Gastroparesis or gastric stasis is the delayed transit of the ingested contents through the stomach in the absence of mechanical obstruction. It can have multiple etiologies, most commonly idiopathic (ID) and diabetic (DM). Gastroparesis can cause significant distress to patients as it leads to symptoms like intractable nausea and vomiting, weight loss, abdominal bloating, early satiety, etc. The pathogenesis is mainly thought to be due to the dysfunction of the gastric pacemaker cells, i.e., interstitial cells of Cajal (ICC), and their interaction with the other gastric motor function regulatory components. There are several proposed treatment options for gastroparesis. Despite that, most patients remain refractory to medical treatment and require additional interventions for symptomatic relief. One such intervention is gastric electrical stimulation or gastric pacemaker, which aids in improving gastric motility. We have searched PubMed, PubMed Central (PMC), Medline, Science Direct, and Google Scholar for articles pertaining to the use of gastric electrical stimulation in gastroparesis published in the last 10 years. The keywords used include "gastroparesis", "gastric stasis", "gastric pacemaker'', "gastric electrical stimulation", "nausea", "vomiting", "abdominal bloating", "gastric neuromodulation". We have finally included twelve studies that were the most relevant to our research question and met the quality assessment criteria. Exclusion criteria consisted of pediatric population studies, studies conducted on animals, books, and grey literature. Overall, these twelve studies helped evaluate the impact of gastric pacemakers on symptoms of gastroparesis like nausea, vomiting, weight loss, abdominal bloating, and quality of life. We found that most studies favored gastric pacemakers, improving the incidence of nausea and vomiting in patients with gastroparesis. There was a marked improvement in the BMI as well. On the other hand, most open-labeled studies showed improved quality of life and Gastroparesis Cardinal Symptom Index (GCSI) scores, while randomized controlled trials and meta-analyses did not reflect the same result. In addition, some other parameters improved with gastric pacemakers, Inflammatory markers, insulin levels (especially in diabetics), and the number of hospitalizations. In conclusion, gastric pacemaker is a potential treatment option for patients with medically refractory gastroparesis. As noted from the results of our study, nausea/vomiting, weight loss, and overall GCSI scores have shown marked improvement with gastric electrical stimulation (GES). Nevertheless, more extensive research is needed to understand better the full extent of this device’s use as a viable treatment option for patients suffering from gastroparesis.

Background: Patients with autoimmune diseases experience a higher burden of metabolic syndrome (MetS) and cardiovascular disease (CVD). There is a paucity of data regarding MetS in patients with inflammatory bowel disease (IBD) and its impact on CVD. In this retrospective study, we aimed to evaluate the prevalence of MetS components in IBD patients, as well as their association with acute coronary syndrome (ACS), heart failure and arrhythmias. Methods: After pooling 5 years of data from the National Inpatient Sample (NIS) Database (2016–2020), we compared traditional cardiovascular risk factors between IBD and non-IBD patients. We then investigated the association between MetS (represented by a calculated metabolic score (CMS) ranging from 0 to 4, based on the presence or absence of hypertension, obesity, dyslipidemia and type II diabetes) and CVD, separately for Crohn’s disease (CD) and ulcerative colitis (UC) patients. Results: The prevalence of the different MetS components was found to be lower in IBD patients compared to non-IBD patients. Comparing CD (n = 806,875) and UC (n = 575,925) identified a higher prevalence of MetS components in UC. Higher CMS was positively associated with ACS and arrhythmias in both CD and UC. This association was evident in heart failure, with the odds ratio increasing from 2.601 for CMS = 1 to 6.290 for CMS = 4 in UC patients and from 2.622 to 5.709 in CD patients. Conclusions: Our study highlights the positive association between traditional components of MetS and CVD in IBD patients. Our findings suggest that chronic inflammation explains only partially the CVD burden in hospitalized IBD patients.

Ischemic colitis (IC) occurs when there is a temporary lack of adequate blood supply to the intestines, particularly in vulnerable areas such as the splenic flexure and sigmoid colon, which lack sufficient collateral blood vessels. Although primarily seen in older individuals with atherosclerotic risk factors, IC can also be triggered by hormonal contraceptives in young women. Although estrogen-containing oral contraceptives are known to increase thromboembolic risk, the impact of progesterone is not well understood. We report a unique case of biopsy-confirmed IC in a previously healthy 30-year-old woman who presented with abdominal pain and bloody diarrhea 2 months after initiation of progesterone-only oral contraceptive. This occurrence, although rare, underscores the need for further research on the impact of progesterone on coagulation, especially concerning mesenteric arteries.

Arterial spin labeling (ASL) is a functional magnetic resonance imaging (fMRI) technique that uses water in arterial blood as a tracer to map an area of interest where the intravascular and extravascular compartments exchange. Our review article focuses primarily on the role of ASL fMRI in assessing perfusion impairment in renal allografts in order to take appropriate steps to eliminate the cause of perfusion impairment at an early stage, thereby extending graft life. The study also highlights various other fMRI techniques that are used to analyze other parameters that affect kidney transplants both acutely and chronically. We gathered our data in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and our search strategy included exclusion/inclusion criteria. Several databases were used in the search strategy, including PubMed, Cochrane, and Science Direct, and the Medical Subject Headings (MeSH) strategy was specifically used for PubMed, and two people scrutinized those papers to conclude that a total of 10 research papers are included in our study. This review article includes papers involving 20 to 98 subjects who had renal allografts within the previous six months and had renal cortical perfusion values measured by ASL fMRI ranging from 35 to 304 ml/100 g/min. Furthermore, when compared to healthy kidney transplant patients, renal ASL perfusion values were significantly lower in subjects with the functional imbalance of kidney transplants. It had a positive correlation with the estimated glomerular filtration rate (eGFR). To summarize, ASL fMRI is critical in detecting renal allograft perfusion impairment.