Background and Aims: In a time of increasing mental health difficulties among college students globally, where 20%–45% experience disorders annually, mood disorders emerge as a prevalent concern. These disorders mainly impact individuals aged 18 to 30 and significantly affect academic performance and long‐term well‐being. This study aimed to assess the psychological well‐being of university students, focusing on alexithymia, depression, anxiety, stress, and their complex relationships. Methods: Using a multi‐stage sampling approach, the study was conducted in 2019 with 260 undergraduate students at Shahrekord University of Medical Sciences, Shahrekord, Iran. The Depression, Anxiety, and Stress Scale (DASS) questionnaire measured depression, anxiety, and stress, while the Toronto Alexithymia Scale‐20 (TAS‐20) assessed alexithymia. The data were analyzed using SPSS v.23.0. Results: The participants had a mean age of 20.7 ± 3.2 years, were mostly female (75.7%), single (90.7%), and of Fars ethnicity (66.1%). The majority lived in dormitories (70.3%). Alexithymia was present in 30.8% of the population, with males scoring higher than females ( p = 0.04). Also, students aged 18–19 had lower depression ( p = 0.04) and anxiety ( p = 0.04) scores. We found significant positive correlations between alexithymia and stress, depression, and anxiety ( p < 0.001). Moreover, a strong positive correlation was observed between depression and both anxiety ( p < 0.001) and stress ( p < 0.001). Additionally, anxiety demonstrated a notable correlation with stress ( p < 0.001), underscoring the intricate interplay among these psychological factors. Conclusion: Identifying alexithymia in medical settings is essential, as it can affect patient–provider communication and care. Students with alexithymic traits may benefit from interventions targeting both alexithymia and co‐occurring mental disorders like depression and anxiety. Future research should focus on developing tailored treatments and early screening to improve emotional regulation and mental health outcomes, particularly in high‐stress academic environments.

Urolithiasis is among the most prevalent and possibly devastating diseases. It affects millions worldwide, and a cheap or rapid biomarker is required to diagnose it. Previous investigations revealed that inflammation has a role in the progression of urolithiasis patients, and an elevated neutrophil-to-lymphocyte ratio (NLR) value can be a valuable biomarker to ensure inflammation and, consequently, renal stones. This study was conducted to summarize the results of studies investigating the role of NLR in urolithiasis. We systematically searched three main databases (Scopus, PubMed, and Web of Science) up to January 1, 2023. Our study was registered in PROSPERO (CRD42024500756). Ultimately, 33 studies were selected for this review article. Patients in either acute or subacute phase exhibited higher NLR levels than healthy controls. Also, patients in acute and subacute phases significantly differed regarding NLR levels. In addition, studies showed that NLR could predict sepsis and systemic inflammatory response syndrome (SIRS) among urolithiasis patients. In addition, evidence reported that NLR was helpful in the prediction of spontaneous stone passage among these patients. Our results support a reliable biomarker that is easily added into clinical settings to help predict urolithiasis patients' condition.

This study investigates the association between student personality traits and alexithymia among university students. In this cross-sectional study, 290 students were selected through multistage cluster sampling. Standard questionnaires of 5 personality traits (NEO Five-Factor Inventory) and the Toronto Alexithymia Scale were used to determine alexithymia and personality traits. An independent t test in SPSS 21.0 was performed to compare the scores of several personality traits between students with and without alexithymia. Also, the logistic regression model was used to investigate the adjusted associations. The mean age of participants was 22.6 ± 3.8 years. Most students were female (77.9%) and single (88.5%). According to the Toronto Alexithymia Scale, 127 of 290 students (43.8%) displayed signs of alexithymia. The neuroticism trait was considerably greater in alexithymic students than the others (27.20 ± 3.90 vs 25.48 ± 4.90; P < .01), as well as the conscientiousness trait (20.16 ± 3.84 vs 21.58 ± 5.00; P = .01). Logistic regression showed that each unit increase in neuroticism trait increases alexithymia odds by 10%, while each unit raises in conscientiousness trait decreases odds by 8%. Considering a significant association between personality traits and alexithymia, better screening and interventional programs through personality traits will prevent or alleviate the symptoms of alexithymia among university students.

Cerebral venous sinus thrombosis (CVST) is an uncommon disorder with an increased mortality risk. Data on the sex-specific clinical profile and related factors can be practical in clinical diagnosis and management. Thus, we aimed to assess CVST characteristics in Shahrekord, the most elevated city among the centers of the provinces of Iran, referred to as the Roof of Iran. In this retrospective cross-sectional study, we reviewed the hospital records of 127 CVST patients between April 2013 and June 2023 to analyze the demographic characteristics, clinical profile, disease outcomes, and risk factors. STROBE guidelines were used to report this study. Females comprised 65.3% of the study. Females’ age was almost equal to male patients (37.51 ± 13.95 years vs 38.09 ± 16.18 years, P = .832), and more than half of the patients (59.1%) were married. Clinical characteristics showed no significant difference between the sexes. In contrast to males, females had multifarious risk factors. However, the main risk factors for both sexes were CVST and hypertension. Most patients had 1 sinus affected (55.9%), and the location of thrombosis was mainly in the right transverse sinus in males (38.63%) and superior sagittal sinus in females (33.73%). However, those with more than 2 affected sinuses were mostly women. Regarding radiological findings, sinusitis was significantly seen in men (18.18% vs 3.61%). Among laboratory data, females significantly had higher erythrocyte sedimentation rate levels than males (21.66 ± 24.39 vs 9.60 ± 8.55). This study indicates that among CVST patients, men have significantly higher occurrences of sinusitis, and higher levels of erythrocyte sedimentation rate were observed in women. However, no other significant differences were found. More extensive studies are essential to fully comprehend the sex-specific aspects of CVST.

Rationale: Primary bilateral macronodular adrenal hyperplasia (PBMAH) is a rare cause of ACTH-independent Cushing syndrome (CS), accounting for <2% of CS cases. Diagnosing PBMAH can be difficult and challenging for clinicians. Patient concerns: We report a 52-year-old female, a patient with a history of intermittent fever for 3 years. She presented with nausea, headache, and dizziness for several days, along with fatigue, myalgia, muscle weakness, exertional dyspnea, hoarseness, spontaneous bruising over the past several months, and long-term psychological complaints. Additionally, we observed periorbital and facial edema, right lower quadrant tenderness, and abdominal striae during the examination. Diagnoses: Her laboratory results showed increased cortisol and suppressed ACTH, and an abdominal CT scan revealed 2 heterogeneous masses in the adrenal glands. These findings led us to the diagnosis of PBMAH in this patient. The existence of aberrant receptors was evaluated, and the tests were negative. Interventions: The patient underwent left adrenalectomy and corticosteroid therapy after the surgery. Her clinical complaints improved after the surgery. Outcomes: However, her dependency on corticosteroids was not transient after unilateral adrenalectomy, and she still needs glucocorticoid supplementation 1 year after surgery. Lessons: This patient is a case of PBMAH who presented with fever and CS symptoms and underwent unilateral adrenalectomy. Interestingly, she had suppressed cortisol levels for at least 1 year after the unilateral adrenalectomy. Therefore, we suggest further research on the most effective treatment strategies for PBMAH.