CLInical Profile and Side Effects of chronic use of oral Amiodarone in cardiology outpatients department (CLIPSE-A Study)- A prospective observational study.

Background: Amiodarone belongs to Class-III anti-arrhythmic drugs. It is one of the most effective anti-arrhythmic drugs used to treat or prevent several types of arrhythmias including atrial fibrillation, atrial flutter, ventricular tachycardia, and wide complex tachycardia, but unfortunately carries a high toxicity profile. Also, side effects of amiodarone involving various organs can be life-threatening. Materials & methods: This was an observational study carried out for six months i.e from April to September. The study included patients who are on amiodarone for greater than or equal to six months. The required data was collected in-person from the case sheets, treatment charts, and by interviewing the patients. The data for 67 patients was documented in suitable data collection form for analysis. Results: From our study data, it was noted that amiodarone was used for 3 different indications-atrial fibrillation, atrial flutter, and ventricular tachycardia. Among 67 patients enrolled, 38 had no side-effects. Side-effects data in the rest grouped basing on the organ system affected: 9 patients had renal effects, 6 patients had ophthalmic effects, 4 patients had endocrine effects, and 5 patients had hepatic effects. Conclusion: From our study, it is concluded that amiodarone is a safe and effective anti-arrhythmic drug at lower doses i.e. 200-1100 mg/week. When treated in lower doses of 1400-2800 mg/week, many side effects have been incident. Although these effects are mild and develop only after prolonged usage of the drug, it should be used judiciously.

Epidemiology, Genotyping, Mutational and Phylogenetic Analysis of Hepatitis B Virus Infection in North-east India.

BACKGROUND/OBJECTIVE: Hepatitis B virus (HBV) infection is a major public health problem globally. Northeast India is home to indigenous tribes with different ethnicity and high rates of drug abuse and HIV infection. The study was designed to estimate the burden of HBV infection across various spectrums of liver diseases from this region. HBV genotypes and subgenotypes play a role in the chronicity of disease, response to treatment and its progression. As very limited data are available from this region, we tried to elucidate the role of HBV genotypes, HBV mutants and their phylogenetic analysis. METHOD: We designed a prospective multicentric study, and included 7464 liver disease cases, 7432 blood donors and 650 health care workers, who were screened for HBV infection. HBV DNA positive patients were genotyped and subjected to surface protein, precore and core mutation and phylogenetic analysis. RESULTS: The prevalence of HBV infection with respect to different types of liver diseases, blood donors and health care workers was 9.9% (1550/15,546). 49.5% (768/1550) cases were found to be HBV DNA positive. The most common genotype was found to be genotype D 74.2% (570/768), followed by genotype C 6.5% (50/768), A 4.4% (34/768) and I 0.9% (7/768). CONCLUSION: This study highlights the high hepatitis B burden in Northeast India, reflecting lacunae in health care needs of the region. Also, the different genotype distribution and presence of mutations may translate into different rates of liver disease progression, prognosis and ultimately, clinical significance. However, further prospective cohort study from Northeast India is warranted, to elucidate the clinical significance of multiple genotypes and mutation in this unique population.

Toxicity and bioaccumulation of manganese and chromium in different organs of common carp (Cyprinus carpio) fish.

The present research work was carried out to determine the bioaccumulation of manganese and chromium in the gills, intestine, muscles, skin and bones, as well as its acute toxicity and effects on hematological and biochemical parameters in Common carp (Cyprinus carpio). Adult carps were exposed for 96 h to manganese sulphate and chromium chloride solution, a sub lethal concentration was used in the experiment. Bioaccumulation was highest in the gills followed by intestine > muscles > skin > bones. The concentration of hematocrit (HCT) (37.3 ± 0.36), hemoglobin (HGB) (9.0 ± 0.04), Red Blood Cells (RBCs) (3.7 ± 0.025), mean corpuscular volume (MCV) (121.2 ± 0.36), mean corpuscular hemoglobin (MCH) (41.3 ± 0.3) and mean corpuscular hemoglobin concentration (MCHC) (41.06 ± 0.072) was significantly higher at 96 h (P < 0.01) after exposure to manganese and chromium, while the concentration of platelets (PLT) (16.8 ± 0.12) and white blood cells (WBCs) (62.7 ± 0.11) was lower at 96 h of exposure. Serum glutamic pyruvic transaminase (SGPT) (40.6 ± 0.4), Blood Urea (13 ± 0.1), serum triglycerides (231.21 ± 0.04), high-density lipoprotein (HDL) (39 ± 0.07), serum Alkaline PO4 (242 ± 0.2), lactate dehydrogenase (LDH) (1239 ± 13.21), and serum Uric Acid (4.81 ± 0.33) were significantly higher (P < 0.01) at 96 h of exposure. The highest concentration of serum cholesterol (339 ± 0.09), serum reatinine (0.9 ± 0.01), low density lipid (240 ± 0.2) was observed at 24 h. Serum glutamic-oxaloacetic transaminase (SGOT) (19 ± 0.13), and serum albumin were at the highest level at 72 h (3.19 ± 0.07) (P < 0.01) post exposure.

Renoprotective effects of stevia (Stevia rebaudiana Bertoni), amlodipine, valsartan, and losartan in gentamycin-induced nephrotoxicity in the rat model: Biochemical, hematological and histological approaches.

The current study investigated the renoprotective effects of stevia, angiotensin-II type 1 receptor (AT1) blocker and calcium (Ca2+) channel blocker in gentamycin-induced nephrotoxicity in rat models. Six groups of male Sprague-Dawley rats of eight weeks old were taken for the experiment: sham control, nephrotoxicity, treatment with amlodipine (4 mg/kg/day); stevia (200 mg/kg/day); losartan (15 mg/kg/day) and valsartan (5 mg/kg/day), accordingly. The blood sample was taken for the assessment of renal and hepatic-functional variables like serum creatinine, blood urea, BUN and SGPT, SGOT, and total serum bilirubin. Hematological parameters were also examined. Histological examination has been done on kidneys and liver. Alterations of the body weight and the organ's weight were documented. Treatment with stevia and valsartan significantly decreased serum creatinine levels. A reduction of liver enzymes, and total serum bilirubin levels were observed in all the treatment groups. Treatment with valsartan and amlodipine, remarkably and stevia, mildly reduced the renal tissue damage, inflammation, and tubular necrosis. However, the present study demonstrated that losartan treatment aggravated kidney damage by increasing protein cast, calcification, tubular necrosis, and injury. This comparison indicated that both stevia and valsartan have beneficial renoprotective effect and valsartan offers a better treatment option in renal damage over losartan.

Study of chemical composition and nutritional values of vegetable wastes in Bangladesh.

The present study was conducted with the objectives of determining the chemical composition and nutritional value of vegetable waste (VW) of households and the marketplace for their suitability as ruminant feed. The crude protein, total digestible nutrients and extent of rumen degradability of dry matter (DM) of VW of households were 140.0 g kg-1, 0.668 and 0.855, respectively; while those of the marketplace were 169.0 g kg-1, 0.633 and 0.80, respectively. The levels of chromium and lead in each respectively, was 13.27 and 1.53 ng kg-1DM; and 31.01 and 5.71 ng kg-1DM. The total aflatoxins in VW of households was 3.08 µg kg-1DM, and undetectable in VW from the marketplace. Considering the chemical composition and safety parameters studied, VW could preliminary be considered as animal feed. The feeding of processed marketplace VW (VWP) at 275 g kg-1DM of a diet or 0.76% of live weight (LW) to growing bulls, replacing 50% of a concentrate mixture as supplement to a Napier silage diet for a period of 34 days reduced the total DM intake (0.0276 vs 0.0343 LW) without any significant (P > 0.05) changes in DM or protein digestibility. Blood urea levels (19.5 vs 23.67 mg dl-1), and serum creatinine levels (1.37 vs 1.08 mg dl-1) differed significantly (P > 0.05) between the two groups but were within normal physiological ranges. Therefore, it may be concluded that the level of incorporation of VWP would be less than 50% replacement of the concentrate in the diet. Further research is required to determine optimum inclusion levels in ruminant diets.