Comparing the Greenness and Validation Metrics of Traditional and Eco-Friendly Stability-Indicating HPTLC Methods for Ertugliflozin Determination.

The literature does not provide any "high-performance thin-layer chromatographic (HPTLC)" techniques for the determination of a novel antidiabetic medicine, ertugliflozin (ERZ). Additionally, there are not many environmentally friendly analytical methods for ERZ measurement in the literature. A rapid, sensitive, and eco-friendly reversed-phase-HPTLC (RP-HPTLC) method was designed and validated in an attempt to analyze ERZ in marketed pharmaceutical tablets more precisely, accurately, and sustainably over the traditional normal-phase HPTLC (NP-HPTLC) method. The stationary phases used in the NP- and RP-HPTLC procedures were silica gel 60 NP-18F254S and 60 RP-18F254S plates, respectively. For NP-HPTLC, a chloroform/methanol (85:15 v/v) mobile phase was used. However, ethanol-water (80:20 v/v) was the preferred method for RP-HPTLC. Four distinct methodologies, including the National Environmental Method Index (NEMI), Analytical Eco-Scale (AES), ChlorTox, and Analytical GREEnness (AGREE) approaches, were used to evaluate the greenness of both procedures. For both approaches, ERZ detection was carried out at 199 nm. Using the NP- and RP-HPTLC techniques, the ERZ measurement was linear in the 50-600 and 25-1200 ng/band ranges. The RP-HPTLC method was found to be more robust, accurate, precise, linear, sensitive, and eco-friendly compared to the NP-HPTLC approach. The results of four greenness tools demonstrated that the RP strategy was greener than the NP strategy and all other reported HPLC techniques. The fact that both techniques can assess ERZ when its degradation products are present implies that they both have characteristics that point to stability-indicating features. 87.41 and 99.28%, respectively, were the assay results for ERZ in commercial tablets when utilizing the NP and RP procedures. Based on several validation and greenness metrics, it was determined that the RP-HPTLC approach was better than the NP-HPTLC method. As a result, it is possible to determine ERZ in pharmaceutical products using the RP-HPTLC approach.

Academic procrastination, loneliness, and academic anxiety as predictors of suicidality among university students.

Suicide is a major public health concern, and university students are at higher risk of suicide than any other age group. The purpose of this study was to examine the prediction power of loneliness, academic anxiety, and academic procrastination on suicidality among university students. A cross-sectional, correlational design was used to recruit 403 university students using the electronic survey format in Jordan. Data were collected regarding loneliness, academic anxiety, academic procrastination, and suicidality. A two-step multiple hierarchical regression analysis was performed. Only 17.1% (n = 69) of students were at risk of suicide, low to moderate level of loneliness, moderate level and moderate to high level of academic procrastination of academic anxiety. The model that included the sociodemographic and the psychological factors was significant (F18,390 = 12.3, p < 0.001) where the total variance in suicidality was 37.3% (R2 = 0.373). Being a working student, being on psychotropic medication, romantic and family relationships domains of loneliness, and academic anxiety were found to be predictors of suicidality (p < 0.05). Suicide is a significant problem among university students. Mental health professionals and policymakers need to enhance the use and access to mental health services and seek psychological counselling to combat the increasingly observed phenomenon of suicide among young people.

Adherence of Type 2 Diabetic Patients to Self-Care Activity: Tertiary Care Setting in Saudi Arabia.

AIM: To analyse the prevalence of self-care practices in T2D patients in KSA. METHODS: The study was conducted in King Fahad Medical City (KFMC) in Saudi Arabia, and 385 patients were selected as samples. Data were collected using the Summary of Diabetes Self-Care Activities-Arabic (SDSCA) and consisted of 14 items related to self-care activities of T2D patients related to management and control of disease and four other aspects related to education and advice from healthcare members regarding management of T2D. RESULTS: The self-care attributes including adherence to medication commitment activities (M = 6.13, SD = 1.25) were the most practised of all the domains. Glucose monitoring (M = 4.15, SD = 2.42) and foot care (M = 3.28, SD = 1.69) were at an average level, and adherence to the diet plan and exercise was found to be at a poor level (M = 2.57, SD = 1.73 and M = 2.13, SD = 2.00) respectively. About 179 patients (74.3%) were found to be advised to follow a low-fat eating plan, and only 89 patients (36.9%) had received information concerning fruits and vegetables in their diet. More than 90% patients were found to be advised to strictly carry out exercise and blood sugar monitoring. CONCLUSION: It was found that adherence to self-care activities including diet, exercise, and foot care was relatively poor while intake of medication was strictly followed. The education provided by healthcare providers related to self-management attributes was found to be significant and had positive effects on the overall health and well-being of T2D patients.

Nurses' attitudes towards diabetes in tertiary care: A cross-sectional study.

AIM: To evaluate the attitude and training of nurses in Saudi Arabia towards the care of patients with diabetes. DESIGN: A cross-sectional study. METHODS: Data were collected in 2016 from 1,695 participants at the King Fahad Medical City using the Diabetes Attitude Scale version 3. RESULTS: Most nurses had not received diabetes training. The agreement score of nurses for the requirement of special training for the management of diabetes is high; the survey found that most nurses were aware of the psychological effect of diabetes. However, the low agreement regarding the perception of the seriousness of diabetes among nurses and the valuing of self-care attributes such as tight control of glycaemic level in patients with diabetes indicates the need for diabetes training.

Patient satisfaction and experience of primary care in Saudi Arabia: a systematic review.

PURPOSE: This systematic review aims to explore patient satisfaction (PS) among patients who used Ministry of Health (MoH) primary care centres in Saudi Arabia, with a focus on their communication with physicians. DATA SOURCES: Medline, CINAHL, Embase, Global Health, the Saudi Medical Journal, Annals of Saudi Medicine, the Journal of Family and Community Medicine and Google Scholar. STUDY SELECTION/DATA EXTRACTION: The review focused on studies concerning PS in Saudi MoH primary care centres published between 2005 and 2017. Two independent reviewers confirmed that the included studies met the selection criteria, assessed the quality of the selected studies and extracted their significant characteristics. All of the articles were examined in terms of the five main domains that determine the patient-physician communication identified by Boquiren, Hack, Beaver et al. (What do measures of patient satisfaction with the doctor tell us? Patient Educ Couns 2015;98:1465-73). RESULTS: The literature search retrieved a total of 846 studies. Only 10 studies met the selection criteria. All of the studies reported at least one domain of PS. There was a strong relationship between the level of education, income and satisfaction rate. Most of the studies reported PS in terms of the domains of availability and accessibility, and communication. Few of the studies covered the other domains, such as relational conduct, views on the physician's technical skills/knowledge and the personal qualities of physicians. CONCLUSION: There was a contradiction between the patients' responses to the surveys on the domains of PS and their actual experience. While the patients reported that they were satisfied with primary care centres, they frequently attended the emergency department directly. This indicated that they were unlikely to be fully satisfied with the primary healthcare centre.

The Referral System between Primary and Secondary Health Care in Saudi Arabia for Patients with Type 2 Diabetes: A Systematic Review.

BACKGROUND: In Saudi Arabia, the mortality of diabetes is currently reported at 6%. A well-administered referral system is crucial in aiding the management of this disease. METHOD: A single reviewer employed a systematic approach to searching the literature databases with regard to the question: what are the attributes of referral systems in Saudi Arabia for patients with type 2 diabetes (T2D)? The results were analysed in order to provide recommendations to improve the Saudi health system. RESULTS: Twelve primary studies were identified from a systematic search. Overall, the 12 studies did not clearly mention any of the factors of a good referral system. The referral problems identified by this study included patients' unnecessary requests for referral, unstructured referral letters, and unclear dissemination guidelines for referral. CONCLUSIONS: This research attempted to identify the efficiency of the referral processes that were implemented for patients with T2D. The majority of the included studies were completely silent on the main referral factors for patients. If this review is representative of the referral system in Saudi Arabia, then, in the context of T2D, current referrals are unsafe. Further research on the quality of the referral system, taking into account at least some of the WHO referral guidelines, is required.

Psychometric Evaluation of the Revised Michigan Diabetes Knowledge Test (V.2016) in Arabic: Translation and Validation.

Objective. To translate the revised Michigan Diabetes Knowledge Test into the Arabic language and examine its psychometric properties. Setting. Of the 139 participants recruited through King Fahad Medical City in Riyadh, Saudi Arabia, 34 agreed to the second-round sample for retesting purposes. Methods. The translation process followed the World Health Organization's guidelines for the translation and adaptation of instruments. All translations were examined for their validity and reliability. Results. The translation process revealed excellent results throughout all stages. The Arabic version received 0.75 for internal consistency via Cronbach's alpha test and excellent outcomes in terms of the test-retest reliability of the instrument with a mean of 0.90 infraclass correlation coefficient. It also received positive content validity index scores. The item-level content validity index for all instrument scales fell between 0.83 and 1 with a mean scale-level index of 0.96. Conclusion. The Arabic version is proven to be a reliable and valid measure of patient's knowledge that is ready to be used in clinical practices.