Atrial fibrillation is the most frequent arrhythmia in clinical practice and causing huge health problem. Therefore, a national guidelines in management of AF that comprise of pathomechanism, clasifications, anticoagulants management for stroke prevention, rate and rhythm control is developed to ensure patients get best therapeutic option. The guidelines is developed in line with variable health care level in Indonesia from primary up to tertiary care.
Objective: Inflammatory disease occurs in the mucosal of the colon, or ulcerative colitis (UC) is one of subtypes of inflammatory bowel disease. The numerous of drug side effects for treatment of colitis give rise to use medicinal herbs as alternative therapies. Pomegranate peel extract has been used for the treatment of pain and inflammatory conditions. This study aimed to investigate the anti-inflammatory effects of pomegranate peel ethanol extract on mice colon through inflammation pathway which reduce inflammation score in mice model of chronic inflammation induced by dextran sodium sulfate (DSS).Methods: Thirty Swiss Webster mice divided randomly into 6 groups: Normal, aspirin 43 mg/kg/d (ASP), ellagic acid 26 mg/kg/d (ELG), DSS 2%b/v (DSS), pomegranate peel ethanol extract 240 mg/kg/d (DOSES-1), and 480 mg/kg/d (DOSES-2). All groups were given DSS 2% over 3 cycles except normal group (where each cycle in the DSS group consisted of 2% DSS in drinking water for 7 days, followed by a 7-day interval with normal drinking water). At the end of the experiment, colon samples were washed with water then buffered neutral formalin 10% fixed and paraffin embedded for histological analysis.Results: DOSES-1 and DOSES-2 were significantly reduced inflammation score in colon mice induced by DSS (p<0.05), mean score 2.01 and 2.02. Expression of cyclooxygenase (COX-2) was significantly decreased (p<0.05), mean score 27.48 and 17.77. Expression of iNOS was also significantly decreased (p<0.05), mean score 54.01 and 36.69. There were no significant differences between DOSES-1 and DOSES-2 groups with ASP and ELG group (p>0.05).
Conclusion:Pomegranate peel ethanol extract has an anti-inflammatory agent by reduces inflammation score, inhibiting COX-2 and iNOS expression on mice colon by DSS induced. Furthermore, pomegranate peel ethanol extract has equivalent effectiveness with aspirin and pure ellagic acid.
Background:
Data on the optimal therapeutic international normalized ratio (INR) for non-valvular and valvular atrial fibrillation (AF) in Indonesia is currently unavailable. Therefore, we designed the Indonesian Registry on Atrial Fibrillation (OneAF) registry in order to seek a safe and beneficial range of INR in Indonesian patients with non-valvular and valvular AF.
Methods/design:
The OneAF registry is a nationwide collaboration of the Indonesian Heart Rhythm Society (InaHRS) enrolling all hospitals with cardiac electrophysiologists in Indonesia. It is a prospective, multicentre, nationwide, observational study aiming to recruit non-valvular and valvular AF patients in Indonesia. The registry was started in January 2020 with a planned 2 years of recruitment. There are 2 respondents for this registry: non-cohort and cohort respondents. Non-cohort registry respondents are AF patients at hospitals who fulfill inclusion and exclusion criteria but did not consent for a 24 month follow up. Whereas patients who consented for a 24 month follow up were included as cohort registry respondents. Key data collected includes basic sociodemographic information, symptoms and signs, medical history, results of physical examination and laboratory test, details of diagnostics and treatment measures and events.
Results:
Currently, a total of 1568 respondents have been enrolled in the non-cohort registry, including 1065 respondents with non-valvular AF (67.8%) and 503 respondents with valvular AF (32.2%). We believe that the OneAF registry will provide insight into the regional variability of anticoagulant treatment for AF, the implementation of rhythm/rate control approaches, and the clinical outcomes concerning cardiocerebrovascular events.
Trial registration:
Registered at clinicaltrials.gov (NCT04222868).
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