Novelty in Biomedicine

Background: The pisiform is a bone that is sometimes considered a sesamoid bone. Pain and tenderness can be due to tendinopathy at the attachment site of the flexor ulnaris tendon, carpal fractures, or osteoarthritis of the pisotriquetral joint. There are limited studies on the association between wrist disorders and pisotriquetral joint effusion; therefore, this study aimed to investigate this association on magnetic resonance imaging (MRI).

Materials and Methods: In this cross-sectional study, which investigated the relationship between wrist disorders and pisotriquetral joint effusion on MRI, all patients referred to the radiology department of Besat Hospital in 2024 for wrist disorders underwent MRI. MRI findings included osteoarthritis of the wrist joints, ganglion cysts, dislocations, subluxations, and osteonecrosis. If there were no positive findings, the MRI was considered normal. The significance level was considered less than 0.05.

Results: Ninety-three patients were assessed. Fifty-seven patients (61.3%) had pisotriquetral joint effusion, and 36 (38.7%) patients did not have pisotriquetral joint effusion. Joint effusion was not associated with age or gender (P-values > 0.05). Also, there was no association between pisotriquetral joint effusion and the occurrence of osteonecrosis, osteoarthritis, subluxation, dislocation, and ganglion cyst (all P-values > 0.05).

Conclusion: There was no association between wrist disorders and pisotriquetral joint effusion.

Background: English has become the primary medium of instruction in medical education, creating linguistic and psychological challenges for non-native speakers. English language learning anxiety may affect both mental health and sleep quality, yet its impact in medical students remains underexplored. This study examined the relationships among English learning anxiety, generalized anxiety, and sleep quality.

Materials and Methods: A cross-sectional survey was conducted with 286 medical students enrolled in English-medium programs. Participants completed the Medical English Language Anxiety Scale (MELAS), Generalized Anxiety Disorder-7 (GAD-7), and Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using descriptive statistics, correlations, and multiple regression analyses.

Results: Moderate-to-high English learning anxiety was reported by 72.4% of students, and 61.5% experienced poor sleep quality. English learning anxiety correlated positively with generalized anxiety (r = 0.48, p < 0.001) and sleep disturbance (r = 0.42, p < 0.001). Regression analyses indicated that language anxiety independently predicted poorer sleep quality, and generalized anxiety partially mediated this relationship.

Conclusion: English language learning anxiety is a significant psychological burden for medical students, affecting both anxiety levels and sleep quality. Integrating language anxiety management and psychological support into medical English curricula may improve students’ well-being and academic performance.

Background: Post-cholecystectomy syndrome is one of the most common complications of laparoscopic cholecystectomy. The present study aimed to investigate factors affecting post-cholecystectomy syndrome in laparoscopic cholecystectomy surgery in patients with gallstones.

Materials and Methods: In this prospective cohort study, 100 patients with gallstones who underwent laparoscopic cholecystectomy were included. Patients were evaluated and followed up for 6 months using a checklist of possible factors affecting post-cholecystectomy syndrome, including demographic, non-biliary, biliary, and extrabiliary factors.

Results: Among the 100 patients participating in this study, 21 (21%) experienced post-cholecystectomy syndrome within 6 months. Higher age (P-value<0.001), male gender (P-value: 0.048), involvement with diabetes (P-value: 0.038), involvement with gastritis (P-value: 0.005), and increased CBD diameter (P-value<0.001) were significantly associated with the occurrence of PCS. Logistic regression analysis revealed that only Helicobacter pylori infection had a significant impact on the incidence of PCS (SE: 1.053, CI95%: 2.592- 160.858, P-value: 0.004), whereas linear regression did not.

Conclusion: The results obtained from this study showed that old age, diabetes, Helicobacter pylori infection, male gender, and gastritis are related to the occurrence of post-cholecystectomy syndrome.

Background: The COVID-19 pandemic has heightened concerns over secondary bacterial infections, which worsen outcomes in hospitalized patients. This study investigated the prevalence and antibiotic resistance of bacteria isolated from clinical specimens of COVID-19 patients admitted to Fatemeh Zahra Hospital in Sari, Iran.

Materials and Methods: From September 2020 to August 2022, 3314 COVID-19 patients were included, with 55 positive cultures (including bacterial and fungal) obtained from 47 patients. The most common sources were urine (52.7%) and respiratory samples (38.1%). Gram-negative bacteria (58.9%), primarily Enterobacteriaceae (84.8%), were predominant, followed by Pseudomonas spp. and Acinetobacter. Gram-positive isolates included Staphylococcus aureus and coagulase-negative staphylococci. ICU-admitted patients showed higher co-infection rates, with increased mortality linked to bacterial infections. Antimicrobial susceptibility testing revealed concerning resistance patterns, including high resistance to ceftazidime (85% in Gram-negatives), imipenem (45% in Acinetobacter), and amikacin (50% in Pseudomonas), underscoring the challenge posed by multidrug-resistant organisms (MDROs). Among Gram-negative isolates, 30% were extensively drug-resistant (XDR).

Results: Despite a low overall co-infection rate (1.3%), bacterial infections significantly impacted disease severity and mortality. The findings align with regional studies highlighting Gram-negative pathogens as major contributors. Compared with pre-pandemic reports from Iran, resistance rates to carbapenems increased from ~43% to 65% among Acinetobacter baumannii. The rise in antimicrobial resistance (AMR) underscores the need for strict antibiotic stewardship and robust infection control measures.

Conclusion: This study emphasizes the critical role of bacterial co-infections in COVID-19 outcomes and calls for continuous surveillance to guide effective treatment strategies during the pandemic.

Background: Some studies suggest that basal-type breast cancer is a subtype of triple-negative breast cancer, and some others mention that it is a unique type of breast cancer. There are limited studies on the results of treatment and outcomes of patients with basal-type breast cancers. Therefore, we aimed to assess the relationship of treated basal-type breast cancer with recurrence, metastasis, and chemotherapy regimen.

Materials and Methods: This retrospective cohort study analyzed patients with treated basal-type breast cancer at Omid Hospital in Mashhad, Iran, from 2016 to 2020. Data were obtained from the Breast Cancer Registry System, including age at diagnosis, affected side (right or left breast), cancer stage, metastasis, relapse, and chemotherapy regimens. Patients were then contacted to assess their two-year survival outcomes. A significance level of less than 0.05 was considered.

Results: Ninety-three patients with a mean age of 47.41 ± 17.16 years were evaluated. Of these, 19 patients (20.4%) presented with metastasis, and 14 patients (15.1%) faced relapse. The two-year survival rate was 74.2%. Age was associated with relapse and metastasis (P-value< 0.01 and 0.03, respectively). Higher tumor stage was associated with increased metastasis (P-value < 0.05). Among patients without relapse, 81.0% survived after two years; among those without metastasis, the survival rate was 86.5%. Chemotherapy type did not show significant associations with metastasis, relapse, age, stage, or survival outcomes (all P-values > 0.05).

Conclusion: The administration of chemotherapy, irrespective of its specific type, has demonstrated beneficial effects on basal-type breast cancer.

Background: Thrombocytopenia is associated with the severity and increased morbidity and mortality of COVID-19. Therefore, understanding this association can aid in diagnosing the disease, predicting outcomes, and reducing mortality and morbidity.

Materials and Methods: Patient data from the teaching hospital's archives were considered. The severity of the disease was classified into four categories: mild, moderate, severe, and very severe, based on the national protocol. A total of 82 patients were analyzed, including 41 with thrombocytopenia and 41 without, who were admitted to the teaching hospital from February 2021 to the end of March 2022. This allowed for a comparative analysis.

Results: Thrombocytopenia was significantly associated with longer hospital stays (p<0.001) of more than 5 days. Thrombocytopenic patients were more likely to be admitted to the ICU (90.2%) compared to non-thrombocytopenic patients (14.6%) (p<0.0001). Thrombocytopenic patients also had lower SpO2, with values below 90% in 90.2% of cases (p=0.046). Thrombocytopenia was linked to DIC and ARDS and had a substantial impact on disease outcome, with mortality rates of 75.6% and 7.3% in thrombocytopenic and non-thrombocytopenic patients, respectively. Severity and various laboratory variables (LDH, D-dimer, CRP, and CPK) also showed significant differences between the two groups. The association between thrombocytopenia and disease severity was significant, with 75.6% categorized as very severe and 22% as severe (p<0.0001).

Conclusion: The study found a clear correlation between hospital stay length and admission location for both patient groups. In the ICU, thrombocytopenic patients experience longer stays and lower SpO2 levels. Thrombocytopenia significantly impacts disease outcome and is closely linked to DIC and ARDS, with an increased risk of mortality. Notable differences exist in LDH, D-dimer, CRP, and CPK levels between the two groups. Thrombocytopenia is associated with higher disease severity, particularly in thrombocytopenic patients. Age, gender, hospital stay length, and disease severity correlate meaningfully. Male patients and those with higher clinical severity tend to have longer stays. Additionally, SpO2 levels, respiratory rate, DIC, disease outcome, CPK, and clinical severity are significantly related.

Background: Water pipe tobacco is one of the methods of smoking that has a high prevalence worldwide, especially in Iran. Since tobacco can affect various body systems, in this study, we decided to review the effect of water pipe tobacco smoking on the kidneys.

Materials and Methods: In this review study, previous studies on the effect of water pipe tobacco on the kidney were reviewed. The time period studied was from 2015 to 2025. Keywords of "Smoking Water Pipe”, "Smoking Water", "Water Pipe Tobacco", Tobacco, "Chronic Renal Disease”, "Chronic Kidney Disease", and "Kidney" were searched in PUBMED, EMBASE, and ELSEVIER databases.

Results: Four studies were reviewed, and all were conducted on mice. According to studies, water pipe tobacco smoking causes various effects on the kidney through various mechanisms such as oxidative stress, decreased Superoxide dismutase, catalase, glutathione peroxidase activity, increased TBARS levels, lipid peroxidation, increased IL-6 and IL-1β, and DNA damage, including destruction of glomerular capillary endothelial cells, vacuolar destruction of proximal convoluted tubules, increased creatinine, blood urea nitrogen, and proteinuria.

Conclusion: Water pipe tobacco smoking may cause kidney damage, but since no study has been conducted on humans so far, it is recommended that studies be conducted on human populations.