Background: Olfactory dysfunction affects approximately 29% of the population and has a profound impact on quality of life. It frequently follows upper respiratory tract infections and lacks effective pharmacological treatments. Vericiguat, a soluble guanylate cyclase stimulator that increases intracellular cyclic guanosine monophosphate, is approved for heart failure and has potential neuro-modulatory effects relevant to olfactory processing. Objective: This pilot study investigates the efficacy of oral vericiguat in improving olfactory function in patients with persistent anosmia following upper respiratory tract infections. Methods: In a double-blind, randomized controlled trial, 88 participants with post-infectious anosmia were assigned to receive either placebo (n = 44) or vericiguat (4 mg, twice daily; n = 44) for 12 months. Olfactory function was assessed monthly using the Sniffin’ Sticks test, measuring Threshold (T), Discrimination (D), and Identification (I) scores. Data were analyzed using repeated-measures ANOVA and post-hoc Bonferroni corrections. Results: At baseline, all olfactory scores were similar between groups. In the vericiguat group, T scores increased from 3.84 ± 0.19 to 4.65 ± 0.20 (P = 0.003), D scores from 8.25 ± 0.65 to 9.20 ± 0.86 (P = 0.008), and I scores from 7.34 ± 0.72 to 8.62 ± 0.79 (P = 0.008). No significant changes were observed in the placebo group. Between-group differences became statistically significant for D at month 4 (P < 0.05), T at month 6 (P < 0.05), and I at month 7 (P < 0.05). However, the mean total TDI improvement in the vericiguat group (+ 3.19) did not reach the clinical threshold of 5.5 points. Conclusion: Vericiguat significantly improved olfactory threshold, discrimination, and identification scores compared to placebo. These findings highlight its potential as a pharmacological option for olfactory dysfunction, although the clinical magnitude of benefit remains below the established threshold. Further studies should explore mechanisms and broader clinical applications. Trial registration: DFM-IRB00012367–23-07-008.

Background: Acetaminophen is generally considered safe when used according to the recommended guidelines. Consumption in excessive doses can lead to severe liver damage and, in critical cases, may even result in death. To reduce the effects of acetaminophen overdose, N-acetylcysteine (NAC) has been established as the preferred intervention to prevent liver damage. Objectives: The purpose of this updated systematic review and meta-analysis is to evaluate the potential benefits of a two-bag N-acetylcysteine (NAC) dosing regimen compared to the traditional three-bag protocol in the treatment of acetaminophen-induced liver toxicity. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The research team utilized the PubMed and Cochrane databases to perform a thorough and comprehensive search of the relevant literature from the inception of these databases up until January 2024. Results: Nine studies were included. The overall use of two-bag NAC was associated with lower anaphylactic reactions and gastrointestinal symptoms compared to the three-bag method. The rate of liver toxicity resolution was the same between the two treatment groups. Conclusions: The two-bag NAC regimen can be considered a safe and effective method for managing acetaminophen toxicity.

Introduction: As the pharmaceutical advertising landscape evolves with digital advancements, this study examines public awareness and perceptions of medication advertisements in Saudi Arabia. It focuses on the effects of regulatory frameworks and evaluates how they influence public understanding and attitudes toward these advertisements. Method: A cross-sectional study was conducted using an electronic survey in Saudi Arabia in December 2023. The survey was distributed on social media platforms and reached a diverse sample of 440 participants. It covered public perception and attitudes toward drug advertisements, knowledge of regulatory laws, and preferences regarding advertising mediums. Results: Out of the 440 participants in the study, who were primarily employees with bachelor’s degrees, there was a clear awareness of drug advertisements. The average age of the group was 33 years, and a significant portion (71.1%) held a bachelor’s degree, with 51.1% being employed. The findings revealed that 25.5% of participants frequently noticed drug ads, while 22.7% saw them very often. Although many found the ads informative, there were significant concerns about unrealistic expectations and the risk of overmedication; 89.8% believed the ads set unrealistic expectations about the effectiveness of medications. Additionally, 60.7% thought that celebrity endorsements might mislead the audience, and 91.1% felt that ads should provide more detailed information about potential risks and side effects. Regarding preferred advertising platforms, mobile apps and websites were favored (47%), followed closely by social media (46.4%). A striking 93.2% of participants believed that drug ads on social media should be subject to stricter regulations, and 96.4% wanted more proactive monitoring of online advertising. Many also reported using other sources, such as medical review sites, to verify medication information. Conclusions: Pharmaceutical advertising in Saudi Arabia must balance ethical transparency with educational value. The influence of digital platforms underscores the necessity for stricter regulation and accurate information dissemination. A collaborative approach is essential to align advertising practices with public health interests and regulatory standards.

Background: Olfactory dysfunction significantly impacts daily life, affecting safety, appetite, and sensory enjoyment. Olfactory receptor neurons (ORNs) are essential for odor detection, but environmental exposure can lead to dysfunction. Regeneration of these neurons is crucial for maintaining olfactory function, and elevated calcium levels in nasal mucus are linked to this dysfunction. Objective: The study evaluated chitosan nasal gel for persistent olfactory dysfunction lasting over 6 months, focusing on ORNs regeneration and reduced calcium levels in nasal mucus. Methods: A randomized, double-blind trial included 215 participants with persistent olfactory dysfunction lasting over 6 months. Participants were divided into two groups: 116 received nasal chitosan gel, and 99 received a control sodium chloride gel. Over 3 months, 11 participants in the chitosan group and 9 in the control group were lost to follow-up. Olfactory function was assessed with the Sniffin’ Sticks test, and calcium levels were measured before and after treatment. Results: Patients treated with chitosan nasal gel showed an increased composite threshold, discrimination, identification (TDI) score, indicating improved olfactory function. Discrimination and identification scores improved, while threshold scores showed no significant change. Notably, while the total TDI score improved by 4.55 points, it did not reach the threshold for clinical significance (5.5 points). Furthermore, chitosan nasal gel significantly reduced calcium levels in nasal secretions compared to the control group. No improvement was observed in the placebo group, likely due to the strict inclusion criteria targeting individuals with treatment-resistant olfactory dysfunction persisting over 6 months. Conclusion: This small-scale pilot study highlights the potential of chitosan nasal gel to improve specific domains of olfactory dysfunction and reduce nasal calcium levels. However, further studies with larger sample sizes, diverse populations, and longer follow-up periods are required to confirm these preliminary findings.

Introduction: Professional certification programs play a crucial role in helping pharmacists develop specialized skills and establish their expertise in the field. This study explores how pharmacists in Saudi Arabia engage with these programs by examining their levels of awareness, attitudes, and participation. It also identifies the key barriers and motivators that influence their decision to pursue certification. Methods: An online survey was conducted among pharmacists in Saudi Arabia to assess participants’ knowledge of certification programs, their perceived benefits, the actual participation rates, and their preferences regarding certification areas and assessment methods. Results: Out of 394 participating pharmacists, around 47% had never participated in a professional certification program, and about 27% of our sample were unaware of such programs in Saudi Arabia. Financial constraints and a lack of awareness were noted as the primary barriers to participation. Almost 55% showed an interest in Clinical Pharmacy Specialties certification, while 54% were inclined toward Pharmacy Management and Leadership certifications. A preference for practical assessments in certification programs was suggested by 55% of participants. Conclusions: This study highlights a significant need for increased awareness and accessibility to professional certification programs among pharmacists in Saudi Arabia. Addressing participation barriers is vital to foster professional development and meet the healthcare sector’s evolving demands in Saudi Arabia.