International Journal of Current Medical and Biological Sciences

The No-reflow Phenomenon in Acute Coronary Syndromes: A Comprensive Review

Zafer Kucuksu — 2026-03-28

Invasive interventions have long been widely used in acute coronary syndromes. Effective reperfusion of the ischemic myocardium should be the primary strategy in patients with acute coronary syndrome. Successful reperfusion is strongly associated with improved clinical outcomes. Conversely, inadequate reperfusion is associated with increased mortality and cardiovascular events in the subsequent period. In some patients, mechanical opening of the coronary arteries is insufficient. Restoring epicardial blood flow does not always ensure microvascular circulation and tissue perfusion. In this microcirculation disorder, called the "no-reflow" phenomenon, there is no mechanical occlusion in the coronary artery, but there is significant myocardial perfusion impairment.

Predictors of In-Hospital Mortality in Infective Endocarditis: A Retrospective Cohort Analysis

Seda Altıner — 2026-03-28

Background: Infective endocarditis (IE) remains a disease of high morbidity and mortality. The epidemiological profile has shifted, with fewer rheumatic cases but more healthcare-associated and prosthetic valve infections. Management remains complex, particularly regarding the role of antithrombotic therapies. We evaluated clinical features, microbiology, and predictors of in-hospital mortality among adult IE patients, focusing on anti-platelet therapy.

Materials and Methods We retrospectively reviewed 122 adult patients diagnosed with definite or possible IE at a tertiary University Hospital between 2000-2013 according to modified Duke criteria. Data on demographics, comorbidities, predisposing factors, clinical presentation, laboratory and echocardiographic findings, microbiology, antithrombotic use, surgical management, and outcomes were extracted. Univariable and multivariable analyses were performed to identify predictors of in-hospital mortality. Results: Results: The mean age was 52.5 ± 14.2 years; 63.1% were male. Rheumatic fever was present in 35.2%, prosthetic valves in 34.4%, and intracardiac devices in 7.4%. The most frequent pathogen was Staphylococcus aureus (25.5%), followed by streptococci (16.3%). Culture-negative endocarditis accounted for 33.3% of cases. The overall in-hospital mortality was 26.2%. Non-survivors were significantly older (57.4 vs. 50.8 years) and had shorter duration of symptoms before admission (<15 days). Multivariable regression showed worsening echocardiographic findings (OR 5.44, p=0.026) and pre-existing antiplatelet therapy (aspirin OR 2.64, p=0.021; other antiplatelets OR 3.95, p=0.015) as the strongest independent predictors of death. Conclusions: This study highlights shifting epidemiology in Turkey with increasing age, prosthetic/device-associated cases, and a rising burden of S. aureus. Antiplatelet use was independently associated with increased mortality.

Brainstem Alteration in Migraine via 3D Volume Segmentation

Gamze Taskın Senol — 2026-03-28

Background: Migraine is a multifaceted and complex disease that can be described as a mild headache or as a very severe headache lasting for days. It is a very common neurological disease in the society. Although migraine has a well-defined phenotype, some gaps in its pathophysiology can be partly filled by neuroimaging studies.

Materials and Methods: In this context, the present study aims to measure and compare the brainstem volumes of both patients diagnosed with migraine and healthy individuals by using 3D volume segmentation method. Brainstem volumes of 98 individuals between the ages of 18 and 50 who did not have any diseases or pathologies and who were diagnosed with migraine were calculated with ITK-SNAP software and the results found were compared with the brainstem volumes of healthy individuals.

Results: Analyses showed a significant difference between migraine patients and healthy individuals in terms of brainstem volume. Brainstem volume of healthy individuals were found to be significantly higher than those of migraine patients.

Conclusions: The present study clearly showed the difference between brainstem volume of migraine patients and healthy individuals and also showed that this difference is statistically significant.

Scientific Accuracy and Reliability Analysis of YouTube Videos on Exosome Therapy: Content and Quality Assessment

Tugba Guler Sonmez — 2026-03-28

Background

This study aimed to assess the accuracy, reliability, and quality of YouTube videos on exosome therapy and their consistency with current scientific evidence and clinical guidelines.

Materials and Methods

This study utilized a descriptive cross-sectional design and systematically examined YouTube content related to “exosome therapy.” A total of 100 videos were initially identified, of which 58 met the inclusion criteria. Each video was categorized by source, content type, and audience engagement indicators, while quality evaluation was independently performed by two reviewers using the DISCERN and JAMA benchmark tools. Statistical analyses were applied to assess group differences and correlations between variables, ensuring methodological rigor and reproducibility.

Results

Among 58 analyzed videos, most were uploaded by physicians (53.4%) or health organizations (39.7%) and mainly offered general educational content. Videos from physicians scored higher on DISCERN and JAMA criteria than those from patients (p = 0.032). A moderate positive correlation existed between video duration and quality (ρ = 0.356, p = 0.007), while popularity metrics such as views or likes showed no significant association with reliability.

Conclusion

The quality of YouTube content on exosome therapy varies considerably. Videos from physicians and health organizations are generally more accurate, yet gaps remain in transparency and disclosure. These results emphasize the need for collaboration among healthcare professionals, academics, and platform managers to provide reliable and transparent health information. Improved regulation, quality content creation, and user education may help reduce misinformation and support informed decision-making.

Effectiveness of intratympanic steroid application in long-term tinnitus cases

Mehmet Akdag — 2026-03-28

Objective: To investigate the efficacy of intratympanic steroid injection in cases of tinnitus not responding to long-term treatment

Materials and methods: The study was performed in 98 patients (62 males, 36 females) with idiopathic subjective tinnitus aged between 21 and 86 years. Patients received a total of four intratympanic steroid injections three days apart. Tinnitus rating index and audiologic tests were performed before treatment and two weeks after completion of the study protocol.

Results: The mean duration of tinnitus was 4.79± 5.54 years. There was a statistically significant decrease in the mean tinnitus degree index after intratympanic steroid injection in both men and women (p<0.05). When the tinnitus degree and tinnitus duration measured before and after intratympanic steroid injection were analyzed, it was found that the difference in the index of early treated cases was significantly higher (p<0.05). When the pure tone mean thresholds of the patients before and after intratympanic steroid treatment were compared, it was observed that intratympanic steroid treatment was not significantly different in the right and left ears (p>0.05).

Conclusion: According to the results of this study, intratympanic methylprednisolone may be an effective treatment to reduce tinnitus severity, especially in tinnitus with a relatively short duration.

Socio-demographic and clinical characteristics of migraine patients and the effect of treatment on their quality of life

Tomris Albay — 2026-03-28

Background:
Migraine is a common neurological disorder that negatively affects quality of life and daily functioning. This study aimed to evaluate the demographic characteristics, clinical features, triggering factors, and treatment response of patients with migraine.

Materials and Methods:
A total of 152 migraine patients (136 females, 16 males), aged between 15 and 55 years, who presented to the Neurology Outpatient Clinic of Kocaeli University Faculty of Medicine, were prospectively evaluated. The diagnosis of migraine was made according to the International Headache Society (IHS) criteria. Findings were statistically analysed in relation to age, gender, and migraine type.

Results:
The mean age of the patients was 36.7 ± 10.0 years. Migraine was three times more frequent in females, and 54.6% of patients had a positive family history. Headache was unilateral in 63.2% and throbbing in 96.1% of cases; 40% had migraine with aura. The most common accompanying symptoms were photophobia (91.4%), phonophobia (92.8%), and nausea (90.8%). Stress (72.4%) was identified as the most frequent triggering factor. After treatment, a significant reduction in attack severity, frequency, and functional impairment was observed (p < 0.01).

Conclusion:
Migraine occurs most frequently between the ages of 20 and 40 and is more common in women. Positive family history, stress, and hormonal factors play important roles in its pathogenesis. Both prophylactic and acute treatments significantly reduced migraine-related symptoms and functional impairment.

Keywords: Migraine: Clinical and Demographic Characteristics, Symptoms, Triggering Factors, Treatment Effectiveness.