Sedation-free upper gastrointestinal endoscopy and its cost-effectiveness

This study aimed to determine the success rate of sedation-free upper gastrointestinal (GI) endoscopy and evaluate the cost-effectiveness of this drug-free approach.The study included patients who underwent gastroscopy between February 2020 and December 2022. Demographic information such as age and gender, along with clinical data including whether the procedure was performed with sedation and the patients' tolerance status, were recorded. Statistical analysis revealed no significant difference between the sedation and sedation-free groups in terms of procedural success. Interestingly, a notable cost difference of 43% was observed between the two groups, with the sedation-free group demonstrating higher cost-effectiveness. Despite the nearly 50% higher cost associated with administering sedation, there was no significant disparity in the successful completion of the procedure between the two groups. The findings of this study indicate that sedation-free upper GI endoscopy can achieve comparable success rates to the sedation-assisted approach. Moreover, the cost-effectiveness analysis highlights the economic advantage of the drug-free alternative, given the substantial cost reduction observed in the sedation-free group. This study underscores the feasibility of implementing sedation-free procedures as a cost-effective and successful option for upper GI endoscopy [Med-Science 2023; 12(3.000): 887-9

The function of obesity related miR223-3p as a potential biomarker for weight loss prediction following bariatric surgery

The objective was to determine how miRNA expression levels related to obesity and weight loss interacted, to forecast how much weight patients could lose after surgery, and to maximize the advantages of a scheduled procedure. 17 patients who planned laparoscopic sleeve gastrectomy were included. Demographic variables, comorbid conditions, and postoperative excess weight loss rates (EWL%) were evaluated. Both intraoperative adipose tissue samples and blood samples were taken. The gene expression levels of the miRNAs (miR27b-3p, miR122- 5p, and miR223-3p) linked to diabetes and obesity were investigated. Mean body mass index was 49.17.6 kg/m2. Six individuals had diabetes mellitus, and their mean blood sugar and HbA1c levels were 133±59.4 mg/dl and 6.4±1.3%, respectively. All preoperative groups had considerably higher levels of miR223-3p expression, it was discovered. Blood samples taken before and after surgery showed considerably higher levels of miR223-3p gene expression than those of miR27b-3p and miR122-5p. Additionally, it was discovered that in individuals with diabetes mellitus, miR122-5p gene expression in fatty tissue was lower than that of miR223-3p and miR27b-3p. MiR223-3p expression has been linked to morbidly obese patients, particularly those with EWLs of 50% and above. After bariatric surgery, the miR223-3p gene may be utilized as a potential biomarker to predict a patient's capacity to lose weight. It is possible to identify patients who will not benefit from surgery and decide to perform a different kind of operation on them. However, additional research involving more patients, additional miRNAs, and various bariatric surgery techniques is required. [Med-Science 2023; 12(2.000): 557-61