The scientific knowledge of three large language models in cardiology: multiple-choice questions examination-based performance.

Background: The integration of artificial intelligence (AI) chatbots like Google's Bard, OpenAI's ChatGPT, and Microsoft's Bing Chatbot into academic and professional domains, including cardiology, has been rapidly evolving. Their application in educational and research frameworks, however, raises questions about their efficacy, particularly in specialized fields like cardiology. This study aims to evaluate the knowledge depth and accuracy of these AI chatbots in cardiology using a multiple-choice question (MCQ) format. Methods: The study was conducted as an exploratory, cross-sectional study in November 2023 on a bank of 100 MCQs covering various cardiology topics that was created from authoritative textbooks and question banks. These MCQs were then used to assess the knowledge level of Google's Bard, Microsoft Bing, and ChatGPT 4.0. Each question was entered manually into the chatbots, ensuring no memory retention bias. Results: The study found that ChatGPT 4.0 demonstrated the highest knowledge score in cardiology, with 87% accuracy, followed by Bing at 60% and Bard at 46%. The performance varied across different cardiology subtopics, with ChatGPT consistently outperforming the others. Notably, the study revealed significant differences in the proficiency of these chatbots in specific cardiology domains. Conclusion: This study highlights a spectrum of efficacy among AI chatbots in disseminating cardiology knowledge. ChatGPT 4.0 emerged as a potential auxiliary educational resource in cardiology, surpassing traditional learning methods in some aspects. However, the variability in performance among these AI systems underscores the need for cautious evaluation and continuous improvement, especially for chatbots like Bard, to ensure reliability and accuracy in medical knowledge dissemination.

Role of artificial intelligence (Google bard) in morphological, histopathological, and radiological image identifications: Objective Structured Practical Examination (OSPE) type-based performance.

OBJECTIVES: To evaluate the role of artificial intelligence (Google Bard) in figures, scans, and image identifications and interpretations in medical education and healthcare sciences through an Objective Structured Practical Examination (OSPE) type of performance. METHODS: The OSPE type of question bank was created with a pool of medical sciences figures, scans, and images. For assessment, 60 figures, scans and images were selected and entered into the given area of the Google Bard to evaluate the knowledge level. RESULTS: The marks obtained by Google Bard in brain structures, morphological and radiological images 7/10 (70%); bone structures, radiological images 9/10 (90%); liver structure and morphological, pathological images 4/10 (40%); kidneys structure and morphological images 2/7 (28.57%); neuro-radiological images 4/7 (57.14%); and endocrine glands including the thyroid, pancreas, breast morphological and radiological images 8/16 (50%). The overall total marks obtained by Google Bard in various OSPE figures, scans, and image identification questions were 34/60 (56.7%). CONCLUSION: Google Bard scored satisfactorily in morphological, histopathological, and radiological image identifications and their interpretations. Google Bard may assist medical students, faculty in medical education and physicians in healthcare settings.

Impact of unstable environment on the brain drain of highly skilled professionals, healthcare workers, researchers, and research productivity in Pakistan.

Background: The geo-strategic position of Pakistan on the world map is incredibly important and idyllic as the country is considered the gateway to central Asia. Pakistan has faced political instability for the last three decades, causing a brain drain and adversely affecting socioeconomic growth. This study aims to investigate the impact of an unstable environment on the brain drain of highly skilled professionals, healthcare workers, researchers, and research productivity in Pakistan from January 2000 to December 2022. Material and Methods: The data were recorded from the World Bank, the Higher Education Commission (HEC) Pakistan, the Pakistan Medical and Dental Council (PMDC), the Bureau of Emigration and Overseas Employment (BEOS), Pakistan, Academic Ranking of World Universities (ARWU), and Web of Science Clarivate Analytics. Initially, 32 documents were selected in this study, and finally, eight fact sheets, official government websites, and international organizations were included. Results: The result revealed that due to political instability, in 2022 about 832,339 highly qualified and accomplished experts headed abroad, among them 17976 (2.15%) were highly qualified and 20865 (2.50%) were highly competent professionals. These include accountants 7197 (0.86%), engineers 6,093 (0.73%), agricultural experts 3,110 (0.37%), doctors 2,464 (0.29%), computer experts 2,147 (0.25%), nurses and paramedics 1768 (0.21%), technicians 23347 (2.80%), electricians 20322 (2.44%), and schools and university faculty 1004 (0.12%). Pakistan has a total of 380 Higher Education Commission-indexed academic journals, among them 11 (2.89%) academic journals were indexed in the Web of Science and 23 journals were placed in the Web of Science emerging indexing. Among these journals, only one journal surpassed the impact factor of more than 2.0. The quartile ranking of Pakistani journals is 01 journal in Q2; 02 in Q3; and the remaining 08 journals in Q4. From August 1947 to December 2022, Pakistan produced a total of 259249 research articles, and from January 2000 to December 2022, the number of articles published was 248457 (95.83%). Since the last 22 years, the trend of research publications was continuously increased; however, the rising trend decreased in 2022 with a declined rate of 1263 (3.42%). Conclusion: The unstable sociopolitical environment in Pakistan caused a brain drain of highly qualified and skilled professionals and impaired the global standing of universities, academic journals, and research productivity in Pakistan. Pakistan must resolve the instability and establish sustainable policies to minimize the brain drain of highly qualified and skilled experts and convalesce their academic institutes and their research productivity for the development of the nation.

Turnitin: Is it a text matching or plagiarism detection tool?

The institutional integrity constitutes the bases of scientific activity. The frequent incidences of similarity, plagiarism, and retraction cases created the space for frequent use of similarity and plagiarism detecting tools. Turnitin is software that identifies the matched material by checking the electronically submitted documents against its database of academic publications, internet, and previously submitted documents. Turnitin provides a "similarity index," which does not mean plagiarism. The prevalence of plagiarism could not reduce tremendously in the presence of many paid and un-paid plagiarism detecting tools because of the assortment of reasons such as poor research and citation skills, language problems, underdeveloped academic skills, etc., This paper may provide an adequate feedback to the students, researchers, and faculty members in understanding the difference between similarity index and plagiarism.

Serum hyaluronic acid level does not reliably differentiate minimal and significant liver disease in chronic hepatitis C.

OBJECTIVE: To evaluate the predictive value of hyaluronic acid (HA) for the assessment of liver fibrosis and inflammation in chronic hepatitis C (CHC). METHODS: This cross-sectional study was conducted at Ziauddin University, Karachi, Pakistan from June 2006 to July 2010. Ninety-eight CHC patients, 52 (53%) males, and 46 (47%) females, with an age range of 20-60 years (mean 36.0+/-10.5) were recruited. Liver fibrosis was staged on a 5-point scale, F0 to F4, and inflammation was graded on a 4-point scale, A0 to A3. Patients were divided into minimal (F<2 and A<2) and significant (F>/=2 or A>/=2) overall disease groups. The HA was measured in the serum by ELISA. Diagnostic value was assessed through receiver operating characteristic (ROC) curve. RESULTS: Significant liver disease was present in 46 (47%) patients. Mean serum HA was significantly different among severity groups (p = 0.001). Area under ROC curve for overall disease was 0.716. Negative predictive value (NPV) for significant overall disease remained 71% at a low HA level of 20 ng/mL. Positive predictive value (PPV) of 85% was obtained at 60 ng/mL and 100% at 120 ng/mL. Those high levels were present in 15% and 10% of the patients. CONCLUSION: Serum HA levels showed a low NPV for significant liver disease. An acceptable PPV was found only in a small proportion of the patients. Hyaluronic acid may not be regarded as a reliable marker for making treatment decisions.

Lung functions in poorly controlled type 1 Saudi diabetic children and adolescents.

OBJECTIVE: To determine the lung function among Saudi type 1 diabetes mellitus (T1DM) children and adolescents. METHODS: This study was conducted in the Department of Pediatrics, Division of Pediatric Pulmonology and University Diabetes Centre, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia from December 2008 to July 2010. A group of 52 (26 male and 26 female) volunteer T1DM children were recruited with an age range from 8-14 years (mean 12.05 +/- 1.42 years), mean duration of disease of 5.25 +/- 0.47 years, and mean glycosylated hemoglobin of 11.27 +/- 0.31%. Spirometry was performed on an Electronic Spirometer (Compact Vitalograph, Stockwell, London, UK). RESULTS: Pulmonary function in children with diabetes showed significant lower mean values of actual lung function parameters forced vital capacity (FVC), peak expiratory flow (PEF), and maximum mid expiratory flow rate (MMEF) compared to their predicted values. However, there was no significant reduction in the actual forced expiratory volume in the first second (FEV1), and FEV1/FVC% compared to their predicted values. CONCLUSION: The actual lung function data among Saudi T1DM children and adolescents showed significantly lower values of FVC, PEF, and MMEF compared to the predicted lung function data.

Effects of mobile phone radiation on serum testosterone in Wistar albino rats.

OBJECTIVE: To investigate the effects of electromagnetic field radiation generated by mobile phones on serum testosterone levels in Wistar albino rats. METHODS: This experimental interventional control study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia during the period December 2006 to April 2008. A total of 34 male Albino rats [Wistar strain], 2 months of age, weighing 150-160 gm were used for the experiment. These animals were divided into 3 groups. The first group containing 6 rats was assigned as a control group. The second group containing 14 rats was exposed to mobile phone radiation for 30 minutes daily and the third group containing 14 rats was exposed to mobile phone radiation for 60 minutes daily for the total period of 3 months. At the end of experimental period, blood was collected into the container, and serum testosterone was analyzed using double-antibody radioimmunoassay method by Coat-A-Count. RESULTS: Exposure to mobile phone radiation for 60 minutes/day for the total period of 3 months significantly decrease the serum testosterone level [p=0.028] in Wistar Albino rats compared to their matched control. CONCLUSION: Long-term exposure to mobile phone radiation leads to reduction in serum testosterone levels. Testosterone is a primary male gender hormone and any change in the normal levels may be devastating for reproductive and general health.

Effect of duration of disease on ventilatory function in an ethnic Saudi group of diabetic patients.

BACKGROUND: Diabetes mellitus is a leading cause of illness and death across the world and is responsible for a growing proportion of global health care expenditures. The present study was designed to observe the effect of diabetes mellitus on lung function in patients with diabetes belonging to a specific ethnic group, namely Saudis. METHOD: In this study, a group of 47 apparently healthy volunteer male Saudi patients with diabetes was randomly selected. Their ages ranged from 20 to 70 years. The patients were matched with another group of 50 healthy male control subjects in terms of age, height, weight, ethnicity, and socioeconomic status. Both groups met exclusion criteria as per standard. Spirometry was performed with an electronic spirometer (Schiller AT-2 Plus, Switzerland), and results were compared by a Student's t test. RESULTS: Subjects with diabetes showed a significant reduction in forced vital capacity (FVC) and forced expiratory volume in the first second (FEV(1)) relative to their matched controls. However, there were no significant differences in the forced expiratory ratio (FEV(1)/FVC%) and the middle half of the FVC (FEF(25-75%)) between the groups. We observed a significantly negative correlation between duration of disease and pulmonary function, as measured by FEV(1) (r = 0.258, p = 0.04), FVC (r = 0.282, p = 0.28), and the middle half of the FVC (FEF(25-75%)) (r = 0.321, p = 0.014). CONCLUSIONS: Pulmonary function in a specific ethnic group of patients with diabetes was impaired as evidenced by a decrease in FVC and FEV(1) compared to pulmonary function in matched controls. Stratification of results by years of disease revealed a significant correlation between duration of disease and a decline in pulmonary function.

Dose response effect of cement dust on respiratory muscles competence in cement mill workers.

Electromyography (EMG) of respiratory muscles is a reliable method of assessing the ventilatory muscle function, but still its use has not been fully utilized to determine the occupational and environmental hazards on respiratory muscles. Therefore, EMG of intercostal muscles was performed to determine the dose response effect of cement dust on respiratory muscles competence. Matched cross-sectional study of EMG in 50 non-smoking cement mill workers with an age range of 20 - 60 years, who worked without the benefit of cement dust control ventilation or respiratory protective devices. EMG was performed by using surface electrodes and chart recorder. Significant reduction was observed in number of peaks (p < 0.0005), maximum peak amplitude (p < 0.0005), peak-to-peak amplitude (p < 0.0005) and duration of response (p < 0.0005) in cement mill workers compared to their matched control. Cement dust impairs the intercostal muscle competence and stratification of results shows a dose-effect of years of exposure in cement mill.

Hazards of X-ray radiation on the quantitative and phagocytic functions of polymorphonuclear neutrophils in X-ray technicians.

Over exposure to X-ray radiation is detrimental to the living cells and may lead to development of life-threatening diseases. It is intuitive to postulate that a low level exposure may lead to functional abnormalities in human immune cells. Therefore, the objective of the present study was to study the effects of X-ray radiation on the total leukocyte count (TLC) and phagocytic activity of Polymorphonuclear neutrophils (PMN). A group of 42 apparently healthy X-ray technicians were recruited with age ranging from 25-50 years. They were matched with another group of 42 control healthy volunteer subjects in terms of age, sex and ethnic variation. The mean exposure level of X-ray radiation in X-ray technicians was 72.4 mrem per calendar quarter and 289.6 mrem per year. TLC was performed by using a Beckman Coulter counter and phagocytic activity of whole blood and PMN was determined by measuring chemiluminescence (CL) response with a chemiluminescence luminometer. The mean value of CL response was significantly decreased (p<0.0005) in X-ray technicians, even though they had low levels of exposure, compared to their controls. However, no significant difference was observed in TLC between the two groups at this low level of exposure. Exposure to X-ray radiation decreases the physiological functions of PMN as measured by decreasing chemiluminescence response even at low levels of exposure.

Lung function in Pakistani wood workers.

The lung function impairment is the most common respiratory problem in industrial plants and their vicinity. Therefore, the purpose was to study the affects of wood dust and its duration of exposure on lung function. This was a matched cross-sectional study of Spirometry in 46 non-smoking wood workers with age range 20 - 60 years, who worked without the benefit of wood dust control ventilation or respiratory protective devices. Pulmonary function test was performed by using an electronic Spirometer. Significant reduction was observed in the mean values of Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), and Maximum Voluntary Ventilation (MVV) in wood workers relative to their matched controls. This impairment was increased with the duration of exposure to wood industries. It is concluded that lung function in wood workers is impaired and stratification of results shows a dose-response effect of years of wood dust exposure on lung function.

Lung function in type 2 Saudi diabetic patients.

OBJECTIVE: To study the effects of type 2 diabetes mellitus on lung function and to determine its severity in relation to duration of disease. METHODS: We conducted this study in the Department of Physiology, College of Medicine, King Khalid University Hospital and Diabetic Centre, King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia during the year 2002 - 2004. A group of 32 apparently healthy volunteer male type 2 diabetic patients were randomly selected with an age range from 24-73 years. We matched the diabetic patients with another group of 40 control healthy male subjects in terms of age, height, weight, and socioeconomic status. Both groups met with exclusion criteria as per standard. Spirometry was performed on an Electronic Spirometer (Schiller AT-2 Plus, Switzerland) and results were compared using the 2-tailed student t-test. RESULTS: Diabetic patients showed a significant reduction in the forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) relative to their matched controls. However, there were no significant difference in the forced expiratory ratio (FEV1/FVC%) and middle half of the FVC (FEF 25-75%) between the groups. CONCLUSION: Lung function in type 2 diabetic patients is impaired by a decrease in FVC, FEV1 and PEF, as compared to their matched controls. Stratification of results by years of disease showed a dose-response effect on lung function.

Assessment of respiratory muscles endurance in diabetic patients.

OBJECTIVE: Respiratory muscle endurance is of interest in pulmonary, critical care and many other areas of medicine. The maximal voluntary ventilation (MVV) test is an objective dynamic method for measuring the working capacity of respiratory muscles. Therefore, we designed the present study to determine the effect imposed by diabetes mellitus on respiratory muscle endurance in Saudi diabetic patients. METHODS: We conducted this study in the Department of Physiology, College of Medicine, King Khalid University Hospital and Diabetic Centre, King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia during the year 2002-2004. In this study, we recruited 39 male diabetic patients and equal number of control subjects and all participants were non-smokers with age range of 23-71 years. The subjects were matched for age, height and weight. We determined the respiratory muscles endurance by a direct MVV test during inspiratory and expiratory phases of respiration by using a MP-100 student Bio Pac system and compared the results using a paired t-test. RESULTS: In inspiratory and expiratory phases of respiration, diabetic patients showed a significant reduction in the mean values of direct MVV test (p<0.001) relative to their matched controls. CONCLUSION: We conclude that in diabetic patients the respiratory muscles endurance is impaired by a decreased in MVV values. This decline in MVV further showed that the diabetic patients have a reduced inhaled and exhaled volumes during consecutive breaths.

Lung function in type 1 Saudi diabetic patients.

OBJECTIVE: To determine the effects of type 1 diabetes mellitus on lung function and its gravity in relation to the duration of disease. METHODS: We carried out this study in the Department of Physiology, College of Medicine and Diabetic Center, King Abdul-Aziz University Hospital, King Saud University, Riyadh, Saudi Arabia during the period 2003-2004. We randomly selected a group of 27 apparently healthy volunteer Saudi male type 1 diabetic patients with age ranging from 19-70 years. We matched the diabetic patients with another group of 27 control healthy male subjects in terms of age, height, weight and socioeconomic status. Both groups met with exclusion criteria as per standard. We performed spirometry on an Electronic Spirometer (Schiller AT-2 Plus, Switzerland) and compared the results by a student t-test (2-tailed). RESULTS: Type 1 diabetic patients showed a significant reduction in the forced vital capacity and forced expiratory volume in one second (FEV1) relative to their matched controls. However, there was no significant difference in the forced expiratory ratio, forced expiratory flow; forced expiratory flow and peak expiratory flow (PEF) between the groups. CONCLUSION: It is concluded that lung function in type 1 diabetic patients is impaired by a decrease in FVC and FEV1 as compared to their matched controls. Additionally, the years of disease showed a dose-response effect on lung function.

Mobile phone related-hazards and subjective hearing and vision symptoms in the Saudi population.

OBJECTIVES: Over the past decade utilization of mobile phones has dramatically increased. They are now an essential part of business, commerce, and communication, however, their use may lead to health problems. Therefore, the present study was designed to investigate a link between the use of mobile phones and hearing and vision symptoms in the Saudi population and also to contribute to the increase in social awareness of health problems associated with the use of these devices. MATERIALS AND METHODS: A total of 873 (57.04% of males and 39.86% of females) subjects using mobile phones were invited to participate in the presented study. A structured questionnaire was distributed among them to collect a detailed medical history. The Chi-square test was employed to observe the relationship between duration of calls and hearing and vision complaints. RESULTS: The present study showed an association between the use of mobile phones and hearing and vision complaints. About 34.59% of problems were related with impaired hearing, ear ache and/or warmth on the ear, and 5.04% of complaints with the decreased and/or blurred vision. CONCLUSIONS: It is concluded that the use of mobile phone is a health risk factor, and thus it is suggested that excessive use of mobile phones should be avoided and social awareness increased through health promotion activities, such as group discussions or public presentations and via electronic and printed media sources.

Lung function among non-smoking wheat flour mill workers.

OBJECTIVES: Flour dust occurs across the range of food industries; its exposure may induce acute or chronic respiratory ailments. The objective of the study was to assess the effects of flour dust on the lung function. MATERIALS AND METHODS: The lung function was studied in forty-six male flour mill workers and a similar number of male control subjects; all participants were non-smokers with the age range from 18 to 65 years. The subjects were matched for age, height, weight and socioeconomic status. The pulmonary function test was performed by using an electronic spirometer (Compact Vitalograph, UK) and results were compared by a paired t-test. RESULTS: Significant reduction in the overall mean values of FVC, FEV1, PEF, and MW were observed in wheat flour mill workers relative to their matched controls. CONCLUSIONS: Based on the results of the present study, we conclude that the flour mill workers in Pakistan, like grain workers elsewhere, are at an increased risk of developing occupationally related pulmonary function impairments. The results suggest that there is an urgent need to improve dust control measures and the health status of flour mill workers.

Health hazards of cement dust.

Even in the 21st century, millions of people are working daily in a dusty environment. They are exposed to different types of health hazards such as fume, gases and dust, which are risk factors in developing occupational disease. Cement industry is involved in the development of structure of this advanced and modern world but generates dust during its production. Cement dust causes lung function impairment, chronic obstructive lung disease, restrictive lung disease, pneumoconiosis and carcinoma of the lungs, stomach and colon. Other studies have shown that cement dust may enter into the systemic circulation and thereby reach the essentially all the organs of body and affects the different tissues including heart, liver, spleen, bone, muscles and hairs and ultimately affecting their micro-structure and physiological performance. Most of the studies have been previously attempted to evaluate the effects of cement dust exposure on the basis of spirometry or radiology, or both. However, collective effort describing the general effects of cement dust on different organ and systems in humans or animals, or both has not been published. Therefore, the aim of this review is to gather the potential toxic effects of cement dust and to minimize the health risks in cement mill workers by providing them with information regarding the hazards of cement dust.

Hematological findings in male x-ray technicians.

OBJECTIVE: In view of the known health hazards of x-ray radiation, this study focuses on the basic hematological parameters: red blood cells (RBCs), white blood cells (WBCs) and platelets count in x-ray technicians. The aim was to identify the affect of x-ray radiation on blood cell counts in x-ray technicians. METHODS: The present study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia during the year 2002. In this study, a group of 40 apparently healthy male x-ray technicians with age ranging from 25-50-years were recruited. They were matched with another group of 40 apparently healthy control subjects in terms of age, sex and ethnic origin. Both groups met with exclusion criteria as per standard. Red blood cells, WBC and platelets count were performed by using a blood cell auto analyser (Beckman coulter counter). RESULTS: The mean value of platelet count was significantly decreased (p<0.01) in x-ray technicians when compared to controls. However, no significant difference was observed in RBC and WBC count between the groups. CONCLUSION: The present study suggests that exposure to x-ray radiation causes decreased platelet count. Further, studies are needed to study the long-term effects of x-ray radiation on blood cell count in x-ray technicians.