Using ChatGPT for Clinical Practice and Medical Education: Cross-Sectional Survey of Medical Students' and Physicians' Perceptions.

BACKGROUND: ChatGPT is a well-known large language model-based chatbot. It could be used in the medical field in many aspects. However, some physicians are still unfamiliar with ChatGPT and are concerned about its benefits and risks. OBJECTIVE: We aim to evaluate the perception of physicians and medical students toward using ChatGPT in the medical field. METHODS: A web-based questionnaire was sent to medical students, interns, residents, and attending staff with questions regarding their perception toward using ChatGPT in clinical practice and medical education. Participants were also asked to rate their perception of ChatGPT's generated response about knee osteoarthritis. RESULTS: Participants included 124 medical students, 46 interns, 37 residents, and 32 attending staff. After reading ChatGPT's response, 132 of the 239 (55.2%) participants had a positive rating about using ChatGPT for clinical practice. The proportion of positive answers was significantly lower in graduated physicians (48/115, 42%) compared with medical students (84/124, 68%; P<.001). Participants listed a lack of a patient-specific treatment plan, updated evidence, and a language barrier as ChatGPT's pitfalls. Regarding using ChatGPT for medical education, the proportion of positive responses was also significantly lower in graduate physicians (71/115, 62%) compared to medical students (103/124, 83.1%; P<.001). Participants were concerned that ChatGPT's response was too superficial, might lack scientific evidence, and might need expert verification. CONCLUSIONS: Medical students generally had a positive perception of using ChatGPT for guiding treatment and medical education, whereas graduated doctors were more cautious in this regard. Nonetheless, both medical students and graduated doctors positively perceived using ChatGPT for creating patient educational materials.

Characteristics and factors associated with hypertensive crisis: a cross-sectional study in patients with hypertension receiving care in a tertiary hospital.

Background: The hypertensive crisis is characterized by poorly controlled hypertension, which can lead to unfavorable outcomes and high utilization. The purpose of this study was to examine the prevalence, clinical characteristics, and factors associated with hypertensive emergency. Material and Methods: This cross-sectional study collected data from the hospital information system that included patients greater than or equal to 18 years who were diagnosed with hypertensive crisis (blood pressure ≥180 and/or 120 mmHg) and receiving care from the primary care unit and emergency department from 2020 to 2022. The prevalence and clinical characteristics of these patients were examined. Multiple logistic regression analysis was used to analyze factors associated with hypertensive emergency. Results: Among 3329 patients with hypertension, 17.33% had a hypertensive crisis (16.64 vs. 0.69%, urgency and emergency types). Most patients were female (63.6%), with a median age of 66 years. Almost half the patients (42.2%) with hypertensive crisis presented without specific symptoms, and the most common presenting symptom was vertigo/dizziness (27.7%). The initial and after treatment blood pressures were 203/98 and 174/91 mmHg. In the hypertensive emergency, the most common end-organ damage was ischemic stroke (33.3%), hemorrhagic stroke (25%), and acute heart failure (20.8%). An oral angiotensin-converting enzyme (57.5%) was the most commonly administered medication. Multiple logistic regression was performed but did not reveal any statistically significant. Conclusion: Our result revealed a high prevalence of hypertensive crises; most were of hypertensive urgency. The most common presenting symptom was vertigo/dizziness. There was no factor significantly associated with the hypertensive emergency in this study. Further studies should explore the cause of the hypertensive crisis to improve care delivery to patients with hypertension.

HBV seroprevalence and liver fibrosis status among population born before national immunization in Southern Thailand: Findings from a health check-up program.

BACKGROUND: Hepatitis B virus (HBV) infection is the leading cause of liver-related death worldwide, particularly in Asia. Patients with either current or past HBV infection are at risk of cirrhosis and hepatocellular carcinoma (HCC). Here, we investigated the HBV seroprevalence in residents of southern Thailand born before the national vaccination program. METHODS: A cross-sectional study of individuals born before the nationwide HBV vaccination program who sought check-up programs which included HBV serology and abdominal ultrasound at a tertiary care hospital in southern Thailand from 2019 to 2020 was conducted. HBV serology, cirrhosis and liver fibrosis status (determined by ultrasonography and FIB-4), and clinical notes regarding management following HBsAg+ detection were obtained. RESULTS: Of 1,690 eligible individuals, the overall prevalence of HBsAg+ and HBsAg-antiHBc+, indicating current and past HBV infections, were 2.9% and 27.8%, respectively. Among current HBV patients, 87.8% were unaware of their infection. Cirrhosis was found in 8.2%, 1.1%, and 0.3% of patients with current, past, and no HBV infection, respectively (p<0.001). One-fourth of past HBV patients had FIB-4≥1.45, which indicated indeterminate or significant liver fibrosis, which may increase the risk of HCC. CONCLUSION: The prevalence of HBsAg+ in Southern Thailand was 2.9%, and that of past infection (HBsAg-antiHBc+) was 27.8%. Patients with current and past HBV infection have an increased risk of cirrhosis and significant liver fibrosis. Most current HBV patients were unaware of their infection. Identifying patients with current and past HBV infection who are at risk for HCC and linking them to a cascade of care is necessary to reduce the burden of HBV-related liver diseases in Thailand.

The association between physical activity and prevalence of anxiety and depression in medical students during COVID-19 pandemic: A cross-sectional study.

BACKGROUND: The COVID-19 pandemic has affected medical students both physically and mentally. Medical students have had to take online classes, which may have decreased their physical activity (PA) and increased their risk of mental health. This research aimed to explore the association between mental health problems and PA levels. MATERIALS AND METHODS: A cross-sectional study was conducted on 1st-6thyear medical students, at a university in Southern Thailand; from September to October 2021. The participants completed online questionnaires; including, demographic data, Global Physical Activity, PHQ-9 and the GAD-7 questionnaire. The association between PA levels and mental health was assessed using ordinal logistic regression. RESULTS: Among 325 medical students, 42.8% were males and 51.1% were clinical medical students. The prevalence of moderate to severe depression and anxiety was 31% and 12.9%. In total, 49.7% of participants had low PA levels. Pre-clinical students had a higher risk of depression (OR 2.11 p-value 0.001) and anxiety (OR 2.20 p-value 0.045) than clinical students. We also found that moderate or high PA levels were not a significant factor with mental health status (p-value of depression 0.447, 0.823 and p-value of anxiety 0.362, p-value 0.574, respectively). CONCLUSION: There were a lot of medical students with moderate to severe depression and anxiety, and about half of those had low PA levels; especially, pre-clinical students that learned online study activities. There was no significant association between PA levels and mental health status. However, the faculty should reconsiderate their medical student to increase physical activities and redesign the curriculum to support their students during these challenging times.

Urinary Malondialdehyde as a Biomarker of Type 2 Diabetes Mellitus Treatment in the Primary Care Unit of a Tertiary Care Hospital.

INTRODUCTION/OBJECTIVES: The examination of Urinary Malondialdehyde (UMDA) as a biomarker in the involvement of inflammatory response and oxidative stress, as a mechanism underlying the development of diabetes; in addition to complications in followed-up patients at a primary healthcare unit. The level of UMDA and its related factors in T2DM patients, between good and poor glycemic control was investigated. METHODS: This analytical cross-sectional study was conducted at the primary care unit, of Songklanagarind Hospital; from May 2020 to August 2020. The voluntary patients were divided into 2 groups, by using a percentage of HbA1c ≤7% as a good control T2DM group, and higher than 7% as a poor control T2DM group. The comparison statistics and logistic regression analysis were performed by using R Program. RESULTS: A total of 71 patients voluntarily participated in this study, and consisted of: 38 patients with poor glycemic control and 33 patients with good glycemic control. There were no significant differences between the patients; with the exception of smoking habits. The average levels of UMDA of the good control group (2.43 ± 0.91 µg/mL) were slightly lower than the poor control group (2.60 ± 0.96 µg/mL): P-value >.05. Patients who had underlying diseases, smoking, or drinking habits displayed significantly different levels of UMDA. Being a non-smoking patients, and having a higher level of HDL-C with significant protective factors, while having increased level of FBS and triglyceride were pointedly negative factors of oxidative stress status. CONCLUSION: Patients who had good control of T2DM produced better health outcomes than the poor control group. UMDA, FBS, HDL-C, and triglyceride levels could be applied as follow-up criteria in T2DM patients within a primary healthcare setting.