The coronavirus disease 2019 (COVID-19) has been linked to many systemic inflammatory reactions and high morbidity and mortality rates. Patients with gastrointestinal symptoms progress more rapidly than others. COVID-19 induced acute pancreatitis is not common and can occur in cases of mild infection or even after resolution of the viral infection. We report a case of a 71-years-old male with multiple comorbidities that was admitted as a case of COVID-19 pneumonia for 10 days. Afterwards, the patient was discharged with resolution of the infection and presented two days later with signs of acute pancreatitis. On further investigation, it was confirmed that his acute pancreatitis was due to his previous COVID-19 infection. In conclusion, COVID-19 induced acute pancreatitis is serious and can develop rapidly. Close monitoring and admission are necessary to keep proper hydration.

Introduction: Adult Still’s disease (ASD) is an uncommon inflammatory disorder characterized by fevers, a salmon-colored rash, and arthritis. Cytokines storm syndrome related to Coronavirus-19 (COVID-19) usually occur in acute period of COVID-19 and can mimic clinical features of ASD. Case report: We present a case of a 27-year-old male who was hospitalized in July 2020 due to fever, sore throat, multiple joint pain, and body rash for 2 weeks. Patient recovered from COVID-19 8 weeks ago but his nasopharyngeal SARS CoV-2 PCR was still positive on current hospitalization. Post COVID-19 cytokines storm syndrome post COVID-19 was suspected but after further assessment and investigations, diagnosis of ASD was established and patient was treated with corticosteroids therapy and had favorable outcome. Conclusion: During COVID-19 pandemic, diagnosis of many other diseases either were delayed or missed. We encourage all clinicians to have a broader differential diagnosis to improve patient care and outcome.

Background The public awareness toward the causes and consequences of antibiotic resistance (AR) is crucial to mitigate the inappropriate use of antibiotics (ABs), particularly in the low- and middle-income countries. There was no previous study that assessed the awareness, attitude, and knowledge about antibiotic use and AR among the Jordanian public in affluent and deprived areas. Objective This study aimed to assess the awareness, attitude, and knowledge about antibiotic use and AR in affluent and deprived areas in Jordan. Setting The survey was conducted in November 2019 in Amman, the capital of Jordan. Method A cross-sectional questionnaire was used to survey households in their areas in each of West Amman (affluent region) and East Amman (deprived region), Households were selected using proportionate random sampling method. Results A total of 620 householders (310 per area) completed the questionnaire. Pharmacists were perceived as strong influencers on householders’ decision, as 80.32% (n = 465/580) of those who used antibiotics in the last year follow pharmacists’ advice. Our results showed poor understanding of antibiotic usage among the Jordanian public, as only 14.2% (n = 44/310) of the sample in West Amman and 2.9% (n = 9/310) in East Amman disagreed with the statement “ Antibiotics work on most coughs and colds.” Householders in West Amman showed much better understanding of AR compared to those in East Amman; 82.3% (n = 255/310) of West Amman respondents agreed with the statement “ Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of the antibiotic.” compared to 31.9% (n = 99/310) of East Amman respondents on the same statement ( P  < .05). Conclusion The Jordanian community generally had poor knowledge and awareness toward antibiotics use and AR. Socio-economic factors could influence the public’s attitude toward antibiotics use and AR.

Background Antimicrobials save millions of lives annually from dying because of bacterial infections, but the rapid emergence of antimicrobial resistance (AMR) becomes a global threat. The Saudi Ministry of Health (MOH) has taken containment measures to limit the misuse of antimicrobials via implementing restrictions on dispensing without prescriptions. Hence, we aim to evaluate the impact of regulating antimicrobial sales and identify challenges that pharmacists are facing to prevent self‐medication with antimicrobial agents. Materials and Methods A cross‐sectional study was conducted using two sources of data: sales reports from 3000 pharmacies in Saudi Arabia and a self‐designed questionnaire. The questionnaire consists of 24 items written in English and Arabic languages, went through multiple steps to ensure validity and reliability and then distributed online. Descriptive analyses were used to present the results. Results A total of 106 pharmacists completed the questionnaire. Sixty‐three per cent of the respondents observed a reduction of 40% in sales, which was consistent with pharmacies’ sales reports, which revealed a 50% reduction in 2018 as compared to 2017. Seventy‐six per cent of respondents agreed that antimicrobials’ sales restrictions were frustrating to patients. The percentage of pharmacists who reported receiving prescriptions with complete information about patients, prescribers, medications and issue date was 70%, 54%, 86% and 77%, respectively. And 69% of respondents revealed receiving support from their employers to prevent dispensing antimicrobial agents without prescription. Conclusion Restriction measures implemented by the Saudi MOH led to a 40% to 50% reduction in inappropriate sales of antimicrobials. Further studies are needed to investigate the methods for improving documentation and prescribing practices.

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