Botulinum toxin A dissolving microneedles for hyperhidrosis treatment: design, formulation and in vivo evaluation.

Multiple periodic injections of botulinum toxin A (BTX-A) are the standard treatment of hyperhidrosis which causes excessive sweating. However, BTX-A injections can create problems, including incorrect and painful injections, the risk of drug entry into the bloodstream, the need for medical expertise, and waste disposal problems. New drug delivery systems can substantially reduce these problems. Transdermal delivery is an effective alternative to conventional BTX-A injections. However, BTX-A's large molecular size and susceptibility to degradation complicate transdermal delivery. Dissolving microneedle patches (DMNPs) encapsulated with BTX-A (BTX-A/DMNPs) are a promising solution that can penetrate the dermis painlessly and provide localized translocation of BTX-A. In this study, using high-precision 3D laser lithography and subsequent molding, DMNPs were prepared based on a combination of biocompatible polyvinylpyrrolidone and hyaluronic acid polymers to deliver BTX-A with ultra-sharp needle tips of 1.5 ± 0.5 µm. Mechanical, morphological and histological assessments of the prepared DMNPs were performed to optimize their physicochemical properties. Furthermore, the BTX-A release and diffusion kinetics across the skin layers were investigated. A COMSOL simulation was conducted to study the diffusion process. The primary stability analysis reported significant stability for three months. Finally, the functionality of the BTX-A/DMNPs for the suppression of sweat glands was confirmed on the hyperhidrosis mouse footpad, which drastically reduced sweat gland activity. The results demonstrate that these engineered DMNPs can be an effective, painless, inexpensive alternative to hypodermic injections when treating hyperhidrosis.

Fabrication and testing of polymer microneedles for transdermal drug delivery.

Microneedle (MN) patches have considerable potential for medical applications such as transdermal drug delivery, point-of-care diagnostics, and vaccination. These miniature microdevices should successfully pierce the skin tissues while having enough stiffness to withstand the forces imposed by penetration. Developing low-cost and simple manufacturing processes for MNs is of considerable interest. This study reports a simple fabrication process for thermoplastic MNs from cycloolefin polymers (COP) using hot embossing on polydimethylsiloxane (PDMS) soft molds. COP has gained interest due to its high molding performance and low cost. The resin master MN arrays (9 × 9) were fabricated using two-photon polymerization (TPP). A previous gap in the detailed characterization of the embossing process was investigated, showing an average of 4.99 ± 0.35% longitudinal shrinkage and 2.15 ± 0.96% lateral enlargement in the molded MN replicas. The effects of bending, buckling, and tip blunting were then examined using compression tests and also theoretically. MN array insertion performance was studied in vitro on porcine back skin using both a prototype custom-made applicator and a commercial device. An adjustable skin stretcher mechanism was designed and manufactured to address current limitations for mimicking skin in vivo conditions. Finite element analysis (FEA) was developed to simulate single MN insertion into a multilayered skin model and validated experimentally using a commercial Pen Needle as a model for the thermoplastic MNs. Margins of safety for the current MN design demonstrated its potential for transdermal drug delivery and fluid sampling. Experimental results indicated significant penetration improvements using the prototype applicator, which produced array penetration efficiencies as high as >92%, depending on the impact velocity setting.

Effects of Reiki Versus Physiotherapy on Relieving Lower Back Pain and Improving Activities Daily Living of Patients With Intervertebral Disc Hernia.

Patients with intervertebral disc herniation (IVDH) seek complementary and conventional medical therapies to manage related problems. This study aimed to determine the effectiveness of Reiki compared with physiotherapy to relieve the lower back pain intensity and to improve the activities of daily living (ADL) in the IDVH patients. In this clinical trial study, 60 patients with IVDH were randomly assigned to one of the Reiki, physiotherapy, and drug therapy groups. The severity of pain and the ADL were measured using visual analog scale (VAS) pain and ADL-Instrumental ADL questionnaire before and after the intervention. A significant difference was found in pain intensity and ADL improvement between Reiki and the drug therapy. However, there was no significant difference between Reiki and physiotherapy groups in managing pain and improving ADL. Reiki and physiotherapy are effective methods in managing pain and improving ADL in patients with IVDH; however, Reiki is more cost-effective and faster treatment method than physiotherapy.