Clinical trials

This randomized controlled trial will investigate the effects of connective tissue massage on insomnia severity, objective and subjective sleep outcomes, and stress- and autonomic-related biomarkers in adults with chronic insomnia. Chronic insomnia is a common sleep disorder characterized by persistent difficulties in initiating or maintaining sleep and is associated with impaired daytime functioning, reduced cognitive performance, and diminished quality of life. Non-pharmacological interventions may provide a safe alternative or complementary approach for individuals with chronic insomnia. A total of 74 adults diagnosed with chronic insomnia by a neurologist and who have not used sleep medication during the previous four weeks will be enrolled. Participants will be randomly allocated to either a connective tissue massage group or a control group. The intervention group will receive 12 sessions of connective tissue massage over a four-week period, with three sessions per week, in addition to sleep hygiene education. The control group will receive sleep hygiene education alone. Assessments will be performed at baseline and immediately after the four-week intervention period. The primary outcome will be the change in insomnia severity, assessed using the Insomnia Severity Index. Secondary outcomes will include objective sleep parameters recorded by actigraphy over five consecutive days, including total sleep time, sleep efficiency, sleep onset latency, and wake after sleep onset. Blood biomarkers associated with hypothalamic-pituitary-adrenal axis activity and autonomic regulation, including cortisol, DHEA-S, alpha-amylase, and oxytocin, will also be assessed. Subjective sleep quality and sleep hygiene will be evaluated using the Pittsburgh Sleep Quality Index and Sleep Hygiene Index, respectively. Adherence to sleep hygiene recommendations will additionally be assessed using sleep diaries. The study aims to determine whether connective tissue massage combined with sleep hygiene education is more effective than sleep hygiene education alone in reducing insomnia severity and improving objective and subjective sleep outcomes and selected physiological biomarkers in adults with chronic insomnia.

Chronic spontaneous urticaria (CSU) is a chronic inflammatory skin disease that can substantially impair quality of life in children and adolescents. Pharmacological treatment may not adequately control symptoms in all patients, increasing interest in dietary interventions. This randomized controlled trial aims to compare the effects of a Mediterranean diet and a low-histamine diet, in addition to standard medical treatment, on disease activity, disease control, and quality of life in pediatric patients aged 12-18 years with chronic spontaneous urticaria. Participants will be allocated to one of three groups: standard treatment alone, standard treatment plus a low-histamine diet, or standard treatment plus a Mediterranean diet. The dietary intervention will last four weeks, with follow-up through eight weeks.

The aim of this study is to evaluate and compare the levels of bone resorption (RANKL, OPG) and oxidative stress (Nitrotyrosine, NQO1) markers, along with pro-inflammatory cytokines (IL-1β), in the saliva and peri-implant sulcular fluid (PISF) of patients with peri-implantitis, periodontitis, and healthy individuals. The study seeks to determine the diagnostic value of these biomarkers in the early detection and progression of peri-implant diseases.

Periodontal disease is a chronic inflammatory condition that affects the tissues supporting the teeth and may contribute to systemic inflammation and oxidative stress. Increasing evidence suggests that maternal inflammation during pregnancy may be associated with adverse pregnancy outcomes, including preterm birth. However, the biological mechanisms linking maternal periodontal inflammation to the intrauterine environment remain unclear. This prospective observational cohort study aims to investigate the relationship between maternal periodontal status and inflammatory and oxidative stress biomarkers measured in both saliva and amniotic fluid. Eighty healthy pregnant women between 28 and 32 weeks of gestation will be recruited from the Obstetrics and Gynecology Clinic of Gulhane Training and Research Hospital. Participants will undergo a comprehensive periodontal examination and provide unstimulated saliva samples. Amniotic fluid samples will be collected during delivery as part of routine obstetric care, without any additional invasive procedures. The concentrations of 8-hydroxy-2'-deoxyguanosine (8-OHdG), malondialdehyde (MDA), interleukin-6 (IL-6), and matrix metalloproteinase-8 (MMP-8) will be measured in saliva and amniotic fluid using enzyme-linked immunosorbent assay (ELISA). Pregnancy outcomes, including gestational age at delivery, birth weight, and pregnancy complications, will also be recorded. The study will evaluate whether maternal periodontal inflammation is associated with changes in inflammatory and oxidative stress biomarkers in saliva and amniotic fluid and whether these biomarkers are related to pregnancy outcomes. The findings may improve understanding of the biological relationship between oral health and pregnancy and may contribute to the identification of biomarkers associated with adverse pregnancy outcomes.

Interoception refers to the process of perceiving and interpreting internal physiological signals and plays a central role in symptom perception. In conditions with a high symptom burden such as chronic obstructive pulmonary disease (COPD), clinical features including dyspnea perception, depression, and sleep quality may be influenced not only by disease severity but also by the interpretation of internal bodily signals. Recent evidence suggests that respiratory-related internal signals are transmitted to the central nervous system through multiple afferent pathways and integrated within cortical and subcortical networks, contributing to subjective experiences such as dyspnea. In this context, dyspnea perception may arise from the interaction between disease severity and interoceptive processes. Depressive symptoms and impaired sleep quality are also closely associated with interoceptive processes and may contribute to the perception of respiratory symptoms. However, studies simultaneously examining interoception, disease severity, dyspnea perception, depression, and sleep quality in hospitalized patients with acute COPD exacerbation are limited. This prospective, observational, cross-sectional study will include 50 individuals aged 40 years and older who are hospitalized with acute COPD exacerbation in a Chest Diseases clinic. Data will be collected at a single time point when patients are clinically stable, without interfering with routine clinical care. Participants will be recruited using a consecutive sampling method. Sociodemographic and clinical data will be obtained from patient records and a structured data collection form. Disease severity will be assessed using oxygen requirement, respiratory rate, oxygen saturation, and arterial blood gas values when available. Interoception will be evaluated using the Multidimensional Assessment of Interoceptive Awareness (MAIA-2). Symptom burden will be assessed with the COPD Assessment Test (CAT), dyspnea with the Modified Medical Research Council (mMRC) scale, sleep quality with the Richards-Campbell Sleep Questionnaire (RCSQ), and depressive symptoms with the Hospital Anxiety and Depression Scale - Depression subscale (HADS-D). Statistical analyses will be performed using IBM SPSS Statistics software. Relationships between variables will be analyzed using Pearson or Spearman correlation depending on data distribution, with a significance level of p\<0.05.

The aim of this study is to compare the effects of tele-rehabilitation-based synchronous and asynchronous dual-task upper extremity training with clinical based dual-task upper extremity training and conventional single-task upper extremity training in patients with Parkinson's disease. The main questions it aims to answer are: * Whether there are differences in motor symptoms, hand dexterity, upper extremity functions, grip strength, executive functions, daily living activities, and treatment satisfaction between tele-rehabilitation-based synchronous and asynchronous dual-task upper extremity training, clinical-based dual-task upper extremity training, and conventional single-task upper extremity training in patients with Parkinson's disease. * Whether there is a difference in telemedicine satisfaction between tele-rehabilitation-based synchronous and asynchronous dual-task upper extremity training in patients with Parkinson's disease. Researchers will compare conventional single-task upper extremity training, clinical-based dual-task upper extremity training, tele-rehabilitation-based synchronous upper extremity training and tele-rehabilitation-based asynchronous upper extremity training. Participants will: * Receive upper extremity exercise training at the study clinic or home, twice a week for approximately 60 minutes each time, for 6 weeks. * Participate in assessments at the study clinic before and after exercise training.

Purpose: This study aims to evaluate the effects of an educational digital escape room game-based Psychological First Aid (PFA) training on the PFA self-efficacy and problem-solving levels of undergraduate midwifery students. Methods: The study will be conducted as a randomized controlled trial with a pretest, posttest, and follow-up design at the Health Sciences University (SBU), Hamidiye Faculty of Health Sciences, Department of Midwifery during the spring semester of the 2025-2026 academic year. Second-year midwifery students will be randomly assigned to either the intervention group or the control group using a stratified randomization method based on their Grade Point Average (GPA). Both groups will receive a standardized theoretical PFA training program. In addition to this training, the intervention group will participate in an interactive digital escape room game developed on the Genially platform, consisting of short web-based scenarios under 20 minutes. The control group will receive only the standard theoretical education. Data will be collected at baseline (Week 1), post-intervention (Week 3), and during follow-up phases using the Psychological First Aid Self-Efficacy Scale and the Problem Solving Inventory to compare the behavioral and educational outcomes between the two groups.

Our study aims to evaluate the effect of interprofessional simulation-based learning on teamwork attitudes among nursing and paramedic students during the patient handover process. The study sample consists of fourth-year (senior) students from the Gülhane Faculty of Nursing at the University of Health Sciences and second-year (senior) students from the Paramedic Program at the School of Health Professions. In this study, the intervention will be conducted in two phases: the preparation phase and the implementation phase.

The aim of this study is to compare the effectiveness of motor-motor dual-task training and cognitive-motor dual-task training in patients with Parkinson's disease.The main questions it aims to answer are: \- Whether there is a difference between motor-motor dual-task training and cognitive-motor dual-task training in patients with Parkinson's disease in terms of their effects on motor symptoms, balance, gait, functional mobility, activities of daily living, dual-task activities, cognitive functions, and balance confidence. Researchers will compare single-task training, motor-motor dual task training and cogvitive-motor dual task training. Participants will: * Receive exercise training at the study clinic twice a week for approximately 45 minutes each time, for 6 weeks. * Participate in assessments at the study clinic before and after exercise training.

Breast milk is considered the most biologically appropriate source of nutrition, essential for the healthy growth and development of newborns. Thanks to its optimal nutrients, immunological factors, and growth regulators, it not only meets nutritional needs but also protects against infections, reducing neonatal morbidity and mortality rates. The Pecha Kucha presentation technique keeps presentations concise and dynamic, creating a fast-paced, light, and engaging experience. It minimizes distractions and maximizes engagement. Because there is no text to read in the Pecha Kucha technique, presenters are required to be more prepared and strive to create a coherent narrative, resulting in a flawless narrative. Thus, the aim is to ensure the success and effectiveness of breastfeeding education with this technique, and ultimately, to promote breastfeeding education using the Pecha Kucha technique to healthcare professionals. The population of this randomized, controlled experimental study consists of primiparous postpartum women who gave birth in the Obstetrics Department of the Physical Therapy Annex Building of the Gaziosmanpaşa Training and Research Hospital at the University of Health Sciences. A power analysis was conducted using the G\*Power package program, Version 3.1.9.4, to determine the sample size of the study. Because no similar research was found in the literature, Cohen's medium effect size was chosen as the effect size, anticipating that tests assessing the difference between two independent groups would be used when examining the differences in variables between the control and intervention groups. Accordingly, with 64 participants in the control group and 64 in the intervention group, a power of 80% was calculated at a significance level of 0.5 (medium) effect size and 0.05, and a minimum sample size of 128 was determined. The study, planned using an experimental design, is planned to be conducted on two groups: an intervention and a control group. Within the scope of the study, pretest data will be collected by administering the Breastfeeding Self-Efficacy Scale and the LATCH Breastfeeding Diagnostic and Assessment Scale, along with an introductory information form, to postpartum women who agree to participate in the study.

Postoperative pain following coronary artery bypass grafting (CABG) via median sternotomy remains a significant clinical problem and is associated with increased opioid consumption and postoperative complications. Fascial plane blocks have emerged as part of multimodal analgesia strategies in cardiac surgery. This prospective, randomized, controlled, single-blinded study aims to evaluate the effect of an induction-time multimodal fascial plane block package-consisting of bilateral superficial parasternal block, bilateral serratus anterior plane block, and adductor canal block-on postoperative analgesia, opioid consumption, and clinical outcomes in patients undergoing elective isolated CABG with saphenous vein graft harvesting. Patients will be randomized in a 1:1 ratio to receive either the multimodal fascial plane block package in addition to standard postoperative analgesia or standard postoperative analgesia alone. The primary outcome is total opioid consumption within the first 24 postoperative hours. Secondary outcomes include pain scores, time to first opioid requirement, extubation time, postoperative pulmonary complications, atrial fibrillation, and length of ICU and hospital stay.

The aim of this study is to evaluate the effects of a trauma-informed yoga intervention on psychological trauma symptoms, difficulties in emotion regulation, and interoceptive awareness in young adult women.

The aim of this study is to determine the effects of a prenatal yoga intervention on traumatic childbirth perception, self-perception, and delivery preferences in pregnant women.

To evaluate the frequency of allergy between 12 and 24 months of age in infants who were treated in the neonatal clinic and had NEC. To investigate the relationship between NEC development and the development of allergy in the later period.

This study will investigate the effect of high-level headphone sound exposure on cardiorespiratory responses and perceived exertion during a submaximal treadmill exercise test in young healthy individuals. Healthy volunteers aged 18 to 30 years will complete two exercise sessions under two different conditions: zero-sound and high-level sound exposure. Heart rate, oxygen saturation, blood pressure, and perceived exertion will be evaluated before, during, and after exercise.

This prospective observational clinical study aims to evaluate the three-dimensional surface wear and clinical survival of orthodontic attachments fabricated with customized composite materials used in clear aligner therapy. Attachments play a critical role in the biomechanical efficiency of aligner treatment by facilitating planned tooth movements. However, the mechanical and surface properties of the composites used for attachment fabrication may affect their wear behavior and long-term stability. In this study, four different composite materials will be tested using a split-mouth design in patients treated with clear aligners. Each quadrant will receive a different composite, including both customized and universal types. All attachments will be fabricated using standardized digital templates and bonded under identical clinical conditions. Surface wear will be evaluated using three-dimensional optical scanning and metrology software at baseline, 1 week, 1 month, 3 months, and 6 months. Lost attachments will be replaced and recorded but excluded from wear analysis. The results of this study are expected to provide valuable insights into the optimal material selection for clear aligner attachments, improving treatment accuracy and clinical durability.

This study aims to evaluate the effects of an Acceptance and Commitment Therapy (ACT)-based group therapy program, combined with an ACT-based mobile app, on emotional eating, emotion regulation, and psychological flexibility in overweight individuals. Emotional eating is a condition in which individuals frequently use eating behavior as a coping mechanism for negative emotions. Participants will be randomly assigned to intervention groups receiving ACT-based group therapy, ACT-based group therapy combined with an ACT-based mobile app, or a control group. The intervention will last six weeks and will include structured group sessions as well as mobile-based exercises, reminders, and coping strategies. Outcome measures will include emotional eating, emotion regulation, and psychological flexibility. Assessments will be conducted at baseline, post-intervention, and during the follow-up phase. The findings of this study are expected to contribute to the development of accessible and effective interventions for emotional eating.

The widespread use of electronic devices such as smartphones, tablets, and laptops has significantly increased screen exposure, especially before sleep. Prolonged screen use may contribute to poor posture by promoting forward head posture, rounded shoulders, and other musculoskeletal problems. In addition, screen exposure before sleep may negatively affect sleep quality and neuromuscular performance, which may in turn influence postural control and balance.

The study aims to examine the acute effects of balance exercises on balance performance in healthy individuals. It will be conducted with healthy males and females aged 18-25. The research is an experimental study with a single-blind pre-test/post-test design. Initially, participants' balance will be assessed using the Single Leg Stance Test. Then, a short balance exercise program lasting 8-10 minutes will be applied. Exercises include single-leg stance, eyes-closed balance, and unstable surface training. After the exercise, the same test will be repeated to evaluate changes. Perceived exertion will be measured using the Modified Borg Scale. The collected data will be analyzed using SPSS software. The results are expected to contribute to improving balance, performance, and reducing injury risk.

Laryngeal squamous cell carcinomas are head and neck malignancies that directly affect both swallowing and voice functions and are associated with a significant deterioration in patients' quality of life throughout the treatment process. The aim of this study is to evaluate quality of life, voice and swallowing functions, pain, anxiety-depression levels, and patient satisfaction at the pre-treatment period and at the 3rd, 6th, and 12th months post-treatment in patients with laryngeal malignancies, using validated questionnaires, in order to: Elucidate the course of functional recovery following treatment, Individualize rehabilitation and follow-up strategies, and Examine the relationship between functional outcomes and oncological survival.

This multicenter, cross-sectional survey study aims to evaluate the perceived level of safety and security against workplace violence among otolaryngology-head and neck surgery (ENT-HNS) physicians in Turkey. The study investigates the association between exposure to workplace violence and perceived safety, as well as the adequacy of institutional support mechanisms. Data will be collected through an anonymous online questionnaire distributed nationwide. The findings are expected to contribute to awareness and the development of preventive strategies and institutional safety policies for healthcare professionals.

This observational cross-sectional study aims to investigate the relationship between daily smartphone usage duration and hand function parameters in young adults. Specifically, the study will examine the association between smartphone screen time and dominant hand grip strength, thumb strength, and wrist and thumb proprioception. Healthy individuals aged 18-35 years will be included. All participants will undergo a single-session assessment including measurement of smartphone usage duration, hand grip strength, pinch strength, and joint position sense of the wrist and thumb. The findings are expected to provide insight into the potential effects of prolonged smartphone use on hand function and proprioceptive performance in young adults.

With the global aging trend, the management of geriatric risks faced by older adults and the effectiveness of health education for this population are gaining increasing importance. Literature indicates that health education for older adults, when delivered through methods that support individual engagement and the use of digital tools, yields more effective results in terms of learning and behavior change. This doctoral study aims to evaluate the effect of a digital education model, structured based on the Health Belief Model and developed using branching scenario animation technique, on geriatric risk knowledge level and frailty status among older adults residing in nursing homes. The study will be conducted as a randomized controlled trial in three nursing homes in Istanbul, with measurements at baseline (T0), immediately post-intervention (T1), 1-month follow-up (T2), and 3-month follow-up (T3). Based on power analysis, 66 participants will be randomly assigned to intervention and control groups (33 per group) using block randomization. The intervention group will receive scenario-based digital animation education developed on the Vyond platform and structured according to the theoretical components of the Health Belief Model. The control group will receive standard care during the study period and will be offered the same digital animation education after completion of all assessments (post 3-month follow-up). The primary outcome is geriatric risk knowledge level, assessed using an interactive digital game called "Knowledge Wheel." Secondary outcomes include frailty status, measured by the Edmonton Frail Scale, and technology acceptance. Changes in knowledge and frailty levels measured through assessment tools will reveal the short- and medium-term effects of the education. Thus, the model's impact on health-related behavior change in older adults will be comprehensively evaluated. The unique aspect of this study is that it will be one of the first experimental studies to implement an interactive scenario-based digital education model in older adults. The findings are expected to contribute to the development of age-friendly health education models.

This study was conducted to determine the effects of a manual vibration technique applied to the chest wall on the duration of chest tube placement, secretion clearance, and hemodynamic parameters in patients with chest tubes.

The goal of this clinical trial is to learn if a structured medication training program can help people with heart failure better manage their condition. The program is based on the Roy Adaptation Model and is designed to support how people adjust to their illness. The main questions it aims to answer are: Does the training program improve heart failure symptoms? Does the training program help participants take their medications as prescribed? Researchers will compare a training program group to a control group receiving standard care to see if the program is effective. Participants will: Be randomly assigned to either a training program group or a control group Receive the training program through WhatsApp after hospital discharge or receive standard discharge education Be followed for 12 weeks Complete questionnaires at the start of the study, at 4 weeks, and at 12 weeks