ChatGPT Versus National Eligibility cum Entrance Test for Postgraduate (NEET PG).

Introduction With both suspicion and excitement, artificial intelligence tools are being integrated into nearly every aspect of human existence, including medical sciences and medical education. The newest large language model (LLM) in the class of autoregressive language models is ChatGPT. While ChatGPT's potential to revolutionize clinical practice and medical education is under investigation, further research is necessary to understand its strengths and limitations in this field comprehensively. Methods Two hundred National Eligibility cum Entrance Test for Postgraduate 2023 questions were gathered from various public education websites and individually entered into Microsoft Bing (GPT-4 Version 2.2.1). Microsoft Bing Chatbot is currently the only platform incorporating all of GPT-4's multimodal features, including image recognition. The results were subsequently analyzed. Results Out of 200 questions, ChatGPT-4 answered 129 correctly. The most tested specialties were medicine (15%), obstetrics and gynecology (15%), general surgery (14%), and pathology (10%), respectively. Conclusion This study sheds light on how well the GPT-4 performs in addressing the NEET-PG entrance test. ChatGPT has potential as an adjunctive instrument within medical education and clinical settings. Its capacity to react intelligently and accurately in complicated clinical settings demonstrates its versatility.

Preoperative scoring system validation and analysis of associated risk factors in predicting difficult laparoscopic cholecystectomy in patients with acute calculous cholecystitis: A prospective observational study.

Objectives: Today laparoscopic cholecystectomy (LC) is the treatment of choice for acute cholecystitis. However, the presence of severe inflammation makes it challenging for the surgeons to accurately recognize the Calot's triangle which increases the risk of intraoperative complications. The aim of this study was to explore the validity of a scoring system used to predict difficult LC and to analyse the risk factors associated with difficult cholecystectomy in the setting of acute calculous cholecystitis. Material and Methods: An observational study was conducted between December 2018 and December 2020 among 132 patients diagnosed with acute cholecystitis, who underwent laparoscopic cholecystectomy. A scoring system by Randhawa et al. was used preoperatively for all of these patients to predict difficult LC, which was correlated to intraoperative difficulties in actual surgery. Data were analysed using the SPSS version 26.0. Results: Mean age was 43.63 ± 13.37, with almost equal representation from both sexes. History of previous attacks of cholecystitis, impacted stone, thickness of GB wall were statistically significant in calculating preoperative difficulty of laparoscopic cholecystectomy. The scoring system had a sensitivity and specificity of 82.6% and 63.5%, respectively. The conversion rate to open cholecystectomy was 6.9%. Conclusion: Analysing the significant risk factors before operating in the presence of an inflamed gallbladder can reduce the overall mortality and morbidity. An accurate preoperative scoring system will enable the operating surgeon to be well prepared with adequate resources and time. The patient attenders can also be counselled regarding the risk involved beforehand.

Is treatment with platelet-rich fibrin better than zinc oxide eugenol in cases of established dry socket for controlling pain, reducing inflammation, and improving wound healing?

OBJECTIVES: To appraise the effectiveness of platelet-rich fibrin (PRF) in the management of established dry socket in terms of pain, inflammation, and wound healing. MATERIALS AND METHODS: Two hundred patients with established alveolar osteitis were studied to determine the efficacy of PRF and zinc oxide eugenol (ZOE) for pain control, inflammation reduction, and wound healing. Patients were randomly allocated to Group A (PRF) or Group B (ZOE). Patients were examined on the 1st, 3rd, 7th, and 14th postoperative day and evaluated for pain using visual analogue scale scores, inflammation with a gingival index score, and wound healing through a determination of the number of bony walls exposed. RESULTS: Group A showed better results in terms of pain remission, control of inflammation, and wound healing compared to Group B. Results between groups were statistically significant (P<0.05). CONCLUSION: PRF is a better alternative than ZOE for the effective management of alveolar osteitis.

Retraction: Is treatment with platelet-rich fibrin better than zinc oxide eugenol in cases of established dry socket for controlling pain, reducing inflammation, and improving wound healing?

[This retracts the article on p. 76 in vol. 45, PMID: 31106135.].

Estimation of Dental and Bone Age in Obese Children of South India.

AIM: Determination of skeletal and dental age is very essential for Pediatric dentist and orthodontist to formulate a treatment plan, and it is a source of supplemental information for Pediatrics, Orthopedics, and Forensics. There are no available studies in the literature about the comparison of dental and bone age with chronological age in obese children of south India. Accordingly, the aim of this study was to evaluate and compare dental age, bone age, and chronological age in obese children of south India. MATERIALS AND METHODS: Ethical approval was obtained from the ethical committee of college, and informed consent was obtained from parents of the study participants. A total of 100 obese study participants were selected between 8 to 14 years age group. Date of birth was considered to obtain chronological age. Demirjian's method was used to assess dental age. Bjork, Grave, and Brown's method was followed to detect bone age using hand-wrist radiograph. The comparison of three ages was done using the unpaired Student's t-test and Pearson's correlation coefficient. RESULTS: Dental age and bone age were advanced in comparison to chronological age in both sexes and its statistically significant (P < 0.001). There was a positive correlationship between three ages in both sexes. CONCLUSION: As per our study, dental age and bone age were advanced in obese children, but dental age was more advanced. Dental age and bone age can be considered as variables for diagnosing the impact of growth in obese children. In the future, further studies are required to support our findings.

Comparative Evaluation of Neem Mouthwash on Plaque and Gingivitis: A Double-blind Crossover Study.

AIM: The present study aimed at evaluating the impact of neem-containing mouthwash on plaque and gingivitis. MATERIALS AND METHODS: This randomized, double-blinded, crossover clinical trial included 40 participants aged 18 to 35 years with washout period of 1 week between the crossover phases. A total of 20 participants, each randomly allocated into groups I and II, wherein in the first phase, group I was provided with 0.2% chlorhexidine gluconate and group II with 2% neem mouthwash. After the scores were recorded, 1-week time period was given to the participants to carry over the effects of the mouthwashes and then the second phase of the test was performed. The participants were instructed to use the other mouthwash through the second test phase. RESULTS: There was a slight reduction of plaque level in the first phase as well as in the second phase. When comparison was made between the groups, no statistically significant difference was seen. Both the groups showed reduction in the gingival index (GI) scores in the first phase, and there was a statistically significant difference in both groups at baseline and after intervention (0.005 and 0.01 respectively). In the second phase, GI scores were reduced in both groups, but there was a statistically significant difference between the groups only at baseline scores (0.01). CONCLUSION: In the present study, it has been concluded that neem mouthwash can be used as an alternative to chlorhexidine mouthwash based on the reduced scores in both the groups. CLINICAL SIGNIFICANCE: Using neem mouthwash in maintaining oral hygiene might have a better impact in prevention as well as pervasiveness of oral diseases as it is cost-effective and easily available.

An Innovative Approach to Retention: Thermoplastic Retainer.

AIM: The aim of this study was to design and introduce a retainer that overcomes the common shortcomings seen in other retainers. MATERIALS AND METHODS: Hard thermoplastic sheet of 0.5 mm thickness is vacuum or pressure-molded onto the patient cast. Lingual portion of the retainer is trimmed according to the contours of the anterior teeth. Contact points between the maxillary and mandibular anterior teeth are marked on the retainer and reduced. Punch cut holes are placed on the retainer for the exit of flash and air bubbles while fixation. The retainer is bonded onto the lingual surface of the anterior teeth using composite. RESULTS: A 1-month review of the retainer showed no patient discomfort, occlusal interference, or bond failure. The aim of the article was found to have been achieved. CONCLUSION: Initial evaluation has shown positive findings. Long-term clinical findings will determine the overall success of this new retainer. CLINICAL SIGNIFICANCE: As compared with other retainers, thermoplastic retainer has shown reduced tendency to debond from occlusal forces, decreased patient discomfort, and occlusal interference.

Treatment of Mandibular Angle Fractures with Single Three-Dimensional Locking Miniplates without Maxillomandibular Fixation: How Much Fixation Is Required?

The aim of this simple nonrandomized and observational study was to evaluate the efficacy of single three-dimensional (3D) plate for the treatment of mandibular angle fractures without maxillomandibular fixation. A total of 30 patients with noncomminuted fractures of mandibular angle requiring open reduction and internal fixation were included in the study. All the patients were treated by open reduction and internal fixation using single 3D titanium locking miniplate placed with the help of transbuccal trocar or Synthes 90-degree hand piece and screw driver. 3D locking titanium miniplates used in our study was four-holed, box-shaped plate, and screws with 2 mm diameter and 8 mm length. The following clinical parameters were assessed for each patient at each follow-up visit: pain (visual analog scale: 0-5), swelling (visual analog scale: 0-5), mouth opening, infection, paresthesia, hardware failure (plate fracture), occlusal discrepancies, and mobility between fracture fragments. A significant decrease in pain level was seen during the follow-up visits. No statistically significant changes were seen in swelling, but mouth opening increased in the subsequent visits. Also better results were seen in terms of fracture stability and occlusion in the postoperative period. Two cases of infection and two cases of hardware failure were noted in sixth postoperative week. 3D plating system is an easy to use alternative to conventional miniplates to treat mandibular angle fractures that uses lesser foreign material, thus reducing the operative time and overall cost of the treatment. Better fracture stability and occlusion was also achieved using the 3D plating system.

High Prevalence of Tobacco Use and Associated Oral Mucosal Lesion Among Interstate Male Migrant Workers in Urban Kerala, India.

BACKGROUND: Kerala is a highly urbanized state in India and interstate migrant laborers working there forms a marginalized community. It was generally perceived that use of tobacco and alcohol was high among the workers, but there are no epidemiological studies assessing the actual burden. OBJECTIVES: To estimate the prevalence of use of tobacco and also the prevalence of oral mucosal lesions associated with such use consumption among the adult male interstate migrant workers in North Kerala. MATERIALS AND METHODS: A cross sectional study was carried out among male migrant workers above 18 years working in different factories in urban parts of Kannur district. Total of 244 participants attending routine health check-up camp were assessed for the use of tobacco/alcohol, type, frequency and duration of their use by a questionnaire. The trained dental interns conducted oral cavity examination for detecting oral mucosal lesions associated with tobacco use. RESULTS: The prevalence of current use of smoked tobacco, smokeless tobacco and alcohol use were 41.8%, 71.7% and 56.6%, respectively among migrants. Oral mucosal lesions (OML) were seen in 36.3% of participants. Among smokeless tobacco users, 44.6% had lesions. Adjusted odds ratio for OML was 4.5 (CI: 1.9 - 19.84) among smokeless tobacco users. CONCLUSIONS: The current use of smokeless tobacco and oral mucosal lesions are highly prevalent among migrant workers.