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This comprehensive manuscript explores the forefront of innovation in microneedle-based drug delivery systems, heralding a paradigm shift in the realm of transdermal medicine. It meticulously examines the landscape of available drug delivery systems, offering a deep dive into their fabrication techniques and providing an exhaustive classification of microneedles in all their diverse forms. Going beyond mere description, the study navigates the vast terrain of biomedical applications, shedding light on both the remarkable potential and the inherent limitations of microneedles. By critically examining the pitfalls and challenges in this field, the manuscript underscores the pivotal role of microneedles in revolutionizing the landscape of painless drug administration. The article culminates with a forward-looking perspective, discussing current applications and illuminating the transformative impact microneedle-based drug delivery systems are poised to make on healthcare practices. As transdermal drug delivery systems gain increasing attention for their unique advantages over conventional administration methods, this review serves as an indispensable resource summarizing the latest developments and emerging trends, catering to the research and business communities alike. It paves the way for a future where microneedles redefine how we administer medication, making it virtually painless and more precise.

Background and Aim: Telemedicine is an evolving tool to provide health‐care services. We evaluated the suitability of telemedicine to deliver effective consultation for hepatobiliary disorders. Methods: In this prospective study spanning over a year, we interviewed hepatologists delivering the teleconsultations through a pre‐validated questionnaire. A consult was deemed suitable based on the physician's judgment in the absence of unplanned hospitalization. We evaluated factors determining the suitability through inferential statistics and machine learning models, namely, extreme gradient boosting (XGB) and decision tree (DT). Results: Of 1118 consultations, 917 (82.0%) were deemed suitable. On univariable analysis, patients with skilled occupation, higher education, out‐of‐pocket expenses, and diseases such as chronic hepatitis B, C, and non‐alcoholic fatty liver disease (NAFLD) without cirrhosis were associated with suitability (P < 0.05). Patients with cirrhosis (compensated or decompensated), acute‐on‐chronic liver failure (ACLF), and biliary obstruction were likely unsuitable (P < 0.05). XGB and DT models predicted suitability with an area under the receiver operating curve of 0.808 and 0.780, respectively. DT demonstrated that compensated cirrhosis with higher education or skilled occupation with age < 55 years had 78% chance of suitability whereas hepatocellular carcinoma, decompensated cirrhosis, and ACLF patients were unsuitable with a 60–95% probability. In non‐cirrhotic liver diseases, hepatitis B, C, and NAFLD were suitable, with a probability of 89.7%. Biliary obstruction and previous failure of teleconsultation were unsuitable, with a probability of 70%. Non‐cirrhotic portal fibrosis, dyspepsia, and dysphagia not requiring intervention were suitable (probability: 88%). Conclusion: A simple decision tree can guide the referral of unsuitable and the management of suitable patients with hepatobiliary diseases through telemedicine. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID‐19) has hampered health care delivery globally. We evaluated the feasibility, outcomes, and safety of telehepatology in delivering quality care amid the pandemic. A telemedicine setup using smartphones by hepatologists was organized at our tertiary‐care center after pilot testing. Consecutive patients availing telehepatology services were recruited between March and July 2020. An adapted model for assessment of telemedicine was used after validity and reliability testing, to evaluate services 7‐21 days after index teleconsultation. Of the 1,419 registrations, 1,281 (90.3%) consultations were completed. From 245 randomly surveyed patients, 210 (85.7%) responded (age [years, interquartile range]: 46 [35‐56]; 32.3% females). Seventy percent of patients belonged to the middle or lower socio‐economic class, whereas 61% were from rural areas. Modes of teleconsultation were audio (54.3%) or hybrid video call (45.7%). Teleconsultation alone was deemed suitable in 88.6% of patients. Diagnosis and compliance rates were 94% and 82.4%, respectively. Patients' convenience rate, satisfaction rate, improvement rate, success rate, and net promoter scores were 99.0%, 85.2%, 49.5%, 46.2% and 70, respectively. Physical and mental quality of life improved in 67.1% and 82.8% of patients, respectively, following index teleconsultation. Person‐hours and money spent by patients were significantly lower with teleconsultation (P < 0.001); however, person‐hours spent by hospital per teleconsultation were higher than in physical outpatient services (P < 0.001). Dissatisfied patients were more likely to have lower diagnosis rate, unsuitability for teleconsultation, noncompliance, poorer understanding, and uncomfortable conversation during teleconsultation. Connectivity issues (22.9%) were the most common barrier. Three patients, all of whom were advised emergency care during teleconsultation, succumbed to their illness. Conclusion: Telehepatology is a feasible and reasonably effective tool for rendering health care services using smartphones during the COVID‐19 pandemic. Systematic implementation, possible integration into routine health care delivery, and formal cost‐effectiveness of telehepatology services need further exploration. [ABSTRACT FROM AUTHOR]