A Scoping Review on the Reported Evidence and Gaps of the Risk of Diabetes in Dyslipidemic Patients under Statin Therapy

With the increasing global burden of dyslipidemia over the past 30 years, it is estimated that more than 200 million people worldwide are under statin therapy. In India, roughly 25–30% of urban populations and 15–20% of rural populations have abnormal lipid levels. Statin, which is deemed to be the gold standard lipid-lowering agent, is the first treatment of choice for these patients. Although statins at one end are highly effective against dyslipidemiaand cardiovascular diseases, at the other end, they cause adverse effects including an increased risk of diabetes mellitus. The objective of this study was to understand the coexistence of diabetes and dyslipidemia in patients undergoing statin therapy. A scoping review was conducted with published articles selected from PubMed and Google Scholar. The obtained results were filtered based on inclusion/exclusion criteria. Our database search provided a total of 822 articles, of which 48 were selected for this review, with results concluding that statin users are potentially at a greater risk of developing diabetes mellitus compared with patients who are not using statins. Although many studies have been conducted to ascertain the onset of diabetes mellitus amongst statin users, the exact mechanism is not yet precisely established. Future studies are essential for identifying the exact cause of diabetes mellitus in statin users

Ethical Conundrums in the Application of Artificial Intelligence (AI) in Healthcare—A Scoping Review of Reviews

Background: With the availability of extensive health data, artificial intelligence has an inordinate capability to expedite medical explorations and revamp healthcare.Artificial intelligence is set to reform the practice of medicine soon. Despite the mammoth advantages of artificial intelligence in the medical field, there exists inconsistency in the ethical and legal framework for the application of AI in healthcare. Although research has been conducted by various medical disciplines investigating the ethical implications of artificial intelligence in the healthcare setting, the literature lacks a holistic approach. Objective: The purpose of this review is to ascertain the ethical concerns of AI applications in healthcare, to identify the knowledge gaps and provide recommendations for an ethical and legal framework. Methodology: Electronic databases Pub Med and Google Scholar were extensively searched based on the search strategy pertaining to the purpose of this review. Further screening of the included articles was done on the grounds of the inclusion and exclusion criteria. Results: The search yielded a total of 1238 articles, out of which 16 articles were identified to be eligible for this review. The selection was strictly based on the inclusion and exclusion criteria mentioned in the manuscript. Conclusion: Artificial intelligence (AI) is an exceedingly puissant technology, with the prospect of advancing medical practice in the years to come. Nevertheless, AI brings with it a colossally abundant number of ethical and legal problems associated with its application in healthcare. There are manifold stakeholders in the legal and ethical issues revolving around AI and medicine. Thus, a multifaceted approach involving policymakers, developers, healthcare providers and patients is crucial to arrive at a feasible solution for mitigating the legal and ethical problems pertaining to AI in healthcare

A Scoping Review on COVID-19 Vaccine Hesitancy among the Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual (LGBTQIA+) Community and Factors Fostering Its Refusal

Background: The ramifications of the existing crisis caused by the coronavirus pandemic are sensed in all walks of life. Among the various efforts made to curb the spread of this novel infection, the development of COVID-19 vaccines had a profound role in flattening the pandemic curve. Even though the rapid vaccine drive received a highly welcoming response among people, the reluctance and ignorance of a part of the population towards available safe vaccines stand as impediments to achieving the desired outcome. The LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual) communities are the least studied groups in this regard. Objective: The purpose of this study is to extensively review and report on COVID-19 vaccine uptake and refusal among the LGBTQIA+ population and enumerate the factors contributing to vaccine hesitancy. The study extends further to outline a conceptual framework for interventions to enhance COVID-19 vaccine acceptance among the LGBTQIA+ population. Methods: We performed a systematic search using key terms on Google Scholar and PubMed. The obtained results were filtered using the eligibility criteria framed for this study. The initial search provided an extensive result of 4510 articles which were later screened at various levels to arrive at the final inclusive collection of manuscripts adding to 17. The studies were analyzed by the authors individually, and the data were categorized using variables. The results are interpreted using charts and graphs. The whole manuscript has been structured in accordance with the PRISMA extension for scoping reviews. Result: The comprehensive search yielded 17 eligible articles for this review. Most of the studies were conducted in the United States (n = 17), and predominantly cross-sectional studies have been conducted. The major comparative factor was the HIV status of the LGBTQIA+ population. HIV-affected patients were more willing to take up COVID-19 vaccination. However, social stigma, discrimination, lack of access and non-prioritization in vaccine drives were found to be the major factors contributing to vaccine hesitancy among this population. Conclusion: The invention of the COVID-19 vaccination revolutionized the healthcare systems burdened with COVID-19. Although this is a breakthrough scientific contribution, many factors are associated with the rate of vaccine acceptance, especially among sexual and gender minorities. The reviewed studies have revealed numerous factors that influence vaccine uptake and refusal with the commonest being concerns on discrimination, social stigma, inequitable access to healthcare, vaccine safety, efficacy, potency, side effects and lack of trust in medical workers. These impediments in vaccine coverage should be meticulously addressed to ensure optimum LGBTQIA+ physical and mental health as well as for providing non-discriminative, equitable and quality healthcare service regardless of the gender or sexual orientation of individuals

Using Mobile Health (mHealth) Interventions to Optimise Breast Cancer Care: A Scoping Review

Introduction: Mobile phones have become ubiquitous in recent years. This portable device can be efficiently utilised to promote health and deliver high-quality healthcare services via Mobile Health (mHealth) technology interventions. In view of the increasing global burden of breast cancer cases, mHealth interventions can be constructive in breast cancer prevention and management. Nevertheless, there is a paucity of evidence to support the utility of mHealth interventions in breast cancer care. Aim: To analyse and synthesise evidence from published literature on the feasibility and effectiveness of mHealth interventions employed for breast cancer prevention, detection, management, and rehabilitation. Additionally, this study intends to draft a conceptual framework for mHealth intervention strategies in breast cancer management. Materials and Methods: A comprehensive literature search was conducted at Panimalar Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India, from June 2022 to December 2022. Google Scholar and PubMed databases were used to find published articles relevant to the study’s objectives. The reviewers selected articles based on the relevance of the article and eligibility criteria. Articles on mHealth interventions for the female population above 18 years of age with breast cancer were included. Results: A total of 13 articles were selected based on the eligibility criteria. Regardless of the type of mHealth technology employed, target population, and purpose of intervention, all the studies strongly support the use of mHealth technologybased interventions over usual care to enhance breast cancer management. Conclusion: The use of mHealth applications has increased exponentially in recent years. Since then, many studies have been conducted to validate their use. However, the usability of these applications is not well established. The involvement of not only patients but also healthcare professionals is crucial to develop well-equipped digital health applications. Personalised applications that provide security and safeguard user privacy are highly preferred by patients. A collaborative approach involving patients, healthcare professionals, and application developers will aid in the development of highly efficient mHealth applications

A Scoping Review on Accentuating the Pragmatism in the Implication of Mobile Health (mHealth) Technology for Tuberculosis Management in India

Background: India continues to share a colossal count of the global tuberculosis load, with a perturbing 19% spring in the reported cases in 2021. With the National Tuberculosis Elimination Program (NTEP) consolidated to bring this epidemic to an end by 2025, the rapidly growing mobile health technologies can be utilized to offer promising results. Even though the implementation of this novel strategy is escalating around the globe, its triumph is still sub optimal in India. Objectives: This scoping review intends to explore the available mobile health (mHealth) technologies and analyse the effectiveness of the same for tuberculosis management in India. Methods: An elaborate search in electronic databases, such as PubMed and Google scholar, using the key terms and focussing from the year 2015, provided very broad results focussing on mHealth interventions and their utilisation in TB management in India. Further selection of the inclusive publications was carried out based upon the eligibility requirements as formulated for this review, pertaining to the objective of this study. Results: The collaborate search yielded a total of 858 scientific research papers. After the filtering of the obtained results, a total of 45 articles were selected to be analysed for this review. Published manuscripts, articles in peer review and abstracts from reliable databases were included to obtain vast range of information. Conclusion: The extensive literature search showed a preponderance of mHealth intervention studies focusing on TB treatment and drug monitoring. There exists a paucity of mHealth applications targeted to educate the public and intercept this infectious disease. The scientific articles reviewed and analysed in this scoping review strongly recommend the demployment of mHealth applications to achieve the target of eradicating TB by 2025 in India

Molecular dynamics simulation of COX-2-C_773 complex.

<p>(A) RMSD trajectory of the protein backbone in reference to the structure obtained subsequent to docking. (B) Superimposition of the complex before and after simulation run. (C) Molecular interactions between the two partners. Hydrogen bond forming residues are shown in green and hydrophobically interacting residues are shown in blue.</p

SA score for all the molecules involved in the study.

<p>SA score for all the molecules involved in the study.</p

Eleven drug molecules developed against COX-2 which were used for the generation of seed structures in LigBuilder.

<p>Eleven drug molecules developed against COX-2 which were used for the generation of seed structures in LigBuilder.</p

Molecular interaction pattern between ligand and protein after docking.

<p>(A) Interactions between COX-2 and C_773. (B) Interactions between COX-2 and C_997. Hydrogen bond forming residues are shown in green and hydrophobically interacting residues are shown in blue.</p

Modelled structure of COX-1 and COX-2.

<p><b>Comparison of modelled structures with their template structures revealed the active sites of located in the enzymes.</b> (A) Membrane binding domain, epidermal growth factor binding domain, peroxidase active site, and cyclooxygenase active site of modeled COX-1 and COX-2 enzymes. Shape of cyclooxygenase active sites are shown in yellow and four helices of membrane binding domains are located just beneath it, represented in red. A heme group was present at the peroxidase active site of COX-2 enzyme. (B) Flurbiprofen (brown) was inherited at the cyclooxygenase active site of COX-1 modelled structure from its template structure (PDB ID: 1CQE). Area of active site is depicted by the use of white dots, yellow mesh surface shows hydrophobic region and green mesh surface shows hydrophilic region of the active site. (C) Diclofenac (cyan) was inherited at the cyclooxygenase active site of COX-2 modelled structure from its template structure (PDB ID: 1PXX). Same colours were used to show the area of active site, hydrophobic region and hydrophilic region of the active site. Green hydrophilic channel in COX-2 was larger than the channel of COX-1 enzyme.</p