Non prescribed sale of antibiotics in Riyadh, Saudi Arabia: A Cross Sectional Study

Background Antibiotics sales without medical prescriptions are increasingly recognized as sources of antimicrobial misuse that can exacerbate the global burden of antibiotic resistance. We aimed to determine the percentage of pharmacies who sell antibiotics without medical prescriptions, examining the potential associated risks of such practice in Riyadh, Saudi Arabia, by simulation of different clinical scenarios. Methods A cross sectional study of a quasi-random sample of pharmacies stratified by the five regions of Riyadh. Each pharmacy was visited once by two investigators who simulated having a relative with a specific clinical illness (sore throat, acute bronchitis, otitis media, acute sinusitis, diarrhea, and urinary tract infection (UTI) in childbearing aged women). Results A total of 327 pharmacies were visited. Antibiotics were dispensed without a medical prescription in 244 (77.6%) of 327, of which 231 (95%) were dispensed without a patient request. Simulated cases of sore throat and diarrhea resulted in an antibiotic being dispensed in (90%) of encounters, followed by UTI (75%), acute bronchitis (73%), otitis media (51%) and acute sinusitis (40%). Metronidazole (89%) and ciprofloxacin (86%) were commonly given for diarrhea and UTI, respectively, whereas amoxicillin/clavulanate was dispensed (51%) for the other simulated cases. None of the pharmacists asked about antibiotic allergy history or provided information about drug interactions. Only 23% asked about pregnancy status when dispensing antibiotics for UTI-simulated cases. Conclusions We observed that an antibiotic could be obtained in Riyadh without a medical prescription or an evidence-based indication with associated potential clinical risks. Strict enforcement and adherence to existing regulations are warranted

A Review of Seaport Microgrids for Green Maritime Transportation: The Shore and the Seaside

Emerging from the field of microgrids is an efficient and persuasive transitional technology with great promise for easing energy crises, environmental worries, and economic limitations in seaports. When it comes to high-performance ports, this technology becomes even more important. One example is smart ports, which use state-of-the-art ICT applications to completely revamp container and vessel management. Strengthening national economic sustainability and global competitiveness are both impacted by this invention. Reducing the environmental impact of the maritime transport business is no easy feat. In this study, we take a look at how seaport microgrids are becoming more important in the quest for environmentally friendly marine transportation. We take a look at the major problems that contemporary seaports are facing, such as the ever-increasing need for energy, the contamination of both the air and water from ship emissions and the unpredictable cost of electricity. The goal is to bring together current information about smarter ports by giving examples and to encourage new ideas and research in this field. As part of our efforts to inspire new research into smart port development, we also outline certain open questions that need answering. This report could serve as a valuable resource for future research on seaport microgrids