelvic floor strength. The second group will do the same pelvic floor exercises plus receive manual therapy methods such as momentum minus mobilisation, sphincter opening, colon massage, global fascial manipulation, trigger point therapy, and myofascial release. Exercises will be done five days a week for six weeks, with manual therapy applied two days a week for the first two weeks and then once a week. Initial assessments and manual therapy sessions will be face-to-face, followed by online telerehabilitation for ongoing exercise. Throughout the study, participants will be advised on nutrition and proper toileting habits to support digestion. Researchers will assess participants before starting and after completing the six-week program using tests including the Constipation Quality of Life questionnaire. This will help evaluate any changes in constipation symptoms and pelvic floor function. Both groups will be monitored for adherence to the exercise program and therapy techniques, with results compared at the end of the study.

Researchers are evaluating a method called peripheral venous pressure (PVP) measurement to better guide diuretic therapy and predict long-term outcomes such as death, hospital readmission, and emergency visits in patients hospitalized with heart failure. This Phase 4 study aims to improve management of congestion in heart failure patients, who often leave the hospital with persistent fluid buildup, increasing the risk of complications. The trial includes adults aged 18 to 99 with new or worsening chronic heart failure, regardless of heart function or cause. Participants will be randomly assigned to receive diuretic treatment guided either by standard clinical evaluation or by PVP measurements taken through a peripheral intravenous line placed in the arm. The PVP group will target a pressure below 9 mmHg before discharge to guide fluid removal. Blood samples, heart tests including ECG and echocardiogram, and fluid balance assessments will be performed. Those who cannot have PVP measured or need advanced support like dialysis during hospital stay will be excluded from certain parts of the study. During the one-year follow-up, researchers will track major adverse events including death, hospitalizations, and emergency visits. They will also analyze correlations between PVP readings and outcomes, kidney function changes, length of hospital stay, and repeat admissions. Data will be collected electronically and analyzed to compare the effectiveness of PVP-guided therapy versus standard care in managing heart failure congestion.