Sivas Merkez

Laparoscopic cholecystectomy is the most common abdominal surgery for treating gallstones, and managing postoperative pain after this procedure is important. This research compares two nerve block techniques, the established transversus abdominis plane TAP block and the newer modified thoracoabdominal nerve block through perichondrial approach M-TAPA, to see which is more effective for pain relief after surgery. Participants receive either a bilateral M-TAPA block or a bilateral TAP block using 0.25% bupivacaine 40 ml total at the end of their laparoscopic cholecystectomy. Both blocks are guided by ultrasound and performed before surgery starts, with the same procedure applied to both sides of the body. The study randomly assigns patients to one of these two nerve block groups. During the study, patients pain levels will be measured using a numerical rating scale over the first 24 hours after surgery. Researchers will also track the amount of tramadol pain medication used in that period. Participants will be monitored closely to assess pain control and any side effects. The study runs until early 2025, aiming to improve pain management after gallbladder surgery.

Researchers are investigating autoinflammatory diseases AID, which involve recurring inflammatory episodes without infection, cancer, or adaptive immune system problems. This study focuses on both monogenic hereditary periodic syndromes and polygenic or multifactorial AID, including rare conditions like Behets disease, Still disease, Schnitzlers disease, PFAPA syndrome, chronic recurrent multifocal osteomyelitis, non-infectious uveitis and scleritis, among others. The goal is to gather detailed data to improve understanding and management of these rare diseases through an international collaboration. The study uses the AIDA registry, a secure online platform for collecting demographic, genetic, clinical, laboratory, radiologic, and therapeutic information. Data are gathered retrospectively and prospectively during routine clinical visits scheduled every 3-6 months. Eleven registries focus on different AID conditions, enabling comprehensive data collection to identify clinical patterns, treatment impacts, and long-term outcomes over a period of at least 10 years. Participants provide information during their usual care visits, allowing researchers to track changes in disease activity, organ involvement, inflammatory markers, visual function, pain levels, fatigue, fertility, and socioeconomic factors. The study monitors these outcomes over multiple timepoints up to 120 months. Data privacy is ensured by pseudonymizing patient information. This registry supports multiple clinical studies and aims to enhance knowledge, awareness, and future research on autoinflammatory diseases worldwide.

Researchers are investigating the success of caudal epidural block anesthesia in pediatric patients aged 1 to 6 years undergoing surgery on the lower abdomen, urogenital area, or lower extremities. This observational study aims to compare traditional methods like changes in mean arterial pressure and heart rate with a newer technique measuring Galvanic Skin Response GSR using a finger probe. The goal is to determine if GSR can detect block success more quickly and objectively than conventional methods. The study involves monitoring pediatric patients who receive caudal epidural blocks during surgery. After the block is performed, researchers will observe and evaluate the success of the anesthesia for 20 minutes. The GSR technique measures changes in skin electrical resistance related to the autonomic nervous system, which may reflect physical or emotional responses. This non-invasive method uses two probes attached to the fingertip to record skin tension changes. Participants will be closely observed during and after the block procedure, with continuous monitoring of vital signs and GSR readings. Researchers will assess how well the block works based on these measurements and compare the speed and objectivity of GSR against traditional evaluation methods. The study emphasizes safety and aims to improve anesthesia management in children by finding a faster, reliable way to confirm block success.

This research aims to compare two nerve block techniques, rhomboid intercostal plane block RIB and serratus posterior superior intercostal plane block SPSIPB, to find the best method for managing pain after video-assisted thoracoscopic surgeries VATS. Forty adult patients undergoing elective wedge resection or biopsy with ASA physical status I-III participated in this randomized, quadruple-masked trial to assess postoperative pain relief. Patients were randomly assigned to receive either the RIB or SPSIPB block after surgery but before extubation. Both blocks involved ultrasound-guided injections of 30 mL of 0.25% bupivacaine in specific muscle planes near the ribs on one side of the chest. In addition, all patients received postoperative pain medications including intravenous paracetamol, dexketoprofen, and tramadol via patient-controlled analgesia. These treatments aimed to relieve pain in the surgical area. Participants were monitored closely for 24 hours after surgery. Pain levels were measured at rest and during movement using the Numerical Rating Score at multiple time points starting once patients reached a certain recovery state. Total tramadol use, side effects like nausea or itching, and the need for extra pain medication were also recorded. The main focus was on pain scores, with tramadol consumption as a secondary measure. This detailed follow-up helped evaluate which block provided better postoperative pain control.

Researchers are evaluating a novel rapid diagnostic device designed to detect Crimean-Congo Hemorrhagic Fever CCHF at the point of care in secondary health care clinics in Turkey. This study aims to determine the sensitivity and specificity of the test using samples of whole blood, serum, and capillary blood from adults suspected of CCHF infection. The goal is to meet or exceed the World Health Organizations minimum sensitivity of 90% and specificity of 80% for this condition. The study involves using a rapid diagnostic test RDT developed by the Liverpool School of Tropical Medicine and Global Access Diagnostics. This device detects CCHF viral antigens quicklyproviding results within 20 minutesand is simpler and more affordable than the standard RT-PCR test. Participants suspected of infection will have blood drawn and tested with the RDT at four endemic secondary health care sites in Turkey. Participants will provide blood samples which will be compared against PCR testing to evaluate the accuracy of the new device. The study will also collect questionnaires from end users to assess usability. Researchers will measure diagnostic sensitivity, specificity, predictive values, test accuracy, and the time taken to obtain results. The study includes follow-up until all diagnostic results and questionnaires are received, which may take up to a month after the last participant is recruited.

Researchers are comparing two types of nerve block techniques, the Deep Iliacus Plane Block DIPB and the Suprainguinal Fascia Iliaca Block SIFIB, to manage pain after primary total hip arthroplasty surgery. The goal is to find out which method provides better pain relief with fewer side effects like motor weakness. This clinical trial is randomized, double-blind, and controlled, involving patients under spinal anesthesia undergoing hip replacement. Seventy patients will be randomly assigned to receive either DIPB or SIFIB at the end of their surgery. Both procedures involve ultrasound-guided injections of 0.25% bupivacaine 30-40 mL adjusted by weight for postoperative pain control. The SIFIB targets mainly the femoral and lateral femoral cutaneous nerves but may miss deeper joint nerves, while DIPB aims to cover both superficial and deep nerves with potentially less motor impairment. Participants will be monitored for 48 hours after surgery, with pain levels measured at rest and during movement at specific times up to 48 hours. Opioid use, motor block severity using the modified Bromage scale, and any complications related to the blocks will also be recorded. This study assesses pain intensity, opioid consumption, motor block, and other outcomes to determine the best approach for safe and effective pain management after hip arthroplasty.

Knee osteoarthritis OA is a common degenerative joint disease that causes cartilage deterioration, joint pain, stiffness, swelling, and muscle weakness, mainly affecting weight-bearing joints. This condition often leads to disability and reduced daily function. Researchers are investigating whether adding core stabilization exercises to routine knee muscle exercises can improve symptoms and functional ability in women with knee osteoarthritis. The study compares two groups of female participants with knee OA. One group receives 10 days of conventional physiotherapy including hot packs, TENS, and ultrasound, followed by 6 weeks of routine knee exercises plus 6 weeks of core stabilization exercises performed three times a week. The other group receives the same physiotherapy and knee exercises without the core stabilization. The core exercises focus on strengthening deep abdominal and trunk muscles through specific movements like bridges, planks, and modified sit-ups. Participants will be assessed at the start and after 6 weeks using tests such as sit-ups, modified push-ups, and core endurance measures to evaluate muscle strength and function. Additional assessments include the 30-second sit-to-stand test, the Western Ontario and McMaster Universities Osteoarthritis Index WOMAC for symptoms, and a single-leg balance test. The study monitors changes in clinical symptoms and functional capacity to understand the effects of the exercise programs.

Researchers are evaluating two techniques, TPR traction-pressure-release and Z-track, to see which is better at reducing pain and medication leakage during intramuscular injections in the ventrogluteal muscle. This randomized, triple-blind clinical trial focuses on patients aged 16 to 40 who are prescribed diclofenac sodium. The study aims to find a more comfortable injection method that could improve patient adherence to treatment. Participants will receive intramuscular injections using both the TPR and Z-track methods, each applied to randomly assigned ventrogluteal muscles. The TPR technique involves applying deep pressure to the muscle and quickly releasing it while the needle is inserted at a 90-degree angle, creating a snapping motion. The Z-track method involves pulling the skin laterally before needle insertion, injecting, and then releasing the skin immediately after. During the study, pain will be measured with a Visual Analog Scale within five minutes after injection, and drug leakage will be observed immediately after injection using millimetric paper and a ruler. All injections are administered by the same nurse, and assessments are done by blinded evaluators. The trial runs from June 2025 to August 2025, and participants will be monitored closely for pain and leakage outcomes to determine the more effective technique.

This research aims to study side effects related to medications prescribed in a periodontology clinic, focusing on their frequency, cause, severity, and impact on patients oral health quality of life. It highlights that although antibiotics, analgesics, and antiseptics are commonly used to treat periodontal diseases, their side effects can reduce patient compliance and safety. The study recognizes limitations of current drug safety databases, which often rely on feedback that may not reflect the true clinical impact of these side effects. Participants who have received at least one prescribed medication in a periodontology clinic will be observed over an 18-month period. The study will use questionnaires to classify side effects by cause using the Naranjo algorithm, assess severity with the Hartwig-Siegel scale, and measure the effects on oral health quality of life via the OHIP-14 questionnaire. This systematic, patient-centered approach aims to deliver objective and standardized data on medication-related side effects. Participants will provide information through questionnaires during the follow-up period. Researchers will evaluate side effect causality, severity, and quality of life impact at 12 months. The study focuses on collecting real-life data to better understand these side effects beyond existing databases. Participation involves completing assessments that help researchers measure these outcomes and contribute to improved safety knowledge in periodontology medication use.

Researchers are studying patients with latent Hepatitis B virus HBV infection who require immunosuppressive therapy and antiviral prophylaxis. The study aims to monitor long-term effects on bone, kidney, and metabolic health associated with oral antiviral treatment and other health factors. This multicenter, prospective research hopes to improve understanding of the safety and management of HBV prophylaxis in immunocompromised patients. Participants will include those starting HBV antiviral prophylaxis under immunosuppressive treatment. The study will follow patients for four years, collecting data at multiple time points including baseline, and weeks 6, 12, 24, and 48. Assessments will include bone density scans, kidney function tests, metabolic profiles, and liver evaluations to analyze organ health during antiviral use. Throughout the study, patients will attend scheduled visits for comprehensive monitoring of their bone, kidney, metabolic, and liver status. Data will be recorded in a centralized system to ensure accurate tracking. The main outcomes measured are kidney function, bone health, and metabolic status over the first year, with additional liver assessments. Participation includes regular testing and follow-up to understand long-term effects of antiviral therapy.