Autoimmune hepatitis is a rare inflammatory disease of the liver that is characterized by elevated liver enzymes. The hemoglobin, albumin, lymphocyte, and platelet score, which is derived from hemoglobin, serum albumin, circulating lymphocyte count, and platelet count, is also associated with inflammatory conditions. The aim was to examine the hemoglobin, albumin, lymphocyte, and platelet score of patients with autoimmune hepatitis and to compare it to that of healthy individuals in this retrospective analysis.

The Ankaferd Blood Stopper (ABS) proves effective in managing various bleedings, particularly in surgical and dental procedures. This study assesses ABS efficacy endoscopically by less-experienced endoscopists for non-variceal upper gastrointestinal bleeding (NVUGB). Between 2016 and 2021, our hospital’s Gastroenterology Department Endoscopy Unit conducted a retrospective data analysis of 653 patients who underwent endoscopy for NVUGB. The study included 202 patients who underwent endoscopic interventions performed by endoscopists with less than 3 years of experience. Based on the method used for endoscopic hemostasis, we classified those treated with ABS (either alone or as a second method) as group 1. In contrast, we classified patients treated with non-ABS hemostatic methods into Group 2. The study included 202 patients, with 96 (47.52%) in Group 1 and 106 (52.48%) in Group 2. All patients in Group 1 achieved bleeding control, while 4 patients in Group 2 initially did not achieve bleeding control; however, bleeding control was subsequently established following ABS administration. After 1 month of follow-up, mortality occurred in 3 out of 202 patients (1.48%), and all these cases were in Group 2. There is a significant difference in the need for blood transfusion between the groups (P < .001). Regarding the bleeding source, bulbus ulcer and gastric cancer were more prevalent in Group 2. On the other hand, although statistical significance was not reached in the comparison of rebleeding rates between groups, numerically, a higher incidence of recurrent bleeding was observed in Group 2 (Group 1: 3 [3.1%], Group 2: 8 [7.5%]; P = .167). Additionally, a similar relationship was noted among intensive care admissions (Group 1: 5 [5.2%]; Group 2: 7 [6.6%]; P = .675). In the group that used ABS, there were significantly higher rates of hypotension, tachycardia, syncope, and the need for transfusion than in the other group. In medical practice, this distinction often stems from the shared preference of clinicians to use ABS as a salvage method in cases of more severe bleeding. Considering all the findings, it is evident that using ABS through endoscopy in cases of NVUGIB significantly improves procedural success, irrespective of the endoscopist’s experience level.

Dışkılama güçlüğü (dissinerjik defekasyon), pelvik ve karın kaslarının koordinasyon bozukluğu nedeniyle ortaya çıkan ve kronik kabızlığı olan hastaların yaklaşık yarısını etkileyen yaygın bir sağlık sorunudur. Tanı sürecinde hasta öyküsü, dijital rektal muayene, anorektal fizyoloji testleri, balon çıkarma testi ve manometri gibi yöntemler kritik rol oynarken, Roma IV kriterleri tanısal standartları belirlemektedir. Etiyolojisi tam olarak bilinmese de davranışsal bir bozukluk olarak kabul edilen bu durum; karın ağrısı, şişkinlik ve anksiyete gibi psikolojik semptomlarla birlikte seyredebilir. Yapısal anormalliklerin ayırıcı tanısında defekografi ve MR gibi görüntüleme tekniklerinden faydalanılır. Tedavi yaklaşımı kişiye özel planlanmalı; standart yaşam tarzı değişiklikleri, lifli beslenme ve tuvalet eğitiminin yanı sıra, tedavinin temelini kısa ve uzun vadede yüksek başarı oranına sahip biofeedback terapisi oluşturmaktadır. Cerrahi müdahalelerin ve botulinum toksin enjeksiyonlarının başarısı sınırlı kalırken, biofeedback'in laksatiflerden daha etkili olduğu kanıtlanmıştır. Difficulty defecating (dyssynergic defecation) is a common health problem caused by the lack of coordination between pelvic and abdominal muscles, affecting approximately half of patients with chronic constipation, and its diagnosis relies on detailed patient history, digital rectal examination, anorectal physiology tests, and Rome IV criteria. Although its etiology remains unclear, it is considered an acquired behavioral disorder often accompanied by abdominal pain, bloating, and psychological symptoms such as anxiety and depression. Diagnostic imaging techniques like defecography and MRI are utilized to differentiate structural abnormalities, while treatment should be individualized, incorporating lifestyle changes, fiber intake, and timed toilet training. Biofeedback therapy stands as the cornerstone of treatment, demonstrating higher short and long-term efficacy compared to laxatives or surgical interventions like myectomy and botulinum toxin injections, which offer only limited improvement.

Background and aims: Serum vitamin B12 may increase during liver injury, but its association with clinical outcomes in acute hepatitis remains incompletely characterized. We evaluated admission vitamin B12 in relation to in-hospital outcomes and explored a combined vitamin B12–ferritin index. Methods: This retrospective single-center study included 186 adults hospitalized with acute hepatitis or acute liver injury during 2018–2025. Clinical outcomes were gastroenterology ward length of stay, liver transplantation, and in-hospital mortality. Additional exploratory analyses evaluated ICU admission, recorded encephalopathy, and a composite of ICU admission, transplantation, or death. Discrimination was assessed using receiver operating characteristic analysis. Eight vitamin B12 results exceeded the assay reporting limit of 4000 pg/mL; available numerical analyses used a top-coded representation, with these observations tied at the upper limit. Results: Nine patients (4.8%) died and one (0.5%) underwent transplantation; 20 (10.8%) met the exploratory composite outcome, all of whom required ICU care. Eleven patients had recorded hepatic encephalopathy. Vitamin B12 AUCs were 0.935 (95% CI 0.891–0.979) for mortality, 0.944 (0.904–0.984) for death or transplantation, and 0.938 (0.897–0.980) for the ICU-inclusive composite. Vitamin B12 was not associated with gastroenterology ward length of stay (Spearman ρ=0.017; P=0.818). The exploratory B12–Ferritin Index had a composite-outcome AUC of 0.892, providing no demonstrated improvement over vitamin B12. Conclusions: Higher admission vitamin B12 was associated with adverse in-hospital outcomes, but not with gastroenterology ward length of stay. The limited event count, assay upper-limit censoring, and uncertain timing of sampling relative to deterioration restrict prognostic interpretation. Prospective validation is required before clinical application.

Background: Benign biliary anastomotic strictures (BAS) remain among the most frequent complications after living donor liver transplantation (LDLT). Although multiple plastic stents (MPS) have traditionally been considered the standard endoscopic treatment, fully covered self-expandable metal stents (FCSEMS) and intraductal fully covered self-expandable metal stents (ID-FCSEMS) have emerged as alternative strategies. This study aimed to compare the efficacy and safety of MPS, FCSEMS, and ID-FCSEMS in the management of post-transplant biliary anastomotic strictures. Methods: This retrospective single-center cohort study included consecutive adult patients who developed benign biliary anastomotic strictures after LDLT and underwent ERCP-based treatment between January 2020 and January 2025. Patients were categorized according to the initial stent strategy: MPS (n = 32), FCSEMS (n = 30), and ID-FCSEMS (n = 25). Primary outcome was overall treatment success. Secondary outcomes included recurrence, number of ERCP sessions, treatment duration, post-procedural hospitalization, stent migration, and procedure-related adverse events. Results: A total of 87 patients were included. Clinical success was achieved in 81.3% of patients treated with MPS, 83.3% treated with FCSEMS, and 92.0% treated with ID-FCSEMS (p = 0.501). Recurrence rates were 18.8%, 10.0%, and 12.0%, respectively (p = 0.579). Patients treated with metal stents required significantly fewer ERCP sessions than those treated with MPS (median 5 vs. 2 vs. 2; p < 0.001). Median treatment duration was significantly shorter in the FCSEMS and ID-FCSEMS groups compared with the MPS group (12 vs. 10 vs. 9 months; p < 0.001). Post-procedural hospitalization was also reduced with metal stents (7 vs. 4 vs. 3 days; p < 0.001). Adverse event rates, including cholangitis, pancreatitis, bleeding, perforation, and mortality, were comparable among groups. Stent migration occurred in 21.9% of MPS patients, 23.3% of FCSEMS patients, and 12.0% of ID-FCSEMS patients (p = 0.525). On multivariable analysis, MELD score was the only independent predictor of treatment success (adjusted OR 0.90, 95% CI 0.83–0.98; p = 0.012). Conclusions: MPS, FCSEMS, and ID-FCSEMS achieved comparable rates of stricture resolution, recurrence, and adverse events in the treatment of biliary anastomotic strictures after LDLT. However, FCSEMS and ID-FCSEMS significantly reduced the number of ERCP procedures, treatment duration, and hospitalization compared with conventional plastic stenting. Among the evaluated strategies, ID-FCSEMS demonstrated the highest numerical success rate and lowest migration rate, suggesting a potential procedural advantage while maintaining comparable safety and efficacy.