Background: Rheumatic heart disease (RHD) is a leading cause of heart disease in children and young adults in developing countries and is considered a significant cause of cardiovascular diseases. Antimicrobial prophylaxis is recommended as secondary prevention for heart complications caused by recurrent acute rheumatic fever. Objective: Our study aims to describe the prescribing patterns of RHD antibiotic secondary prophylaxis among eligible patients and highlight the frequency of valvular heart disease complications requiring intervention. Materials and Methods: A single-center retrospective study was conducted at a tertiary hospital in Saudi Arabia. The study included all patients 5 years old and above diagnosed with rheumatic heart fever and/or RHD and eligible for secondary prevention between January 2009 and December 2018. The primary outcome is the frequency of RHD secondary prophylaxis prescribed for eligible patients. Results: Among 806 patients who were screened, 272 patients were eligible for inclusion. A total of 194 (71.3%) were female, and 146 (53.67%) were older than 40. RHD secondary prophylaxis prescribing adherence was found in only 14 of 272 (5.14%). A total of 185 of 272 (68%) patients had at least one cardiac-related intervention during the follow-up period. Valvular heart disease progression was found in 72 of 185 (38.9%) after a primary intervention. Overall mortality was 30 (11%). Conclusion: Our study found low prescribing adherence to RHD secondary prevention among eligible patients in an area with a high disease prevalence. A larger sample size is needed to confirm these findings.

Background: In Saudi Arabia, asthma is one of the most common chronic respiratory diseases. Previous studies have identified that asthma management can be influenced by patients’ cultural beliefs and levels of asthma education. Therefore, community pharmacists should have good knowledge of both asthma and Saudi cultural beliefs to be able to effectively educate Saudi patients. Objective: The purpose of this study was to explore Saudi community pharmacists’ knowledge, experiences, and perspectives on providing care for Saudi patients with asthma. Materials and Methods: A qualitative method was employed to conduct semistructured interviews in the Eastern Province of Saudi Arabia. Community pharmacists were interviewed on the phone using an interview guide, and participants were recruited purposively. Verbatim transcripts of interviews were then thematically analyzed. Results: Analysis of 22 interviews resulted in five emergent themes: (1) lack of asthma knowledge among community pharmacists; (2) cultural and religious issues; (3) counseling issues; (4) patient medication issues and navigating the healthcare system; and (5) the need for asthma recourse and training. The findings indicate that community pharmacists have unsatisfactory levels of asthma knowledge and lack access to asthma guidelines in Saudi Arabia. It was also evident that the asthma management of Saudi patients was influenced by patients’ cultural and religious beliefs, which pharmacists needed to consider during patient counseling. Conclusions: Due to the lack of knowledge about asthma among our participants, there is an urgent need for asthma training. Furthermore, pharmacists should consider the impact of cultural issues on Saudi asthma patients to achieve better clinical outcomes.

Background: Patient education (PE) during the coronavirus disease-2019 (COVID-19) pandemic faced various challenges because of social distancing that was implemented to limit the transmission of COVID-19. As a result, traditional, face-to-face PE may have been jeopardized. Objectives: The aim of this study was to therefore compare PE frequency and methods used before and after the pandemic as well as assess the use of technology in this practice. Materials and Methods: A cross-sectional observational study conducted in Jeddah, Saudi Arabia targeted the public of different age groups. An electronic link was shared with questionnaire items that included: (1) respondent’s demographics, (2) PE frequency and methods used before and during the pandemic, (3) familiarity with QR code use, and (4) reasons and deterrents for its use in PE. Results: Our results showed that majority of respondents before COVID-19 pandemic (60.4%) relied on face-to-face method for PE; however, a switch to technology-based methods, such as phone calls 44.8% (n = 86), telehealth 29% (n = 56), and QR code 15.6% (n = 30), was perceived during COVID-19 pandemic. Most respondents (70.3%) support QR code technology for PE particularly due to ease of use (70.8%), followed by accuracy of information 65% (n = 125) and reduce medication errors 57.8% (n = 111). Conclusion: QR code technology suggests a futuristic way that can allow pharmacists to keep a 2-m social distance from patients to reduce the risk of human-to-human transmission of COVID-19 infection. This is an innovative way that uses technology in pharmacy and can be used even after the pandemic.

Introduction: Acute acalculous cholecystitis is an acute gallbladder inflammation in the absence of cholelithiasis associated with high morbidity and mortality rates. Fungal organisms are an infrequent cause of gallbladder infections. Although many coronavirus disease-19 (COVID-19) patients reported gastrointestinal symptoms, there is little evidence of gallbladder and biliary tract involvement. we report a case of fungal acute acalculous cholecystitis secondary to COVID-19. Case Presentation: A 71-year-old man with a past medical history of benign prostatic hyperplasia, essential hypertension, and hyperlipidemia was admitted for COVID-19 and received appropriate treatment with dexamethasone, remdesivir, and convalescent plasma. The patient continued to be lethargic, weak, and had elevated inflammatory markers. He was transferred to the intensive care unit (ICU) for intubation and mechanical ventilation. The total bilirubin started to increase over the following days and reached 8 mg/dL (136.8 μmol/L). The ultrasound did not show cholelithiasis and the bile culture grew Candida albicans, indicating acalculous Candida cholecystitis. The patient had a significant deterioration in clinical status and passed away after being transferred to comfort care. Conclusion: Our case represents acute acalculous cholecystitis possibly secondary to COVID-19 infection that was resulted in an invasive fungal infection involving the gallbladder Future research could help facilitate a better pathophysiological understanding of gallbladder complications and provide a more precise explanation of the long-term effects of COVID-19.