Impact of Atmospheric Polycyclic Aromatic Hydrocarbons (PAHs) of Falling Dust in Urban Area Settings: Status, Chemical Composition, Sources and Potential Human Health Risks.

The present work is considered to investigate the sources, concentration, and composition of polycyclic aromatic hydrocarbons (PAHs) and associated health risk assessment of road dust in Riyadh City, Saudi Arabia. The study region included an urban area, strongly affected by traffic, a bare and an industrial area. A total of 50 locations were selected for sampling and 16 different PAHs were determined. The concentration of PAHs in road dust and their estimated lifetime average daily dose (LADD) for adults (human) ranged from 0.01 to 126 ng g−1 and 1950 to 16,010 mg kg−1 day−1, respectively. The ADDing was calculated separately for children (>6), teenagers (6−12), and adults (>12) for all PAHs with each collected sample. Moreover, the average daily exposure dose by ingestion (ADDing) and average daily exposure dose by dermal absorption (ADDder) were more in children (<6 years) as compared to teenagers (6−12 years) and adults (>12 years). Likewise, total equivalency factor based on BaP (TEQBaP) calculations pointed out that PAHs having more benzene rings or having high molecular weight showed high TEQBaP as compared to low molecular weight PAHs. The data revealed that the children population is at high risk for asthma, respiratory and cardiovascular diseases, and immunity suppression as compared to adults in the particular area of investigated region. These outcomes of this study can be used to deliver significant policy guidelines concerning habitants of the area for possible measures for controlling PAHs contamination in Riyadh City to protect human health and to ensure environmental sustainability.

Heavy metal pollution and associated health risk assessment of urban dust in Riyadh, Saudi Arabia.

Depending on their particle size and concentration, heavy metals in urban dust pose a health hazard to humans. This study investigated the total concentration, health risk, integrated pollution load index (IPI), and enrichment factor (EF) of various heavy metals in urban dust at different locations in Riyadh City. Surface dust samples were collected from 50 different residential yards in the north, south, west, east, and central corners of the city and analyzed for cadmium (Cd), chromium (Cr), copper (Cu), manganese (Mn), nickel (Ni), lead (Pb), and zinc (Zn). With respect to concentrations heavy metals were in the following order Zn > Cu > Mn > Cr > Ni > Pb > Cd. The EF trends exposed repeated anthropogenic activities were responsible for Mn, Cr, and Ni, while Pb, Zn, and Cu appeared to come from Earth's crust. Since the heavy metal concentrations were lower than the threshold values, children and adults are exposed to lower health risk in investigated area. Also, there are no pollution of heavy metals in the dust with respect to IPI which is less than the critical limit (<1) with the exception of a sampling location in north side of the city with higher IPI showed unhealthy respiration conditions in particular areas. It was concluded that rapid industrialization and urbanization and their concentrations in dust may cause health problems in near future in north side as well as other sides of Riyadh City.

Description of pharmacists' reported interventions to prevent prescribing errors among in hospital inpatients: a cross sectional retrospective study.

BACKGROUND: Prescribing errors (PEs) are a common cause of morbidity and mortality, both in community practice and in hospitals. Pharmacists have an essential role in minimizing and preventing PEs, thus, there is a need to document the nature of pharmacists' interventions to prevent PEs. The purpose of this study was to describe reported interventions conducted by pharmacists to prevent or minimize PEs in a tertiary care hospital. METHODS: A retrospective analysis of the electronic medical records data was conducted to identify pharmacists' interventions related to reported PEs. The PE-related data was extracted for a period of six-month (April to September 2017) and comprised of patient demographics, medication-related information, and the different interventions conducted by the pharmacists. The study was carried in a tertiary care hospital in Riyadh region. The study was ethically reviewed and approved by the hospital IRB committee. Descriptive analyses were appropriately conducted using the IBM SPSS Statistics. RESULTS: A total of 2,564 pharmacists' interventions related to PEs were recorded. These interventions were reported in 1,565 patients. Wrong dose (54.3 %) and unauthorized prescription (21.9 %) were the most commonly encountered PEs. Anti-infectives for systemic use (49.2 %) and alimentary tract and metabolism medications (18.2 %) were the most common classes involved with PEs. The most commonly reported pharmacists' interventions were dose adjustments (44.0 %), restricted medication approvals (21.9 %), and therapeutic duplications (11 %). CONCLUSIONS: In this study, PEs occurred commonly and pharmacists' interventions were critical in preventing possible medication related harm to patients. Care coordination and prioritizing patient safety through quality improvement initiatives at all levels of the health care system can play a key role in this quality improvement drive. Future studies should evaluate the impact of pharmacists' interventions on patient outcomes.

Clinical Efficacy of Hydroxychloroquine in Patients with COVID-19: Findings from an Observational Comparative Study in Saudi Arabia.

The aim of this study was to assess the clinical effectiveness of Hydroxychloroquine-based regimens versus standard treatment in patients with the coronavirus disease admitted in 2019 to a hospital in Saudi Arabia. A comparative observational study, using routine hospital data, was carried out in a large tertiary care hospital in Al Baha, Saudi Arabia, providing care to patients with COVID-19 between April 2019 and August 2019. Patients were categorized into two groups: the Hydroxychloroquine (HCQ) group, treated with HCQ in a dose of 400 mg twice daily on the first day, followed by 200 mg twice daily; the non HCQ group, treated with other antiviral or antibacterial treatments according to protocols recommended by the Ministry of Health (MOH) at the time. The primary outcomes were the length of hospital stay, need for admission to the intensive care unit (ICU), time in ICU, and need for mechanical ventilation. Overall survival was also assessed. 568 patients who received HCQ (treatment group) were compared with 207 patients who did not receive HCQ (control group). HCQ did not improve mortality in the treated group (7.7% vs. 7.2%). There were no significant differences in terms of duration of hospitalization, need for and time in ICU, and need for mechanical ventilation among the groups. Our study provides further evidence that HCQ treatment does not reduce mortality rates, length of hospital stay, admission and time in ICU, and need for mechanical ventilation in patients hospitalized with COVID-19.

Perceptions regarding antimicrobial use and resistance among adult hospital patients in Saudi Arabian Ministry of Health (MOH) hospitals.

BACKGROUND: Education, a key strategy within antimicrobial stewardship programmes (ASPs), has been mainly directed towards healthcare professionals and prescribers more than hospitalised patients. AIM: To examine patients' knowledge and perceptions of antibiotic use and resistance, while evaluating the institutional role of patient education on antibiotic use in two Saudi Arabian hospitals, one with an implemented ASP and one without an ASP. METHOD: A cross-sectional self-administered survey was developed and piloted. A total of 400 surveys were distributed, 200 within the hospital with an ASP and another 200 within the hospital without an ASP. Data were coded and analysed. Ethical approval was obtained before the start of the study. FINDINGS: 176 patients responded to the survey with 150 surveys completed and analysed. 78% of patients agreed that they should only take an antibiotic when prescribed by the doctor, however they still tended to keep left over antibiotics for future use. 84% of patients were unaware 'antibiotic resistance', with 48% believing that antibiotics help them get better quicker when they had a 'cold'. Information on antibiotic use and resistance were provided to patients in the hospital with an ASP in contrast to the hospital without an ASP. CONCLUSION: Overall there are poor perceptions regarding antibiotic use and resistance among hospital patients in Saudi Arabia. Patients in the hospital with ASP demonstrated greater knowledge during their hospitalisation. ASPs should not only focus on educating healthcare professionals but should involve the patients and seize the opportunity to educate them while hospitalised.