Safety of Amiodarone in Ventricular Arrhythmia in Patients Admitted in Bangabandhu Sheikh Mujib Medical University

Background: Amiodarone is the most effective antiarrhythmic medications available today for the treatment of both atrial and ventricular arrhythmias. It is an iodinated benzofuran derivative with demonstrated efficacy against a range of cardiac arrhythmias, including atrial fibrillation, paroxysmal supraventricular tachycardias, and life-threatening ventricular arrhythmias. Objective: To evaluation the status of amiodarone with therapeutic dose in Bangladeshi population. Materials and Methods: The quasi experimental study was conducted in the Department of Cardiology in Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka during April, 2019 to March, 2020 Patients got admitted in the Department of Cardiology, BSMMU, consecutive patients who had been treated with amiodarone for arrhythmia were included in this study. Patients without an amiodarone prescription were assumed and patients who will not give informed written consent were excluded in this study. Results: The most common adverse event was bradycardia or conduction disturbance (9.0%) followed by 4(2.2%) thyroid toxicity, 3(1.7%) hepatic toxicity, 2(1.1%) eye toxicity and 1(0.6%) pulmonary toxicity. In multi variable logistic regression, bradycardia or conduction disturbance, amiodarone daily dose (≥300 mg) and duration of amiodarone (>4 month) was found to be significantly (p<0.05) associated with adverse effects of amiodarone. Conclusion: The most common adverse event was bradycardia or conduction disturbance followed by thyroid toxicity, hepatic toxicity, eye toxicity and pulmonary toxicity. Bradycardia or conduction disturbance, amiodarone daily dose (≥300 mg) and duration of amiodarone (>4 month) was found to be significantly associated with adverse effects of amiodarone. University Heart Journal Vol. 17, No. 2, Jul 2021; 118-121

Protective Effects of Myo-Inositol and Selenium on Cadmium-Induced Thyroid Toxicity in Mice

Cadmium (Cd) damages the thyroid gland. We evaluated the effects of myo-inositol (MI), seleno-L-methionine (Se) or their combination on the thyroids of mice simultaneously administered with Cd chloride (CdCl2). Eighty-four male mice were divided into 12 groups (seven mice each). Six groups (controls) were treated with 0.9% NaCl (vehicle), Se (0.2 mg/kg/day), Se (0.4 mg/kg/day), MI (360 mg/kg/day), MI+Se (0.2 mg/kg) and MI+Se (0.4 mg/kg). The other six groups were treated with CdCl2 (2 mg/kg), CdCl2+MI, CdCl2+Se (0.2 mg/kg), CdCl2+Se (0.4 mg/kg), CdCl2+MI+Se (0.2 mg/kg) and CdCl2+MI+Se (0.4 mg/kg). An additional group of CdCl2-challenged animals (n = 7) was treated with resveratrol (20 mg/kg), an effective and potent antioxidant. All treatments lasted 14 days. After sacrifice, the thyroids were evaluated histologically and immunohistochemically. CdCl2 reduced the follicular area, increased the epithelial height, stroma, and cells expressing monocyte chemoattractant protein-1 (MCP-1) and C-X-C motif chemokine 10 (CXCL10). CdCl2+Se at 0.2/0.4 mg/kg insignificantly reversed the follicular and stromal structure, and significantly decreased the number of MCP-1 and CXCL10-positive cells. CdCl2+MI significantly reversed the thyroid structure and further decreased the number of MCP-1 and CXCL10-positive cells. CdCl2+MI+Se, at both doses, brought all indices to those of CdCl2-untreated mice. MI, particularly in association with Se, defends mice from Cd-induced damage. The efficacy of this combination was greater than that of resveratrol, at least when using the follicular structure as a read-out for a comparison. We suggest that the use of these nutraceuticals, more specifically the combination of MI plus SE, can protect the thyroid of Cd-exposed subjects.