Acute appendicitis is one of the most common causes of acute abdominal diseases seen between the ages of 10 and 19, mostly seen in males. The lifetime risk of developing acute appendicitis is 8.6% for males and 6.7% for females. We aimed to investigate the efficacy of the complete blood count parameters, C-reactive protein, and Lymphocyte-C-reactive Protein Ratio laboratory tests in the diagnosis of acute appendicitis, as well as their relationship with appendix diameter. We retrospectively examined all patients who underwent appendectomy between 1 January 2012 and 30 June 2019 in the General Surgery Clinic of Gaziosmanpasa University Faculty of Medicine. Laboratory tests, imaging findings, age, and gender were recorded. Lymphoid hyperplasia is considered as normal appendix—in other words, as negative appendicitis. The distribution of Lymphoid hyperplasia and appendicitis rates were statistically different in the groups formed according to appendix diameter (≤6 and >6 mm) (p < 0.001). We found a significant correlation between appendix diameter and WBC (White blood count), Lymphocyte, Neutrophil, RDW(Red blood cell distribution width), NLR(Neutrophil to lymphocyte ratio), and PLT/L (Platelet to lymphocyte ratio), MPV (Mean platelet volume) and RDW were significantly different in patients with an appendix diameter of ≤6 mm (p = 0.007, p = 0.006, respectively). WBC, Neutrophil, PDW, and NLR values were significantly different between appendicitis and hyperplasia groups in patients with an appendix diameter of >6 mm. The sensitivity of the NLR score (cutoff = 2.6057) in the diagnosis of appendicitis was 86.1% and selectivity was 50% in these patients. Complete blood count parameters evaluation with the clinical findings revealed that NLR is an important parameter that may help the diagnosis of acute appendicitis with an appendix diameter of >6 mm. In patients whose pathological results indicated acute appendicitis but who had a diameter of ≤6 mm, we found an elevated MPV and low RDW values.

Background. Early diagnosis of gastric cancer is one of the most important parameters affecting the survival of the disease. In this study, we aimed to stress the importance of antrum wall thickness in CT examination.Method. The study included 111 patients between ages of 18 and 95 who had antral wall thickening in computed tomography and also had endoscopic evaluation performed in the same clinic. The patients were divided into two groups as benign and malignant according to the pathology results. The thickness of the antrum wall in computed tomography, hemoglobin and albumin levels, and age was compared among these two groups. Parameters with significant differences were further analyzed by multivariate analysis using logistic regression analysis.Results. Of the 111 patients included in the study, 57 were male and 54 were female. Mean age was 65 years. Fifty-one patients were classified as benign and 60 patients as malignant. Mean age of the malignant patients was 70, while that of benign patients was 59 (p<0.05). Antrum wall thickness was 13.68 ± 3.27 mm in malignant patients and 9.22 ± 2.17 mm in benign patients (p<0.05). Similarly, hemoglobin level was significantly different in malignant and benign patients (10.78 ± 1.57 g/dl and 12.64 ± 1.43 g/dl, respectively;p<0.05). Albumin levels were 3.36 ± 0.57 mg/dl in malignant patients and 3.97 ± 0.57 mg/dl in benign patients (p<0.05).Conclusion. Evaluation of antrum wall thickness, age, hemoglobin, and albumin values together may contribute to distinguishing the benign and malignant pathologies involving this region in patients with suspected stomach wall thickening in abdominal CT scan.

Background and Objectives: Bariatric surgery is the most effective method for achieving sustainable weight loss, improving quality of life, and resolving obesity-related comorbidities over the long term. However, data from long-term studies remain scarce and contradictory. Materials and Methods: This study is a retrospective analysis of prospectively collected data over a 7-year follow-up period involving 211 patients diagnosed with morbid obesity who underwent sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), or mini gastric bypass (MGB) at Samsun University Training and Research Hospital, Department of General Surgery, between 1 January 2014 and 1 January 2018. Changes in weight, remission of associated comorbidities, postoperative complications, re-admission rates, and revision requirements were compared among the patients. Results: Of the 211 patients, 20.4% were male, and 79.6% were female. During the study period, 61.1% of patients underwent SG, 29.4% underwent MGB, and 9.5% underwent RYGB. There was no statistically significant difference among the three surgical techniques in terms of weight change parameters, comorbidity remission, postoperative complications, and readmission rates. However, revision rates were significantly higher among patients who underwent SG (p < 0.05). Conclusions: SG, MGB, and RYGB techniques are comparable and reliable methods in terms of long-term weight loss, surgical outcomes, and complications. After a 7-year follow-up period, all three techniques were found to be similar in terms of HT, T2DM, and GERD remission; however, SG was observed to have a higher revision requirement compared to the other surgical techniques.

Background: Obesity is still a major global public health problem and its incidence is increasing. Obesity leads to deterioration in thyroid functions. Even when they are within normal ranges, high normal levels of thyroid-stimulating hormone (TSH) increase morbidity and mortality. This study aimed to evaluate the body mass index (BMI) and TSH levels in 300 euthyroid patients with obesity before and after laparoscopic sleeve gastrectomy (LSG). Material/Methods: A total of 300 euthyroid patients who underwent LSG between 2019 and 2021 were included in the study. Body mass index (BMI), thyroid-stimulating hormone (TSH), and free triiodothyronine (FT) 3 and tetraiodothyronine (FT4) levels were recorded before surgery and at 6 and 12 months after surgery and subsequently analyzed. Results: Mean BMI values were significantly lower at 6 and 12 months after surgery (P<0.001). There was a significant difference between mean TSH and FT4 levels before surgery and those at 6 and 12 months after surgery (P<0.001). However, mean FT3 levels remained unchanged 1 year after surgery (P=0.005). Conclusions: LSG is not only effective in terms of weight loss, but also exhibits improving effects on thyroid hormone homeostasis in obese patients and provides protection against further adverse effects of TSH.

Gastritis is a progressive disease that evolves from a non-atrophic to atrophic state and progresses through intestinal metaplasia, with some cases leading eventually to gastric cancer. Since gastritis by definition is an inflammatory process of the mucosal lining of the stomach and is usually associated with pain, we aimed to identify any association between the severity of gastritis and pain and a simple inflammatory marker derived from a complete blood count (CBC). This was a prospective cross-sectional study which enrolled 155 consecutive adult patients who underwent an upper endoscopy. Prior to the endoscopy, all patients were given a questionnaire, numerical rating scale (NRS) and complete blood count evaluation. The biopsy was obtained from the gastric mucosa according to the modified Sydney classification and scored with the Operative Link for Gastritis Assessment (OLGA) scoring system. The results showed a significant correlation between NRS and intestinal metaplasia (p < 0.01); moreover, a correlation was also found between the NRS and OLGA stage (r = 0.469, p < 0.001). A nonlinear curve was constructed for OLGA stage estimation according to NRS scores (r² was found to be 0.442, with p < 0.001). The results also showed a correlation between the neutrophil to the lymphocyte ratio (NLR) and OLGA stage (p < 0.01). No correlation was found between the other gastric parameters and NLR (p > 0.05). Helicobacter pylori positivity did not correlate with NRS and NLR. As a conclusion, pain measured by NRS and NLR, which are simply calculated from the CBC prior to endoscopy, may be used to predict OLGA stages and estimate the severity of gastritis in endoscopy patients.