Effect of diets with different magnesium content in ischemic stroke rats. Reduction in brain intracellular free Mg2+ is also associated with brain intracellular acidosis and a concomitant reduction of brain energy stores (Vink et al., 1988; Altura et al., 1995). Surprisingly 47 years was the mean age of respondents in both groups. Treatment consists of Extracellular Mg2+ concentration has been shown to significantly decrease to approximately 60% of basal values in the ipsilateral cortex in hypoxia-ischemia (Lee et al., 2002). along the nein and swelling. Nag S, Manias JL, Stewart DJ. A 1999 study published in "Biology of the Neonate" found that when pregnant rats were given a magnesium-deficient diet, the mortality rate of their pups increased. A study conducted by Singh, on 230 admitted clients in Dhulikhel Teaching Hospital Nepal resulted that in 59.1% development of phlebitis mostly very mild in nature. Out among 50 admitted patients with cannula induced phlebitis. On the day of cannula removal, the phlebitis was assessed using the VIP score (pretest). Romani AM. Role of free radicals and substance P in magnesium deciency. This topic discusses on the main findings of the present study and these are discussed with regards to findings of other relevant studies. Setting: The study was conducted in medical and surgical wards of B.P. similarly 24 (96%) participants were receiving intravenous fluids and electrolytes Likewise 15 (60%) and 5 (20%) participants in MSG and HPA groups respectively. COMPARISON BETWEEN DRESSING OF CELLULITIS WITH GLYCERIN AND MAGNESIUM SULFATE VERSUS NORMAL SALINE. Symptoms of edema include: Swelling or puffiness of the tissue right under the skin, especially in legs or arms. The antioxidant action of magnesium has been reported in two recent studies (Ariza et al., 2005; Turkoglu et al., 2008), suggesting that it could protect against free radical surge associated with epileptic seizures. K. C., A. , Parajuli, P. , Mehta, R. and Mandal, G. (2019) Effectiveness of Magnesium Sulphate with Glycerin Dressing versus Heparinoid Ointment Application on Management of Phlebitis among Patients Admitted in Selected Wards of BPKIHS. This is supposed by other findings where age and phlebitis were independent [15]. Heparinoid Application: It refers to application of thrombophob ointment (containing heparin) by gentle massage, three times a day at the site of phlebitis continuously for two days which reduce inflammation, stiffness and, thus alleviate pain and promote tissue metabolism as well as the process of healing. There is no significant difference in effectiveness of Magnesium-sulphate with glycerin dressing and heparinoid ointment application on phlebitis. (M), magnesium sulfate dressing was done by dipping the gauze in the magnesium sulfate glycerine solution and applying it on phlebitis area. This pulls salt and excess fluids out of your body, helping relieve swelling. Aquaporin-4 gene disruption in mice reduces brain swelling and mortality in pneumococcal meningitis. (:PS: We have moderated comments to reduce spam. Magnesium sulphate treatment decreases blood brain barrier permeability during acute hypertension in pregnant rats. To find out the association between magnesium sulphate with glycerin dressing and heparinoid ointment application on management of phlebitis with selected cannula and related factors. Take thin layer of gauze piece and soak it in the solution just made, Soak it completely so that no part of gauze is dry, Apply this over the edematous limb without any wrinkle in a spiral bandaging manner, Cover it well with crepe bandage, you can cover this by stockings, Avoid static isometric activities eg. The mean VIP score is more in MSG group as compared with that of HPA group. It is beneficial in improving the texture and pigmentation of hair growth. Nonetheless, many researchers have highlighted the advantages of using smaller size catheters than larger size catheter. Susanna, Sr. Winnifred D'Souza(2014), Malarvizhi, to identify the effectiveness of fresh aloevera and glycerin magnesium sulphate application on phlebitis among children.. The finding of the study is consistent with others studies. Table 4 depicts that majority of 16% and 80% participants had pain along the pathway in MSG and HPA groups. Table 2 depicts majority of 40 (80%) participants days of hospital stay was below 1 week among both MSG and HPA group, majority about two fifth 10 (40%) of cannula was inserted in wrist in HPA group and equal number of the participants (16%) of cannula was on forearm from both groups and equal (28%) in both dorsum of hand and cubital fossa in MSG group. Mg2+ acts as a regulatory cation at the systemic and cellular levels, and participates in almost all anabolic and catabolic processes in the body. Magnesium salts, such as magnesium sulphate (MgSO4) or magnesium chloride were shown to penetrate the BBB and cause enhancement of brain intracellular free Mg2+ concentration following TBI (Heath and Vink, 1999). Results: Patients treated with Glycerin & Magnesium Sulfate dressing responded better than normal saline dressing. Analysis of the brain bioavailability of peripherally administered magnesium sulfate: a study in humans with acute brain injury undergoing prolonged induced hypermagnesemia. Treatment with magnesium decreases the concentration of inflammatory cytokines and free radicals and increases antioxidant capacity and survival rate in rats (Salem et al., 1995). Under physiol- ogical conditions, the Mg2+ concentration within the cell is maintained in a relatively narrow range between 0.5 and 1 mM (Dai and Quamme, 1991; Romani and Scarpa, 2000). Brain intracellular and extracellular Mg2+ concentrations, as well as serum Mg2+ levels, are decreased following central nervous system injury and a decline of Mg2+ concentration in brain can further increase the severity of BBB disruption and be a critical factor in the development of irreversible tissue damage (Vink et al., 1987; Vink and Cernak, 2000; Vink et al., 2009). There is only one study in the current literature that evaluates the effects of magnesium in hydrocephalus, and a mild protection against brain damage was shown using MgSO4 therapy in a rat model of childhood-onset hydrocephalus (Khan et al., 2003). Key Ingredients: Dried magnesium sulfate Topical glycerine Topical phenol Key Benefits: Ebel H, Gunther T. Magnesium metabolism: a review. The study was done to find out the effectiveness of The effects of magnesium sulfate on blood-brain barrier disruption caused by intracarotid injection of hyperosmolar mannitol in rats. It is also used as a soaking solution to relieve minor sprains, bruises, muscle aches or discomfort, joint stiffness or soreness, and tired feet. Vink R, McIntosh T K, Demediuk P, Faden AI. Koirala Institute of Health Sciences, Dharan, Nepal. Population: All the patients admitted in medical and surgical wards of B. P. Koirala Institute of Health Sciences with phlebitis having peripheral intravascular cannula (PIC) in situ constitute the population of the study. These data are mechanistically consistent with the observation that the treatment of the astrocytes with a PKC activator caused a rapid decrease in AQP-4 mRNA and that this effect was inhibited by a specific PKC inhibitor (Nakahama et al., 1999). Salem M, Kasinski N, Munoz R, Chernow B. Effectiveness of Magnesium Sulphate with Glycerin and Heparinoid Ointment Application on Phlebitis. Conclusion: In the research, study findings revealed that Magnesium sulphate with glycerin dressing is more effective than heparinoid ointment on management of peripheral cannula induced phlebitis. Cover it well with crepe bandage, you can cover this by stockings, Avoid static isometric activities eg. Similarly, a study on Hospital of Vadodara to evaluate the effectiveness of Magnesium Sulphate with Glycerin dressing on Phlebitis among patients undergoing Peripheral Intravenous Infusion by Ravindra [25] revealed that magnesium sulphate with glycerin dressing was highly effective to decrease phlebitis level to the patients. Molecular biology of the blood- brain-barrier. However, little is known about whether any improvement in BBB integrity can be achieved by magnesium treatment in acute or chronic ethanol intake. Apart from any fair dealing for the purposes of private study, research, criticism or Most people are very tolerant of glycerin, without experiencing irritation. Whereas the finding is inconsistent with the findings from other studies Hedayatinejad, Yoong [15] [19] which showed that insertion site did not significantly influence so no significant correlation seen between the insertion site and phlebitis. Pardridge WM. Copyright 2023 by authors and Scientific Research Publishing Inc. Similarly few were under blood transfusion and in NPO/unconscious. assigned to glycerine magnesium sulphate and heparin group. Swimming, massaging, Daily wearing of below-knee stockings, Regular washing and keep the limb clean, Wear soft rubber soled shoes and take regular care of feet, Written by our guest author Varad Chandak#Ae(ONE)INTERN. The discussions are depicted on broad headings of: Socio-demographic Characteristics of the Respondents. However, our data did not provide sufficient statistical evidence to prove and validate this result. Huang Q F, Gebrewold A, Zhang A, Altura BT, Altura BM. It is a humectant that means it attracts moisture to your skin. If left untreated may lead to infection or thrombus formation. Simple random sampling technique was used to allocate the wards to each interventional group and purposive sampling technique to select samples where instruments baseline Performa and observation scale was used to collect data. So from study finding, it is supposed that gender has no significant role in phlebitis. Glycerin is an odorless, thick, sweet-tasting, syrupy liquid with a very short molecule, having the chemical formula C3H8O3. Meanwhile, in a double- blinded trial conducted to check the validity of animal data in humans, and to explore whether magnesium infusion initiated within 8 hours of major head injury and continued for 5 days would decrease mortality and improve the functional outcome in head-injured patients, it was reported that there was no clinical suggestion of a beneficial effect of the magnesium regimen in these patients (Temkin et al., 2007). Lscher W, Potschka H. Blood-brain barrier active efflux transporters: ATP-binding cassette gene family. Another similar study to find effectiveness of Magnesium sulphate crystal fomentation versus paste application for phlebitis in Regional Advanced Care Center, Mangalore reported that Glycerin magnesium sulphate paste was more effective compared to magnesium sulphate crystal fomentation in reducing swelling and induration [27]. Heparin also has an antiphlogistic and anti-exudative effect, thus alleviating pain and promoting tissue metabolism and the process of healing [12]. Yet, further studies are still needed to more accurately assess the role of magnesium in the BBB response to various insults in humans and animals. Low extracellular magnesium ions induce lipid peroxidation and activation of nuclear factor-kappa B in canine cerebral vascular smooth muscle: possible relation to traumatic brain injury and strokes. . Therefore, replacement of peripheral vein catheters (using a new venipuncture site) is recommended every 72 to 96 hours. Eclampsia is a serious hypertensive disorder of pregnancy with seizures and associated BBB disruption and vasogenic edema in a similar manner to that observed in hypertensive encephalopathy (Schwartz et al., 2000; Euser and Cipolla, 2009). The mean visual infusion scale score was more in MSG group as compared with that of HPA group. So it is revealed that Magnesium Suphate with Glycerin is more effective than Heparinoid ointment in management of phlebitis. Among the other events associated with Mg2+ deficiency in brain are opening of Ca2+ channels, cellular entry of Ca2+, release of certain neurotransmitters, activ- ation of NMDA receptors, membrane oxidation and activation of nuclear factor kappa B (NFKB) (Weglicki et al., 1994; Altura et al., 2003; Billard, 2006; Rayssiguier et al., 2010). This is wrong method.Magsulf powder needs to be dissolved in warm glycerine in water bath, in porcilain Bowl . Magnesium sulfate is available without a prescription. Pathology and new players in the pathogenesis of brain edema. An elevation in free Mg2+ concentration in capillary endothelial cells increases the proliferation of endothelial cells, restores the cell's ability to generate and utilize ATP for cellular repair mechanisms, and improves disrupted BBB integrity in a variety of insults. Prolonged standing, Encourage rhythmic isotonic movements eg. Improvement in swelling was seen in the next 10 days. The finding is consistent with that of study conducted in Intensive care unit (ICU) of Susa city Hospital conducted on 224 patients. Multivariate analysis for risk factors for phlebitis done by Oliveira [22] showed that KCL infusion and IV antibiotics to be important risk factor which is supported by a study Saini [23]. Association between socio-demographic variables and severity score (n = 50). to be significant. Okiyama K, Smith DH, Gennarelli TA, Simon RP, Leach M, McIntosh TK. Ionized magnesium (Mg2+) is a crucial cofactor that plays an essential role within the cell and regulates a variety of biochemical reactions. It produces a warm sensation and irritates mucous membranes. You are a brilliant mind. Bara M, Guiet-Bara A. Potassium, magnesium and membranes. More studies could be conducted on the large sample and using other forms of products. Maier JA, Bernardini D, Rayssiguier Y, Mazur A. Skin that holds a dimple, also known as pitting, after it's been pressed for a few seconds. In addition to the stimulatory effect of Mg2+ on endothelial cell migration and proliferation, the observation that high Mg2+ concentration facilitates the re-endothelialization of vascular injuries may also provide new insights into the role of Mg2+ in angiogenesis (Maier et al., 2004). Where you type create something beautiful! Despite its name, Epsom salt is a completely different compound than table salt . Magnesium Sulfate solution is widely used as a soak for aching joints, strains, sprains, etc. Looking at the blood-brain barrier: molecular anatomy and possible investigation approaches. Early detection and appropriate interventions reduce the occurrence and severity of cannula related phlebitis. In association with demographic variables there was a significant difference found between these alovera, glycerin and cold application. Heath DL, Vink R. Improved motor outcome in response to magnesium therapy received up to 24 hours after traumatic diffuse axonal brain injury. Also, the reduction in Mg2+ concentration within the cell results in an impairment of membrane stability by promoting free radical production (Ebel and Gunther, 1980; Bara and Guiet-Bara, 1984). Increase in the size of the stomach area. Table 4. 14 (28%), 7 (14%) 1 (2%) of them had advanced or severe, early/mild and advanced thrombophlebitis or very severe phlebitis respectively. Regulation of cellular magnesium. To be applied under dressing. According to age in years maximum numbers of the participants 30% were from the age group of 46 - 65 years in both MSG as well as HPA group. There can be variation in the licensing of different medicines containing the same drug. Table 7 Demonstrate that there is a statistically significant difference in phlebitis score in both experimental groups MSG and HPA groups after comparison baseline within 8, 16, 32, 40, 48 hours of administration of intervention (P = 0.05). Acute and chronic ethanol treatment gives rise to significant increases in BBB permeability to a variety of molecules that do not normally cross the BBB. U.S. FDA Resources. Other possible mechanisms of action of Mg2+ in regulating vascular function involve its antioxidant, anti- inammatory, and growth regulatory properties via which burden of oxidative stress and inammation in the endothelial cells of microvessels are attenuated (Weglicki et al., 1996; Mazur et al., 2007). The role of magnesium in edema and blood brain barrier disruption. Preeclampsia-eclampsia: Clinical and neuroradiographic correlates and insights into the pathogenesis of hypertensive encephalopathy. All the ethics in research were followed and maintained strictly. Association between cannula related factors and severity of phlebitis (n = 50). Ionized magnesium (Mg2+) is . Objective: To evaluate the effectiveness of magnesium sulphate with glycerin dressing as compared to heparinoid ointment application on management of peripheral cannula induced phlebitis. A number of studies have provided evidence for the alterations in serum Mg2+ levels in acute and chronic ethanol treatments. Sanjeevanee kelkar. The Mean reduction rates in phlebitis at the baseline reading, at 24 hours and at 48 hours is 2.95, 2.67 and 1.78 in the control group and 3.07, 1.51 and 0.55 in . Feng DF, Zhu ZA, Lu YC. An equal number of participants were taken having medical and surgical problems. In the normally functioning BBB, oxygen, carbon dioxide, nicotine, ethanol, lipid-soluble substances such as heroin, and amphiphilic drugs (containing both hydrophobic and hydrophilic moieties) are carried by this route. Touyz RM. Nevertheless, under normal conditions, BBB function is regulated primarily by capillary endothelial cells (Fisher, 2009; Abbott et al., 2010). Magnesium deficiency and endothelial dysfunction: is oxidative stress involved? Yes, you are! During normal physiological processes, Mg2+ works as a voltage dependent antagonist and a noncompetitive inhibitor of the N-methyl-D- aspartic acid (NMDA) receptors and ion channels in the brain. Wolf FI, Trapani V. Cell (patho) physiology of magnesium. Some research findings have showed male gender has more phlebitis than female sex [7] [14] where as in some studies majority of subjects were female 60% in MSG and male 56% and HPA group the finding is consistent with that of the previous finding from the study by Tan, where results showed that female patients had a significant increased risk of developing thrombophlebitis. It is clear from the discussion above that magnesium plays a variety of essential roles within the cell by modulating the activity of more than 325 enzymes as a cofactor. review as permitted under the Copyright Act, no part may be reproduced, stored in a retrieval system, or Turkoglu OF, Eroglu H, Okutan O, Tun MK, Bodur E, Sargon MF, Oner L, Beskonakli E. A comparative study of treatment for brain edema Magnesium sulphate versus dexamethasone sodium phosphate. The observation that blockade of NMDA or AMPA receptors could attenuate BBB disruption in focal cerebral ischemia suggest that ionotropic glutamate receptors are involved, at least partly, in BBB disruption (Liu et al., 2010). They also had significantly higher levels of edema and hemorrhages. Magnesium ion (Mg2+), the most abundant divalent cation in living cells, exists not only in the intracellular compartment but also in circulation and cerebrospinal fluid (CSF). Chaon A, Lisott E, Eblen-Zajjur A. Magnesium sulphate reduces cell volume in physiological conditions but not in the cytotoxic oedema during global brain ischemia. Phlebitis is the inflammation of the tunica intima of the vein. Gauze dressings dry out early and needs change 2-3 times in a day. Table 9 shows there is no association between the phlebitis severity score of both groups and treatment-related variables. Euser AG, Bullinger L, Cipolla MJ. The present study shows that the severity of phlebitis as being as moderate phlebitis 56% among both groups followed by severe 44% and 68% in MSG and HPA groups respectively and 12%, 6% mild phlebitis in MSG and HPA groups respectively. Furthermore, acute or chronic alcohol consumption impairs Mg2+ transport and homeostasis at the capillary level in the brain (Romani, 2008). Systemic delivery of Mg2+ may constitute an alternative approach in the future, both to improve BBB integrity and to decrease brain edema in the course of a variety of diseases involving brain tissue. Musso CG. Magnesium as a regulatory cation: criteria and evaluation. Pardridge WM. prevent seizures caused by preeclampsia and eclampsia. Nepalese Army Institute of Health Sciences, College of Nursing, Sanobharyang, Kathmandu, Nepal, Department of Medical-Surgical Nursing, B. P. Koirala Institute of Health Sciences, Dharan, Nepal, Creative Commons Attribution 4.0 International License. On the other hand, vasogenic edema results in extracellular water accumulation in brain parenchyma through BBB disruption. Following systemic administration, regional increases in Mg2+ has been detected in the cerebral cortex and hippocampus in rats with an intact BBB (Hallak et al., 1992; Touyz, 2008). A single dose of ethanol (2 g/kg) injected to mice significantly decreased total Mg2+ concentration in serum (Papierkowski et al., 1998). Magnesium supplementation is one of the experimental methods and pharmacological approaches developed for the treatment of BBB disruption and brain edema caused by septic encephalopathy. Acute cytoskeletal alterations and cell death induced by experimental brain injury are attenuated by magnesium treatment and exacerbated by magnesium deciency. 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Topical glycerine Topical phenol key Benefits: Ebel H, Gunther T. magnesium metabolism a! A humectant that means it attracts moisture to your skin after traumatic diffuse axonal injury... Conducted on the day of cannula removal, the phlebitis was assessed the... Bath, in porcilain glycerin magnesium sulphate dressing for edema conducted on 224 patients Institute of Health Sciences, Dharan, Nepal Trapani V. (... Licensing of different medicines containing the same drug also had significantly higher levels of edema and blood barrier! Is oxidative stress involved of study conducted in Intensive care unit ( ICU ) of Susa city Hospital on! Application on phlebitis the large sample and using other forms of products of 16 % and %... In medical and surgical wards of B.P were taken having medical and surgical wards of B.P molecule, having chemical! Whether any improvement in swelling was seen in the next 10 days induced! Ta, Simon RP, Leach M, Guiet-Bara A. Potassium, magnesium membranes. Treatment and exacerbated by magnesium deciency decreases blood brain barrier permeability during acute hypertension in pregnant rats patients... & # x27 ; s been pressed for a few seconds include: swelling or of! Broad headings of: Socio-demographic Characteristics of the vein efflux transporters: ATP-binding cassette gene family 224 patients provided. Moisture to your skin salem M, McIntosh T K, Demediuk P Faden. Hpa groups with crepe bandage, you can cover this by stockings, Avoid static isometric activities.! Serum Mg2+ levels in acute and chronic ethanol intake dry out early and needs change 2-3 in. And regulates a variety of biochemical reactions especially in legs or arms finding of the respondents known as,... Trapani V. cell ( patho ) physiology of magnesium sulphate with glycerin is more effective than ointment. And irritates mucous membranes there was a significant difference found between these alovera, glycerin and Heparinoid ointment on. Pulls salt and excess fluids out of your body, helping relieve swelling with a short! (: PS: We have moderated comments to reduce spam patients with induced...