Background: Acute heart failure is a rapid onset of new or worsening of signs and symptoms of heart failure that requires hospitalization or a visit to the emergency department. The aim of this study was to evaluate treatment outcome and determine factors that predict a poor treatment outcome in acute heart failure patients at a Tertiary Care Hospital in Ethiopia.Methods: A prospective observational study design was used. Data were collected using a structured questionnaire as a tool. Outcome variables were assessed at the time of discharge from the hospital. Bivariate and multivariate logistic regression analyses were used to determine factors that predict in-hospital mortality. A p-value ≤0.05 was considered as statistically significant.Results: Out of the 169 patients, the median age of patients with acute heart failure was 34 years (IQR = 23 to 50) and median hospital stay was 4.0 days (IQR = 3.0 to 6.0). The leading precipitating factor and underlying disease at the time of admission were pneumonia (47.5%) and chronic rheumatic heart disease (48.5%), respectively. The inhospital mortality was found to be 17.2%. Smoking (adjusted odds ratio (AOR) = 8.7, p = 0.006), diabetes mellitus (AOR = 10.2, p = 0.005), pulmonary hypertension (AOR = 4.3, p = 0.016), and the presence of adverse drug events (AOR = 4.2, p = 0.003) were predictors of in-hospital mortality.Conclusion: High in-hospital mortality was observed among acute heart failure patients admitted to a Tertiary Care Hospital in Ethiopia. Smoking, diabetes mellitus, pulmonary hypertension and the presence of adverse drug events were predictors of in-hospital mortality.

Cassia arereh is traditionally used as a fish poison and to manage different disease conditions including gastrointestinal tract (GIT) disorders, infertility, diabetes, insect bite, and infections. Free radicals have been implicated in the pathogenesis of a range of chronic diseases; and many medicinal plants are thought to be effective in managing such diseases, mainly through their free radicals scavenging ability. The objective of this study was to conduct phytochemical screening and investigate the free radical scavenging activity of various extracts of pods of C. arereh. Petroleum ether, ethanol, and water extracts were prepared from the pods powder and tested for their radical scavenging activity using 1, 1-Diphenyl-2-picrylhydrazyl (DPPH) assay. The pods powder was also subjected to preliminary phytochemical screening. The results revealed that ethanol and water extracts possessed strong DPPH radical scavenging activity with 50% inhibitory concentration (IC 50 ) values of 8.84 and 16.76μg/ml, respectively. Ascorbic acid was used as a standard and exhibited a radical scavenging IC 50 value of 2.0µg/ml. Results of preliminary phytochemical screening indicated the possible presence of anthraquinones, carbohydrates, deoxy-sugars, saponins, tannins, and terpenoids. It can be concluded that pods of C. arereh may contain medicinally relevant constituents such as terpenoids and displayed strong radical scavenging activity, which may partly contribute to the possible scientific basis for its traditional use to alleviate different disease conditions.

Background: Heart failure (HF) is associated with severe complications, hospitalization, and poor quality of life. Patients with heart failure had poor physical and emotional symptoms, functional status and worse health outcomes.Objective: The aim of this systematic review and meta-analysis will be to investigate whether pharmacist intervention is effective in improving health related quality of life (HRQoL) and clinical outcomes among patients with heart failure.Method: Systematic review and meta-analysis will be conducted. Published journals in English and indexed in Medline (PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Google scholar will be searched from 1990 to December 2019. Data will be extracted by one author and will be approved by other two authors independently. Data will be analyzed in accordance with the Cochrane handbook. Standardized mean differences will be used as an estimate of the effect size. Quality of included studies will be assessed using the modified Downs and Black checklist. Analysis for the dichotomous outcome studies will be converted into standardized mean difference and present with 95% confidence intervals. The review is approved in the International Prospective Register of Systematic Reviews (PROSPERO) with registration ID CRD42020158236.Discussion: Currently there are important gaps on the effectiveness of pharmacist intervention in improving health-related quality of life and clinical outcomes. We believe this review will provide comprehensive evidence on the effectiveness of pharmacist intervention among patients with HF.