Optimization of minoxidil microemulsions using fractional factorial design approach

The objective of this study was to apply fractional factorial and multi-response optimization designs using desirability function approach for developing topical microemulsions. Minoxidil (MX) was used as a model drug. Limonene was used as an oil phase. Based on solubility, Tween 20 and caprylocaproyl polyoxyl-8 glycerides were selected as surfactants, propylene glycol and ethanol were selected as co-solvent in aqueous phase. Experiments were performed according to a two-level fractional factorial design to evaluate the effects of independent variables: Tween 20 concentration in surfactant system (X₁), surfactant concentration (X₂), ethanol concentration in co-solvent system (X₃), limonene concentration (X₄) on MX solubility (Y₁), permeation flux (Y₂), lag time (Y₃), deposition (Y₄) of MX microemulsions. It was found that Y₁ increased with increasing X₃ and decreasing X₂, X₄; whereas Y₂ increased with decreasing X₁, X₂ and increasing X₃. While Y₃ was not affected by these variables, Y₄ increased with decreasing X₁, X₂. Three regression equations were obtained and calculated for predicted values of responses Y₁, Y₂ and Y₄. The predicted values matched experimental values reasonably well with high determination coefficient. By using optimal desirability function, optimized microemulsion demonstrating the highest MX solubility, permeation flux and skin deposition was confirmed as low level of X₁, X₂ and X₄ but high level of X₃.     

Effectiveness of a self‐management support program for Thais with type 2 diabetes: Evaluation according to the RE‐AIM framework

Delivering diabetes self‐management support is an enormous challenge for healthcare providers with limited human resources. We conducted a cluster randomized controlled trial to assess the effectiveness of a DSMS program incorporating the computer‐assisted instruction. The RE‐AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework was applied to evaluate the DSMS program. Ten Public Health Centers in Bangkok, Thailand were randomized into either DSMS program or usual care. Forty eligible patients with type 2 diabetes in each Public Health Center were randomly selected. Totally, 403 patients (200 controls and 203 interventions) participated. About 93.8% participants completed the six‐month follow‐up. Over six months, adjusted mean changes of hemoglobin A1c (?0.14%, 95% confidence interval = ?0.02 to ?0.26, fasting plasma glucose (?6.37 mg/dL, ?1.95 to ?10.78), health behaviors (3.31 score, 2.27 to 4.34), and quality of life (1.41 score, 0.69 to 2.12) were significantly improved in intervention compared to control group. In conclusion, the DSMS program facilitates Public Health Centers to accomplish their support for people with diabetes.