Background: Practitioners of traditional medicine use the decoction of Ononis natrix L. to treat hyperglycemia. The literature offers no evidence to support the use. Objective: To investigate the effect of the decoction of Ononis natrix L. on the blood glucose concentration in Wistar rats (Rattus norvegicus) with streptozotocin-induced diabetes mellitus. Methods: We obtained 35 Wistar rats from the animal colony of The University of Jordan School of Medicine. We induced diabetes by a single intraperitoneal injection of streptozotocin (60 mg/kg body weight) and 23 rats (66%) survived to allocation. We randomly assigned the rats to one of four groups: negative control (1% Tween 80 in distilled water), positive control (100 mg/kg metformin), high-dose treatment (7.5 mL of the decoction), and low-dose treatment (3.5 mL of the decoc-tion). We administered the doses twice daily by oral gavage for two weeks and measured the tail-blood glucose concentration twice daily, once before the first dose and another time after the second dose. We used linear mixed-effects regression to model the change in blood glucose concentration as a function of the experimentation groups, with adjustments for pseu-doreplication and temporal variation. Results: The estimated mean change was 1 mmol/L (−30 to 31 mmol/L) for the negative control group, −26 mmol/L (−56 to 5 mmol/L) for the positive control group, −75 mmol/L (−108 to −42) for the low-dose treatment group, and −82 mmol/L (−111 to −53 mmol/L) for the high-dose treatment group. Conclusion: In conclusion, we demonstrate, for the first time, the hypoglycemic effect of Ononis natrix L. in an animal model of diabetes.

Introduction: Atrial fibrillation (AF) is the most common sustained arrhythmia with an increasing incidence and prevalence in older age groups compared to younger individuals and the general population. Younger patients with AF often have different clinical characteristics, risk factors, and outcomes. Because AF among the young has not been studied in Middle Eastern populations, we conducted this study to provide valuable insights into the differences in the baseline clinical characteristics and the one-year adverse events between young and older AF patients, and thus contribute to formulate future treatment strategies and improve health outcomes. Methods: Consecutive adult patients previously or newly diagnosed with AF in 30 hospitals and out-patient cardiology clinics were enrolled in the Jordan AF study from May 2019 to October 2020. All patients were followed-up for one year. Baseline clinical characteristics and the one-year adverse events were assessed in young (<50 years) and older (≥ 50 years) adult patients with AF. Results: Of the 2020 AF patients enrolled in the study, 201 (10%) were young. Young patients were more likely to be men (75.6% vs. 43.8%, p<0.001), and had a lower prevalence of hypertension (31.3% vs. 79.3%, p<0.001), diabetes mellitus (10.4% vs. 47.2%, p<0.001), and previous stroke (9.0% vs. 16.1%, p=0.027) compared to older patients. Furthermore, young patients had a lower mean CHA DS -VASc score (1.1±1.4 vs. 3.9±1.7, p<0.001) and mean HAS-BLED score (0.6±0.7 vs. 1.8±1.1, p<0.001). The use of oral anticoagulant agents was significantly lower in young patients (39.3% vs. 75.0%, p<0.001). Young patients also had lower one-year all-cause mortality (1.1% vs. 13.7%, p=0.001), cardiovascular mortality (1.1% vs. 7.7%, p=0.04) and major bleeding (0% vs. 2.7%, p=0.021) compared to older patients. The rate of stroke and systemic embolization was similar in both groups (3.4% vs. 4.4%) Conclusion: The findings of the Jordan AF study suggest that young patients (<50 years of age) comprise a small proportion (10%) of the overall AF patient population. They had more favorable baseline clinical characteristics and risk scores compared to older patients. The one-year mortality and major bleeding rates in young patients were also lower than that in older patients.

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Aims: Few studies have investigated premature ST-elevation myocardial infarction (STEMI) in the Middle East. We aimed to compare the clinical characteristics and one-year prognosis of young (<45 years) and older (≥45 years) Middle Eastern adults with STEMI. Methods and Material: A total of 706 patients with STEMI, who were prospectively enrolled in the First Jordanian Percutaneous Coronary Intervention Registry, were stratified into two groups (<45 or ≥45 years). Baseline clinical variables and one-year major adverse cardiovascular events (MACE) were evaluated. Results: Young patients (<45 years) comprised 17.4% of STEMI patients (123 of 706). Compared with older patients (≥45 years), young patients were mostly male (96% vs 82%, P<0.001), smokers (86% vs 49%, P<0.001) and less likely to have multi-vessel disease (26% vs 44%, P=0.001). Anterior STEMI was the most common diagnosis and left anterior descending artery was the most common culprit vessel in both groups. There were no significant differences between the younger and older patients in in-hospital (20% vs 19%, P=0.12) and one-year MACE (24% vs 26%, P=0.68). However, none (0%) of the young died during one-year follow-up while 21 (4%) of the older patients died (P=0.036). Conclusions: Young adult patients in the Middle East with STEMI are more likely to be smoking men with multiple risk factors and single vessel disease by angiography. Although, younger patients had similar one-year MACE to older patients, their mortality rate appears to be better. A larger study is warranted to investigate this vulnerable group of patients to prevent future events.