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Purpose: Bacterial virulence factors play a major role in the pathogenesis of Helicobacter pylori infection. The aims of this study were to evaluate virulence genes in H. pylori isolates and to compare the presence of these genes and associated clinical pathologies. Methods: A total of 148 H. pylori isolates, recovered from adult dyspeptic patients, were used. The patients, from whom the isolates were obtained, were assigned to two groups by their endoscopic findings, which manifested as chronic gastritis or peptic ulcer. The presence of gastric atrophy and intestinal metaplasia was recorded for each patient, based on histopathological examination. Analyses of the virulence genes were performed by the polymerase chain reaction technique. Results: The patients had a mean age of 47 ?± ?15 years and 86 (58%) of them were female. Based on endoscopic examination, 103 (69.6%) patients were diagnosed with chronic gastritis and 45 (30.4%) with peptic ulcer. Histopathological examination revealed intestinal metaplasia in 30 (20%) patients and gastric atrophy in 12 (8%) patients. The prevalence rates of cagA, cagE, iceA1, iceA2, and babA2 were determined to be 87%, 74%, 58%, 26%, and 95%, respectively. The most prevalent vacA alleles were s1/s1a (82%/97%) and the least prevalent allele was s2 (20%). A new vacA genotype (s1as1bs1c) was detected, for the first time, in 18 (12%) isolates. No significant difference was found between the patient groups with chronic gastritis and peptic ulcer for the prevalences of the virulence genes (p ?> ?0.05). Furthermore, intestinal metaplasia and gastric atrophy showed no significant correlation with the virulence genes (p ?> ?0.05). Conclusions: It is thoughted that H. pylori isolates with predominant cagA, cagE, VacA (s1, s1a), and babA2 virulence genes are associated with gastroduodenal diseases. However, there is no correlation between gastric premalignant lesions and virulence genes. © 2022 Indian Association of Medical Microbiologists

Giriş ve Amaç: Kronik hepatit C enfeksiyonu karaciğer sirozu ve hepatoselüler karsinomun nedenleri arasındadır. Bu çalışmada primer olarak kronik hepatit C’li heterojen bir hasta grubunda güncel olarak kullanılan ikinci kuşak direk etkili oral antivirallerin tedavi etkinliği ve yan etki profillerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Retrospektif olan bu çalışmaya ikinci kuşak direk etkili oral antiviral tedavi alan 72 hasta dahil edilmiştir. Hastalara ait klinik ve laboratuvar verileri poliklinik takip dosyalarından elde edilmiştir. Bulgular: Hastaların yaş ortalaması 58±14 olup, 39’u (%54) kadın idi. Baskın genotip 1b idi (%74.6). Non-sirotik, kompanse siroz ve dekompanse siroz hastaların sayıları sırasıyla; 56 (%77.8), 14 (%19.4) ve 2 (%2.8) idi. On sekiz hasta (%25) tedavi deneyimli idi. Paritaprevir/ritonavir/ombitasvir + dasabuvir, ledipasvir/sofosbuvir, ledipasvir/sofosbuvir + ribavirin, sofosbuvir + ribavirin, glekaprevir + pibrentasvir ve paritaprevir/ritonavir/ombitasvir + ribavirin alan hasta sayıları sırasıyla; 38 (%52.8), 13 (%18.1), 7 (%9.7), 7 (%9.7), 6 (%8.3) ve 1 (%1.4) idi. Toplam 71 hasta tedaviyi tamamladı ve bunların 69’unda (%97.2) kalıcı viral yanıt elde edildi. Ayrıca başlangıç aspartat aminotransferaz, alanin amimotransferaz, gama glutamil transferaz ve alfa fetoprotein düzeylerinde tedavi ile birlikte anlamlı bir düşüş izlendi (p, Background and Aims: Chronic hepatitis C infection is one of the causes of liver cirrhosis and hepatocellular carcinoma. The purpose of this study was primarily to examine the treatment efficacy and side effect profiles of second-generation direct-acting oral antivirals currently used in a heterogeneous patient group with chronic hepatitis C. Materials and Methods: This retrospective study included 72 patients who received second-generation direct-acting oral antiviral therapy. Clinical and laboratory data of the patients were collected from outpatient follow-up files. Results: The mean age of the patients was 58±14 years, of which 39 (54%) were women. The predominant genotype was 1b (74.6%). Patients with no cirrhosis, compensated cirrhosis, and decompensated cirrhosis were 56 (77.8%), 14 (19.4%), and 2 (2.8%), respectively. Eighteen patients (25%) were treatment experienced. On the other hand, patients treated with paritaprevir/ritonavir/ombitasvir + dasabuvir, ledipasvir/sofosbuvir, ledipasvir/sofosbuvir + ribavirin, sofosbuvir + ribavirin, glecaprevir + pibrentasvir, and paritaprevir/ritonavir/ombitasvir + ribavirin were 38 (52.8%), 13 (18.1%), 7 (9.7%), 7 (9.7%), 6 (8.3%), and 1 (1.4%), respectively. A total of 71 patients completed the treatment and 69 of them (97.2%) was obtained sustained viral response. In addition, a significant decrease was observed in the initial aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transferase, and alpha fetoprotein levels during treatment (p

DRESS (Drug Reaction with Eosinophilia and systemic symptoms) syndrome is thought to be a cause severe organ dysfunction syndrome. It is due to insufficient detoxification of drugs. When DRESS cases are screened, it is usually seen to be linked to antiepileptic drugs. Antibiotics can make DRESS syndrome even more rarely. We showed that with this case, DRESS may develop due to all drugs., DRESS (Drug Reaction With Eosinophilia And Systemic Symptoms) sendromunun ciddi organ işlev bozukluklarına yol açan bir sendrom olduğu düşünülmektedir. İlaçların yetersiz detoksifikasyonuna bağlıdır. DRESS vakaları tarandığında genellikle antiepileptik ilaçlara bağlı olduğu görülmektedir. Antibiyotikler ise daha nadir de olsa DRESS sendromu yapabilir. Biz bu vaka ile tüm ilaçlara bağlı DRESS gelişebileceğini göstermek istedik.

We present a female patient manifested by AIH associated with systemic lupus erythematosus related antiphospholipid syndrome.

The mechanisms underlying acute pancreatitis have not been well elucidated. Over the last 20 years, there has been increasing awareness regarding the role played by oxidative stress in acute pancreatitis, but it is less well defined in human clinical trials. The aim of this study was to identify the relationship between antioxidants and acute pancreatitis.We performed a cross-sectional trial on patients with mild acute pancreatitis. The study population consisted of 53 patients with mild acute pancreatitis and 55 healthy controls. Serum paraoxonase, arylesterase activity, total antioxidant status, total oxidant status and thiol levels were measured, and oxidative stress index was calculated.Paraoxonase, arylesterase activity, thiol and total antioxidant status levels were significantly lower in the acute pancreatitis group than in the control group (p = .024, p .001, p .001, p = .010, respectively). Oxidative stress index and total oxidant status levels were higher in the acute pancreatitis group than in the control group, but the difference was not statistically significant (p = .135, p = .253, respectively).This study demonstrates that decreased antioxidant levels are associated with mild acute pancreatitis. No association was observed between mild acute pancreatitis and total oxidant status.

BACKGROUND/AIMS The dynamic thiol/disulfide homeostasis plays pivotal roles in many physiological mechanisms in an organism. We aimed to investigate whether dynamic thiol/disulfide homeostasis changes among patients with acute pancreatitis. MATERIALS AND METHODS This prospective trial contained 45 patients with acute pancreatitis and 45 sex-and age-matched healthy volunteers as control group. Thiol/disulfide homeostasis parameters were measured by a novel and automated assay, and detected results were compared between the two groups. RESULTS Disulfide/total thiol percent ratio and disulfide/native thiol percent ratios were significantly higher in acute pancreatitis group; besides the native thiol, total thiol levels and native thiol/total thiol percent ratios were significantly lower (for all p < 0.001). CONCLUSION The thiol/disulfide homeostasis is impaired in acute pancreatitis with a shift toward the oxidative status, and this deficiency might be a pathogenic factor in acute pancreatitis. The correction of this thiol/disulfide imbalance may be a new target in the management of acute pancreatitis.

Gastrointestinal stromal tumors (GIST) are mesenchymal tumors of the gastrointestinal tract. Although bleeding is one of the most symptoms seen in GIST, significant acute bleeding is an unusual finding. Here in, three cases with gastrointestinal bleeding due to GIST are presented. Of these patients one had duodenal, one had jejunal and the other had ileal GIST. The duodenal GIST was detected by endoscopy while the jejunal GIST was found by capsule endoscopy and the ileal GIST was shown on magnetic resonance enterography. All patients underwent surgery and the diagnoses of GISTs were confirmed by histopathological evaluation.

Hepatic portal venous gas (HPVG) is a rare radiologic finding that is usually precipitated by intestinal ischaemia, intra-abdominal abscesses, necrotising enterocolitis, abdominal trauma, infectious enteritis, and inflammatory bowel disease. In this study, we present a case of HPVG in a 66-year-old female patient who underwent colonoscopy for evaluation of haematochezia and a review of the literature focused on HPVG following colonoscopy.

Background/aim: The present observational study aimed to determine the predictive value of 3-year recurrence adenoma characteristics at baseline conventional colonoscopy in patients with high-risk adenoma.Materials and methods: A total of 47 patients with high-risk adenoma at baseline colonoscopy were followed up and underwent a surveillance colonoscopy at 3 years. Correlations between adenoma recurrence and baseline adenoma characteristics (size, number, histological features, and location) were analyzed.Results: Among 135 patients with high-risk adenoma, 47 patients (35%) who underwent surveillance colonoscopy at 3 years following baseline colonoscopy were included in the study. In these 47 patients, at least one new adenoma was detected in 19 (40.4%) patients, and new advanced adenomas were detected in 5 (10.6%) patients during the surveillance colonoscopy. No significant difference was found in patients who had adenoma recurrence versus those who did not in terms of size of adenomas (P = 0.143), number of adenomas (P = 0.562), histological properties of adenomas (P = 0.658), or locations of adenomas (P = 0.567).Conclusion: Baseline adenoma characteristics were not associated with the recurrence of adenomas or advanced adenomas in patients with high-risk adenoma.

Background/Aims: In Turkey, there are a limited number of studies including the characteristics of colorectal polyps, and the number of patients was too small in most of them. The aim of this study was to evaluate histological characteristics of colorectal polyps that were determined by colonoscopy and clinical features of patients who had removal of the polyp. Materials and Methods: Patients who underwent colonoscopy were analyzed retrospectively from January 2007 to December 2011. Adult patients (≥18 years) with no history of previous colorectal neoplasms who had removal of colorectal polyp were included. Results: A total of 2222 colorectal polyps were removed in 896 patients. Of these, 621 were male (69.3%) and 275 were female (30.7%). Most of the patients with polyps presented in the age group of 50-59 years (251 patients, 28%). It was recorded that 1816 (81.7%) of all polyps were adenomas. Of 1816 adenomas, 1577 (86.8%) were tubular adenomas. Of patients with adenomas, 19.7% was younger than 50 years. A total of 337 (37.6%) patients were in the high-risk group. Mean age of the high-risk patients was higher than the others (62±13 years and 58±13 years, respectively, p=0.001). Conclusion: This study is the largest series of colorectal polyps in Turkey to date. We determined the clinical and histologic characteristics of colorectal polyps and consider that the detection rate of colorectal adenomas in patients under the age of 50 years may be increased by the widespread use of colonoscopy as a diagnostic test.

Background and Aims: Endoscopic clipping has been widely used for upper gastrointestinal bleeding. It has been shown that hemostasis with endoscopic clipping is successful in bleeding peptic ulcers, Dieulafoy's lesions, and Mallory-Weiss tears. The aim of this study was to evaluate the efficacy of endoscopic clipping in our endoscopy unit. Materials and Methods: Patients presenting with upper gastrointestinal bleeding were evaluated retrospectively. Twenty-seven patients were treated with endoscopic clipping. The etiology of bleeding, rebleeding rates, need for packed red blood cell transfusion, mortality rate, and the Rockall and Glasgow-Blatchford scores were noted. Results:The mean age of the patients (17 male, 10 female) was 58,7 years. Five patients had gastric ulcer (1 Forrest 1a, 2 Forrest 1b, 2 Forrest 2a), 10 patients duodenal ulcer (5 Forrest 1b, 5 Forrest 2a), 7 patients MalloryWeiss tears, and 4 patients Dieulafoy's lesion as the etiology of upper gastrointestinal bleeding. One patient had Forrest 2a duodenal ulcer and Mallory-Weiss tears. Two of the patients (7,4%) rebled. Nineteen patients needed packed red blood cell transfusion with a total of 72 units. The mean Rockall score was 2,9 and the mean Glasgow-Blatchford score was 8,5. Conclusions:Although our patient population was high-risk, the rebleeding rate was low, and none of the patients died., Giriş ve Amaç: Endoskopik klip uygulaması üst gastrointestinal sistem kanaması tedavisinde yaygın olarak kullanılmaktadır. Kanayan peptik ülser, Dieulafoy lezyonu ve Mallory-Weiss yırtığında klip ile kanama kontrolünün sağlanabileceği gösterilmiştir. Biz bu çalışmada kliniğimizin üst gastrointestinal sistem kanamasında endoskopik klip uygulama verilerini değerlendirdik. Gereç ve Yöntem:Üst gastrointestinal sistem kanaması nedeniyle yatırılan ve endoskopik klip uygulanan 27 hasta retrospektif olarak incelendi. Klip uygulama nedenleri, tekrar kanama sıklığı, eritrosit süspansiyon ihtiyaçları, mortalite sıklığı, Rockall skoru ve Glasgow-Blatchford skoru değerlendirildi. Bulgular:Çalışmaya dahil edilen hastaların 17'si erkek, 10'u kadın idi ve yaş ortalaması 58,7 yıl olarak hesaplandı. Klip uygulanan 5 hastada gastrik ülser (1 hasta Forrest 1a, 2 hasta Forrest 1b, 2 hasta Forrest 2a); 10 hastada duodenal ülser (5 hasta Forrest 1b, 5 hasta Forrest 2a); 7 hastada Mallory-Weiss yırtığı ve 4 hastada Dieulafoy lezyonu üst gastrointestinal sistem kanamasının nedeni idi. Hastalardan birinde ise hem Forrest 2a duodenum ülseri hem de Mallory-Weiss yırtığı mevcuttu. 27 hastanın 2'sinde (%7,4) işlem sonrası takip sırasında kanama tekrarladı. Hastaların 19'unda (%70) eritrosit süspansyonu ihtiyacı oldu ve toplam 72 ünite ES verildi. Hastaların ortalama Rockall skoru 2,9 ve ortalama Glasgow-Blatchford skoru 8,5 idi. Sonuç: Prognoz açısından riskli olan hastalarımızda mortalite saptanmamış ve tekrar kanama riski düşük bulunmuştur.

Warfarin is an anticoagulant agent known to have a common complication, bleeding. Intramural intestinal haematoma is an uncommon incidence of warfarin-induced haemorrhage. Abdominal pain is its most frequent symptom and presentation with upper-gastrointestinal haemorrhage is rarely seen. Here, we present a 67-year-old male who was admitted to the hospital with active upper-gastrointestinal haemorrhage. In this case, the cause of bleeding has been attributed to duodenal intramural haematoma due to warfarin overuse.

Background/Aims: The aim of this study was to evaluate the gastric polyps detected by endoscopy in our institution with respect to their frequency, size, anatomic location, presence of dysplasia, and histopathologic features. Materials and Methods: Records of a total of 14,240 patients who underwent endoscopy between January 2008 and January 2012 were reviewed retrospectively. Of the 14,240 patients, 174 determined to have at least 1 histopathologically proven polyp were included in the study. Results: Three hundred eleven gastric polyps were found in 174/14,240 (1.2%) patients (1.79 polyps per patient). Gastric polyps were found most commonly in the antrum (41.5%). Of all gastric polyps, 189 (60.8%) were less than 1 cm. Histopathologically, the most common polyp type was hyperplastic (n: 261, 83.9%), followed by adenomatous (n: 23, 7.4%). Eight (34.8%) of the adenomatous polyps showed dysplasia, and in 4 (17.4%) of these cases, the dysplasia was high-grade. Nineteen (6.1%) of all gastric polyps were identified to be fundic gland polyps. Conclusion: According to this study from Turkey, the majority of polyps detected by endoscopy was solitary, smaller than 1 cm, and found in the antrum; furthermore, the most common type was a hyperplastic polyp.

Giris ve Amac: Kolonoskopinin tanisal etkinligi barsak hazirligi rejiminin basarisina baglidir. Daha once yapilan bir calismada polietilen glikol kolonoskopi hazirlik rejimine ananas suyu eklenmesinin barsak temizligini artirdigi gosterilmistir. Bu calismanin amaci sennosid A+B kalsiyum hazirlik rejimine ananas suyu eklemenin barsak temizligi uzerine olumlu etkisinin olup olmadiginin degerlendirilmesidir. Gerec ve Yontem: Kolonoskopi yapilmak uzere unitemize yonlendirilen hastalar randevu verilmesi esnasinda ananas grubu ve kontrol grubu olarak iki gruba ayrildi. Tum hastalara barsak hazirligi icin islemden bir gun once sennosid A+B kalsiyum 300 mg, bol su ile icmeleri onerildi. Ananas grubunda yer alan hastalara ise buna ek olarak islemden bir gun once bir tam ananasi kati meyve sikacagindan gecirerek icmesi onerildi. Islemi yapan endoskopist barsak temizligini Ottawa barsak temizligi skalasi yardimi ile degerlendirdi ve sonuclar karsilastirildi. Bulgular: Calisma icin uygun olmayan hastalar dislandiktan sonra kontrol grubunda 46, ananas grubunda ise 44 hasta degerlendirmeye alindi. Total Ottawa barsak temizligi skalasi skoru ve her kolon segmenti icin ayri ayri hesaplanan temizlik miktarlari acisindan iki grup arasinda istatistiksel olarak anlamli fark saptanmadi. Total Ottawa barsak temizligi skalasi ananas grubu ve kontrol grubu icin sirasiyla 4,77 ve 5,00 olarak hesaplandi. Sonuc: Sennosid A+B kalsiyum hazirlik rejimine ananas suyu eklemenin barsak temizligi uzerine olumlu katkisi saptanamamistir.

Drug-induced pancreatitis has been reported rarely. Bortezomib is a selective and reversible proteasome inhibitor used for the treatment of patients with multiple myeloma (MM). Recently, one case report about acute pancreatitis (AP) caused by bortezomib was published in the international literature. Herein we report a case of AP in a 67-year-old male on bortezomib therapy. On the fourth day after the first administration of bortezomib, the patient admitted to the hospital with symptoms of AP. The common etiological factors for AP were all excluded. Than the patient was diagnosed as bortezomib-induced pancreatitis.

Wandering spleen is the displacement of the spleen due to the loss or weakening of the ligaments of the spleen and is seen very rarely with an incidence of less than 0.5 %. It can cause portal hypertension, but gastric variceal hemorrhage is a quite rare condition within the spectrum of this uncommon disease. We report a 22-year-old woman with wandering spleen presenting with life-threatening gastric variceal hemorrhage. Her diagnosis was made by computerized tomography. Endoscopic therapy was not adequate to stop the bleeding, and urgent splenectomy was performed. After surgery she has been well with no symptoms until now.

Background/Aims: There are a limited number of studies including the impact of antiplatelet drugs use on hospital outcomes for nonvariceal upper gastrointestinal bleeding. The aim of this study was to determine the effect of anti-aggregant, anti-coagulant and non-steroidal anti-inflammatory drugs upon hospital outcomes in patients with peptic ulcer bleeding. Materials and Methods: The patients under treatment with antiaggregant, anticoagulant or non-steroidal anti-inflammatory drugs were categorized as exposed group (n = 118) and the patients who were not taking any of these drugs were categorized as non-exposed group (n = 81). We analyzed the data of drug intake, comorbid disease, blood transfusion, duration of hospital stay, Blatchford/total Rockall score and diagnosis of patients. Results: In total, 199 patients were included. Of these 59.3% (exposed group) were taking drugs. The patients in exposed group were significantly older than those in non-exposed group (62.9 ± 17.3 years; 55.5 ± 19.3 years, P = 0.005, respectively). Mean number of red blood cell units transfused (2.21 ± 1.51; 2.05 ± 1.87, P = 0.5), duration of hospital stay (3.46 ± 2.80 days; 3.20 ± 2.30 days, P = 0.532) and gastric ulcer rate (33% vs 23.4%, P = 0.172) were higher in exposed group than in non-exposed group but the differences were not statistically significant. Total Rockall and Blatchford scores of the patients were significantly higher in exposed group than in non-exposed group (3.46 ± 1.72 vs 2.94 ± 1.87, P = 0.045; 10.29 ± 3.15 vs 9.31 ± 3.40, P = 0.038). Conclusıon: Our study has shown that anticoagulants, antiaggregants and nonsteroidal anti-inflammatory drugs do not effect duration of hospital stay, red blood cell transfusion requirement and rebleeding for peptic ulcer bleeding.