Sivas Merkez

Laparoscopic cholecystectomy is a common abdominal surgery used to treat gallstones and is considered the standard technique in developed countries. Managing postoperative pain after this surgery is complex due to factors like nerve irritation, abdominal distension, and individual patient differences. Researchers are comparing two regional analgesic methods, the Modified Thoracoabdominal Nerve Block Through Perichondrial Approach (M-TAPA) and the Transversus Abdominis Plane (TAP) block, to evaluate their effectiveness in controlling pain after laparoscopic cholecystectomy. The study involves two groups receiving either the M-TAPA or TAP block. Both blocks are performed after the patient is asleep but before surgery begins, using ultrasound guidance and sterile techniques. For M-TAPA, local anesthetic is injected beneath the costochondrium at the 9th to 10th rib level on both sides. For TAP block, anesthetic is injected between specific abdominal muscles at the mid-axillary line. Each procedure uses 40 ml of 0.25% bupivacaine divided equally on both sides with an ultrasound probe and needle. Participants will be assessed for pain levels 24 hours after surgery using a numerical rating scale. Researchers will monitor postoperative analgesia requirements and pain scores to compare the two nerve block techniques. The study includes adult patients aged 18 to 80 who undergo elective laparoscopic cholecystectomy under general anesthesia. Safety and cooperation during pain assessment are also monitored throughout the study.

This research aims to improve understanding of rare autoinflammatory diseases (AID), which cause repeated inflammatory episodes without infection or cancer. The study focuses on hereditary periodic syndromes (monogenic AID) caused by gene mutations, as well as related polygenic or multifactorial AID like Behcet's disease, Still disease, Schnitzler's disease, PFAPA syndrome, chronic recurrent multifocal osteomyelitis, non-infectious uveitis and scleritis, spondyloarthritis, and Castleman disease. The goal is to gather detailed clinical and therapeutic data to expand knowledge of these rare conditions, which are often difficult to diagnose outside specialized centers. Participants will be enrolled in the AIDA international registry, which uses a secure online platform to collect retrospective and prospective information. Data collected include demographics, genetics, clinical features, laboratory and radiologic results, treatments, and socioeconomic impact. The registry covers multiple specific AID types and will track patients over at least 10 years through routine clinical visits usually every 3-6 months. The platform supports data sharing and analysis to identify disease patterns, treatment responses, and long-term outcomes. During the study, patients' medical records will be regularly updated with clinical and laboratory data. Researchers will analyze changes in patient numbers and disease characteristics over time. The registry also aims to foster international collaboration, improve early diagnosis, assess quality of life and socioeconomic effects, and support future research and clinical trials. Patient data privacy is maintained by using pseudonyms and complying with data protection laws throughout the study.

Caudal epidural anesthesia is a regional anesthesia technique used since 1933, becoming more common in pediatric surgeries after the 1960s. This study focuses on evaluating the success of caudal epidural blocks in children undergoing surgery, aiming to find faster and more objective measures of block success. The research compares traditional methods like monitoring mean arterial pressure and heart rate with a newer method measuring Galvanic Skin Response (GSR) using a finger probe, which reflects changes in skin electrical resistance related to nervous system activity. The study involves pediatric patients aged 1 to 6 years who undergo lower abdominal, urogenital, or lower extremity surgeries with caudal epidural block anesthesia. GSR is measured non-invasively via probes on the fingertip to detect skin resistance changes during the procedure. After performing the caudal block, researchers will monitor the block's success for 20 minutes, comparing the GSR results with traditional indicators like heart rate and blood pressure. Participants in the study will have their vital signs and skin responses assessed throughout the procedure to determine anesthesia effectiveness. The primary outcome is to evaluate how well the block works by observing these measures shortly after administration. This approach aims to improve anesthesia management by offering a quicker and more objective way to confirm successful caudal epidural blocks in children.

This research aims to compare the rate of postoperative delirium in adults undergoing coronary artery bypass grafting (CABG) who receive either dexmedetomidine or midazolam during surgery. The study focuses on understanding which sedation method might influence the occurrence of delirium after surgery. Participants will be divided into two groups: one receiving an intravenous dexmedetomidine infusion at a dose of 0.3-0.7 µg/kg/h, and the other receiving an intravenous midazolam infusion at a dose of 0.03-0.06 mg/kg/h. Both infusions are given following the induction of standard general anesthesia during the operation. During the surgery, researchers will record demographic data and monitor heart rate, blood pressure, oxygen levels, brain activity, and cerebral oxygenation at set times. They will also track carbon dioxide levels, surgery duration, recovery time, and ICU stay length. The main outcome measured is delirium within 24 hours after surgery, assessed using a standardized delirium evaluation method.

Researchers are evaluating the effectiveness of two regional anesthesia techniques, the Deep Iliacus Plane Block (DIPB) and the Suprainguinal Fascia Iliaca Block (SIFIB), for managing pain after primary total hip arthroplasty. The study focuses on improving postoperative pain control to support early movement, reduce complications, and enhance recovery. It is a randomized, double-blind clinical trial enrolling 70 patients undergoing elective hip replacement under spinal anesthesia. Participants will be randomly assigned to receive either the DIPB or SIFIB block at the end of surgery. Both procedures use ultrasound guidance to deliver 0.25% bupivacaine (30-40 mL, adjusted by weight) to specific areas near the hip to provide pain relief. DIPB targets the deep surface of the iliacus muscle to block nerves supplying both the deep joint capsule and skin, while SIFIB primarily blocks superficial nerves. The study compares these blocks to see if DIPB offers better pain relief with less motor weakness. During the 48 hours after surgery, patients will have their pain levels measured at rest and during movement using a numeric scale at set times. Researchers will track opioid use, motor function using a standardized scale, and any side effects or complications related to the nerve blocks. The goal is to assess which block provides more effective and safer pain control to improve recovery after hip surgery.

Osteoarthritis (OA) is a common chronic joint disease that mainly affects weight-bearing joints, causing cartilage, synovial membrane, and joint capsule deterioration. People with knee OA often experience weakness in trunk and surrounding muscles, which increases joint load and contributes to disease progression. This research explores how adding core stabilization exercises to usual knee muscle exercise programs influences symptoms and functional ability in women with knee osteoarthritis. Participants receive conventional physiotherapy treatments including hot packs, TENS, ultrasound, and routine knee strengthening exercises for 10 days in a hospital setting. Afterward, they continue routine knee exercises for an additional four weeks. In addition, one group performs core stabilization exercises three times a week for six weeks, involving activities like abdominal curls, bridges, planks, and other movements designed to activate deep abdominal and trunk muscles. During the study, researchers measure outcomes such as sit-ups, modified push-ups, and core endurance at the start and after six weeks to assess improvements in strength and function. The study focuses on women aged 40 to 65 with moderate knee osteoarthritis, monitoring clinical symptoms and functional capacity. The total participation duration includes the initial 10-day treatment plus six weeks of exercise follow-up.

Researchers are evaluating two techniques, TPR (traction-pressure-release) and Z-track, for delivering intramuscular injections in the ventrogluteal area to reduce pain and medication leakage. This triple-blind, randomized clinical trial involves patients aged 16 to 40 who are prescribed diclofenac sodium. The study aims to find a more effective and comfortable injection method to improve patient experience and treatment adherence. Participants will receive intramuscular injections using both TPR and Z-track methods in randomly assigned ventrogluteal muscles. The Z-track technique involves pulling the skin laterally before needle insertion, while the TPR method applies deep pressure to the muscle during injection followed by a rapid release to aid medication delivery. All injections are given by the same nurse to ensure consistency. During the study, pain will be measured shortly after each injection using a visual analog scale, and medication leakage will be assessed with millimeter paper and a ruler. Blinded assessors will evaluate outcomes to maintain objectivity. The trial includes 76 patients and will help determine which technique better minimizes pain and leakage during intramuscular injections.

This research aims to evaluate how internal jugular vein catheterization affects intracranial pressure in intubated patients in the intensive care unit by measuring the optic nerve sheath diameter. The study focuses on adults who are on mechanical ventilation support and monitored in the ICU. It seeks to understand changes in intracranial pressure during and after the catheterization procedure. Participants will undergo internal jugular vein catheterization as the main procedure. Before the catheter insertion, baseline optic nerve sheath diameter (ONSD) measurements will be taken in both the supine and Trendelenburg positions (15 degrees head down). Immediately after catheter insertion, measurements will be taken again while still in the Trendelenburg position, followed by additional measurements at 5, 15, and 30 minutes after returning to the supine position. Ultrasound with a linear probe will be used to perform the transorbital ONSD measurements gently on the eyelids without applying pressure to the eyes. Throughout the study, optic nerve sheath diameter will be measured vertically in both eyes, and the average will be recorded. These measurements will help assess changes in intracranial pressure related to the catheterization. The total participation involves monitoring and measuring ONSD before and at several time points after the catheter placement, providing detailed data on intracranial pressure changes in this critical care setting.

Researchers are evaluating how combining core stabilization exercises with a 360-degree breathing technique affects balance and proprioception in adults aged 18 to 65 who have had non-specific low back pain for more than 12 weeks. Non-specific low back pain is a common condition that can impact balance and daily function. This study aims to explore whether adding breathing exercises to core workouts can provide additional benefits compared to core exercises alone. Participants will be randomly assigned to one of two groups. One group will perform core stabilization exercises such as pelvic tilt, bridge, dead bug, bird dog, mini squats on a balance board, and wall planks five days a week for three weeks. Repetitions and plank duration will progressively increase, with warm-up and cool-down included. The other group will perform the same core exercises combined with a novel 360-degree breathing technique designed to promote deep and controlled inhalations throughout the lungs, also five days a week for three weeks. Throughout the study, participants will be assessed for changes in proprioception and balance using specific tests like the Y Balance Test after three weeks of training. Researchers will monitor improvements related to trunk stability and balance mechanisms. This single-blind randomized controlled trial will help determine the acute effects of combining breathing exercises with core stabilization on individuals with non-specific low back pain.

Stroke is a condition that causes symptoms like weakness on one side of the body, speech problems, vision issues, and difficulties with balance and coordination due to disrupted blood flow in the brain. Treatments often focus on motor learning, neural plasticity, and motor control principles. Task-Oriented Training (TOT), commonly used in physiotherapy for neurological diseases, has shown benefits mainly for balance and walking, but its effects on upper limb function have been less studied. Task-Oriented Circuit Training (TOCT) is a specific program involving 15 exercise stations designed to improve upper limb skills and has been effective in Parkinson's disease, but its impact on stroke patients is not yet known. This study aims to explore how TOCT affects upper extremity motor functions and dual-task performance in people who have had a stroke. This is a randomized controlled study where participants will be divided into two groups: one group will receive TOCT along with standard physiotherapy and occupational therapy exercises, and the other group will receive only the standard exercises. The TOCT group will complete 18 one-on-one training sessions, three times per week for six weeks, involving daily life activities such as reaching, grasping, writing, and manual tasks. Both groups will continue receiving exercises aimed at improving balance, walking, and upper limb function. Participants will be assessed before and immediately after the interventions on measures including manual dexterity, finger and hand function, upper extremity coordination and function, and grip strength. The study will evaluate disease severity, disability, and manual dexterity to understand the impact of TOCT. The total participation period includes these assessments and the six-week treatment phase.