Global Climate Report. NOAA National Centers for Environmental Information (http://www.ncdc.noaa.gov). July 2019.

It’s summer, and it is hot out there; but if it feels like record-breaking temperatures are becoming more common globally, they are. The National Oceanic and Atmospheric Administration and European Copernicus Climate Change Service announced that July 2019 was the hottest month across the globe ever measured since measurements began, in 1880. Global temperatures averaged 16.73°C in July, which is 0.95 °C higher than the 20th-century average of 15.78°C . Average Antarctic sea-ice coverage was 8.5% below the 1981-2010 average. And sea ice coverage was 10.5% below the overall average, which is based on records beginning in 1979. The scientists also released geographical data, showing that the regions where temperatures varied furthest from averages, were Alaska, Central Europe, Northern and Southwestern parts of Asia, and certain regions in Africa and Australia. These findings corroborate scientific predictions regarding the effects of man-made climate change. Human activities, primarily from burning fossil fuels, emit carbon dioxide and other greenhouse gases that trap heat in the atmosphere. Increasing greenhouse gas emissions are associated with warmer global surface temperatures. The planet’s 10 hottest years on record have all fallen in the past two decades. Scientists and policymakers around the globe are also feeling this heat.

Unless significant measures to curb greenhouse gas emissions are adopted, scientists expect temperature records to keep falling. Scientists say global temperatures could increase by at least 3°C this century, which will create conditions on Earth that have not been seen in more than 2 million years. Given the notable trends in higher temperatures and natural disasters, we might be pushing the climate system toward states that we haven’t seen in our societal experience – and even in our species’ experience.

Manipulation of brain circuits using smartphone-controlled device

Qazi R et al. Wireless optofluidic brain probes for chronic neuropharmacology and photostimulation. Nature Biomedical Engineering, August 2019.

Scientists recently designed a device that can regulate brain circuits using a tiny brain implant controlled by a smartphone. This bluetooth-enabled device utilizes replaceable lego-like drug cartridges to target neurons with drugs and light. Existing methods to deliver drugs and light to the brain typically involve metal tubes and optical fibers. These tools are rigid and can substantially damage the brain’s soft tissue over time. Moreover, this bulky equipment often limits the patient’s movement because of the wired connections, making them unfit for long-term use. To achieve chronic remote-controlled drug delivery without exhaustion and evaporation of drugs, scientists invented a neural device with a replaceable drug cartridge, which could allow neuroscientists to study the same brain networks for several months without depleting the drug supply. These “plug-n-play” drug cartridges were integrated into a brain implant for mice with a soft and ultrathin probe (about the thickness of a human hair), which consisted of microfluidic channels and tiny LEDs (smaller than a grain of salt), for unlimited drug doses and light delivery. The implant is regulated via a smartphone, allowing researchers to trigger precise combinations and sequences of drug and light delivery. In animal models, these stimuli can be triggered with the target outside of the laboratory, allowing researchers to wirelessly instill changes in the animal’s brain while in its natural habitat. Using these neural devices, researchers are now able to perform fully automated animal studies where the behavior of one animal could positively or negatively affect behavior in other animals by conditional triggering of light and/or drug delivery. This device will allow researchers to better dissect the neural circuit basis of behavior and how specific neuromodulators in the brain tune behavior in various ways. In addition, the device can be utilized in complex pharmacological studies to develop potentially new therapeutics for pain, addiction, and emotional disorders.

The secret weapon of E.Coli 

Melson E. at al. The sRNA DicF integrates oxygen sensing to enhance enterohemorrhagic Escherichia colivirulence via distinctive RNA control mechanisms. Proceedings of the National Academy of Sciences, June 2019.

Scientists have revealed how E. coli (Escherichia coli) bacteria seeks out the most oxygen-free parts of your colon to cause the worst infection possible. E. coli normally live in the intestines of healthy people and animals. Most varieties of E. coli are harmless or cause relatively brief diarrhea. But a few particularly nasty strains can cause cramps, diarrhea, vomiting – even kidney failure and death. Children are particularly at risk. A new study uncovers how this foodborne pathogen knows where and when to begin colonizing the colon on its way to making you sick. Bacterial pathogens typically colonize a specific tissue or organ in the host. Therefore, as part of their infection strategies, bacterial pathogens precisely time deployment of proteins and toxins to these specific colonization niches in the human host. This allows the pathogens to save energy and avoid detection by our immune systems and ultimately cause disease. The researchers in this study identified how E.Coli detects low oxygen levels in the large intestine and then produces proteins that allow it to attach to host cells and establish infection. Oxygen actually diffuses from the intestinal tissue into the gut, and there are comparably higher levels in the small intestine than the large. Remarkably, E. coli specifically waits until it has reached the-low oxygen large intestine before striking. E. coli controls this process via a small form of RNA that activates particular genes when oxygen levels are low. This is the point when the infection really gets established and the bacteria are able to begin to manufacture harmful Shiga toxins. The researchers predict that other bacterial pathogens, such as Shigella and Salmonella, likely utilize a similar control mechanism. Researchers suggest that if we can find a way to block oxygen sensing, we may be able to prevent the infection by allowing E. coli to pass harmlessly through the body.

The fascinating aspect of these materials stems from the fact that when certain particles or devices are manufactured on the nanometer size region by means of special chemical and physical methods, they start showing distinct properties dependent on size, shape, and elemental compositions (such as huge amount of light absorption/emission, plasmonic resonance, high surface area, ability to convert light into heat, desirable magnetic properties, etc). Each of these features have found many applications in technology and they provide superior properties when compared to conventional materials. This article will not cover each technology based on nanomaterials but rather focus on the medical aspects and applications of nanotechnology and the direction it is heading.

Nano-medicine is a novel branch of nanotechnology seeking to deliver medically relevant drugs and imaging agents to the desired sites of the body. Biomedical imaging and drug delivery fields are benefitting from nanotechnology to a greater extent because not only do nanomaterials provide unprecedented results in diagnosis and therapies, considerable amounts of incentives in the form of governmental and private funding also drive topnotch institutions and scientists to study these materials around globe. For instance, iron oxide—when designed and manufactured on the nanometer order—can compete with, if not replace, most of the commercial magnetic resonance imaging (MRI) contrast agents due to some of its attributes, (i.e., being much more sensitive) requiring a less amount compared to other contrast agents, non-toxic to humans, and easy to manipulate in terms of its chemistry (1). Nanometer-sized spherical and rod-shaped Cadmium/Tellerium/Lead sulfides and selenides, also known as “Quantum Dots,” can absorb and emit light from ultra-violet (UV) to infrared region (IR) and this phenomenon could be utilized to construct biomedical sensors capable of detecting biologically relevant species (such as blood glucose, tumor markers, hormones, and etc.) with great accuracy and speed (2). Even by using multiple colors emitting “Quantum Dots,” one can, in principle, detect more than one biological entity simultaneously. Furthermore, their superior emissive properties could be harnessed to develop sensitive and selective fluorescence imaging techniques and assays which can lead to simple and early diagnosis of diseases. Gold nanorods, if irradiated with IR lasers, can generate extreme local temperatures in the surrounding medium owing to “plasmonic resonance of surface electrons,” and this feature could be directed to killing of localized tumor tissues known as “Photothermal Theraphy” (3).

Another class of nanomaterial called liposomes (4) can actually mimic lipid bilayer of the cell membrane which gives rise to a protective layer around organelles and nucleus, and maintains the transport of ions and molecules in and out of the cell. Synthetic liposomes, strikingly, can accommodate various cargoes extending from drugs to imaging agents in their inner cavity and render controlled release of its cargo as it circulates in the body, thereby providing longer bio-availability.

One of the most alluring uses of nanoparticle formulations in cancer therapy is their dimension. Certain sizes of nanoparticles can permeate into tumoral sites and be retained in that region longer than small particles or molecules. This extraordinary feature of nanoparticles, called “enhanced permeability and retention effect” (5), was utilized with liposomes to deliver chemotherapeutics to cancerous tissues effectively in a slow and controlled manner. In addition, chemical malleability of nanoparticles give rise to smart formulations which could respond to external stimuli in drug delivery applications. For example, the fact that cancer cells have lower pH values as compared to normal cells has been used to trigger release and delivery of drugs on site (6).

An alternative approach to conventional treatments is gene therapy in which the malfunctioning or mutant gene has been reintroduced into cells with a properly functioning one in order to restore the malady (7). Nanoparticles, especially polymeric counterparts, have shown promising results in encapsulating, carrying and delivering the gene of interest into desired cells.

Apart from synthetic nanoparticles, naturally occurring nanoparticles, have lately received great attention due to their unique structures and properties such as biocompatibility, uniform size, as well as suitability to chemical and genetic engineering. Plant and bacterial viruses, known as viral nanoparticles (8), have been tested for imaging and drug delivery applications, and because they infect only plants and bacteria, they are considered to be benign towards mammalians. Their inner and outer amino acids could be chemically modified with drugs and imaging modalities and cleverly engineered drug release mechanism could be invoked to operate upon external or internal stimulus.

Nanomaterials are, furthermore, suitable candidates for vaccine development. The immune system normally recognizes certain chemical groups on the surface of antigens (pathogens) and develops its defense mechanism based on this recognition. Multiple copies of these chemical groups could be chemically tailored around the surface of nanomaterial, and thereby could trigger the same immune response more efficiently (9).

The future of medicine will be shaped and enhanced through a targeted delivery of drugs and imaging contrasts into desired sites. Promisingly, nanoparticles will be able to assist in this regard to a considerable extent. Today’s cancer chemotherapy rely mostly on administering a variety of cancer drugs via intravenous (injecting through the vein) or oral means which delivers drugs to cancer cells as well as a considerable amount to healthy tissues which causes major side effects. In order to accumulate higher doses of drugs in tumor cells selectively and minimize nonspecific delivery, nanoparticles loaded with drugs and chemically decorated with “smart molecules” which have the ability to recognize cancer cells and specifically bind to them have been designed and tested successfully (10). These smart groups (organic molecules, antibodies, peptides and small molecules), surprisingly, have higher binding affinities toward some receptors over-expressed in cancer cells. Furthermore, encapsulation of drugs by nanomaterials provides a protective shell which prevents leakage of drugs to other sites.

An important drawback of cancer therapy is drug resistance in which cancer cells develop mechanisms to pump chemotherapeutics out of cells and decreases the efficacy of drugs. Nanoparticles, however, invalidate these resistance mechanisms by encapsulating drugs and should therefore not be exposed directly to surrounding cell environment. When nanoparticles reach the desired destination in the cell, an engineered mechanism or stimulus augment the release and drugs are expected to show their activity without any compromise (11).

It is fascinating to see how these small nanoparticles behave cleverly and orderly even though they look like inanimate and unconscious clusters of atoms. The extraordinary art, design and engineering witnessed in macro dimensions can also be seen in nano dimensions which means that a conscious and purposeful Hand of Power is present and visible in this nanoworld.

To sum up, nanomaterials could be ideal platforms for drug delivery and imaging applications and could complement the deficiencies in conventional therapies. Loading multiple copies of these entities into nanoparticles and devising clever mechanisms to target and deliver them into desired sites would be key elements in the nanomedicine of the future. We are living in a world where each of us has someone in our families or among our friends who are going through painful cancer treatments, which is a heart-rending and traumatic experience. Hopefully, nanomaterial-based therapies would give rise to solutions and success in battling against cancer. For in one prophetic tradition the Prophet Muhammad, peace be upon him, says: “O servants of God! Search for ways for treatment of illnesses. If God gives you ailments, for sure He bestows upon you cures for those.”

And why can’t this bestowal be in the nano form?

References

• Qiao RR, Yang CH, Gao MY. “Superparamagnetic iron oxide nanoparticles: from preparations to in vivo MRI applications” (vol 19, pg 6274, 2009). J Mater Chem 2009;19:9286-9286.
• Raymo FM, Yildiz I. “Luminescent chemosensors based on semiconductor quantum dots.” Phys Chem Chem Phys 2007;9:2036-2043.
• Giljohann DA, Seferos DS, Daniel WL, Massich MD, Patel PC, Mirkin CA. “Gold Nanoparticles for Biology and Medicine.” Angew Chem Int Edit 2010;49:3280-3294.
• Jesorka A, Orwar O. “Liposomes: Technologies and Analytical Applications.” Annu Rev Anal Chem 2008;1:801-832.
• Sancey L, Barbier E, Hirsjarvi S et al. “Enhanced Permeability and Retention (EPR) effect in tumors: characterization by MRI and fluorescence imaging.” B Cancer 2011;98:S67-S67.
• Hruby M, Konak C, Ulbrich K. “Polymeric micellar pH-sensitive drug delivery system for doxorubicin.” J Control Release 2005;103:137-148.
• Waehler R, Russell SJ, Curiel DT. “Engineering targeted viral vectors for gene therapy.” Nat Rev Genet 2007;8:573-587.
• Yildiz I, Shukla S, Steinmetz NF. “Applications of viral nanoparticles in medicine.” Curr Opin Biotech 2011;22:901-908.
• Peek LJ, Middaugh CR, Berkland C. “Nanotechnology in vaccine delivery.” Adv Drug Deliver Rev 2008;60:915-928.
• Ruoslahti E, Bhatia SN, Sailor MJ. “Targeting of drugs and nanoparticles to tumors.” J Cell Biol 2010;188:759-768.
• Liang XJ, Chen C, Zhao Y, Wang PC. “Circumventing tumor resistance to chemotherapy by nanotechnology.” Methods Mol Biol 2010;596:467-88.

The problem of pulmonary tuberculosis in pregnancy has attracted the attention of doctors for many years and it is still a current issue. Modern researchers and physicians divide tuberculosis into several independent problems which have difficult solutions. On the one hand, there is the influence of tuberculosis on the course of pregnancy and child delivery as well as on the health of a mother and her child. On the other hand, there is the influence of pregnancy and childbirth, the puerperal period and lactation on the course and progress of tuberculosis.

Research on how pregnancy influences the course of tuberculosis has been carried out for many years. Even in the oldest available documents we can find instructions for “personal precautions” and preventative measures against tuberculosis, as well as thoughts about pregnancy and tuberculosis. In 1400 BC the Law of Manu from ancient India prohibited marriages to girls from families with tuberculosis. In different world religions, including Islam and Christianity, there are special restrictions concerning people who suffer from this illness.

In ancient times Hippocrates and Galen taught that pregnancy has a positive influence on the function of lungs. But the Islamic doctors, Arabian as well as Spanish, of the Cordoba Caliphate considered that the blessed process of pregnancy must not be complicated by pulmonary diseases.

With time European medical science changed its point of view. From the second part of the 17th century until the beginning of the 19th century doctors considered that pregnancy had a bad effect on the course of tuberculosis, but then the situation, for some reason, changed. Doctors began to think that pregnancy had a good influence on lung diseases. They even started to advise girls who were susceptible to tuberculosis to marry. Time passed and doctors began to change their opinion on tuberculosis in pregnancy and the extremes in views became less obvious. This happened due to the introduction of an artificial pneumothorax into the treatment of tuberculosis.

Since then the third period in the understanding of the relationship between pregnancy and tuberculosis has begun. The opinion about the course of tuberculosis in pregnant women has changed due to the successful therapy of tuberculosis with the help of the artificial pneumothorax.

During the gestation period, all the organs and tissues of the entire organism experience an increased load, as they are trying to satisfy both their own needs and that of the developing fetus. These morphological and functional changes do not lead to any pathological state in the mother if she is healthy and her course of pregnancy is normal. If the woman’s organism has been weakened by a chronic immunodeficiency due to poor environmental conditions or if she has a tuberculosis process in her organism, then functional changes and tissue dystrophies can develop in her nervous system which will lead to metabolic disorders. Changes in ergasia caused by pregnancy and connected with changes in higher nervous activity, as well as with endocrine reorganization, can influence the development and the course of the tubercular process.

Before penicillin was discovered, pregnancy usually led to the progression of the disease and in many cases even ended fatally. Nowadays due to the use of effective antituberculous medicines the attitude towards possible pregnancy of women who have active tuberculosis has considerably changed.

Tuberculosis in a pregnant woman usually starts in an acute form; at this stage infiltrative forms of the disease with necrogenic and bacterioexcretion prevail, often combined with exudative pleurisy, trachea, larynx and bronchi lesions.

Frequent consecutive pregnancies have a negative effect on the state of women who suffer from tuberculosis; they weaken the organism and can cause the recrudescence of the tuberculosis process. This is very typical of many families in poor Asian and African countries. More than half of all pregnant women suffering from an active form of tuberculosis experience a progressive iron deficiency anemia during the first three months of pregnancy and in the second trimester of pregnancy this can be observed in almost all patients. Malaria is also widespread in Asian and African countries that are situated to the south of Sahara and are the second reason for iron deficiency anemia.

According to modern views, one of the reasons for the recrudescence of the tubercular process during pregnancy is an irregular or non-systematic treatment of this illness or the absence of any treatment at all. The recrudescence of the process observed in those suffering from destructive pulmonary tuberculosis is caused by the severity of the illness itself when new conditions for the organism occur. In this case, pregnancy begins against the background of an advanced chronic immune deficiency. At the same time, due to the feto-placental complex operation, functional changes in the nervous, respiratory, cardiovascular and urinary systems, as well as hormonal changes, in the organism of a pregnant woman take place.

Moreover, the development of the fetal skeleton requires calcium which is absorbed not only via the blood of the mother, but also from the healed niduses of tuberculosis and as a result, the progression of a specific process can appear.

The reactivation of the tubercular process happens due to a decrease in the responsiveness of the organism and because of an increase in the activity of the reproductive hormones and the loosening of the connective tissues which are physiologically involved in pregnancy. The amount of plasma and extra vascular fluid increases. Due to these changes, a swelling and loosening in the inactive tubercular niduses with the mycobacteria of tuberculosis can appear. And loosening, in its turn, enables a lymphohematogenous spread of mycobacteria.

In addition to these, the delivery of a child leads to a speedy reorganization of all the functions of the organism; lactation and nursing in their turn are combined with an increased loss daily of nutritious matters and a large amount of protein and fats. In case of destructive pulmonary tuberculosis, due to the fact that the diaphragm descends (resulting in the abdominal decompression ceasing to have a therapeutic action of pneumoperitoneum) bronchogenic dissemination appears in the unaffected parts of the lungs.

A specific active process can be observed in women belonging to the high-risk group in connection with tuberculosis. The high-risk group combines women who have recently suffered from tuberculosis (less than one year after treatment), those who have just been operated on for a tuberculosis connected illness (less than one year), women with tuberculosis of different localizations younger than 20 years (for Asia and Africa) and those older than 35 years (for Europe and the USA), those with widespread forms of the tubercular process withstanding its stage, women who have had contact with people discharging bacteria or people suffering from tuberculosis but not discharging bacteria, and also those who have coexisting illnesses (diabetes, chronic nonspecific pulmonary illnesses, problems with kidneys, stomach and duodenum ulcer), and also women who use alcohol, narcotics, those who smoke and lead asocial ways of life. In these cases, the women must be properly examined during the gestation period, including X-rays.

Treatment of tuberculosis during pregnancy

All other conditions being equal, the timely detection of active tuberculosis during pregnancy allows doctors to provide a full course of treatment, allowing the woman to recover and give birth to a healthy child. Untreated active tuberculosis of the mother is much more dangerous for the fetus than anti-tuberculosis chemotherapy.

Special attention must be paid to healthy women who are in contact with bacillary patients. Quite often these women might undergo active tuberculosis for the first time during pregnancy or after the delivery itself.

In the pre-penicillin era the recrudescence of the tubercular process during pregnancy and after the delivery proceeded in an acute form with frank infiltrative changes, a necrogenic process, bloody expectoration and very often a generalization of the process. Nowadays, the clinical outlook for complications and the recrudescence of tuberculosis against the background of pregnancy is less gloomy. It more resembles the toxicosis of pregnancy or respiratory diseases.

While examining a patient, special attention must be paid to chest problems like moist or dry coughs, bloody expectoration, pain in the chest and shortness of breath. If the patient coughs with expectoration for 2 weeks then she must be examined for mycobacteria with the usage of a microscopic technique.

Another syndrome, which is also very important, is a complex of intoxication symptoms (weakness, hidrosis, anorexia, weight loss, long-lasting low grade fever and hyperirritability) which need to be detected to discover the reason for their development. While examining the anamnesis of a pregnant woman it is necessary to learn if she has ever suffered from tuberculosis before, if she has had any possible contacts with infected people, whether there are cases of tuberculosis or concomitant diseases in her family as all of these can be very useful for the verification of tuberculosis.

When active pulmonary tuberculosis is suspected an X-ray examination is necessary. When the chest is in frontal projection, the X-ray exposure of the fetus is 10 times lower than that of its mother (with compulsory use of a protective apron). Examination of the cough expectoration for the presence of tubercular mycobacteria is one of the easiest, most effective and informative diagnostic methods.

Chemotherapy, which destroys the tubercle bacillus that spread in the organism, plays a leading role in the variety of methods for tuberculosis treatment. By reducing the population of bacteria, chemotherapy supports the healing process, the dispersion of inflammatory changes, the closing of caverns, the encapsulation of the remaining loci as well as preventing the development of sclerosis. When the patient suffers from tuberculosis, the healing processes are very slow; the first stage of the recovery process of mycobacteria ceases and only after some months, in the case of a successful treatment of tuberculosis, does the healing process finish.

The necessary treatment of pregnant women who suffer from tuberculosis must start as soon as the diagnosis has been made. Chemotherapy implies taking antibacterial medicines (isoniaside, rifampicin, pyrazinamide, ethambutol, ethionamide and etc.) in different combinations. The choice of this or that combination depends on the stage of the disease as well as on any undesirable reactions to the medicines prescribed.

The treatment of tuberculosis (if there are indications) continues during the entire pregnancy and lactation period. In particular, patients with tuberculosis that has been diagnosed during the pregnancy are in need of treatment. When there is a systematic treatment, up to the moment of delivery and in the puerperal period, positive clinicoradiologic dynamics can be observed regarding the specific inflammation (stoppage of bacterioexcretion, closing of caverns, dispersion of loci, infiltration and exudate). Patients who reject treatment during the process of pregnancy suffer from an advancement of the illness.

Transplacental infection of the fetus with tuberculosis almost never occurs, but the baby can be infected from the mother in the puerperal period. There is also a possibility of contamination during delivery, but this is a rare occurrence.. God truly protects the innocent!

Permission to breast feed must be given by a joint resolution of an obstetrician, a pediatrician, and a specialist of tuberculosis taking into account the state of a woman and the form and the stage of the tubercular process. Overall precautionary measures must be taken (a nonbacterial mask of 5-6 layers covering the nose and the mouth, a kerchief covering the head and thoroughly washed hands).

A bacteriological study of the breast milk of women who suffer from tuberculosis shows that typical mycobacteria rarely vegetates (no more than 0.33%). Human milk has the ability to suppress the development of the mycobacteria of tuberculosis. This must be connected with the rich spectrum of ferments, immunoglobulins, cellular elements, macro-phages, the complement system, interferon and other factors of nonspecific protection which human milk contains.

The contraindications for nursing are as follows: tuberculosis of the lactiferous gland, an acute form of tuberculosis, active pulmonary tuberculosis with bacterioexcretion, active tuberculosis of any organs detected at the end of the pregnancy or after the delivery, and recrudescence of tuberculosis during the pregnancy. Children born to such mothers are immediately isolated after their birth and bottle fed, they are vaccinated and stay in the hospital for 6 weeks if possible (the minimum period for compulsory postvaccinal isolation).

Thus the tubercular process in the lungs, especially an active one, will have a negative influence on pregnancy and delivery. Babies born to such mothers belong to a high-risk group as far as the possibility of neonatal pathology and antenatal death of the fetus are regarded. Women with pulmonary tuberculosis must undergo regular consultations with both an obstetrician-gynecologist and a phthisiologist from the very early stages of their pregnancy. They must also receive special treatment until all the signs of active tuberculosis have been eliminated.

WHAT MAKES THE BABY CALM IN HIS MOTHER’S ARMS?

According to some researchers, the rhythmic heartbeat of parents is one of the main factors that influence baby’s feelings. Several experiments have been performed based upon this hypothesis. Some babies who were crying for food were taken to a room where pre-recorded heartbeats and lullabies were playing. It was observed that the crying babies became silent and fell asleep in a short while. The researchers came up to the conclusion that, during pregnancy, babies become accustomed to the heartbeats of the mother in her womb. After the baby is born, this familiar sound becomes a sort of music that relieves the baby.

Most mothers unintentionally lean her babies on their left arms during breast-feeding and over their hearts when trying to lull them. This instinctive behavior leads researchers to focus on the impact of the heartbeats upon babies’ feelings.

Associate Professor of the College of Nursing at Marmara University, Nuran Komurcu, is a distinguished person who has dedicated herself to medical science and takes her inspiration from small details. She had even tried proving the truthfulness of her hypothesis that musical therapy was effective during the delivery of a baby. Dr. Komurcu had continued most of her studies in Bakirkoy Yenimahalle Maternity hospital. She usually used the beautiful sounds of nature such as the babbling sound of water and a mystic wind instrument, ney, which is used to perform Sufi music, for her experiments. She divided her patients into two groups and placed them in two different rooms. One room was prepared for patients who would listen to the kind of music mentioned above, and the other room was for the group who would not listen to any music. Meanwhile, one question raised from her mind, “what if the babies fall asleep in the mothers’ womb before labor?”

Dr. Komurcu then selected her patients among those who would most probably give birth to their babies first and made them listen to music just a couple of hours before delivery. Being treated in a very comfortable room, the patients almost did not have any fear of the delivery.

First, the patients who were regarded as experimental and the control group, were asked whether they liked music or not, what kind of music they listened to, and other questions concerning their personalities. Then, their blood pressure was measured. The measurement of the blood pressure was essential for the assessment of the experiment because it led to more accurate results among the other tests which are conducted for the determination of the effects of music, in terms of pain relieving, mood enhancing, and delivery stress. She hoped to see the stimulating muscle contractions caused by the ney, which is proved by former research. Her patients listened to the music at 20-minute intervals before the labor time. It was observed that the pain during the labor time became more frequent. This showed that the music decreased the labor period.

Music therapy is playing an important role to help patients gain self- confidence and subsequently overcome labor pain. The results state that the patients who listened to music during delivery were less tense and nervous than the other group. The determination of differences of blood pressure among the groups is assumed to be caused by the efficiency of music therapy on the blood circulation, respiration, and muscle physiology.

Having hypothesized that music could ease delivery, Dr. Komurcu has reported the beneficial effects of music therapy from her research. However, she emphasized that it would not just be enough to apply music therapy when women are in labor. It is recommended that music therapy be started at least 3 months before the expected delivery time in order to get full advantage of it.