We report the first case of native aortic and mitral valve endocarditis due toGemella bergeriaefrom the Middle East in a young patient with rheumatic heart disease. Our case illustrates a fulminant course of infection withG. bergeriaeendocarditis that was complicated by embolic stroke, as well as intracerebral and subarachnoid haemorrhage secondary to rupture of a mycotic aneurysm in the right middle cerebral artery. This case highlights the dire, unreported neurological complications of infective endocarditis due to a rare causative organism—G. bergeriae.

Objectives The aim of the present study was to evaluate the counselling services provided by outpatient pharmacists using the criteria specified by Medication Counseling Behaviour Guideline (US Pharmacopoeia (USP) 1997). The study also assessed the perceptions of patients and pharmacists with regard to counselling. Methods The study was carried out over a period of 5 months at outpatient pharmacies located in different regions of Dubai. The study design included structured observation of over 700 pharmacist–patient encounters, and performances were assessed based on USP Medication Counseling Behaviour Guidelines. Over 1600 patient surveys and pharmacist questionnaires were also carried out/completed to investigate perceptions on counselling. Data was computed and analysed using bivariate analysis and logistic regression. Results The majority of the pharmacist–patient interactions (72.1%) were classified as stage 1 of counselling (that is, the information exchanged was brief, basic and non-individualised). Less than 1% reached stage 4 (that is, a detailed, interactive and collaborative discussion). A significant correlation was found between the USP Medication Counseling Staging score and the pharmacists’ behaviour and communication assessment score. The overall mean patient satisfaction score was 4.71 (a score of 5 indicated most satisfied and 1 indicated least satisfied). Men, older patients and patients who considered the pharmacist to be competent and skilled were generally more satisfied with the consultations. Among patients with chronic conditions who came for medication refills, 41.8% believed that, although they needed counselling, it was not provided by the pharmacist. The majority of pharmacists cited the non-availability of a counselling room as the main barrier they encountered when counselling patients. Conclusions This study identifies the strong need to educate and train pharmacists with better counselling skills and also to provide them with better resources.

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