Background: Liver cirrhosis is a complex disorder that affects nearly 122 million patients worldwide. This study synthesizes global prevalence estimates of depression and anxiety among patients with cirrhosis, together with associated risk factors and geographic distribution. Method: An electronic search was conducted on Medline, Embase, Cochrane Central and Web of Science databases. Results were then filtered according to the inclusion criteria over two stagesData from eligible studies were extracted into a standardized spreadsheet, which was then subjected to analysis and evidence synthesis. Results: Our search yielded 23 articles from countries all over the world describing 979,113 patients.The pooled prevalence was 0.37 [95% C.I. 0.29–0.46, p = 0.01] for depression and of 0.53 [95% C.I. 0.33–0.73, p < 0.010] for anxiety, in cirrhotic patients, however, high heterogeneity was noted. Meta-regression was performed to assess the ability of demographic factors (Ager, Sex), and etiological factors to predict depression in cirrhotic patients. Age, alcoholism, and viral etiologies, were linked to depression incidence. Advancing age was associated with increased depression prevalence among cirrhosis patients ( p = 0.02). Conclusion: Depression and anxiety substantially impair quality of life in patients with cirrhosis, but their diagnosis remains limited and under-investigated. Standardizing depression and anxiety screening for cirrhosis patients can improve their outcomes and quality of life significantly.

Background: Fexuprazan is a newly emerging potassium-competitive acid blocker (P-CAB) medication. P-CAB drugs have been introduced as alternative medications for gastroesophageal reflux disease (GERD) instead of traditionally used proton-pump inhibitors (PPIs). Aim: This study aims to compare the efficacy and safety of fexuprazan in contrast to esomeprazole. Methods: An electronic search was conducted on major databases, and retrieved results were subjected to two stages of filtration based upon a preset inclusion criterion. The first stage filtered articles based on their titles and abstracts, and the second stage filtered articles based on their full texts. Articles found fit to include in this study were extracted using a pre-set piloted extraction form. Extraction results were introduced into a spreadsheet. Data was divided into categorical and numerical data. Categorical data was reported as counts and frequencies, while continuous data was reported as proportions, means, and standard deviations. Common and random effect meta-analyses were conducted as found fit. Risk of bias assessment was performed using the Cochrane’s risk of bias assessment (RoB 2.0) tool. Results: Five articles were included in the present review, describing 965 patients managed with fexuprazan 40 mg or esomeprazole 40 mg for a mean of 9.6 weeks. The mean age of patients was 50.2 ± 13.0 years. GERD symptom scores showed a numerically lower value in the fexuprazan group (SMD − 0.41 [95% CI: −1.10; 0.29], p = 0.25), though this difference was not statistically significant and the confidence interval crosses the null ( I ² = 94.5%, p < 0.01). The proportion of patients reporting symptom improvement did not differ significantly between groups (RR 0.85 [95% CI: 0.6; 1.22], p = 0.39; I ² = 91.3%, p < 0.01). No significant difference was observed in the incidence of treatment-emergent adverse events (TEAEs; RR 1.07 [95% CI: 0.9; 1.27], p = 0.45; I ² = 0.0%) or adverse drug reactions (ADRs; RR 1.10 [95% CI: 0.79; 1.53], p = 0.59; I ² = 0.0%). Conclusion: No statistically significant difference in efficacy was identified between fexuprazan and esomeprazole; however, preliminary findings are consistent with non-inferiority. No statistically significant difference in the incidence of TEAEs or ADRs was observed between treatments, suggesting a comparable safety profile. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261286108 .

Background: Gastroesophageal reflux disease (GERD) is a highly prevalent gastrointestinal disorder worldwide. Management strategies include lifestyle modification, pharmacologic therapy, and surgical interventions. Diaphragmatic breathing exercises have been proposed as a non-pharmacological treatment aimed at improving lower esophageal sphincter function and reducing reflux episodes. Methods: A systematic search of PubMed/MEDLINE, Scopus, ScienceDirect, Google Scholar, and ClinicalTrials.gov was conducted from database inception to 10 March 2026 to identify randomized controlled trials evaluating diaphragmatic breathing in patients with GERD. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane Risk of Bias 2.0 tool. Random-effects meta-analyses were performed to estimate pooled mean differences for symptom scores and quality-of-life outcomes. Results: Ten randomized controlled trials including 476 patients were analyzed (mean age: 39.9 ± 11.3 years). Diaphragmatic breathing interventions were performed in 229 participants, with an average duration of 20.36 min per session over approximately 5.1 weeks. Meta-analysis demonstrated a modest improvement in GERD symptom scores favoring diaphragmatic breathing (SMD −0.74; 95% CI −1.36 to −0.12; p = 0.019), with substantial heterogeneity (I² = 79.7%). Subgroup analyses comparing breathing with medication and sham breathing controls produced similar trends. Quality-of-life outcomes did not demonstrate statistically significant improvement (MD −2.35; 95% CI −6.35 to 1.65; p = 0.25) and showed considerable heterogeneity (I² = 85.3%). Risk-of-bias assessment revealed “some concerns” in several studies, primarily related to randomization procedures and outcome reporting. Conclusions: Although pooled results demonstrated a statistically significant reduction in GERD symptom scores favoring diaphragmatic breathing, this finding must be interpreted with considerable caution given the substantial heterogeneity observed. The current evidence remains limited by methodological heterogeneity, and inconsistent outcome assessment is insufficient to support definitive clinical recommendations, and the observed benefit may not be generalizable across patient populations or clinical settings. Larger standardized randomized trials are required to determine the clinical role of diaphragmatic breathing in GERD management.

A 43‐year‐old male with newly diagnosed diabetes developed methicillin‐sensitive Staphylococcus aureus (MSSA) bacteremia following a foot injury. Despite appropriate antibiotic treatment, the patient’s blood cultures remained persistently positive, and imaging revealed septic pulmonary emboli. Both transthoracic and transesophageal echocardiography showed no evidence of right‐sided infective endocarditis. A gallium scan, followed by CT and MRI, identified a perinephric abscess as the source of infection. After drainage of the abscess and prolonged antibiotic therapy, the bacteremia was resolved, and pulmonary septic foci were reduced. This case highlights the importance of considering extracardiac sources, such as perinephric abscesses, in cases of persistent bacteremia and septic pulmonary emboli, especially when there is no evidence of endocarditis. And the remarkable utility of gallium scans to detect hidden infections.

Background: Gastroesophageal reflux disease (GERD) is a common problem that affects patients. The constant irritation of the esophageal mucosa, in addition to the potential aspiration, has been suggested as a predisposing factor for lung cancer (LC). This study aims to investigate the association between GERD and LC. Methods: An electronic search was conducted on EMBASE, CENTRAL, and PubMed databases from inception through November 2025. Studies evaluating the association between GERD and lung cancer in adult populations were included. Reviews, non-English articles, pediatric studies, and non-human studies were excluded. Twelve studies involving 2,900,965 patients met the inclusion criteria. Three types of common and random effect meta-analyses were utilized, namely meta-analysis of proportion, log(HR) and log(OR) models. Included studies were examined for risk of bias using the Newcastle–Ottawa scale. Results: Twelve articles describing 2,900,965 patients were found to be fit for inclusion. Male and female sexes were equally represented. On average, patients were 57.67 ± 10.02 years of age. Pooled proportion of co-occurring LC and GERD in patients was estimated at 64% [95% C.I.: 15–95%; p = 0.02], with significant heterogeneity (I² = 96.8%, p < 0.01). Among studies calculating for hazard ratio (HR), an estimated pooled log(HR) of 1.01 [95% C.I.: 0.36–2.8; p = 0.98] with significant data heterogeneity (I² = 88%, p < 0.01) was found. In comparison, five studies included estimates of odds ratio (OR), which resulted in a pooled log(OR) of 1.32 [95% C.I.: 1.2–1.46; p < 0.01], with less heterogeneity (I² = 59.1%) which was marginally significant (p = 0.04). Conclusions: Our findings may suggest a possible association between LC and GERD; however, estimates were discordant across effect measures and heterogeneity was substantial, so this association should be interpreted with caution.

Background: Crohn's disease (CD) is an inflammatory bowel disease (IBD) that has evolved into a global health concern, with a rising cumulative burden that makes periodic, up-to-date quantification essential for health-system planning. In recent decades, its incidence has stabilized in early-industrialized regions while rising rapidly in newly industrialized ones, resulting in an increasing cumulative disease burden in high-income regions. This epidemiological transition necessitates precise burden estimation to inform strategic health policies. Methods: The study was conducted using openly available modeled estimates from the Global Burden of Disease (GBD) 2023 study, in an independent effort to analyze the regional and global burden of CD from 1990 to 2023. This analysis was conducted in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting. Main outcome measures were disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs), expressed as absolute values and age-standardized rates per 100,000 people across 21 GBD regions. The contributions of population growth and age-standardized rate change to the observed DALY were examined after being separated using a two-component decomposition, in addition to the temporal patterns across the whole period. YLLs and YLDs were calculated for each year, and for 2023, male-to-female DALY rate ratios were observed over time. Results: Between 1990 and 2023, aggregate DALYs attributable to CD rose from approximately 271,700 to 414,300 (+52.5%), while the age-standardized DALY rate declined modestly (-5.6%). Decomposition indicated that this increase was driven predominantly by demographic change rather than by rising age-standardized risk. Eight of the 21 GBD regions nevertheless showed genuine rate-driven increases, most prominently in Tropical Latin America and in Sub-Saharan Africa. Burden remained highly heterogeneous, with a greater than 20-fold difference between the highest age-standardized rate (Australasia, 19.70 per 100,000; 95% UI: 13.86-26.89) and the lowest (East Asia, 0.95; 95% UI: 0.67-1.30). The YLD share of DALYs rose from 49.2% to 55.4%, indicating a shift toward disability-dominated burden. Male-to-female rate ratios varied widely across regions, with female predominance concentrated in Sub-Saharan Africa. In the North Africa and Middle East region, the age-standardized rate fell by 12.3% while absolute burden nonetheless grew. Conclusion: The global burden of Crohn's has increased since 1990, driven principally by population expansion rather than worsening disease risk. However, genuine rate-driven increases in Tropical Latin America and Sub-Saharan Africa signal epidemiological transitions demanding targeted surveillance and resource allocation. The shift toward disability predominant burden underscores a growing need for long-term disease management globally. These findings are limited to regional aggregates for CD only; country-level analyses incorporating ulcerative colitis data are needed to fully characterize the global IBD burden.