Evaluating ChatGPT to test its robustness as an interactive information database of radiation oncology and to assess its responses to common queries from radiotherapy patients: A single institution investigation.

PURPOSE: Commercial vendors have created artificial intelligence (AI) tools for use in all aspects of life and medicine, including radiation oncology. AI innovations will likely disrupt workflows in the field of radiation oncology. However, limited data exist on using AI-based chatbots about the quality of radiation oncology information. This study aims to assess the accuracy of ChatGPT, an AI-based chatbot, in answering patients' questions during their first visit to the radiation oncology outpatient department and test knowledge of ChatGPT in radiation oncology. MATERIAL AND METHODS: Expert opinion was formulated using a set of ten standard questions of patients encountered in outpatient department practice. A blinded expert opinion was taken for the ten questions on common queries of patients in outpatient department visits, and the same questions were evaluated on ChatGPT version 3.5 (ChatGPT 3.5). The answers by expert and ChatGPT were independently evaluated for accuracy by three scientific reviewers. Additionally, a comparison was made for the extent of similarity of answers between ChatGPT and experts by a response scoring for each answer. Word count and Flesch-Kincaid readability score and grade were done for the responses obtained from expert and ChatGPT. A comparison of the answers of ChatGPT and expert was done with a Likert scale. As a second component of the study, we tested the technical knowledge of ChatGPT. Ten multiple choice questions were framed with increasing order of difficulty - basic, intermediate and advanced, and the responses were evaluated on ChatGPT. Statistical testing was done using SPSS version 27. RESULTS: After expert review, the accuracy of expert opinion was 100%, and ChatGPT's was 80% (8/10) for regular questions encountered in outpatient department visits. A noticeable difference was observed in word count and readability of answers from expert opinion or ChatGPT. Of the ten multiple-choice questions for assessment of radiation oncology database, ChatGPT had an accuracy rate of 90% (9 out of 10). One answer to a basic-level question was incorrect, whereas all answers to intermediate and difficult-level questions were correct. CONCLUSION: ChatGPT provides reasonably accurate information about routine questions encountered in the first outpatient department visit of the patient and also demonstrated a sound knowledge of the subject. The result of our study can inform the future development of educational tools in radiation oncology and may have implications in other medical fields. This is the first study that provides essential insight into the potentially positive capabilities of two components of ChatGPT: firstly, ChatGPT's response to common queries of patients at OPD visits, and secondly, the assessment of the radiation oncology knowledge base of ChatGPT.

Postoperative coagulopathy after live related donor hepatectomy: Incidence, predictors and implications for safety of thoracic epidural catheter.

BACKGROUND: Coagulopathy after living donor hepatectomy (LDH) may endanger donor safety during removal of thoracic epidural catheter (TEC). The present study was conducted to evaluate the extent and duration of immediate postoperative coagulopathy after LDH. MATERIALS AND METHODS: A retrospective analysis of perioperative record of LDH over three years was conducted after IRB approval. Variables such as age, gender, BMI, ASA classification, liver volume on CT scan, preoperative and postoperative INR, platelet count (PC) and ALT of each donor for five days was noted. In addition, duration of surgery, remnant as percentage total liver volume (Remnant%), blood loss, day of peak in PC and INR were also noted. Coagulopathy was defined as being present if INR exceeded 1.5 or platelet count fell below 1 × 10 5 /mm 3 on any day. Data was analyzed using SPSS 20 for Windows. Between group comparison was made using the Student 't' test for continuous variables and chi square test for categorical variables. Univariate analysis was done. Multiple logistic regression analysis was used to find independent factor associated with coagulopathy. RESULTS: Eighty four (84) donors had coagulopathy on second day (mean INR 1.9 ± 0.42). Low BMI, % of remnant liver and duration of surgery were independent predictors of coagulopathy. Right lobe hepatectomy had more coagulopathy than left lobe and low BMI was the only independent predictor. There was no correlation of coagulopathy with age, gender, blood loss, presence of epidural catheter, postoperative ALT or duration of hospital stay. High INR was the main contributor for coagulopathy. CONCLUSIONS: Coagulopathy is seen after donor hepatectomy. We recommend removal of the epidural catheter after the fifth postoperative day when INR falls below 1.5.

Dyskeratosis congenita induced cirrhosis for liver transplantation-perioperative management.

Dyskeratosis congenita (DC) is an inherited disorder with progressive multisystem involvement. End stage liver disease (ESLD) in patients with DC is rare. We describe the perioperative management of a patient with DC induced ESLD and severe hepatopulmonary syndrome for living donor liver transplantation.

Direct red decolorization and ligninolytic enzymes production by improved strains of Pleurotus using basidiospore derived monokaryons.

In the present investigation the efficiency of three species of Pleurotus and their improved dikaryons (heterokaryons) was assessed for decolorization of direct red and production of lignin peroxidase (LiP), manganese peroxidase (MnP) and laccase enzymes. All the species of Pleurotus i.e. P. flabellatus, P. ostreatus, and P. citrinopileatus decolorized the dye Direct Red well. However, Pfo 6X9 and Poc 9X6 decolorized the dye more effectively than three species of Pleurotus. The improved dikaryons also showed higher ligninolytic activity than the parental species. Poc 9X6 showed higher LiP (76.27U), MnP (623.24U) and laccase activity (594.80U). In the present work different pH, age and concentration of inoculum and effect of surfactant i.e. sodium dodecyl sulphate (SDS) and Tween—80 were analyzed in order to determine the optimum ones to decolorize maximum concentration of dye. 5 ml of 10 days old culture on pH 5.5 and 0.1% Tween—80 supported maximum decolorization of direct red dye.

Biodegradation of wheat straw by Pleurotus ostreatus.

Wheat straw pretreated with chemicals as well as hot water was subjected to degradation by edible mushroom Pleurotus ostreatus. Lignin, cellulose and hemicelluloses component of both chemically as well as hot water treated wheat straw was degraded by the fungus and in turn the edible and nutritious fruiting body of the mushroom was produced. Biodegradation of wheat straw in terms of loss of lignin, cellulose and hemicellulose showed positive correlation with cellulases, xylanase, laccase and polyphenol oxidase (PPO) activity of the fungus. During vegetative growth of the fungus, lignin degradation was faster and during fructification, lignin degradation was slower than cellulose and hemicellulose. The carbon content of the wheat straw decreased while, nitrogen content increased during degradation of the waste. Hot water treated wheat straw supported better production of enzymatic activity and degraded more efficiently than chemically sterilized substrate. The cumulative yield and biological efficiency (BE) of the mushroom was maximum on the hot water treated substrate. Degradation of the hot water treated wheat straw was better and faster than chemically treated substrate.

Production of ligninolytic enzymes by white rot fungi on lignocellulosic wastes using novel pretreatments.

Production of extracellular ligninolytic enzymes (laccase and polyphenol oxidase) secreted by three species of white rot fungi (Pleurotus florida, P. flabellatus and P. sajor—caju) under in vivo condition was studied on two lignocellulosic substrates i.e., paddy straw and wheat straw. These lignocellulosic substrates were treated with neem (Azadirachta indica) oil and ashoka (Saraca indica) leaves extract. Between the two lignocellulosic substrates, paddy straw pretreated with neem oil supported maximum activity of laccase and polyphenol oxidase (PPO). The activities of both the enzymes were low on the 5th day of cultivation which increased on the 10th day and reached at peak on the 15th day. Thereafter, there was continuous decrease in the enzymatic activity. Among the three species, P. flabellatus (P3) showed maximum ligninolytic enzymatic activity followed by P. florida (P2)and P. sajor—caju (P1).

Production of cellulolytic enzymes by Pleurotus species on lignocellulosic wastes using novel pretreatments.

In the present investigation three species of Pleurotus i.e. P. sajor—caju (P1), P. florida (P2) and P. flabellatus (P3) along with two lignocellulosic substrates namely paddy straw and wheat straw were selected for evaluation of production of extracellular cellulolytic enzymes. During the cultivation of three species of Pleurotus under in vivo condition, the two lignocellulosic substrates were treated with plants extracts (aqueous extracts of ashoka leaves (A) and neem oil (B)), hot water (H) and chemicals (C).Among all treatments, neem oil treated substrates supported better enzyme production followed by aqueous extract of ashoka leaves, hot water and chemical treatment. Between the two substrates paddy straw supported better enzyme production than wheat straw. P. flabellatus showed maximum activity of exoglucanase, endoglucanase and β—glucosidase followed by P. florida and P. sajor—caju.

Brachial plexus injury in live related donor hepatectomy: a chart review.

Retrieval of the partial liver graft is a complicated and time-consuming procedure and reported to be associated with brachial plexus injury. We present a case series of brachial plexus injury in live related donor hepatectomy of 95 donors analyzed retrospectively. Seven donors suffered from brachial plexus injuries of varying severity and duration. Out of these, one donor had residual paresis. The reasons could be application of retractors, which may have led to traction and compression above the nerve roots.

Comparative evaluation of prophylactic use of pregabalin, gabapentin and diclofenac sodium for prevention of succinylcholine-induced myalgia: a randomized, double-blinded study.

CONTEXT: Succinylcholine a depolarizing muscle relaxant with rapid onset, predictable course and short duration of action is associated with myalgia. AIM: The aim of this study is to evaluate the efficacy of pregabalin, gabapentin and diclofenac on the incidence and severity of succinylcholine-induced myalgia. SETTINGS AND DESIGN: Tertiary Care Teaching Hospital. MATERIALS AND METHODS: A total of 120 patients undergoing laparoscopic cholecystectomy were randomly assigned into three groups: Pregabalin group received 150 mg of pregabalin, gabapentin group received 600 mg of gabapentin and diclofenac group received 100 mg of diclofenac sodium orally 2 h prior to surgery. Anesthesia was induced with fentanyl 3 µg/kg, propofol 2-2.5 mg/kg and succinylcholine 1.5 mg/kg and was maintained with oxygen with sevoflurane in the air and intermittent vecuronium bromide. A blinded observer recorded post-operative pain scores on visual analog scale at different time intervals and myalgia at 24 h. Post-operative pain relief was provided with fentanyl based patient-controlled analgesia. Fentanyl consumption in 24 h was recorded as a primary outcome. STATISTICAL ANALYSIS: Patients' characteristics and total fentanyl consumption were compared using one-way ANOVA followed by post-hoc test. Pain score was compared amongst the groups using Kruskal Wallis test. RESULTS: The myalgia occurred in 15, 14 and 13 patients in pregabalin, gabapentin and diclofenac sodium group respectively (P > 0.85). Patients in diclofenac group had significantly higher fentanyl consumption (674.85 ± 115.58 µg) compared with pregabalin group (601.87 ± 129.57 µg) (95% confidence interval [CI] = 34.8-120.7) and gabapentin group (612.29 ± 105.12 µg) (95% CI = 14.9-170.5). However, there was no significant difference in fentanyl consumption between pregabalin and gabapentin groups (95% CI = -34.8-120.7). There was a significant difference in visual analog score at time points 12, 18 and 24 h among the study groups. CONCLUSION: Pre-treatment with pregabalin, gabapentin and diclofenac had equal efficacy in reducing the incidence and severity of succinylcholine-induced myalgia. However, pre-treatment with pregabalin and gabapentin decreased post-operative pain scores and fentanyl consumption.

Hepatorenal syndrome: a decade later.

Hepatorenal syndrome is a unique form of acute kidney injury seen in patients with acute liver failure or chronic liver disease in absence of any other identifiable cause of renal failure. It is primarily a diagnosis of exclusion. Despite of good pathophysiological understanding and better available therapeutic options for management of hepatorenal syndrome, it is still associated with significant morbidity and mortality. Liver transplantation forms the cornerstone for its management. In this review article, we have attempted to assimilate and summarise the advances made in the previous decade with regards to pathophysiology, classification and management of this entity.

Extracellular xylanase production by Pleurotus species on lignocellulosic wastes under in vivo condition using novel pretreatment.

The production of extracellular xylanase by three species of Pleurotus species i.e. P. florida, P. flabellatus and P. sajor caju was studied under in vivo condition during their cultivation on pretreated lignocellulosic wastes. Neem (Azadirachta indica) oil and ashoka (Saraca indica) leaves extract were used for pretreatment of paddy straw and wheat straw. Between these two wastes, paddy straw pretreated with neem oil, supported better xylanase production than wheat straw. Initially, xylanase production was low but it increased in subsequent days and reached at peak on 25th day of cultivation of Pleurotus species. Thereafter, there was decrease in the activity of the enzyme. On 25th day of incubation P. florida produced maximum xylanase on neem oil pretreated paddy straw i.e. 10.59 Uh—1ml—1. Among the three species, P. florida showed maximum enzyme activity followed by P. flabellatus and P. sajor caju.

Biodegradation of sugarcane bagasse by Pleurotus citrinopileatus.

The chemically as well as hot water treated agrowaste sugarcane bagasse was subjected to degradation by Pleurotus citrinopileatus. The fungus degraded lignin, cellulose, hemicellulose, and carbon content of both chemically as well as hot water treated waste and produced in turn the edible and nutritious fruiting body. Biodegradation of the waste in terms of loss of lignin, cellulose and hemicellulose showed positive correlation with cellulases, xylanase, laccase and polyphenol oxidase (PPO) activity of the fungus. During mycelial growth of the fungus, lignin degradation was faster and during fructification, lignin degradation was slower than cellulose and hemicellulose. The carbon content of the sugarcane bagasse decreased while, nitrogen content increased during degradation of the waste. Hot water treated substrate supported better production of enzymatic activity and degraded more efficiently than chemically sterilized substrate. The total yield and biological efficiency of the mushroom was maximum on the hot water treated substrates. Degradation of the hot water treated sugarcane bagasse was better and faster than chemically treated substrates.

Azo dye (direct blue 14) decolorization by immobilized extracellular enzymes of Pleurotus species.

Four species of Pleurotus i.e., P. florida, P. ostreatus, P. citrinopileatus and P. eryngii were evaluated for laccase and MnP production in submerged condition. Among these P. ostreatus showed highest production of laccase and MnP. Twelve days old culture of P. ostreatus produced 1096 U/ml and 693.5 U/ml of the laccase and MnP, respectively. Crude extracts of enzymes from P. ostreatus were immobilized in Ca— alginate matrix and tested for decolorization activity of the azo dye (Direct blue; CI 23850) in aerobic and microaerophilic condition for 24h. Treatment of dye with the immobilized enzymes decolorized up to 99% in eighteen hour.

Biodegradation of brassica haulms by white rot fungus Pleurotus eryngii.

The white rot fungus P. eryngii was grown on chemically and hot water treated agrowaste Brassica haulms. The fungus degraded lignin, cellulose, hemicellulose and carbon content of both chemically as well as hot water treated waste and produced in turn the edible and nutritious fruiting body. The progressive breakdown of lignin, cellulose and hemicellulose was correlated with apparent increase in the activities of lignolytic, cellulolytic and hemicellulolytic enzymes. Lignin degraded at faster rate during the vegetative phase and at slower rate during reproductive phase whereas, cellulose and hemicellulose depleted slowly during vegetative phase and rapidly during reproductive phase. The carbon content of the agrowaste decreased while, the nitrogen content increased and the C/N ratio came closer during degradation of the waste. Hot water treated substrate supported better production of enzymatic activity and degraded more efficiently than chemically sterilized substrate. The total yield and biological efficiency of the mushroom was the maximum on the hot water treated substrates.

Organophosphorus derivatives containing isatin-3-hydrazones as chemotherapeutants against fungal pathogens of sugarcane.

A total of 20 novel organophosphorus derivatives have been synthesized by the reactions of O,O-diethylchlorophosphate/thiophosphate with isatin-3-(substituted benzoic acid/phenoxy acetic acid hydrazones). The derivatives have been characterized on the basis of analysis and spectral (IR and (1)H and (13)C NMR) data. Fungicidal activities of the derivatives against Colletotrichum falcatum , Fusarium oxysporum , and Curvularia pallescence have been evaluated. The screening results have been correlated with the structural features of the tested compounds. The greater potency has been observed with thiophosphates compared to phosphates, with substituted phenoxy acetic acid hydrazones compared to substituted benzoic acid hydrazones, and with substitutent Cl(-) attached to the aromatic ring compared to other substitutents. O,O-Diethylchlorophosphate compounds containing isatin-3-(4-chlorophenoxy acetic acid hydrazone) (IIe) and the compound containing two molecules of O,O-diethylchlorophosphate attached to isatin-3-(4-hydroxy phenoxy acetic acid) hydrazone (IIh) were proven to be more active than some prevalent commercial synthetic fungicides.

Synthesis and pharmacological study of novel pyrido-quinazolone analogues as anti-fungal, antibacterial, and anticancer agents.

A versatile method for novel pyrido-quinazolones was described here and tested for anti-fungal, antibacterial, and anticancerous activities. These synthesized compounds were characterized on the basis of spectroscopic techniques and evaluated for specific radiopharmaceuticals. Preliminary radiolabeling results with (99m)Tc and biological evaluation studies showed promising results for further evaluation in vivo. The efficiency of labeling was more than 98% and complexes were stable for about 18 h at 25 degrees C in the presence of serum.

Vibrational spectra of 2 (3H) benzofuranone studied by Raman, IR spectroscopy and AM1 semiempirical molecular orbital calculations.

Raman spectra of 2 (3H) benzofuranone have been recorded in the region 400-3200 cm(-1) and the IR spectra have been recorded in the region 200-4000 cm(-1). Vibrational frequencies for the fundamental modes of this bicyclic heteroatomic molecule have also been calculated using Austin method 1 (AM1) semiempirical molecular orbital method. Vibrational assignments have been made for the fundamental modes and the observed combination and overtone bands are also assigned. A splitting in the carbonyl group (C=O stretching) frequency observed at 1640-1660 cm(-1) in both Raman and IR spectra, is explained as Fermi-resonance. Net atomic charges for each atom of this molecule along with its heat of formation were also calculated. It is evident from the calculations that the 2 (3H) benzofuranone is more stable than the 3 (2H) benzofuranone in contrast to earlier estimates.

Quinazolyl benzophenothiazines as potential antiviral agents.

The reaction of anthranilic acid with excess of benzoylchloride in the presence of pyridine yielded 2-phenyl(3H) 4-oxo-3,1-benzoxazine(I). Interaction of (I) with 2-aminoethanol afforded 2-phenyl-3-hydroxy-ethyl(3H) 4-oxo-quinazoline (II). The condensation of (II) with beta-naphthol in the presence of conc. H2SO4 gave 1-(2'-phenyl-3'-ethyl-4'-oxo-quinazolyl) beta-naphthol (III). The reaction of (III) with primary aromatic amines in the presence of anhydrous zinc-chloride afforded 1-(2'-phenyl-3'-ethyl-4'-oxo-quinazolyl)-beta-naphthyl phenyl amine (IV). When (IV) was heated with sulphur and iodine, 1-(2'-phenyl 3'-ethyl -4'-oxo-quinazolyl)-benzophenothiazine (V) was obtained. All the five synthesised benzophenothiazines were screened for their antiviral activity and two compounds exhibited significant inhibition of virus multiplications.

Synthesis of alpha-methyl-benzamido-alpha'-substituted styryl cyclohexanone thiosemicarbazones as potential antifertility agents.

Cyclohexanone was condensed with N-hydroxymethyl benzamide in conc. sulphuric acid to give alpha-methyl-benzamido-cyclohexanone (I). The reaction of (I) with thiosemicarbazide in ethanol resulted in alpha-methyl-benzamido-cyclohexanone thiosemicarbazone (II). Condensation of (II) with various aromatic aldehydes in the presence of ethanol afforded alpha-methyl-benzamido-alpha'-substituted-styryl-cyclohexanone thiosemicarbazones (III) in yields ranging from 40 to 50 percent. The compounds exhibited pronounced antiimplantation activity in female albino rats.