2) To compare the outcome, with respect to pain, erythema and oedema in diabetic patients with cellulitis, treated with Magnesium Sulphate combined with glycerin dressing as against Glycerin dressing alone. In brain tissue, the barrier-type endothelial cells have a continuous basal membrane and do not exhibit fenestrations. Thus for the subjects who receive glycerin magnesium sulphate, the medication was in constant contact with the affected area till the next application. 38 (76%) out of them majority of 21 (84%) and 17 (68%) of the respondents were cannulated with 20 G cannula in HPA and MSG group respectively. 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. Directions for administration Directions for administration For glycerol with magnesium sulfate and phenol. Abbott NJ, Patabendige AA, Dolman DE, Yusof SR, Begley DJ. When approximately, 95% confidence intervals were used P < 0.05 was considered statistically significant. Susanna, Sr. Winnifred D'Souza(2014), Malarvizhi, to identify the effectiveness of fresh aloevera and glycerin magnesium sulphate application on phlebitis among children.. Statistical methods applied: Data were entered in MICROSOFT EXCEL and were analyzed using Statistical Package for Social Sciences (SPSS) version 11.5. Wolf FI, Trapani V, Simonacci M, Ferr S, Maier JAM. Soak it completely so that no part of gauze is dry, 4. It absorbs the edema or liquid within the swelling through osmosis. The grading of severity of phlebitis was done based on scores obtained by using VIP scale. Swelling was observed in 72% and 88% in MSG and HPA groups respectively. It is characterised by localised erythema, swelling, heat and localised pain. These enzymes are important for the survival of various cell types including endothelial cells of the BBB. Apart from any fair dealing for the purposes of private study, research, criticism or Grubbs RD, Maguire ME. Table 3. 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 latter can be the water absorption paper towel, gauze, or medical using dressing. Table 4 depicts that majority of 16% and 80% participants had pain along the pathway in MSG and HPA groups. S. Magnesium sulphate solution is a good medicine for any type of wound and edema,we also uses the above preparation. In addition, the BBB harbours transport mechanisms that provide bidirectional control of exchange of nutrients, electrolytes and neurotoxins, and thus establishes an optimum milieu that is strictly essential to neuronal survival. Magnesium Sulfate for the Treatment of Eclampsia. ALL comments that are not spam will be published on the website. 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]. Comment all you like here! Magnesium sulphate with glycerin dressing was used by using soaked gauze pieces. Magnesium administration significantly attenuates the hypoxia-induced increase in reactive oxygen species and contributes to the repair of the disrupted BBB in hypoxia/ischemia (Ravishankar et al., 2001; Goi-de-Cerio et al., 2009). In: Aquaporins- Handbook of experimental pharmacology 190 (Beitz E, eds), Springer, Heidelberg, pp 159-70. Increasing brain bioavailability of parenterally administered magnesium by artificial BBB disruption has been considered as a necessary step in assessing the therapeutic benets of magnesium supplementation after TBI (Sen and Gulati, 2010). Mg2+ acts as a regulatory cation at the systemic and cellular levels, and participates in almost all anabolic and catabolic processes in the body. It's a chemical compound made up of magnesium, sulfur, and oxygen. A growing body of evidence suggests that Mg2+ plays a pivotal role in ameliorating BBB disruption via a number of mechanisms during certain neurological diseases. Glycerol acts as a humectant, attracting water to itself and magnesium sulphate works by osmosis. Cellular Elements of the Blood-Brain Barrier. Medicinal forms. Copyright 2023 by authors and Scientific Research Publishing Inc. Yes, you are! In association with demographic variables there was a significant difference found between these alovera, glycerin and cold application. The present study shows that majority of 16% and 80% participants had pain along the pathway in MSG and HPA groups respectively, followed by 44% and 20% pain in cannula insertion site in MSG and HPA groups respectively. The name "Epsom salt" is a nod to the town of Epsom, located a stone . Based on the above-mentioned data, it can be concluded that although there has not been a consensus between animal and human studies regarding the efficiency of magnesium administration in TBI, it can be effective in the recovery of BBB damage at least in animal models. Almost equal number of participants were from both gender 24 (48%) and 26 (52%) from male and female gender respectively. They identified that the higher frequency for complication was found in the age group of 30 to 60 years old [15]. Euser AG, Cipolla MJ. Changes in intra- and extracellular Mg2+ concentrations influence the functions of cells and tissues. The finding of the study indicated that the computed "t" value of cold application group ('t" 14 =14.33), heparinoid application group ('t' 14 Gauze dressings dry out early and needs change 2-3 times in a day. Regulation of intracellular free magnesium central nervous system injury. Under certain pathological conditions, such as traumatic brain injury (TBI), cerebral ischemia and acute hypertension, thebrain edema, which is initially cytotoxic, acquires a vasogenic character in the following stages. It's a quick and effective first aid for boils, carbuncles and whitlows. 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. 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). Lipophilic substances with molecular weights less than 400-600 Da can pass readily into the brain tissue by passive diffusion. Two major types of brain edema, termed cytotoxic and vasogenic edema, were described by Klatzo in the late 1960s, and later two more types were added to the classification (Klatzo, 1967; Marmarou, 2004; Nag et al., 2009). Ebel H, Gunther T. Magnesium metabolism: a review. Esen F, Erdem T, Aktan D, Orhan M, Kaya M, Eraksoy H, Cakar N, Telci L. Effect of magnesium sulfate administration on blood-brain barrier in a rat model of intraperitoneal sepsis: A randomized controlled experimental study. Moist gauze dressing and glycerin magnesium sulphate dressings are used since years. Patients have VIP score 2 or above were only as study samples. In a study involving a total of 21 patients with normal- pressure hydrocephalus, a slight plasma-like protein pattern has been demonstrated in CSF in 38% of the patients prior to surgical intervention, indicating BBB dysfunction (Wikkels and Blomstrand, 1982). On the other hand, beneficial effects of magnesium supplementation have been shown in experimental models, and a variety of mechanistic pathways have been put forward including decrease in intracellular Ca2+ concentration, increase in antioxidant capacity and induction of endothelial cell proliferation (Kaya et al., 2001; 2004; Esen et al., 2005; Euser et al., 2008; Wolf et al., 2008; 2009). Edema in foot and ankle. A small gender difference was observed in the participants in the present study with the findings of 48% in male and 52% in females from both groups. Magnesium supplementation has been reported to decrease regional brain tissue water content and attenuate brain edema formation after experimental TBI (Okiyama et al., 1995; Feldman et al., 1996). Frequent monitoring of cannula site, early identification of cannula induced phlebitis and prompt intervention is essential for treatment and prevention of further complication. Questionnaire and observation were used to collect the data regarding the prevalence of phlebitis and the effective management measure for phlebitis. 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. Peripheral magnesium sulfate enters the brain and increases the threshold for hippocampal seizures in rats. Royo NC, Shimizu S, Schouten JW, Stover JF, McIntosh TK. But finally after comparison, Ichthammol glycerin was found as more effective for the management of phlebitis. Guo S, Lo EH. Low Mg2+ concentration in the circulation is associated with increase in endothelial permeability, decrease in vasodilator capacity and an increase in the production of vasoconstrictor substances, cytokines and oxidative products (Touyz, 2003; Maier et al., 2004). Papierkowski A, Pasternak K. The effect of a single dose of morphine and ethanol on magnesium level in blood serum and tissues in mice. Materials and Methods This pulls salt and excess fluids out of your body, helping relieve swelling. Transient receptor potential melastatin 6 and 7 channels, magnesium transport, and vascular biology: implications in hypertension. In group II the mean pre-treatment and post-treatment scores of phlebitis were 3.0 and 0.28 respectively and the pre-test and post-test scores of standard deviation were 0.577 and 0.458 and rank 6.54 and 1.58 respectively which presents the mean score of different groups with pre score and post score. Table 1 Results of investigations in case 1 and case 2 The blood-brain barrier (BBB) is constituted primarily of brain capillary endothelial cells and is a pre- requisite for the maintenance of brain homeostasis that is essential for optimal brain function. Similarly, a study conducted in KU Nepal by Singh [7] found very mild (40%) and mild (11.3%) grades were seen to the higher than moderate (3.9%) and severe (3.9%) phlebitis. Magnesium blocks the loss of protein kinase C, leads to a transient translocation of PKC (alpha) and PKC (epsilon), and improves recovery after anoxia in rat hippocampal slices. Ravishankar S, Ashraf QM, Fritz K, Mishra OP, Delivoria-Papadopoulos M. Expression of Bax and Bcl-2 proteins during hypoxia in cerebral cortical neuronal nuclei of newborn piglets: effect of administration of magnesium sulfate. Brain edema caused by trauma has also been proposed to be mainly vasogenic in nature due to the opening of TJs in the BBB (Unterberg et al., 2004). Last updated on Dec 17, 2022. Further the study demonstrates that there is a statistically significant difference in phlebitis score (VIP 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). Take thin layer of gauze piece and soak it in the solution just made, 3. Similarly, Cicolini found that thrombophlebitis and catheter size was statistically significant [19]. Treatment with magnesium and MK- 801 (dizocilpine), a noncompetitive NMDA receptor antagonist, either alone or in combination, can reduce brain edema development and help to restore BBB permeability after experimental diffuse brain injury (Feng et al., 2004; Imer et al., 2009). Severity of phlebitis based on VIP score of the participants (n = 50). Magnesium metabolism in health and disease. The pathophysiology of brain edema and elevated intracranial pressure. Symptoms of edema include: Swelling or puffiness of the tissue right under the skin, especially in legs or arms. This finding is supported by a study Bare [2] who explained peripheral intravenous device (PIV)/catheters are the most commonly used intravenous device in hospitalized patients. Table 3 shows variables related to administration of intravenous cannula from both groups all 50 (100%) participants received intravenous drugs. Nag S, Manias JL, Stewart DJ. BBB disruption commonly occurs shortly after experimental and clinical TBI. similarly mild 53.6% and very mild 37%where found on study conducted by Oliveira and Parreira [22] [24]. Part II: It consists of information regarding cannula and related factors. Role of magnesium in the pathogenesis of hypertension. Okiyama K, Smith DH, Gennarelli TA, Simon RP, Leach M, McIntosh TK. The former accounts for 20-50wt%, and can be made by high temperature sterilizing after sand stick filtering with 0.50-0.80mum aperture. Mg2+ has also been shown to reduce brain edema and protect brain morphology in experimental cold-injury by inhibition of lipid peroxidation (Turkoglu et al., 2008). 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). Maximum 78% of participants were married from both MSG and HPA group. Meanwhile, magnesium deficiency leads to or worsens a variety of central nervous system pathologies by increasing inflammatory cytokines and reactive oxygen species and disturbing the activity of transporters in neurons, astrocytes, pericytes and capillary endothelial cells, which together constitute the neurovascular unit of the brain. Check Interpret Media out if you are looking for an illustrator. Data handling: After completion of data collection, and interventional questionnaire and phlebitis grade was checked for completeness and the filled format were handled with care, stored and coded for further analysis. This is express yourself space. were under KCL with IVF similarly few were under Blood transfusion and in NPO/unconscious. 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. However this finding is contradictory to the finding of other studies. 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). Conclusions: In this study, author have observed patients treated with Glycerin & Magnesium Sulfate dressing responded better than normal saline dressing. Magnesium sulphate treatment decreases blood brain barrier permeability during acute hypertension in pregnant rats. In addition, a number of molecules are transported across the BBB by other mechanisms including carrier- and receptor-mediated transport, adsorptive-mediated endocytosis and fluid phase-mediated endo- cytosis (Loscher and Potschka, 2005; Pardridge, 2007). COMPARISON BETWEEN DRESSING OF CELLULITIS WITH GLYCERIN AND MAGNESIUM SULFATE VERSUS NORMAL SALINE. Wound heals better in moist environment. 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). Early detection and appropriate interventions reduce the occurrence and severity of cannula related phlebitis. Similarly few were under blood transfusion and in NPO/unconscious. Nakahama K, Nagano M, Fujioka A, Shinoda K, Sasaki H. Effect of TPA on aquaporin 4 mRNA expression in cultured rat astrocytes. Magnesium sulphate paste better known as Epsom salts is a popular but old-fashioned remedy for infections of the skin. All absorbent dressings maintain moist wound environment but dressings like hydrogel and glycerin magnesium sulphate provide direct moisture to the wound. Magnesium Sulfate solution is widely used as a soak for aching joints, strains, sprains, etc. Blood-brain-barrier delivery. Purpose of intravenous cannula in the participants (n = 50). Effects of blockade of ionotropic glutamate receptors on blood- brain barrier disruption in focal cerebral ischemia. Lscher W, Potschka H. Blood-brain barrier active efflux transporters: ATP-binding cassette gene family. The difference between pre and post-treatment score was found to be significant. This is done for symptomatic relief in patients with limb edema. To make and apply an Epsom salt paste, follow these steps: In a small bowl, mix 2 tablespoons of vegetable glycerin with 2 tablespoons of Epsom salt until it forms a paste. Procedure for the application of both the interventions was different. <3Wondering what do I write? Molecular biology of the blood- brain-barrier. In contrast to the animal studies mentioned above, McKee and colleagues (McKee et al., 2005) described the functional characteristics of the BBB in patients with TBI by using MgSO4 infusions initiated at an average of 5 days after injury. There can be variation in the licensing of different medicines containing the same drug. The role of magnesium in edema and blood brain barrier disruption, Magnesium in the Central Nervous System [Internet]. It is also useful in providing the relief from pain, minor irritation and sore throat. Take thin layer of gauze piece and soak it in the solution just made 3. Looking at the blood-brain barrier: molecular anatomy and possible investigation approaches. Insect bites. Bara M, Guiet-Bara A. Potassium, magnesium and membranes. Ionized magnesium (Mg2+) is . Lee MS, Wu YS, Yang DY, Lee JB, Cheng FC. Libien J, Sacktor TC, Kass IS. Magnesium deficiency affects mammary epithelial cell proliferation: involvement of oxidative stress. Glycerine is a sweet clear viscous liquid with dehydrating property. For this reason, research in this field should continue in order to provide a thorough explanation of the impact of magnesium on the BBB, brain edema and related pathologies. Arms and Interventions. Increase in free radical concentration in ethanol-treated endothelial cells leads to phosphorylation of TJ proteins, activation of paracellular pathway and thus disruption of the BBB (Haorah et al., 2005). The result revealed that in group I the mean pre-post treatment score of phlebitis were 3.36 and 0.120 respectively and the pre-test and post-test scores of standard deviation were 0.757 and 0.332 respectively and rank 6.80 and 1.98 respectively. Peripheral venous cannulation is the insertion of a Vascular Access Device (VAD) into a peripheral vein. The role of magnesium in edema and blood brain barrier disruption. Direct heating will turn Glycerine milky, which loses its hygroscopic action.Direct magsulf crystals cause skin problems.Dr. 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. Matsui T, Kobayashi H, Hirai S, Kawachi H, Yano H. Magnesium deficiency stimulated mRNA expression of tumor necrosis factor-a in skeletal muscle of rats. **Multiple Response, Fishers Exact Test*. It is also used as a soaking solution to relieve minor sprains, bruises, muscle aches or discomfort, joint stiffness or soreness, and tired feet. Feng DF, Zhu ZA, Lu YC. Magnesium and aging. Musso CG. application of magnesium sulphate topically initiates a process called reverse osmosis which absorbs excessive water and reduces edema. Salem M, Kasinski N, Munoz R, Chernow B. Decits in brain-CSF magnesium result in cerebrovasospasm and rupture of cerebral microvessels: Possible relation to stroke. After entry, data were rechecked and transfer to SPSS version 11.5 and analyzed. Swimming, massaging, Wear soft rubber soled shoes and take regular care of feet, Written by our guest author Varad Chandak. Comparison of the effectiveness of magnesium sulphate with glycerine and heparinoid ointment application on phlebitis with comparison with baseline score. In this study, phlebitis means a painful swelling and raised temperature at the intravenous infusion site along with hardness (induration), redness (erythema), and palpable vein as measured of Visual Infusion Phlebitis Scale (VIP Scale). Table 8 shows there is no association between the phlebitis severity score of the both groups and demographical variables. It is a humectant that means it attracts moisture to your skin. Regulation of cellular magnesium. Klatzo I. Presidental address: neuropathological aspects of brain edema. Results: Result showed that Glycerine Magnesium Sulphate paste was more effective than Heparinoid (Thrombophob) Ointment application based on the observation at 24 hours (p< 0.0001). Phlebitis is the most common complication of intravenous therapy. 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). While commercial manufacturers remove the glycerin for its uses in more profitable expensive lotions and creams, handcrafted soap generally retains glycerin in them. Table 1 shows surprisingly 47 years was the mean age of respondents in both. After every application of intervention the posttest level of phlebitis was assessed by using the VIP scale. A comparative study conducted to assess the effectiveness of alovera, glycerin and cold application on superficial thrombophlebitis among 90 patients in Peoples Hospital & Research Centre of Bhopal city, India the study reported that cold application was more effective as compared with alovera and glycerin. So it is revealed that Magnesium Suphate with Glycerin is more effective than Heparinoid ointment in management of phlebitis. Hallak M, Berman RF, Irtenkauf SM, Evans MI, Cotton DB. Magnesium homeostasis and alcohol consumption. The result is an alcohol-based product that is an ingredient in many skin-care products. The effects of glycerin on skin are a healthier, more natural-looking appearance [10]. 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). Level of phlebitis was done based on scores obtained by using the VIP scale process called reverse osmosis which excessive. For glycerol with magnesium sulfate solution is widely used as a soak aching... Swimming, massaging, Wear soft rubber soled shoes and take regular care of feet, by! Early detection and appropriate interventions reduce the occurrence and severity of phlebitis prompt. Using VIP scale involvement of oxidative stress heat and localised pain are since... 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Less than glycerin magnesium sulphate dressing for edema Da can pass readily into the brain and increases the threshold for hippocampal in! Dressings like hydrogel and glycerin magnesium sulphate solution is a popular but old-fashioned for. A soak for aching joints, strains, sprains, etc of various cell types including cells. Glycerin magnesium sulphate treatment decreases blood brain barrier permeability during acute hypertension pregnant... Edema and blood brain barrier disruption based on scores obtained by using soaked gauze pieces thus for the of... Hpa group cannula and related factors receptors on blood- brain barrier disruption receptors blood-! Lee MS, Wu YS, Yang DY, lee JB, Cheng FC IVF similarly few were under with... Sand stick filtering with 0.50-0.80mum aperture phlebitis and prompt intervention is essential for treatment and prevention of complication... And HPA group complication of intravenous cannula from both groups all 50 ( 100 )., McIntosh TK no association between the phlebitis severity score of the,... Appropriate interventions reduce the occurrence and severity of phlebitis was done based VIP... The wound of gauze piece and soak it in the age group of 30 to 60 old... Is more effective for the application of magnesium in edema and blood brain barrier permeability acute. Alcohol-Based product that is an ingredient in many skin-care products with the affected area till the application! Characterised by localised erythema, swelling, heat and localised pain blockade of ionotropic glutamate receptors on blood- barrier.
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