Shiraz E-Medical Journal最新文献

{"title":"ChatGPT, a Friend or a Foe in Medical Education: A Review of Strengths, Challenges, and Opportunities","authors":"Mahdi Zarei, Maryam Zarei, S. Hamzehzadeh, Sepehr Shakeri Bavil Oliyaei, Mohammad-Salar Hosseini","doi":"10.5812/semj-145840","DOIUrl":"https://doi.org/10.5812/semj-145840","url":null,"abstract":"Background: ChatGPT is a large-scale language model that utilizes artificial intelligence (AI) to answer a broad range of scientific inquiries, create clinical scenarios, and evaluate educational programs. While its use offers numerous advantages, it also presents several challenges. Objectives: The aim of this study is to conduct a comprehensive review of ChatGPT's functionality and explore the benefits, challenges, existing solutions, and future prospects of using AI in medical education. Method: A comprehensive literature review was conducted using various databases such as PubMed, Scopus, Web of Science, and Google Scholar. The search phrases used were ChatGPT, Artificial Intelligence, Chatbot, Medical Education, and large language models (LLMs). Results: The application of ChatGPT in medical education offers several advantages, such as enhanced quality of interaction between medical students and patients, improved education quality, enhanced research opportunities, personalized learning, virtual patient simulations, and cost-effectiveness. However, there are also critical challenges, such as ethical and transparency concerns, limited access to reliable databases, restricted information availability after 2021, limited development of students' critical thinking ability, and the risk of generating hallucinations. Conclusions: Artificial intelligence models have become a popular tool for researchers to access scientific resources, comprehend articles and textbooks, and create scientific texts. ChatGPT has been used extensively in medicine and medical education in a short period. It is essential to weigh the benefits and challenges, use expert supervision, conduct frequent assessments, and provide feedback reviews to guarantee its efficacy. Although this technology should not replace human labor, it is essential to prepare for the changes brought by AI and create appropriate guidelines and curricula by reviewing existing solutions and conducting extensive studies.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"124 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141282026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological and Molecular Characteristics of Malignant Breast Tumors in the Kurdish Population During 2019 - 2021","authors":"B. Nikkhoo, Muhammad Rasul Fathi, Sherko Nasseri, Bayazid Ghaderi, Hassan Moaiery, Leila AzizKhani, Khaled Rahmani","doi":"10.5812/semj-143049","DOIUrl":"https://doi.org/10.5812/semj-143049","url":null,"abstract":"Background: Breast cancer, the most prevalent cancer in women and the second leading cause of cancer-related deaths worldwide, is a complex and heterogeneous disease characterized by multiple tumor types with distinct tissue patterns, biological characteristics, and clinical behaviors. Given the critical role of histopathological and molecular characteristics in the treatment and management of breast cancer. Objectives: This study was undertaken to investigate the histopathological characteristics of malignant breast masses in the city of Sanandaj from 2019 to 2021. Methods: In this descriptive-analytical study, out of 1,631 pathology reports from breast tissue samples collected in Sanandaj, a city in northwest Iran, between 2019 and 2021, 597 (36%) malignant cases were examined for their pathological type and molecular characteristics. Data analysis was performed using SPSS 26 software, employing chi-square and Fisher's exact tests. Results: The mean age of the patients at diagnosis was 49.7 ± 11.9 years. The most prevalent molecular subtype was luminal A (56.4%), followed by triple-negative (16.7%), human epidermal growth factor receptor 2 (HER2)-positive/enriched (14.1%), and luminal B (14%). Invasive ductal carcinoma was the predominant histological type, accounting for 82.7% of cases, followed by lobular invasive carcinoma (8.2%). Papillary carcinoma accounted for 5.9% of cases, metaplastic carcinoma for 1.8%, and mucinous carcinoma for 1.3%. Higher grades at the time of diagnosis were associated with the metaplastic subtype (P < 0.001). The only biomarker that showed a significant association with pathological types of breast cancer was Ki-67. The percentage of cases positive for Ki-67 was higher in three types of breast cancer: Infiltrating ductal carcinoma, metaplastic, and papillary (intraductal) carcinoma, compared to the other types (P < 0.001). Conclusions: According to our data, infiltrating ductal and lobular carcinoma are the most prevalent pathological types, and luminal A is the most common molecular subtype among Kurdish women in Iran. It is recommended that future studies examine patient survival based on the pathological and molecular types of tumors, including the evaluation of additional biomarkers. Furthermore, comparing these results with those from other ethnic groups could provide valuable insights into the impact of ethnicity on breast cancer characteristics and outcomes.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"21 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140979950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Maternal Vitamin B12 and Folate Levels with Gestational Diabetes Mellitus and Insulin Resistance","authors":"Shahram Zarei, Mahmood Soveid","doi":"10.5812/semj-142064","DOIUrl":"https://doi.org/10.5812/semj-142064","url":null,"abstract":"Background: The incidence of gestational diabetes mellitus (GDM) has increased in recent decades. Established prevention methods for GDM include diet and exercise. Recent interest has focused on the roles of vitamin B12 and folate in the development of GDM. These micronutrients are essential for one-carbon metabolism, which is involved in many metabolic pathways. However, the study results were conflicting and varied by geographic area. Objectives: The aim of this study was to evaluate the relationship between GDM and vitamin B12 levels in our region. Methods: This case-control study enrolled 180 pregnant women at 24 - 28 weeks of gestation. Half of the participants had GDM, and the other half were healthy individuals. All participants attended outpatient pregnancy care clinics at Shiraz University of Medical Sciences from June 2020 to April 2021. Gestational age, age, and body mass index were matched between the two groups. Vitamin B12, folate, insulin, and homocysteine levels were measured in both groups and insulin resistance was calculated. The results were compared between the two groups, and the relationship between vitamin B12 levels and insulin resistance in each group was investigated. Results: Vitamin B12 deficiency was present in 15.6% of the women with GDM. There were no cases of vitamin B12 deficiency in the control group. The GDM group had lower vitamin B12 levels (365.22 ± 136.82 pg/mL vs. 496.08 ± 156.46 pg/mL, P = 0.001). There was a negative correlation between serum vitamin B12 level and insulin resistance index (P = 0.001, r = -0.62). Folate levels were higher in the GDM group (17.93 ± 3.66 ng/mL vs. 14.60 ± 5.32 ng/mL, P = 0.001), but these levels did not significantly relate to insulin resistance or GDM. Conclusions: In our region, there is a significant relationship between low levels of vitamin B12 and both insulin resistance and GDM, which suggests the need for larger studies and attention to the detection and treatment of vitamin B12 deficiency during pregnancy.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"8 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140665071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study Protocol for Assessing the Effectiveness of Agomelatine on the Severity and Frequency of Episodic Migraine Attacks Without Aura: A Randomized Triple-Blind, Placebo-Controlled Trial","authors":"Nahid Dehghan Nayeri, Kourosh Farzin, Mahdi Shafiee Sabet, Abbas Tafakhori","doi":"10.5812/semj-142956","DOIUrl":"https://doi.org/10.5812/semj-142956","url":null,"abstract":"Background: Migraine is a chronic condition characterized by moderate to severe headache attacks, adversely affecting individual and social quality of life. Given the chronic nature of this disease, it is crucial to find medications that offer fewer side effects and enhanced effectiveness. Agomelatine, a synthetic analogue of the hormone melatonin, shares similar pharmacodynamics, such as stimulating melatonin receptors and inhibiting the 5HT2c receptor. Due to its favorable side-effect profile and high tolerability, agomelatine presents a viable alternative to traditional preventive treatments for migraines. Objectives: The primary objective of this trial is to evaluate the effectiveness of agomelatine in reducing the severity and frequency of episodic migraine attacks without aura. Methods: This study utilizes a parallel, triple-blind controlled trial design. Patients, aged between 18 and 60 years, who have been definitively diagnosed with episodic migraine without aura and have not received prior severity treatment, are eligible for this randomized controlled trial (RCT). A convenience sample of patients will be recruited from individuals visiting the clinic for migraine issues. If these individuals agree to participate and meet the inclusion criteria, they will be randomly assigned to either the intervention or control group using a random number table or software. The intervention group will receive 25 mg of agomelatine daily, while the control group will be given vitamin B1 as a placebo. Both the frequency and severity of migraine attacks will be monitored, along with the mean monthly migraine days (MMD) and migraine disability assessment (MIDAS) scores, before and after the intervention.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"48 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140667352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Ethical Challenges of Umbilical Cord Blood Stem Cell Banking: A Qualitative Study","authors":"Madjid SoltaniGerdfaramarzi, Seyed Ali Enjoo, Leila Afshar, M. Fadavi, M. Kiani, S. Bazmi","doi":"10.5812/semj-142330","DOIUrl":"https://doi.org/10.5812/semj-142330","url":null,"abstract":"Background: Umbilical cord blood serves as a potent source of hematopoietic stem cells, utilized in treating specific diseases and preserved in blood banks. Objectives: This study aims to explore the ethical issues associated with these repositories. Methods: This qualitative research involved conducting 14 interviews with experts and the families of recipients or donors of umbilical cord blood. Participants were selected purposefully from May to November 2021. Results: The investigation identified five principal ethical challenges: presentation of information, interpersonal relationships among involved parties, respect for human dignity, adherence to rules and regulations, and the handling of tissue samples. These challenges encompassed various categories and subcategories, including informed consent, communication and advertising of information, financial considerations, conflicts of interest, professional interactions, ownership rights concerning the child and parents, privacy and confidentiality issues, compliance with regulations and guidelines, and the clinical and research uses of the tissue samples. Conclusions: The study unveiled significant ethical concerns in the domain of umbilical cord blood stem cell banking. Addressing these ethical dilemmas necessitates the involvement of health policymakers and medical ethics experts, along with a comprehensive understanding of these banks' multifaceted nature by the community.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"4 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relative Frequency of Anxiety and Its Correlation with Individual and Family Factors Among Adolescents in Shiraz, 2020: A Cross-Sectional Study","authors":"Zahra Zeinali, N. Sharifi, M. Edraki","doi":"10.5812/semj-140159","DOIUrl":"https://doi.org/10.5812/semj-140159","url":null,"abstract":"Background: Anxiety disorders are the most common mental health problems in adolescents. Uncontrolled anxiety disorders during this period not only negatively affect adolescents' current performance but can also have long-term negative consequences on their physical and mental health. Objectives: This study is designed to investigate the relative frequency of anxiety and its correlation with individual and family characteristics among first-grade high school students in Shiraz, 2020. Methods: This is a descriptive and analytical cross-sectional study, conducted on 360 first-grade high school students who were selected using a multi-stage sampling method in Shiraz, Iran. Data were collected through online questionnaire software, which included the Beck Anxiety Inventory and a Demographic Questionnaire, and were analyzed using SPSS software version 24. Results: The relative frequency of anxiety disorders in the study samples was 59.7% (60.9% in girls and 56.6% in boys); among them, 13.1% experienced severe anxiety, 16.9% had moderate anxiety, and 29.7% had mild anxiety. The results of univariate analysis showed correlations between anxiety disorders and factors such as father's unemployment (P = 0.04), a history of physical and mental problems in teenagers (P = 0.04 and P = 0.001, respectively), and the lack of friendly relations between family members (P = 0.001). Additionally, the results of logistic regression analysis indicated that adolescents with mental illness and those lacking friendly relationships within their family had higher chances of experiencing anxiety disorders compared to other participants (OR = 5.00, P = 0.04 and OR = 9.95, P = 0.002, respectively). Conclusions: In this study, mental illness and the lack of friendly relations between family members emerged as significant factors contributing to adolescents' anxiety. Therefore, identifying and addressing these related factors, along with timely diagnosis and treatment of this disorder in adolescents, should be prioritized by mental health officials.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"8 30","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140708221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Inequality Trend in Health Resource Distribution in Iran: A Case Study in Bushehr Province","authors":"M. Rezaee, Mohamad Azmal, Farhad Lotfi, H. Omranikhoo","doi":"10.5812/semj-141095","DOIUrl":"https://doi.org/10.5812/semj-141095","url":null,"abstract":"Background: Equity in access to health resources is a fundamental goal of health systems worldwide. Objectives: This study aims to assess the distribution of essential health resources necessary for healthcare provision in Bushehr Province. Methods: This cross-sectional study spans ten years and utilizes several widely recognized indices in health resource distribution equity and equality, including the Gini Coefficient, Concentration Index, Horizontal Inequity, Robin Hood Index, Theil Index, Atkinson Index, and Quantile Ratio. These indices were calculated based on both the population level and the proposed resource allocation model (PRAM) using Excel Software 2018 and Stata version 18. Results: The findings indicate a degree of inequality in the distribution of all health resources examined, with special beds exhibiting much higher levels of inequality than others. The sensitivity of the studied indices varied across the distributed resources. Moreover, the trend of inequality generally decreased for all examined resources. The PRAM results suggest that adopting a different approach to resource distribution can significantly reduce inequality levels. Conclusions: Despite a downward trend in the inequality of health resource distribution, significant disparities persist. Altering the resource distribution system from the conventional geographical division could aid in achieving equity and equality in healthcare. Such changes could also reduce the costs associated with the health system.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"84 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140712663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Large Language Models in Modern Medical Education: Opportunities and Challenges","authors":"Abdollah Mahdavi, M. Amanzadeh, M. Hamedan","doi":"10.5812/semj-144847","DOIUrl":"https://doi.org/10.5812/semj-144847","url":null,"abstract":"<jats:p />","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"68 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140721819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Risk Factors for Post-COVID-19 Functional Gastrointestinal Disorders After One Year","authors":"M. Soheilipour, Safa Ahoon, Amir Ghaderi, Elham Tabesh, Peyman Adibi Sedeh","doi":"10.5812/semj-134849","DOIUrl":"https://doi.org/10.5812/semj-134849","url":null,"abstract":"Objectives: In light of the global COVID-19 pandemic and the subsequent emergence of functional gastrointestinal disorders (FGIDs) post-recovery, this study aimed to evaluate the frequency and risk factors associated with FGIDs one year after recovering from COVID-19. Methods: This cross-sectional study included a total of 357 patients who had recovered from COVID-19 for a year and were seen at Al-Zahra Hospital in 2021. Participants were chosen through simple random sampling. The ROME questionnaire, alongside patients' clinical histories regarding irritable bowel syndrome (IBS) and its variants, functional dyspepsia (FD), and other GI symptoms, was utilized for data collection. Results: Findings indicated that one year post-COVID-19, the prevalence rates of IBS, GI symptoms, and FD stood at 15.4%, 44.9%, and 9.5%, respectively. It was observed that women had a higher propensity than men to develop these FGIDs (P-value = 0.044). Anxiety was linked to a 1.910-fold increase in IBS risk (P-value = 0.039), a 2.225-fold surge in GI symptoms (P-value < 0.001), and a 1.110-fold rise in FD risk (P-value = 0.042). Moreover, depression was associated with a 1.772-fold and 3.753-fold elevated risk of developing IBS (P-value = 0.040) and FD (P-value < 0.001), respectively. Conclusions: The findings suggest that FGIDs such as IBS, FD, and other GI symptoms are significant long-term sequelae of COVID-19 infection. Anxiety and depression appear to be key risk factors for these conditions, with a more pronounced impact observed in women than in men.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"110 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140724639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Positive Psychological Interventions on Social Isolation of Girl Students During the COVID-19 Pandemic","authors":"Ziba Karimi, Bahman Kord Tamini, Sana Nourimoghadam","doi":"10.5812/semj-135961","DOIUrl":"https://doi.org/10.5812/semj-135961","url":null,"abstract":"Background: Past studies have revealed that positive psychological intervention has a positive impact on social isolation. Objectives: The purpose of this investigation was to examine the effect of positive psychological interventions on students' social isolation during the COVID-19 pandemic. Methods: The research design of the study was quasi-experimental, comprising post-test and pre-test types with experimental and control groups. The population of this study included all female students of the 10th grade at Isfahan Conservatory during the academic year 2022 - 2023. The sample size consisted of 30 female students who were selected through convenience sampling and randomly assigned to two groups: the control group (15 students) and the experimental group (15 students). Eight sessions of positive psychological intervention were conducted with the experimental group, while the control group did not receive any intervention. Results: The results of Fisher’s Exact test and chi-square test did not reveal any significant difference between the two groups of fathers in terms of education level (P = 0.169), and there was also no significant difference between the two groups of mothers in terms of education level (P = 0.715). The mean scores of social isolation (control: 50.00 ± 7.44, intervention: 30.00 ± 7.60) significantly decreased in the intervention group (P = 0.0001), but there was no significant decrease in the control group (P = 0.45). Accordingly, the pre-test mean scores of social isolation (P = 0.143) did not show significant between-group differences, and the post-test mean scores of social isolation (P = 0.001) in the intervention group were significantly lower than in the control group. Conclusions: The positive psychological intervention had a significant effect on the students' social isolation in the experimental group during the COVID-19 pandemic, indicating that this intervention can be used to reduce the social isolation of students.","PeriodicalId":507014,"journal":{"name":"Shiraz E-Medical Journal","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140748200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}