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Background and Aim The endoscopic retrograde cholangiopancreatography (ERCP) procedure is generally performed in patients with high comorbidity. We aimed to reduce the consumption of propofol by adding lidocaine before ERCP. Methods Eighty ERCP patients with ASA I–III, aged between 45–75 years, were randomly divided into two groups. Lidocaine group (group L, n = 40), received 1‐mg midazolam, 1.5 mg/kg lidocaine, and 1 mg/kg propofol intravenously. The control group (group C, n = 40) received 1‐mg midazolam, saline in the same volume as the lidocaine group, and 1 mg/kg propofol intravenously. Propofol was administered with intermittent bolus doses. Propofol consumption, oropharyngeal reflex, recovery time, endoscopist satisfaction, ketamine need, and side‐effects were recorded. Results Propofol consumption during the procedure was statistically lower in group L than in the control group (157.25 ± 39.16 mg vs 228.75 ± 64.62 mg respectively, P < 0.001). Additionally, recovery time was statistically faster in group L compared with the control group (7.78 ± 3.95 min vs 11.92 ± 3.24 min respectively, P < 0.001). The oropharyngeal reflex was less in group L than control group (6/40 vs 15/40 respectively, P = 0.042). There was no significant difference between the two groups regarding visual analogue scale scores and endoscopist satisfaction (P > 0.05). Conclusions We recommend the use of intravenous lidocaine before the ERCP procedure as it reduces propofol consumption, recovery times, and oropharyngeal reflex.

Background Aim. In case of high-dose acetaminophen intake, the active metabolite can not bind to the glutathione, thereby inducing cellular necrosis through binding to the cytosol proteins. This trial was performed to histologically and biochemically investigate whether leptin was protective against liver damage induced by paracetamol at toxic doses. Material and Method. In our trial, 30 female rats, divided into 5 groups, were used. IP leptin administration was performed after an hour in the group of rats, in which paracetamol poisoning was induced. The groups were as follows: Group 1: the control group, Group 2: 20 µg/kg leptin, Group 3: 2 g/kg paracetamol, Group 4: 2 g/kg paracetamol + 10 µg/kg leptin, and Group 5: 2 g/kg paracetamol + 20 µg/kg leptin. Results. The most significant increase was observed in the PARA 2 g/kg group, while the best improvement among the treatment groups occurred in the PARA 2 g/kg + LEP 10 µg/kg group (p < 0.05). While the most significant glutathione (GSH) reduction was observed in the PARA 2 g/kg group, the best improvement was in the PARA 2 g/kg + LEP 10 µg/kg group (p < 0.05). Conclusion. Liver damage occurring upon paracetamol poisoning manifests with hepatocyte breakdown occurring as a result of inflammation and oxidative stress. Leptin can prevent this damage thanks to its antioxidant and anti-inflammatory efficacy.

Background & aims Ulcerative colitis (UC) is an inflammatory bowel disease characterized by mucosal inflammation. Endocan, a proteoglycan secreted by endothelial cells in response to inflammatory cytokines, has been reported to be overexpressed in inflammatory conditions. In this study, we aimed to evaluate the utility of endocan level in determining the extent and severity of disease in patients with ulcerative colitis and to determine whether it can be a candidate marker for noninvasive evaluation and monitoring since there is not enough data in the literature. Materials and methods Sixty-five people were included in the study, including thirty-five with ulcerative colitis and thirty in the control group. Patients with first diagnosed ulcerative colitis clinically, endoscopically, and histopathologically, without any treatment, and with normal liver and kidney tests were included in the study. Endoscopic scoring of all patients was performed according to the Mayo endoscopic scoring (MES) system. Blood samples for CRP (C-reactive protein) and endocan were taken from the patients simultaneously. Results There was a significant statistical difference between all patients with ulcerative colitis and the control group in both endocan level and CRP level (p < 0.001). There was a statistically significant difference between endocan levels and CRP levels between the left-distal group and pancolitis (diffuse colitis) patients, but there was no statistical difference between age and MES. Conclusion Serum endocan level can be useful in determining the extent of ulcerative colitis and planning treatment.

Objectives:The aim of the study was to evaluate the oxidative stress level in patients, diagnosed with H. pylori infection, using a novel marker (thiol/disulphide homeostasis) and to compare the level in infected individuals with that in healthy volunteers. Methods: A total of 60 patients diagnosed with gastritis, erosive gastritis or ulcer by endoscopy were included and biopsied. The 30 patients diagnosed with H. pylori and 30 healthy individuals were enrolled. Medical histories, physical examination results, body mass index (BMI), hemogram, free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), urea, creatinin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, total cholesterol, triglycerides, high density lipoprotein (HDL), low density lipoprotein) LDL and thiol/disulphide levels obtained in the study groups were compared. Results: There was no significant difference between the total thiol, native thiol, disulphide/native thiol and dissulphide/total thiol ratios of the patient and control group. When the H. pylori patients were stratified by endoscopic evaluation as having mild (superficial gastritis or normal appearance) or severe (ulcer or erosive areas) symptoms, there were significant differences in disulphide, disulphide/native thiol, disulphide/total thiol and native thiol/total thiol levels. We also observed BMI and the total, native thiol levels of H. pylori patients were inversely related.( r: 0.562, p = 0.001; r: 0.0552, p = 0.002). Conclusions: Thiol/disulphide homeostasis is likely to differ with both duration and severity of H. pylori infection. Further investigations are needed to investigate the effect of H. pylori on oxidative stress.

Background and study aims: Endothelial cell specific molecule-1 (ESM-1), also known as endocan, is a soluble proteoglycan secreted by human vascular endothelial cells. In some studies, it has been found that endocan have important effects on cell adhesion, inflammation and angiogenesis. In this study, we aimed to evaluate the endocan level in patients with pancreatitis and the availability of endocan level in determining the severity of the disease. Patients and methods: A total of 42 patients with pancreatitis and 33 healthy individuals were included in the study. The serum endocan levels in patients were evaluated 1st and 3 th days after the symptom’s onset. Current scoring systems and the relationship between the severity of the disease and endocan levels were evaluated. Results: The endocan levels of the patients on day 1 are significantly correlated only with the APACHE II score (p=0.039 r=0.319), while the endocan values on day 3 are significantly correlated with the BISAP (bedside index of severity in acute pancreatitis) (p=0.013 r=0.380), APACHE II (Acute Physiology and Chronic Health Evaluation)(p<0.001; r=0.53) and Ranson (p=0.037 r=0.32) scores. The cutoff level of endocan (day 3) was calculated 92.2 pg/ml (83% sensitivity and 50% specificity; p=0.039 area under the curve 0.706) for severe pancreatitis when considering the patients with a score of 8 or higher in the APACHE II scoring system. Conclusion: Serum endocan level can be used as a marker of prognosis in patients with pancreatitis. However, studies involving large populations are needed on this matter.

Background and study aim Ulcerative colitis (UC) is an inflammatory bowel disease characterized by mucosal inflammation that starts from the rectum (distal) and extends proximally, involving the entire colon (pancolitis). In this study, we aimed to evaluate the usability of endocan level in determining the extent and severity of disease in patients with ulcerative colitis and to determine whether it can be a candidate marker for noninvasive evaluation and monitoring since there is not enough data in the literature. Materials and Methods Sixty-five people were included in the study, including thirty-five with ulcerative colitis and thirty in the control group. patients with newly diagnosed ulcerative colitis clinically, endoscopically, and histopathologically, without any treatment, and with normal liver and kidney tests were included in the study. Endoscopic scoring of all patients was performed according to the mayo endoscopic scoring (MES) system. Blood samples for CRP (C-reactive protein) and endocan were taken from the patients simultaneously. Results There was a significant statistical difference between all patients with ulcerative colitis and the control group in both endocan level and CRP level (p < 0.001). There was a statistically significant difference between endocan levels and CRP levels between the left-distal group and pancolitis (diffuse colitis) patients, but there was no statistical difference between age and MES. Conclusion Serum endocan level can be a useful test in determining the extent and severity of ulcerative colitis, making hospitalization decisions, and planning treatment. Stool markers may not always be available due to patient compliance.