Influence of black tea on Streptococcus mutans and Lactobacillus levels in saliva in a Saudi cohort.

OBJECTIVES: Dental caries are associated with high counts of Streptococcus mutans (SM) and Lactobacillus (LB) and low saliva buffering capacity (BC). This study aimed to evaluate the antimicrobial activity of black tea on salivary cariogenic microflora, SM and LB species in an adult population. Antimicrobial activity was measured from the number of colony forming units (CFUs) of SM and LB, and BC of saliva. METHODS: In this prospective experimental study, unstimulated saliva samples were acquired from the participants before, immediately after, and 1 h after drinking tea by collecting saliva in sterilised containers. Samples were taken to the laboratory for incubation and subsequent counting. SM and LB counts and BC of saliva were calculated using the caries risk test (CRT). RESULTS: A total of 21 participants, 13 males and 8 females, with a mean age of 32.6 ± 8.02, were recruited in this study. Black tea had no significant effect on reducing the cariogenic bacterial counts (p > 0.05). CONCLUSION: Based on this study, it can be deduced that black tea exhibits an insignificant antimicrobial effect against Streptococcus mutans and Lactobacillus bacteria.

Faculty perceptions regarding community-based medical education: The case of KSA.

OBJECTIVES: There is great concern about the selection and quality of health college graduates and about their ability to respond to local community health needs. Community-based medical education (CBME) is a means of achieving educational relevance to community needs. In KSA, medical education has rapidly progressed in tandem with huge expansions in community health needs and expectations. This study aimed to assess the perceptions of the faculty members of the colleges of medicine and dentistry towards different concepts reflecting CBME. METHODOLOGY: This analytical, observational and cross-sectional study used a self-administered questionnaire that was given to the faculty members of the colleges of medicine and dentistry at Taibah University, KSA. RESULTS: As many as 136 faculty members responded, a response rate of 64%. The percentage of agreement was strongest among the faculty members of the college of medicine. The study findings also showed a relationship between different concepts of CBME and faculty teaching experiences by academic positions for applying CBME. There were significant differences in the social, cultural, and ethnic aspects of medical practice. CONCLUSION: CBME is a means of achieving educational relevance to community needs and consequently serves as a means of implementing a community-oriented education programme.

Patient safety culture as a quality indicator for a safe health system: Experience from Almadinah Almunawwarah, KSA.

OBJECTIVES: Safety culture assessments allow healthcare organisations to get a clear understanding of those aspects of patient safety requiring urgent attention and highlight safety culture strengths and weaknesses. This study aimed to evaluate the extent to which the culture supports patient safety at a hospital in KSA. METHODS: A cross-section analytical observational study was conducted at King Fahad Hospital in Almadinah Almunawwarah, KSA. RESULTS: After the survey, the staff felt less certain about the patient safety culture inside the institution. The greatest positive scores were obtained for teamwork within units, safety culture composites, feedback, communication about error, management expectations, actions promoting patient safety, organisational learning, and continuous improvement. However, none of these features achieved a positive score of 75% or more as an area of strength. The rest of the aspects were negatively ranked as areas for probable development, with the lowest scores obtained for non-punitive reaction to error, staffing, hospital handoff and transition, communication openness, and hospital management support for patient safety. CONCLUSION: Commitment to quality care as an outcome is certainly correlated with patient safety. There is a strong need to improve and promote applicable policies to improve the culture of patient safety in hospitals. The development of strong management competence to promote an environment of open consultation and administrative wisdom will contribute to improving patient safety culture.

Validated Spectrophotometric and RP-HPLC-DAD Methods for the Determination of Ursodeoxycholic Acid Based on Derivatization with 2-Nitrophenylhydrazine.

This work describes the development, validation, and application of two simple, accurate, and reliable methods for the determination of ursodeoxycholic acid (UDCA) in bulk powder and in pharmaceutical dosage forms. The carboxylic acid group in UDCA was exploited for the development of these novel methods. Method 1 is the colorimetric determination of the drug based on its reaction with 2-nitrophenylhydrazine hydrochloride in the presence of a water-soluble carbodiimide coupler [1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide hydrochloride] and pyridine to produce an acid hydrazide derivative, which ionizes to yield an intense violet color with maximum absorption at 553 nm. Method 2 uses reversed-phase HPLC with diode-array detection for the determination of UDCA after precolumn derivatization using the same reaction mentioned above. The acid hydrazide reaction product was separated using a Pinnacle DB C8 column (4.6 × 150 mm, 5 µm particle size) and a mobile phase consisting of 0.01 M acetate buffer (pH 3)-methanol-acetonitrile (30 + 30 + 40, v/v/v) isocratically pumped at a flow rate of 1 mL/min. Ibuprofen was used as the internal standard (IS). The peaks of the reaction product and IS were monitored at 400 nm. Different experimental parameters for both methods were carefully optimized. Analytical performance of the developed methods were statistically validated for linearity, range, precision, accuracy, specificity, robustness, LOD, and LOQ. Calibration curves showed good linear relationships for concentration ranges 32-192 and 60-600 µg/mL for methods 1 and 2, respectively. The proposed methods were successfully applied for the assay of UDCA in bulk form, capsules, and oral suspension with good accuracy and precision. Assay results were statistically compared with a reference pharmacopeial HPLC method, and no significant differences were observed between proposed and reference methods.

Patient's Bill of Rights: Is it a Challenge for Quality Health Care in Saudi Arabia?

BACKGROUND: Increasing interest in patients' rights and the certainty of its impact on the quality of patient care has led to extensive research in both developed and developing countries. In 2006, the Government of Saudi Arabia publicized the Patient's Bill of Rights (PBR) that was aimed at improving patients' and health-care professionals' experience, with a focus on the quality of care provided. OBJECTIVE: To determine the degree of awareness of rights among patients admitted to hospitals in Al-Madinah Al-Munawarah. The results would help policymakers understand the impact of patients' rights, and thus provide them with evidence to provide quality health-care service delivery and patient care through patients' rights. METHODOLOGY: This is an observational, analytical, cross-sectional study implemented in Al-Madinah Al-Munawarah, Saudi Arabia, using a self-administered questionnaire. RESULTS: The study had a response rate of 83.01% and found an association between gender and knowledge for the selected items of patients' rights. However, there was no statistically significant difference between the knowledge of males and females regarding the consent form, with an awareness rate of 90% among the total sample size. However, almost half had never heard about patients' rights. CONCLUSION: This study shows that in Al-Madinah Al-Munawarah, Saudi Arabia, there is a low level of awareness among patients admitted to hospitals regarding their rights. Further, it was found that wall placards, mass media and health-care providers are important sources of knowledge regarding patients' rights. Health-care policymakers in Saudi Arabia should recognize the importance of patients' rights as means of providing better quality care and a higher rate of patient satisfaction by establishing measures to tackle obstacles that may impede the implementation of PBR.

High-performance liquid chromatography with diode array detection method for the simultaneous determination of seven selected phosphodiesterase-5 inhibitors and serotonin reuptake inhibitors used as male sexual enhancers.

This work presents a simple, sensitive and generic high-performance liquid chromatography with diode array detection method for the simultaneous determination of seven drugs prescribed for the treatment of erectile dysfunction and premature ejaculation. Investigated drugs include the phosphodiesterase-5 inhibitors: sildenafil, tadalafil, and vardenafil, in addition to the selective serotonin reuptake inhibitors: dapoxetine, duloxetine, fluoxetine, and paroxetine. The drugs were separated using a Waters C8 column (4.6 × 250 mm, 5 µm) with the mobile phase consisting of phosphate buffer pH 3, acetonitrile and methanol in the ratio 60:33:7. The flow rate was 1.2 mL/min, and quantification was based on measuring peak areas at 225 nm. Peaks were perfectly resolved with retention times 3.3, 3.9, 6.4, 7.5, 9.5, 10.7, and 13.4 min for vardenafil, sildenafil, paroxetine, duloxetine, dapoxetine, fluoxetine, and tadalafil, respectively. The developed method was validated with respect to system suitability, linearity, ranges, accuracy, precision, robustness, and limits of detection and quantification. The proposed method showed good linearity in the ranges 5-500, 2-200, 2-200, 3-300, 1.5-150, 2-200, and 2-200 µg/mL for sildenafil, tadalafil, vardenafil, dapoxetine, duloxetine fluoxetine, and paroxetine, respectively. The limits of detection were 0.18-0.38 µg/mL for the analyzed compounds. The applicability of the proposed method to real life situations was assessed through the analysis of commercial tablets, and satisfactory results were obtained.

Validated spectrophotometric methods for determination of sodium valproate based on charge transfer complexation reactions.

This work presents the development, validation and application of four simple and direct spectrophotometric methods for determination of sodium valproate (VP) through charge transfer complexation reactions. The first method is based on the reaction of the drug with p-chloranilic acid (p-CA) in acetone to give a purple colored product with maximum absorbance at 524nm. The second method depends on the reaction of VP with dichlone (DC) in dimethylformamide forming a reddish orange product measured at 490nm. The third method is based upon the interaction of VP and picric acid (PA) in chloroform resulting in the formation of a yellow complex measured at 415nm. The fourth method involves the formation of a yellow complex peaking at 361nm upon the reaction of the drug with iodine in chloroform. Experimental conditions affecting the color development were studied and optimized. Stoichiometry of the reactions was determined. The proposed spectrophotometric procedures were effectively validated with respect to linearity, ranges, precision, accuracy, specificity, robustness, detection and quantification limits. Calibration curves of the formed color products with p-CA, DC, PA and iodine showed good linear relationships over the concentration ranges 24-144, 40-200, 2-20 and 1-8µg/mL respectively. The proposed methods were successfully applied to the assay of sodium valproate in tablets and oral solution dosage forms with good accuracy and precision. Assay results were statistically compared to a reference pharmacopoeial HPLC method where no significant differences were observed between the proposed methods and reference method.

Validated spectrofluorimetric determination of two pharmaceutical antihypertensive mixtures containing amlodipine besylate together with either candesartan cilexetil or telmisartan.

Amlodipine besylate (AML) is available in fixed-dose combination tablets with either candesartan cilexetil (CAN) or telmisartan (TEL). This work describes a simple, selective and sensitive spectrofluorimetric method for analysis of AML/CAN and AML/TEL binary mixtures without prior separation. The method involves measurement of the native fluorescence of AML at excitation and emission wavelengths of 367 and 454 nm, respectively, in water without interference from either of the two drugs. By contrast, the intrinsic fluorescence of CAN was measured at excitation and emission wavelengths of 265 and 392 nm, respectively, in ethanol, while TEL was measured at 366 nm in 0.05 M sodium hydroxide solution using 294 nm as the excitation wavelength. The proposed spectrofluorimetric procedure was validated with respect to linearity, ranges, precision, accuracy, selectivity, robustness, detection and quantification limits. Regression analysis showed a good correlation between fluorescence intensity and concentration over the ranges 0.1-1.4, 0.025-0.25 and 0.0025-0.05 µg/mL for AML, CAN and TEL, respectively. Limits of detection were 0.034, 0.0063 and 0.0007 µg/mL for AML, CAN and TEL, respectively. The proposed method was successfully applied for the analysis of several synthetic binary mixtures of different ratios and laboratory-prepared tablets with good recoveries, and no interference from common pharmaceutical additives was observed.

New simple spectrophotometric method for determination of the binary mixtures (atorvastatin calcium and ezetimibe; candesartan cilexetil and hydrochlorothiazide) in tablets.

A new simple spectrophotometric method was developed for the determination of binary mixtures without prior separation. The method is based on the generation of ratio spectra of compound X by using a standard spectrum of compound Y as a divisor. The peak to trough amplitudes between two selected wavelengths in the ratio spectra are proportional to concentration of X without interference from Y. The method was demonstrated by determination of two drug combinations. The first consists of the two antihyperlipidemics: atorvastatin calcium (ATV) and ezetimibe (EZE), and the second comprises the antihypertensives: candesartan cilexetil (CAN) and hydrochlorothiazide (HCT). For mixture 1, ATV was determined using 10 µg/mL EZE as the divisor to generate the ratio spectra, and the peak to trough amplitudes between 231 and 276 nm were plotted against ATV concentration. Similarly, by using 10 µg/mL ATV as divisor, the peak to trough amplitudes between 231 and 276 nm were found proportional to EZE concentration. Calibration curves were linear in the range 2.5-40 µg/mL for both drugs. For mixture 2, divisor concentration was 7.5 µg/mL for both drugs. CAN was determined using its peak to trough amplitudes at 251 and 277 nm, while HCT was estimated using the amplitudes between 251 and 276 nm. The measured amplitudes were linearly correlated to concentration in the ranges 2.5-50 and 1-30 µg/mL for CAN and HCT, respectively. The proposed spectrophotometric method was validated and successfully applied for the assay of both drug combinations in several laboratory-prepared mixtures and commercial tablets.