Background: Globally, antibiotics misuse by the public has been reported in the era of COVID‐19, despite the discouraging instructions of the World Health Organization, especially for mild cases.Objective: Is to describe this antibiotic misuse and its contributing factors. Also, to measure the pharmacists' application of infection preventive practices during the pandemic.Methods: A cross‐sectional study was conducted among randomly selected Egyptian community pharmacists (Center, East, Delta, and Upper Egypt) using a questionnaire and direct interviews from 1 to 30 August 2020. The questionnaire consisted of two parts, the first covered pharmacist's demographic data and their application of basic infection preventive practices (eg, wearing face masks, regular hand sanitization, etc), and the other part was related to antibiotic dispensing patterns. Data were descriptively analyzed and the impact of participant experience on the responses was evaluated using the χ² test.Results: From 480 randomly selected Egyptian community pharmacists, 413 (87%) consented to participate in the study. 86.7% of the participants were keen to wear face masks (n = 358) and 86.2% kept regular hand sanitization (n = 356); whereas, 46.9% (n = 194) maintained adequate antibiotic stock supply during the pandemic. Nearly 67% (n = 275) of the pharmacists reported that patients were more likely to be given antibiotics for showing any sign or symptom of COVID‐19 infection, and 82% (n = 74 278) of the dispensed antibiotics were given upon physician recommendation. Azithromycin, Ceftriaxone, and Linezolid were the major antibiotics dispensed to COVID‐19 presumptive patients Azithromycin was given to ~40% of presumptive patients showing only mild or moderate symptoms for 5‐10 days. Additionally, antibiotic combinations were given to 74% (n = 62 479) of home‐isolated patients for a maximum of 2 weeks.Conclusions: Pharmacists applied suitable sanitation and infection control protocols. Meanwhile, antibiotics were dispensed heavily during this pandemic without proper clinical indication and for long durations supporting the idea of antibiotic misuse.

Non-alcoholic fatty liver disease (NAFLD) is related to metabolic syndrome via insulin resistance, where preventing disease progression is crucial in the management process. The study included 240 NAFLD patients with type 2 diabetes who were randomly allocated into empagliflozin 25 mg (EMPA group), ursodeoxycholic acid 250 mg (UDCA group), or the control group (placebo). The study outcomes included: changes in liver fat content (LFC; %) (utilizing the Dixon-based MRI-PDFF approach), liver enzymes, lipid and glycemic profiles, FIB-4 index, and non-alcoholic fatty liver score (NFS). All endpoints were assessed at baseline and after 6 months. EMPA outperformed UDCA and placebo in decreasing LFC (−8.73% vs. −5.71% vs. −1.99%; p < 0.0001). In post-treatment ultrasound images and MRI-PDFF calculations, more patients had normal fatty liver grade (no steatosis or LFC < 6.5%) with EMPA compared to UDCA. EMPA and UDCA showed significant regression in the FIB-4 index (−0.34 vs. −0.55; p = 0.011) and NFS scores (−1.00 vs. −1.11; p = 0.392), respectively. UDCA achieved higher reductions in insulin resistance than EMPA (p = 0.03); however, only EMPA significantly increased beta-cell function (54.20; p = 0.03). When exploring the differences between the two drugs, EMPA was better in decreasing LFC (%), while UDCA achieved higher reductions in liver fibrosis scores. Both showed a similar safety profile in managing liver steatosis.

After the era of the COVID-19 pandemic, the role of pharmacists was emphasized in the battle against highly spreading and infectious diseases like human Monkeypox (hMPV). Assess the hMPV knowledge of the community, clinical pharmacists, and general practitioners (GPs) and raise their awareness about hMPV. A web-based questionnaire was distributed randomly to Egyptian community pharmacists, clinical pharmacists, and GPs from all governorates. The questionnaire was divided into two sections: one for demographic information and the other for hMPV knowledge (nature of the disease, incubation period, transmission, symptoms, Prophylaxis, Prevention, and management). The evidence-based answers were provided after completing the submission. Data were descriptively analyzed using IBM SPSS software. From a total of 753 respondents, only 710 participants were included in the final data analysis. The % of respondents who presented good total knowledge scores about hMPV was comparable between study groups (P = 0.826). There were no differences between groups identifying different disease clinical characteristics (P = 0.689) and hMPV management (P = 0.324). Community pharmacists had better knowledge scores than GPs in the prevention and prophylaxis domain (P = 0.037). Pharmacists and GPs have good and similar knowledge levels of hMPV. However, a gap exists in recognizing the right hMPV incubation period, prophylaxis, and omitting antibiotics from hMPV management. Pharmacists and GPs are the frontline health care providers (HCPs), so they would require more knowledge enhancement about such contagious diseases to offer the best possible patient care.

Background: The use of EkoSonic Endovascular System (EKOS) that combines ultrasound technology with catheter-directed thrombolysis has shown promising outcomes in patients with pulmonary embolism (PE) in dissolving clots effectively. This method targets thrombus removal precisely, minimizing systemic exposure to thrombolytic agents and thereby reducing bleeding risks. Given its minimally invasive approach and focused delivery, EKOS offers a safer alternative for intermediate high-risk patients in whom traditional anticoagulation or systemic thrombolysis may pose higher risks of complications. This study compares the safety and effectiveness of EKOS versus intravenous (IV) alteplase infusion in managing acute PE. Methods: A retrospective cohort study was conducted at a tertiary care hospital, examining patient records from 2022 to 2024 according to predefined eligibility criteria. Individuals aged 18 years or older diagnosed with intermediate- to high-risk PE, who showed clinical deterioration after 48 h of anticoagulation, were enrolled, as assessed by the National Early Waning Score (NEWS). Patients were excluded if they had a stable PE or were at a high risk of hemodynamic decompensation at the time of presentation. The primary outcomes were the change in tricuspid annular plane systolic excursion (TAPSE) and right ventricular-to-left ventricular (RV/LV) diameter ratio from baseline to 1-week outpatient follow-up. Results: Out of 104 eligible patients, 54 received EKOS (EKOS group) and 50 received IV alteplase infusion (control group). The RV/LV diameter ratio significantly decreased, while TAPSE improved significantly in the EKOS and control groups. At the end of follow-up, the incidence of major bleeding events within 72 h was significantly lower in the EKOS group (2 vs. 8; p = 0.03). Although all-cause mortality at 6 months was lower in the EKOS group, the difference was not statistically significant (p = 0.3). Conclusion: EKOS showed comparable efficacy to systemic thrombolysis, reducing right heart strain, improving RV function, and minimizing complications in patients with intermediate- to high-risk PE after failed anticoagulation, with deterioration in clinical condition and the need for rescue thrombolysis. In addition, EKOS had a lower incidence of major bleeding within 72 h, making it a safer option for rescue thrombolysis.