Obesity, a growing global health challenge, requires effective treatment modalities, among which bariatric surgery is the gold standard for patients with Class III obesity (BMI ≥ 40 kg/m² or ≥ 35 kg/m² with comorbidities). While surgical outcomes are well established, the role of routine preoperative Esophagogastroduodenoscopy (EGD) remains debated. This study evaluates the role of EGD in preoperative planning among a Turkish cohort. We conducted a retrospective cross-sectional analysis of 117 patients who underwent Laparoscopic Sleeve Gastrectomy (LSG) or Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) between 2018 and 2021. Data on demographics, comorbidities, endoscopic and histopathologic findings, and surgical modifications were collected. Preoperative EGD revealed pathology in 86.3% of patients, including antral gastritis (64.1%), hiatal hernia (22.2%), and erosive esophagitis (18.8%). Chronic gastritis was confirmed histopathologically in 74.4%, and active Helicobacter pylori infection was identified in 15.4% of surgical specimens. Notably, EGD findings led to changes in surgical management in 18.8% of cases. Our findings support the utility of routine EGD in bariatric surgery, emphasizing its role in identifying otherwise undetected pathologies that influence surgical decision-making. Further multicenter prospective studies are warranted.

In intensive care units (ICUs), serum lactate and methemoglobin (metHb) levels are considered significant biomarkers for predicting mortality in critically ill patients. This study investigates the relationship between lactate and metHb levels in blood gas analyses at admission and 24 h later, as well as their association with mortality in ICU patients. The study was conducted retrospectively between March and December 2022 at Adıyaman Training and Research Hospital, evaluating 114 patients, with statistical analyses performed on the collected data. The results indicated a statistically significant decrease in lactate levels between admission and 24 h after (p = 0.004). However, no significant change was found in metHb levels (p > 0.05). Lactate clearance was significantly lower in deceased patients compared to survivors (p = 0.037), whereas metHb clearance showed no statistically significant association with mortality. Lactate is highlighted as a key indicator of tissue hypoxia and plays a critical role in managing critically ill patients. Elevated lactate levels are associated with impaired oxygenation and worse prognoses. The literature consistently supports the association between high lactate levels and increased mortality in conditions such as sepsis and hemorrhagic shock. Similarly, this study confirms the prognostic value of lactate, particularly in the early phases of ICU admission. In contrast, metHb levels were not found to significantly impact mortality. Although some studies suggest a potential role of metHb as a biomarker for oxidative stress in inflammatory diseases, this relationship was not supported by the current findings. In conclusion, serum lactate levels serve as a crucial tool for mortality prediction and patient management in ICUs, while metHb levels have limited prognostic value. These findings suggest that greater emphasis should be placed on lactate monitoring in the management of critically ill patients.

Aim: This study aimed to determine the incidence of hypophosphatemia and evaluate anemia parameters following intravenous iron sucrose (IS) and iron carboxymaltose (FCM) therapy in patients diagnosed with iron deficiency anemia (IDA). Methods: This retrospective study included 108 patients aged 18– 67 who were diagnosed with IDA and received either FCM or IS therapy. The patients were divided into two groups: iron sucrose (n=55, 51%) and ferric carboxymaltose (n=53, 49%). We collected and analysed data on patient demographics, doses of FCM and IS, and laboratory parameters including serum phosphorus, ferritin, total iron-binding capacity (TIBC), iron, and haemoglobin (Hg) values. Results: The pre-treatment blood phosphorus levels were significantly lower in the IS group than in the FCM group (p = 0.029). Following intravenous iron treatment, the TIBC and phosphorus levels were higher in the IS group compared to the FCM group (p = 0.011 and p < 0.001, respectively). The ferritin levels were significantly higher in the FCM group compared to the IS group (p = 0.002). Conclusion: It is important to be aware that hypophosphatemia may occur after intravenous iron therapy for iron deficiency anemia. Therefore, phosphate levels should be monitored closely following treatment. Furthermore, it would appear that hypophosphatemia is more prevalent following FCM therapy compared to IS.