Gastroesophageal reflux disease (GERD) is a condition characterized by the reflux of stomach contents into the esophagus which leads to heartburn and regurgitation. GERD has been categorized its types according to severity. The categories that have been discussed in this study are reflux esophagitis (RE), non-erosive reflux disease (NERD), and Barrett's esophagus. Our study compared various studies and showed that the subjects with GERD had a high level of anxiety and depression. Gastroesophageal reflux disease has a significant negative impact on the quality of life (QoL) by perturbing daily activities. The majority of GERD patients use antacid drugs to control their acid symptoms. However, these symptoms are sometimes difficult to control, even with the most potent proton-pump inhibitors (PPIs) and these patients tend to have a lower response rate. According to the clinical data, Anxiety, and Depression are linked to the development of GERD. A major focus of this study is to explore psychological influences such as anxiety and depression, and how they relate to GERD. This study also reviews the effect of these conditions on the younger population. It is concluded that the QoL of subjects with GERD is reduced by depression and anxiety.

Alzheimer's, a neurodegenerative disease that starts slowly and worsens progressively, is the leading cause of dementia worldwide. Recent studies have linked the brain with the gut and its microbiota through the microbiota-gut-brain axis, opening the door for gut-modifying agents (e.g., prebiotics and probiotics) to influence our brain's cognitive function. This review aims to identify and summarize the effects of fecal microbiota transplantation (FMT) as a gut-microbiota-modifying agent on the progressive symptoms of Alzheimer's disease (AD). This systematic review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A systematic search was done using Google Scholar, PubMed, PubMed Central, and ScienceDirect databases in June 2022. The predefined criteria upon which the studies were selected are English language, past 10 years of narrative reviews, observational studies, case reports, and animal studies involving Alzheimer's subjects as no previous meta-analysis or systematic reviews were done on this subject.Later, a quality assessment was done using the available assessment tool based on each study type. The initial search generated 4,302 studies, yielding 13 studies to be included in the final selection: 1 cohort, 2 case reports, 2 animal studies, and 8 narrative reviews. Our results showed that FMT positively affected AD subjects (whether mice or humans). In humans, the FMT effect was measured by the Mini-Mental State Examination (MMSE), showing improvement in Alzheimer's symptoms of mood, memory, and cognition. However, randomized and nonrandomized clinical trials are essential for more conclusive results.

Urinary tract infection (UTI) is common in older adults, mainly due to several age-related risk factors. Symptoms of UTI are atypical in the elderly population, like hypotension, tachycardia, urinary incontinence, poor appetite, drowsiness, frequent falls, and delirium. UTI manifests more commonly and specifically for this age group as delirium or confusion in the absence of a fever. This systematic review aims to highlight the relationship between UTI and delirium in the elderly population by understanding the pathologies individually and collectively. A systematic review is conducted by searching PubMed with regular keywords and major Medical Subject Heading (MeSH) keywords, Science Direct, and Google Scholar. The inclusion criteria consisted of studies based on male and female human populations above the age of 65 in the English language, available in full text published between 2017 and 2022. However, the exclusion criteria were animal studies, clinical trials, literature published before 2017, and papers published in any other language except English. A total of 106 articles were identified, and nine final studies were selected after a quality assessment, following which a valid relationship between delirium and UTI was identified in this systematic review.

Major depressive disorder (MDD) is a common neuropsychiatry manifestation that is more prevalent lately. Many contributing factors are present (for example, neurochemical, physiological, pathophysiological, and endocrinological factors). Patients with increased serum parathyroid levels are usually linked to psychosis symptoms but not to depressive symptoms. We conducted this systematic review to explore a correlation between depressive disorder and increased serum parathyroid levels, a major endocrinological pathology, and help establish mental wellness in patients suffering from hyperparathyroidism.We conducted a thorough literature search using five major databases, MEDLINE, PubMed, PubMed Central (PMC), ScienceDirect, and Google Scholar, using three keywords-MDD, depression, and hyperparathyroidism. We included mixed method studies, including observational studies, non-randomized controlled trials, case reports, and review articles published in the last ten years, focusing on the adult and geriatric population (>18 years) and on depressive and anxiety symptoms associated with patients with hyperparathyroidism. We included 11 articles (seven observational studies + four case reports) for qualitative synthesis after screening the literature. The reviewed studies showed an association between high serum parathyroid level, high serum calcium level, high serum alkaline phosphatase level, low serum phosphorous level, and increased depressive neurocognitive symptoms. After a patient with hyperparathyroidism is treated for hypercalcemia or undergoes parathyroidectomy and the serum parathyroid levels are lowered, a decrease in severe depressive symptoms is noted. The qualitative analysis of the reviewed literature showed an association between major depressive disorder and hyperparathyroidism. This paper can guide clinicians to assess patients with increased serum parathyroid levels for depressive neuropsychiatric symptoms and plan treatment, as treatment of their hyperparathyroidism can significantly lower their depressive symptoms. More randomized controlled trials should be conducted to find the treatment effectiveness of depression in patients with hyperparathyroidism.

Introduction: Extra Corporeal Membrane Oxygenation (ECMO) is a device applied to maintain cardiopulmonary support in patients in whom there is a failure of the cardiopulmonary function to maintain perfusion to vital organs. Previously, ECMO was used in pulmonary embolism, cardiogenic shock, myocarditis, and heart failure cases. Its use in refractory acute respiratory distress syndrome (ARDS) in coronavirus disease 2019 (COVID-19) has increased, but the data regarding its safety, efficacy, and mortality benefit remains unclear. The focus of our review is to further expand on these areas and outline the indication, techniques, and complications associated with its use. Methods: We did an extensive search of various databases such as PubMed, Cochrane, ScienceDirect, and Jama Network and studied 41 papers, including free full articles such as systematic reviews, meta-analyses, and clinical trials published within the past five years. Results: Implementation of ECMO is advantageous when the PaO2/FiO2 is in the range of 100 to 150 mmHg. For COVID-19 patients, the most appropriate approach is to drain from a femoral venous cannula and thread it to the inferior vena cava just 1-2cm below the cavoatrial junction.  It was seen that the most common complication of ECMO use is coagulopathy. Limb ischemia had a variable incidence from 10 to 70% and is more common in venous-arterial ECMO. Conclusion: ECMO is lifesaving in a highly selected group of patients to prolong survival, reduce complications and provide a good prognosis in terms of mortality. To prevent circuit thrombosis, anticoagulation is key, and understanding feasible intra-atrial communication sites, such as a patent foramen ovale or atrial septal defects, is beneficial to mitigate the risk of stroke and cutting down consequences of thromboembolism.