Cardiovascular diseases play major roles in the health problems worldwide especially in Indonesia. Percutaneous coronary intervention (PCI) is a minimally invasive procedure with relatively low complications. However, high inflammatory response post-PCI has showed adverse events even after administration of standard medication. Previous studies showed that curcumin was able to reduce inflammatory response in adult patients with stable coronary heart disease (CHD). This article determines the efficacy of oral administration of curcumin in reducing inflammatory response post-PCI with stable CHD. A double-blind randomized controlled trial on 50 adult patients comparing curcumin and placebo was performed in Cipto Mangunkusumo General Hospital and Jakarta Heart Center within April and June 2015. Either curcumin (45 mg/day) or placebo was given 7 days prior to PCI until 2 days after PCI. Inflammatory markers (high-sensitivity C-reactive protein [hsCRP] and soluble CD40 ligand [sCD40L]) were measured in three phases (7 days prior PCI, 24 hours post-PCI, and 48 hours post-PCI). There were no significant differences in the reduction of hsCRP and sCD40L between curcumin and placebo groups in three phases of measurement. Curcumin significantly reduce the serum hsCRP (p = 0.006) and sCD40L (p = 0.002) 7 days before PCI to 48 hours post-PCI. The decrement of hsCRP (–14.2% vs. –7.4%) and sCD40L (–24.3% vs. –13.2%) from 24 to 48 hours post-PCI was higher in the curcumin group than placebo group. The administration of curcumin 45 mg dose daily for 7 days prior PCI until 48 hours post-PCI is useful in reducing inflammatory response post-PCI with stable CHD.

Vitamin D has an immunomodulatory effect that increases antimicrobial responses in macrophages by inducing antibacterial proteins, stimulating autophagy, and increasing autophagosome activity through various signaling pathway. This review emphasizes the several signalling pathway of vitamin D and vitamin D receptor (VDR) to induce autophagy in infection and its role in infectious disease. This study was performed based on PRISMA guidelines. Literature search conducted from Cochrane, PubMed, Science Direct and ProQuest using the terms "vitamin D" and “VDR” and "autophagy in infection". The inclusion criteria were original article, publication in English, published in 2012-2022, investigating vit D, VDR pathway and autophagy mechanism in infection. Twelves studies met our criteria. Despite numerous autophagy signalling in vitamin D and VDR, there are 2 main mechanisms vit D induces autophagy; increase expression LL-37/cathelicidin, CAMP, DEFB4 and upregulated autophagy genes (LC3B, ATG5, BECN1, MMPI, ATG16L1, PR39). While, vit D induced autophagy via expression CYP27B1 and VDR in co-infection HIV and tuberculosis. In sepsis, artesunate relates with VDR to enhance autophagy via NF-κB. Similarly, vitamin D could enhance cell resistance to Aspergillus fumigatus after modulating NF-κB. Vitamin D3 through PDIA3-STAT3-MCOLN3-Ca2+ axis and CAMP/LL-37 (cathelicidin antimicrobial peptide) are mediator for autophagy induction in H. pylori. Upregulated autophagy gene activity through vit D/VDR appears as new target therapy for infection in future.

BACKGROUND: Percutaneous coronary intervention (PCI) is the most common intervention for coronary artery disease (CAD) with very low complications. High oxidative stress post-PCI is associated with further atherosclerosis progression. Curcumin, extracted from a specific type of herbs, exhibits anti-oxidant properties by acting as hydrogen and electron donor for superoxide radicals. The aim of this study is to determine the effect of curcumin’s antioxidant properties in reducing oxidative stress of post-PCI in stable CAD.METHODS: This study was a double-blind parallel randomized controlled trial among 50 stable CAD patients undergoing PCI in Cipto Mangunkusumo General Hospital and Jakarta Heart Center. The subjects received either 45 mg/day curcumin or placebo 7 days pre-PCI until 48 hours post-PCI. Reduced oxidative stress markers (decreased MDA or increased GSH) were measured in 3 phases (7 days pre-PCI, 24 hours post-PCI, 48 hours post-PCI).RESULTS: Curcumin group showed increased MDA from baseline to 24 hours (Δ1=0.01 vs. 0.03; p=0.3) and decreased MDA from baseline to 48 hours (Δ2=-0.06 vs. 0.03; p=0.9). While, curcumin group showed decreased GSH from baseline to 24 hours (Δ1=-49.7% vs. 12.2%; p=0.4) and from baseline to 48 hours (Δ2=-19.09% vs. 11.4%; p=0.6). However, no significant changes were found in malondialdehide (MDA) and glutathione (GSH) level after the intervention.CONCLUSION: The 45 mg/day curcumin supplementation from 7 days pre-PCI until 48 hours post-PCI had no significant antioxidant effect in stable CAD post-PCI.KEYWORDS: coronary artery disease, curcumin, antioxidant, percutaneous coronary intervention

Background: An increasing number of patients with chronic kidney disease (CKD) impact an increased need for hemodialysis. Inadequate hemodialysis affects morbidity in patients with CKD. Determination of the urea removal index can be accomplished by several invasive and non-invasive methods. The purpose of this study was to compare the urea reduction ratio (URR) and dialysis efficiency (Kt/V) calculated automatically by hemodialysis machines to assess the adequacy of hemodialysis in patients with CKD.Methods: A cross-sectional analysis study was conducted on 58 CKD patients with age ≥18 years, conventional 5-hour hemodialysis sessions twice weekly, using single use-hollow fiber dialyzers, and who had been receiving hemodialysis for ≥6 months in the hemodialysis unit at Wangaya Hospital from April 2022 to May 2022. Study data were obtained from medical records then described and analyzed using the statistical package for the social sciences (SPSS) program.Results: The mean of URR was 70.74±10.04, while the mean of Kt/V delivered by machine was 1.27±0.19. More hemodialysis patients received adequate hemodialysis based on URR parameters compared to Kt/V parameters (84.5% versus 1.7%). There was no significant difference between age, sex, body mass index (BMI), comorbidities, vascular access and duration of dialysis with adequacy hemodialysis. There was a significant difference between URR and Kt/V in the evaluation adequacy of hemodialysis (p=0.000). In addition, there was a positive correlation between URR and Kt/V in the evaluation adequacy of hemodialysis (r=0.592, p=0.000).Conclusions: The URR is a more accurate parameter, but the Kt/V delivered by machine can help the URR demonstrate the adequacy of haemodialysis patients with CKD.