An artificial intelligence-driven Chatbot called Chat Generative Pre-trained Transformer, created by Open artificial intelligence, is making waves in many industries. Its foundation in the Generative Pre-trained Transformer language model is where its name originates. The most promising aspect of Chat Generative Pre-trained Transformer is that, compared to other artificial intelligence models, it can provide responses to text input that are almost human-like through the use of deep learning techniques. The public's increasing reliance on artificial intelligence technology is indicated by its quick integration across a range of businesses. Therefore, it is crucial to assess Chat Generative Pre-trained Transformer's possible effects on clinical and translational medicine research in academic settings seriously.

Background

The meta-analysis aimed to assess and compare the effect of Chinese herbal medicine as an adjunctive technique to standard treatment for people with diabetic foot ulcers.

Methods

Using dichotomous or contentious random or fixed effect models, the outcomes of this meta-analysis were examined, and the odds Ratio (OR) and the mean difference (MD) with 95% confidence intervals (CIs) were computed. 17 examinations from 2006 to 2021 were enrolled for the present meta-analysis including 1140 personals with diabetic foot ulcers.

Results

Chinese herbal medicine had a significantly higher total effective rate (OR, 2.77; 95% CI, 1.89-4.07, p<0.001), lower wound size after treatment (MD, -2.44; 95% CI, -3.46- -1.43, p<0.001), lower number of patients without any improvement (OR, 0.26; 95% CI, 0.15-0.45, p<0.001), and lower time of diabetic wound ulcer healing (MD, -10.46; 95% CI, -14.91- -6.37, p<0.001) compared to standard treatment in personal with diabetic foot ulcers. However, no significant differences were found between Chinese herbal medicine and standard treatment in the number of patients with 30% or more reductions in the ulcer area of the diabetic foot ulcer (OR, 2.69; 95% CI, 0.70-10.30, p=0.15).

Conclusions

The examined data revealed that Chinese herbal medicine had a significantly higher total effective rate, lower wound size after treatment, lower number of patients without any improvement, and lower time of diabetic wound ulcer healing, however, no significant differences were found in the number of patients with 30% or more reductions in the ulcer area compared to standard treatment in personal with diabetic foot ulcers. Yet, attention should be implemented while relating to its values since most of the selected examinations had a low sample size and some comparisons had a low number of selected studies.

The COVID-19 pandemic showed us that the world should have a proper protocol for the handling of such pandemics. A similar severe coronavirus pandemic occurs in 1918 (The spinach flu pandemic) and took two years to finish. Both pandemics took a lot of lives.

The 1918 Spanish flu pandemic was prevented with lower healthcare facilities. The main prevention method was social distancing. The effect of this social distancing was obvious when it was broken in Denver, the USA with its double-humped mortality curve of the Spanish flu pandemic in 1918. Even though this pandemic is also a coronavirus pandemic but some differences were observed in COVID-19. This commentary was to discuss the situation that occurs in COVID-19 and compare it to the Spanish flu pandemic in 1918 to reach a protocol for handling any possible upcoming coronavirus pandemics.

Backgrounds

A meta-analysis research was executed to appraise the effect of the continuous intervention for intraoperative pressure wound ulcers (IOPWUs) associated problems in breast cancer (BC) females.

Methods

Inclusive literature research till March 2023 was done and 436 interconnected researches were revised. The 8 picked researches, enclosed 1267 BC females were in the utilized researches' starting point, 636 of them were utilizing CI, and 631 were control. Odds ratio (OR) and 95% confidence intervals (CIs) were utilized to appraise the effect of CI for IOPWUs associated problems in BC females by the dichotomous, or contentious approaches and a fixed or random model.

Results

Continuous intervention had significantly lower IOPWUs (OR, 0.18; 95% CI, 0.13-0.24, p<0.001), higher Braden risk score (BRS) (OR, 2.11; 95% CI, 1.91-2.31, p<0.001), and higher quality of life (OR, 9.75; 95% CI, 6.90-12.60, p=0.02) compared to control in BC females.

Conclusions

Continuous intervention had significantly lower IOPWUs, higher BRS, and higher quality of life compared to control in BC females. However, caution must be taken when interacting with its values since there was a low number of nominated research found for some comparison in the meta-analysis.

Background: The aim is to present an electronic CPR calculator combined with CDSS (clinical decision support system) as a safer and faster method for CPR calculation than manual calculation.

Methods: A group of 70 nurses were randomly selected to calculate a CPR card and then enter the patient data into the CPR calculator. The time needed to complete the calculations and the time needed to enter patient information into the CPR calculator were measured. In addition, the number of medication calculation errors were recorded.

Result: The time to finish the CPR card manually was 00:08:31 minutes and the time to generate the CPR card electronically was 00:01:15. The number of nurses who made errors in manual calculation was 23, the total number of errors was 101. There were no errors with the calculator.

Conclusion: The CPR calculator has provided an accurate (with no errors) and faster way to generate CPR cards compared to the manual method.

Background:

To increase the public's acceptance of the vaccine, knowledge of its side effects is crucial. Thus, the purpose of this study was to identify side effects in the Saudi population following vaccinations with Pfizer BioNTech and AstraZeneca.

Method:

In Saudi Arabia, an online survey was conducted between March and October of 2021. Participants from Saudi Arabia who received two doses of the Pfizer BioNTech or AstraZeneca vaccine took part. The survey identified side effects following vaccinations.

Results:

AstraZeneca and Pfizer BioNTech administered vaccines to 174 and 224 of the 398 subjects, respectively. Fatigue (83.9%), local pain (78.2%), bone or joint pain (74.1%), fever (67.8%), vomiting or loss of appetite (24.1%), swelling (24.1%), and redness (21.8%) were the most commonly reported side effects for participants who took AstraZeneca. 

For the participants who received Pfizer BioNTech, the most common adverse effects that were reported were fatigue (43.8%), bone or joint pain (38.4%), swelling (28.6%), fever (22.8%), redness (15.1%), and nausea or vomiting (11.2%). Local pain accounted for 90.6% of the adverse effects that participants reported.

Conclusions:

After receiving the COVID-19 vaccine, the majority of participants reported experiencing at least one side effect. Whereas the AstraZeneca vaccination was linked to a higher prevalence of systemic side effects, the Pfizer BioNTech vaccination was linked to a higher prevalence of local adverse effects. Most adverse events following vaccination are not fatal. After receiving an AstraZeneca or Pfizer BioNTech vaccination, side effects were more common in women and younger age groups. Vaccinations against coronavirus have a good safety record.

Backgrounds:

This study aims to determine the relation between ABO and RhD and the prevalence and severity of COVID-19 disease.

Methods:

Data of 495 SARS-CoV-2 infected patients admitted to hospitals were collected. The ABO and RhD were determined for each patient to detect any possible relation between the prevalence of SARS-CoV-2 infection and each blood group. The patients were followed up to determine oxygen saturation and surveillance outcome (died or improved) to detect any possible relation between the severity of COVID-19 disease and each blood group.

Results:

A+ blood group was found to have a percentage of 32.3%, O+ to have a percentage of 30.3%, B+ to have a percentage of 21.2%, and AB+ to have a percentage of 10.1%. 19% of all the patients died. 20% of the dead patients were with O+ blood group, 60.5% were with A+ blood group, 10% with B+ blood group and 5% were with O- blood group.

The mean ± SD oxygen saturation on hospital admission was 94.2 ± 6.2% for the patients with O+ blood group, 91.06 ± 7.5% for the patients with A+ blood group, 92.8 ± 6.9% for the patients with B+ blood group, 93.4 ± 3.5% for the patients with AB+ blood group, and 94.5 ± 5.9% for the patients with O- blood group.

Conclusion:

Blood group A+ was the most common in the COVID-19 patients followed by O+ then B+ then AB+. Patients with blood group A+ had the worst oxygen saturation at hospital admission and had a higher mortality rate.

Background: Measurement of educated people knowledge about COVID-19 is important to enhance health measures to reduce the rate of infection. Also, knowing the most usable source of data for the public is important point for enhancing the public awareness about the disease. Hence, this study aimed to evaluate the awareness and the practices related to COVID-19 among educated people.

Methods: 360 participant received a questionnaire that was divided into several parts aimed at collecting data about participant awareness regarding COVID-19. Data collected using a designed questionnaire; to evaluate the knowledge related to COVID-19. The questionnaire was classified into 6 parts covering all aspects of COVID-19 awareness data. The first part was to evaluate the respondent’s general knowledge [6 items]; the second was to evaluate symptoms knowledge [1 item]; the third was to evaluate transmission knowledge [2 items]; the fourth was to evaluate preventive knowledge [4 items]; the fifth was to evaluate treatment knowledge [2 items] and the sixth was indicted the main source of gathering information about the disease [1 item].

Results: A total of 360 participants participated, 91% of them know the main clinical symptoms of COVID-19. 86% believed that following preventive measures (the etiquette of sneezing, coughing, personal hygiene or wearing a mask) reduce infection transmission. More than 90 % of participants used the social media for gathering information about the disease, while highly educated (Master and PhD holders) used the published articles as a source for their knowledge, however they represent a few percent of the participant.

Conclusion: Overall, the study participants had good knowledge about COVID-19, however, more efforts are needed to maximize the awareness of the public. Further clinical study is required to evaluate the effect of such good knowledge on decreasing the infection rate.

Background: The objective of this study was to compare the cost of outpatient ferric carboxymaltose (FCM; Ferinject®) versus Iron sucrose complex (ISC; Ferosac®), two prevalent intravenous iron therapy used in the treatment of iron-deficiency anemia (IDA) in the Kingdom of Saudi Arabia (KSA) from a tertiary care hospital perspective.

Methods: A retrospective study was performed for all patients who were administered FCM in the outpatient clinical setting at Prince Sultan Military Medical City from January 1, 2019, until December 31, 2019. The descriptive data was analyzed using Microsoft Excel 2019 (Microsoft Corporation, Redmond, WA, USA). The total cost of treatment reflected the cost of drugs, the cost of disposables for each infusion, drug monitoring costs during infusion, the cost of productivity loss, and patient traveling cost.

Result: Overall, 993 patients with IDA, treated with FCM in 1,688 outpatient visits were recruited in the study. In the outpatient setting, the per annum cost of treatment was SAR 1,434,092.50 with FCM treatment and SAR 1,715,299.70 with ISC treatment, with a corresponding saving of 16.4% (SAR 281,207.20) with FCM. The cost savings with FCM treatment can be attributed to the reduced frequency of patient visits and corresponding reduction in drug monitoring costs (SAR 266,995.20;77.3%), loss of productivity per year (SAR 163,550.20; 77.3%), and cost of transportation per year (SAR 573,920.00; 77.3%).

Conclusion: The use of FCM, as opposed to ISC resulted in a reduced number of iron infusions (4.4 visits for ISC as compared to one visit for FCM), accompanied by a reduction in the total cost. FCM may represent a cost-saving option compared with the existing alternative therapy used for the management of IDA in KSA.

Background

We performed a meta-analysis to evaluate the effects of neuraxial anesthesia compared to general anesthesia on postoperative results in hip fracture surgery subjects.

Methods

A systematic literature search up to January 2021 was done and 20 studies included 298785 subjects with hip fracture surgery at the start of the study; 80783 of them were under neuraxial anesthesia, and 218002 of them were under general anesthesia. They were reporting relationships between the effects of neuraxial anesthesia compared to general anesthesia in subjects with hip fracture surgery. We calculated the odds ratio (OR) or the mean difference (MD) with 95% confidence intervals (CIs) to assess the effects of neuraxial anesthesia compared to general anesthesia in subjects with hip fracture surgery using the dichotomous or continuous method with a random or fixed-effect model.

Results

Neuraxial anesthesia in subjects with hip fracture surgery was significantly related to lower acute myocardial infarction (OR, 0.73; 95% CI, 0.54-0.99, p=0.04), hypotension (OR, 0.37; 95% CI, 0.20-0.70, p=0.002), and postoperative cognitive dysfunction postoperative 1day (OR, 0.27; 95% CI, 0.17-0.42, p<0.001) compared to general anesthesia.

However, no significant difference was found between neuraxial anesthesia and general anesthesia in subjects with hip fracture surgery in a postoperative cognitive dysfunction postoperative 7days (OR, 0.64; 95% CI, 0.37-1.09, p=0.10), pneumonia (OR, 0.69; 95% CI, 0.29-1.62, p=0.39), length of hospital stay (MD, 0.75; 95% CI, -1.39-2.90, p=0.49),  deep venous thrombosis (OR, 1.21; 95% CI, 0.50-2.95, p=0.68), 30-day mortality (OR, 1.12; 95% CI, 0.53-2.34, p=0.77), blood loss (MD, -57.47; 95% CI, -123.36-8.41, p=0.09), and delirium (OR, 0.98; 95% CI, 0.32-2.49, p=0.96).

Conclusions

Neuraxial anesthesia in subjects with hip fracture surgery may decrease the risk of acute myocardial infarction, hypotension, and postoperative cognitive dysfunction postoperative 1 day compared to general anesthesia. Furthers studies are required to validate these findings.

Background:

We performed a meta-analysis to evaluate the effects of dual antithrombotic treatment (DATT) including direct oral anticoagulants (OAs) versus triple antithrombotic (TAT) with vitamin K antagonist on bleeding and ischemic results in atrial fibrillation (AF) after percutaneous coronary intervention.

Methods:

A systematic literature search up to April 2021 was done and 5 studies included 8019 subjects with AF using antithrombotic treatment after percutaneous coronary intervention at the start of the study; 4325 of them were using DATT and 3694 were using TATs. They were reporting relationships between the effects of DATT including direct OAs versus TAT with vitamin K antagonist on bleeding and ischemic results in AF after percutaneous coronary intervention. We calculated the odds ratio (OR) with 95% confidence intervals (CIs) to assess the effects of DATT including direct OAs versus TAT with vitamin K antagonist on bleeding and ischemic results in AF after percutaneous coronary intervention using the dichotomous method with a random or fixed-effect model.

Results:

Dual antithrombotics had significantly lower major bleeding (OR, 0.58; 95% CI, 0.51-0.66, p<0.001), and thrombolysis in myocardial infarction major and minor bleeding (OR, 0.49; 95% CI, 0.36-0.67, p<0.001) compared to TATs in subjects with AF using antithrombotics treatment after percutaneous coronary intervention.

However, antithrombotics had no significantly difference in all-cause mortality (OR, 1.08; 95% CI, 0.88-1.33, p=0.46), cardiovascular mortality (OR, 1.07; 95% CI, 0.83-1.38, p=0.63), myocardial infarction (OR, 1.16; 95% CI, 0.92-1.46, p=0.01), stent thrombosis (OR, 1.42; 95% CI, 0.94-2.12., p=0.09), and stroke (OR, 0.86; 95% CI, 0.59-1.25, p=0.42) compared to TATs in subjects with AF using antithrombotics treatment after percutaneous coronary intervention.

Conclusions:

Dual antithrombotics may have a lower risk of major bleeding, and thrombolysis in myocardial infarction major and minor bleeding compared to TATs in subjects with AF using antithrombotic treatment after percutaneous coronary intervention. However, antithrombotics had no significant difference in all-cause mortality, cardiovascular mortality, myocardial infarction, stent thrombosis, and stroke compared to TATs in subjects with AF using antithrombotics treatment after percutaneous coronary intervention. Furthers studies are required to validate these findings.

Backgrounds

The meta-analysis aims to estimate the effect of antibiotic prophylaxis (AP) on surgical site wound infection (SSWI) in third molar surgery (TMS).

Methods

Examinations comparing AP to placebo for TMS were utilized in the meta-analysis from various languages that met the inclusion criteria. Using dichotomous random or fixed effect models, the results of these investigations were examined, and the Odd Ratio (OR) with 95% confidence intervals was computed (CIs).

18 examinations from 2001 to 2023 were recruited for the current analysis including 4063 personals with TMS who were in the utilized examinations' starting point.

Results

AP had significantly lower SSWI (OR, 0.46; 95% CI, 0.33-0.65, p<0.001) with no heterogeneity (I² = 1%) compared to placebo in personals with TMS.

Conclusions

The examined data revealed that AP had significantly lower SSWI compared to placebo in personals with TMS. Nevertheless, caution should be exercised while interacting with its values since examinations were performed by different surgeons with different skills on different types of personals and the low sample size of numerous of the examinations selected for the meta-analysis.

Background:

A meta-analysis research was implemented to appraise gingival wound healing management by photobiomodulation as adjunctive management to periodontal treatments.

Inclusive literature research till April 2023 was done and 908 interconnected researches were revised. Methods

The 9 picked researches, enclosed 517 periodontal disease persons were in the utilized researchers' starting point, 258 of them were utilizing photobiomodulation, and 259 were control. Odds ratio (OR) and 95% confidence intervals (CIs) were utilized to appraise the consequence of photobiomodulation in treating gingival wound healing by the dichotomous, and contentious approach and a fixed or random model.

Results:

Photobiomodulation had a significantly higher Landry wound healing index (MD, 0.87; 95% CI, 0.40-1.34, p<0.001), and complete wound epithelialization (OR, 6.47; 95% CI, 2.05-20.44, p=0.001) compared to the control of gingival wound healing in periodontal disease persons. However, photobiomodulation and control had no significant difference in the remaining wound area (MD, -10.03; 95% CI, -22.83-2.77, p=0.12) of gingival wound healing in periodontal disease persons.

Conclusions:

Photobiomodulation had a significantly higher Landry wound healing index, and complete wound epithelialization, however, no significant difference was found in the remaining wound area compared to control of gingival wound healing in periodontal disease persons. However, caution needs to be taken when interacting with its values since there was a low sample size of most of the chosen research found for the comparisons in the meta-analysis and a low number of chosen investigations for some of the comparisons.

Anthracyclines are a crucial component of chemotherapy regimens used to treat a range of malignancies in children and adults. However, cardiac dysfunction and heart failure frequently limit the therapeutic efficacy of anthracyclines. The risk of heart dysfunction increases with increasing doses of anthracycline. Cardiotoxicity is a challenging side effect of DOX, which is cumulative and irreversible; this necessitates assessing the cardiac functions in cancer patients before and after the use of    DOX to avoid permanent cardiac damage. Serial measurements of left ventricle ejection fraction (LVEF) are commonly used for cardiac monitoring during anthracycline treatment. In some studies, cardiotoxicity was defined as LVEF decrease by an absolute 10% and/or below 55%; in others, cardiotoxicity was defined as a decrease below 45%. A serious disadvantage of this test is radioactivity exposure and the low predictability of pre-symptomatic cardiac damage. Blood cardiac biomarkers, such as cardiac troponins and B-type natriuretic peptide (BNP), have been used in heart failure diagnostics. Susceptibility to DOX cardiotoxicity is largely individual, with some patients developing cardiomyopathy at low doses and others tolerating much higher cumulative doses, and this may suggest the presence of genetic predisposition factors. Genetic variations in CBR3 and ABCC1 genes were suggested to contribute to DOX adverse effects. This review highlights the genetic basis for anthracycline-related cardiac dysfunction, focuses on particular genes that have been implicated in innate predisposition to ACT, and assessment of cardiotoxicity.

Coronavirus disease 2019 (COVID-19); caused by the novel coronavirus (SARS-CoV-2) is the talk of everyone all over the world in 2020 since it has been considered as a public health emergency of international concern by WHO in 30^th January, 2020. COVID-19 is a highly transmittable disease with different symptoms which can vary from mild to severe and life threatening. Scientists all over the world are working on finding a treatment or vaccine for this disease. All of these studies are currently not finished yet during writing this review. However, in this review a summary about the current status of these studies is given. This summary includes medicinal plants and natural products, antivirals like remdesivir, favipiravir, oseltamivir and nelfinavir as well as other miscellaneous drugs like chloroquine, hydroxychloroquine and ivermectin which showed promising results in treating COVID-19. In conclusion, the review recommends conducting further investigations worldwide and reporting them in peer-reviewed publications to aid in improving the drugs’ dosing regimens and clinical studies.

Cardiovascular disease (CVD) is the major cause of death and disability worldwide. Major and well-established cardiovascular disease risk factors include advancing age, male sex, hypertension, smoking, diabetes, elevated total serum low-density lipoprotein (LDL) cholesterol, and decreased high-density lipoprotein (HDL) cholesterol. Genetic polymorphism represents an additional risk factor for cardiovascular disease and is not explored and researched thoroughly. In this review article, a total of 31 scientific articles studying the association between different genetic polymorphisms and the risk of cardiovascular disease were studied. Different genetic polymorphisms were found to be associated with an increased risk of cardiovascular disease and coronary heart disease incidence, and genotyping of these different genetic polymorphisms should be considered as routine screening for cardiovascular disease.

Background

Most patients infected with COVID-19 experienced cold-like symptoms. Some other patients developed more serious symptoms such as pneumonia. N-Acetylcysteine ​​(NAC) is known to be effective against acute respiratory distress syndrome (ARDS) due to its anti-inflammatory and antioxidant properties. The effect of NAC on hospitalized COVID-19 patients was unknown. Therefore, this meta-analysis aimed to establish a relationship between the effects of NAC and non-NAC protocols in inpatients with COVID-19.

Method

By March 2022, a systemic review was conducted to assess the effects of NAC and non-NAC in inpatients with COVID-19. The clinical trials were identified in 20553 subjects admitted with COVID-19 at baseline. 2909 was treated with NAC and 17644 was treated without NAC. This study attempts to compare the effects of NAC and non-NAC in COVID-19 patients hospitalized with pneumonia. Statistical analysis uses the dichotomous method as a tool for odds ratio (OR) at  95% confidence interval (CI) to assess the effectiveness of NAC and non-NAC in COVID-19 patients hospitalized with pneumonia in random or fixed-effect model.

Results

Patients managed with NAC had fewer days in the ICU (OR, 2.79; 95% CI, -1.11-6.69, p = 0.16), lower mortality (OR, 0.69; 95% CI, 0.40-1.20, p = 0.19), and fewer number needed mechanical ventilation (OR, 0.74; 95% CI, 0.25-2.21, p = 0.59) compared with non-NAC in COVID-19 subjects hospitalized with pneumonia.

Conclusion

NAC has decreased the days stayed in the ICU, number of deaths, and number of patients needed mechanical ventilation in COVID-19 hospitalized with pneumonia, although, this difference was insignificant. Further studies are required that could affect the level of significance.