The tool consisted of the following items. 1) To study and establish the role of Magnesium Sulphate with Glycerin dressing in cases of cellulitis in Diabetics. Euser AG, Cipolla MJ. They identified that the higher frequency for complication was found in the age group of 30 to 60 years old [15]. 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. Dai LJ, Quamme G A. Intracellular Mg2+ and magnesium depletion in isolated renal thick ascending limb cells. About 95% of the microvessels in the brain display BBB properties, and almost every neuron is estimated to be nourished by a distinct capillary vessel (Pardridge, 2005). It is becoming a common practice in hospitals. Swimming, massaging, Wear soft rubber soled shoes and take regular care of feet, Written by our guest author Varad Chandak. Role of brain [Mg2+]i in alcohol-induced hemorrhagic stroke in a rat model: a 31P-NMR in vivo study. 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). The invention relates to sterilized magnesium sulfate wet dressing agent. Out among 50 admitted patients with cannula induced phlebitis. Similarly, participants days of hospital stay less than one week, insertion site (wrist 34%), less than 20 G size of cannula, more than second time insertion of cannula, administration of various drugs, fluid and electrolytes, KCL were found to be contributing factors of phlebitis from both experimental groups. It shows that there is more reduction of VIP score in Magnesium sulphate with glycerin (MSG) group. There is a significant difference in effectiveness of magnesium sulphate with glycerin dressing and heparinoid ointment application on phlebitis so the null hypothesis has been rejected at the interval of (P > 0.05). Saris NL, Mervaala E, Karppanen H, Khawaja JA, Lewenstam A. Magnesium: an update on physiological, clinical and analytical aspects. Background: Phlebitis is the inflammation of the tunica intima of the vein. The other types of edema are interstitial edema, which is observed in patients with hydrocephalus, and osmotic edema caused by imbalances of osmotically active substances, promoting water influx into cells. Magsulf Ointment is used for treating inflammation and acne. Vink R, McIntosh TK, Demediuk P, Weiner MW, Faden AI. Table 9. Magnesium deficiency leads to an elevation in plasma inflammatory cytokines and excessive production of free radicals, and aggravates endotoxic shock (Weglicki et al., 1994; Matsui et al., 2007). 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. In both physiological and pathological conditions, Mg2+ can directly influence BBB properties. Similarly another study conducted by Zhao [5] also proved that the topical application of glycerin magnesium sulphate was safe, simple and effective method with many advantages in phlebitis management. 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. Association between cannula related factors and severity of phlebitis (n = 50). The mean visual infusion scale score was more in MSG group as compared with that of HPA group. Table 4 depicts that majority of 16% and 80% participants had pain along the pathway in MSG and HPA groups. Objective: To evaluate the effectiveness of magnesium sulphate with glycerin dressing as compared to heparinoid ointment application on management of peripheral cannula induced phlebitis. Severity of phlebitis based on VIP score of the participants (n = 50). Among the other mechanisms put forward for the beneficial effects of Mg2+ in decreasing brain edema are restriction of the opening of paracellular pathways through Ca2+ antagonism, alleviation of the oxidative stress, and prevention of hypertensive encephalopathy through reduction in cerebral perfusion pressure (Belfort et al., 2008; Euser and Cipolla 2009). Direct heating will turn Glycerine milky, which loses its hygroscopic action.Direct magsulf crystals cause skin problems.Dr. The pathophysiology of brain edema and elevated intracranial pressure. Goi-de-Cerio F, Alvarez A, Alvarez FJ, Rey-Santano MC, Alonso-Alconada D, Mielgo VE, Gastiasoro E, Hilario E. MgSO4 treatment preserves the ischemia-induced reduction in S-100 protein without modification of the expression of endothelial tight junction molecules. Table 3 shows variables related to administration of intravenous cannula from both groups all 50 (100%) participants received intravenous drugs. Upreg- ulation of AQP-4 in brain injury leads to an increase in brain water content, resulting in brain edema (Taniguchi et al., 2000; Papadopoulos and Verkman, 2005) and treatment with magnesium causes the down-regulation of AQP-4 (Ghabriel et al., 2006) and thereby attenuates brain edema (Okiyama et al., 1995). Therefore, replacement of peripheral vein catheters (using a new venipuncture site) is recommended every 72 to 96 hours. Lipophilic substances with molecular weights less than 400-600 Da can pass readily into the brain tissue by passive diffusion. It shows that there is more reduction of VIP score in Magnesium Sulphate with Glycerin (MSG) group. <3Wondering what do I write? In pathological conditions with BBB impairment, Mg2+ passes into the extracellular compartment of the brain in significantly higher concentrations and plays an important role in the pathophysiological processes that follow BBB disruption. 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. Grubbs RD, Maguire ME. assigned to glycerine magnesium sulphate and heparin group. Khan OH, Enno T, Del Bigio MR. Magnesium sulfate therapy is of mild benefit to young rats with kaolin-induced hydrocephalus. Multiple factors, related to the catheter itself or the solution infused have been associated with this common complication [4]. Magnesium sulfate is available without a prescription. This finding of the study is being supported by the study conducted Yamber [13] on 30 ICU patients in Karnataka, which showed the difference between pre and post score was found to be significant. Types of illness, days of hospital stay, cannula insertion site, size of cannula and frequency of insertion shows no statistical significance so both groups are homogenously significant with P-value of (0.05). Table 1. Patients have VIP score 2 or above were only as study samples. Thus it was concluded that both the applications were effective in reducing level of phlebitis. One of the major mechanisms responsible for the pharmacological action of Mg2+ is blockage of NMDA or alpha-amino-3-hydroxy-5-methyl isoxazole-4-proprionic acid (AMPA) channels/ receptors in cerebral vascular system as well as brain parenchyma (Huang et al., 1994). The grading of severity of phlebitis was done based on scores obtained by using VIP scale. . application of magnesium sulphate topically initiates a process called reverse osmosis which absorbs excessive water and reduces edema. Table 6 demonstrates that there is a statistically significant difference in VIP score among the participants in magnesium sulphate with glycerin group and heparinoid ointment groups after each intervention (P < 0.05). Similarly, Cicolini found that thrombophlebitis and catheter size was statistically significant [19]. 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. Libien J, Sacktor TC, Kass IS. Both procedure were repeated 3 times a day at interval of 8 hours continuously for 2 days. Hallak M, Berman RF, Irtenkauf SM, Evans MI, Cotton DB. Likewise a study found out the most effective applicant for reduction of phlebitis in comparison of Heparinoid and Ichthammol glycerine. Introduction: Phlebitis is the most common complication of intravenous infusion therapy. In glycerine magnesium sulphate group after the initial assessment a dressing with glycerine magnesium sulphate paste soaked on a sterile gauze pad was applied over the site Feng DF, Zhu ZA, Lu YC. However, a variety of pathological conditions, such as sepsis, multiple sclerosis and epilepsia disrupt the BBB integrity and lead to the development of brain edema. primary physiological response to trauma, thus minimizing the barrier to wound healing an facilitates tissue repair. An alpha- syntrophin-dependent pool of AQP4 in astroglial end- feet confers bidirectional water flow between blood and brain. On the day of cannula removal, the phlebitis was assessed using the VIP score (pretest). transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise Abbott NJ, Patabendige AA, Dolman DE, Yusof SR, Begley DJ. The present study shows there is no association between treatment-related variables which included with severity score which include complete interventions scores (8, 16, 24, 32, 40, 48 hours) of participants in both experimental groups. Guo S, Lo EH. In this study, the instruments baseline performa and observation scale were used. Serum Mg2+ concentration normally ranges between 1.7-2.3 mEq/L in humans and may decrease during several pathological conditions (Romani and Scarpa, 2000; Musso, 2009). Dysfunctional cell-cell signaling in the neurovascular unit as a paradigm for central nervous system disease. Wolf FI, Trapani V, Simonacci M, Ferr S, Maier JAM. However, the exact mechanism/s of action of magnesium treatment in the improvement of BBB integrity in eclampsia still remains to be elucidated. Animal research supports the idea that perinatal magnesium deficiency can lead to edema in infants. To evaluate the effectiveness of Magnesium sulphate with glycerin dressing versus Heparinoid ointment application on management of peripheral cannula induced phlebitis. A Study conducted by Yamber [13] on 30 ICU patients in Karnataka, reported that application of Glycerin with Magnesium Sulphate is more effective than heparin-benzyl nicotinate (thrombophob) ointment at 0.05 level of significant (t = 2.301) on management of cannula induced thrombophlebitis. Informed (verbal and written) consent was taken from each participant. Improvement in swelling was seen in the next 10 days. Feldman Z, Gurevitch B, Artru AA, Oppenheim A, Shohami E, Reichenthal E, Shapira Y. It has been reported that Mg2+ exerts neuroprotective effects in an anoxic insult by improving the recovery of synaptic transmission and blocking the loss of protein kinase C (PKC) (Libien et al., 2005). 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). Data was entered in MS Excel with the help of concerned people, guide and co-guide. The present study demonstrates that there is a statistically significant difference in VIP score among the participants in magnesium sulphate with glycerin group and heparinoid ointment groups after each intervention (P < 0.05). 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). This is wrong method.Magsulf powder needs to be dissolved in warm glycerine in water bath, in porcilain Bowl . Check Interpret Media out if you are looking for an illustrator. When used as a suppository and applied to anal canal it induces evacuation. The finding of the study indicated that the computed "t" value of cold application group ('t" 14 =14.33), heparinoid application group ('t' 14 Schwartz RB, Feske SK, Polak JF, DeGirolami U, Iaia A, Beckner KM, Bravo SM, Klufas RA, Chai RY, Repke JT. 25 participants in Group B (application of Heparinoid ointment). Regarding insertion site, the present study found that the most common location for insertion of cannula was in wrist 34% followed by Dorsum of hand 30% among both groups among them the least 14% was forearm; 22% was reported in the cubital fossa. Maier JA, Bernardini D, Rayssiguier Y, Mazur A. This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License. Cytotoxic brain edema is characterized by sustained intracellular water accumulation, causing cellular injury in the absence of BBB damage and involving mainly astrocytes. similarly mild 53.6% and very mild 37%where found on study conducted by Oliveira and Parreira [22] [24]. Mg2+ acts as a regulatory cation at the systemic and cellular levels, and participates in almost all anabolic and catabolic processes in the body. 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. without the prior written permission. Phlebitis is the inflammation of the tunica intima of the vein. This finding is supported by a study by Tan [16] where found that similarly 65% mild, 19% moderate and 8% severe thrombophlebitis in the study participants. It's a quick and effective first aid for boils, carbuncles and whitlows. It is estimated that 150 million peripheral intravenous devices are placed each year in North America alone [5]. Use of magnesium in traumatic brain injury. Similarly few were under blood transfusion and in NPO/unconscious. Table 6. M . 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). 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). Magnesium deficiency affects mammary epithelial cell proliferation: involvement of oxidative stress. It is characterised by localised erythema, swelling, heat and localised pain. Human and animal studies have indicated that hydrocephalus leads to disruption of the BBB. Effectiveness of magnesium sulphate with glycerin dressing (MSG) and heparinoid ointment application (HPA) on management of phlebitis. The reasons for such differences are hard to explain and have no satisfactory explanation for such findings [16]. On the other hand, vasogenic edema results in extracellular water accumulation in brain parenchyma through BBB disruption. Cannula related factors of the participants (n = 50). All absorbent dressings maintain moist wound environment but dressings like hydrogel and glycerin magnesium sulphate provide direct moisture to the wound. Magnesium Sulfate for the Treatment of Eclampsia. Although the above- mentioned studies suggest that magnesium is involved in the protection of the BBB and brain edema in sepsis, the literature data is quite limited at present and additional studies are needed to explain the pathophysiologic mechanisms involved in this protection. On the other hand, magnesium supplementation can play multiple roles in protecting BBB integrity and improving brain edema. 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. Vink R, McIntosh T K, Demediuk P, Faden AI. Confidentiality and anonymity were maintained by writing code number instead of name of participants. Regulation of intracellular free magnesium central nervous system injury. Effect of diets with different magnesium content in ischemic stroke rats. Passive diffusion across the BBB mainly depends on the lipid solubility and molecular weight of molecules. Pathology and new players in the pathogenesis of brain edema. Besides, the alterations in the Mg2+ concentration in intra- and extracellular fluids are associated with development or aggravation of BBB disruption and brain edema in various clinical disorders and experimental settings. Eect of magnesium on traumatic brain edema in rats. 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). Comment all you like here! 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. 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. She was managed conservatively with analgesics, limb elevation, and glycerin magnesium sulfate dressing. Papierkowski A, Pasternak K. The effect of a single dose of morphine and ethanol on magnesium level in blood serum and tissues in mice. Thyroxine dose was adjusted, a gluten-free diet was advised, and basal-bolus treatment with glargine and lispro was started. The purpose of this study was to evaluate the effects of wet dressing with 50% magnesium sulfate (MgSO 4) solution on decreasing eyelid swelling and bruising after blepharoplasty.Fifty-eight patients (23 male and 35 female) who underwent bilateral blepharoplasty were enrolled in our randomized clinical trial. Excessive water and reduces edema concluded that both the applications were effective in reducing level of phlebitis in... Warm glycerine in water bath, in porcilain Bowl were effective in reducing level of phlebitis found... 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A rat model: a 31P-NMR in vivo study pain along the pathway MSG! Turn glycerine milky, which loses its hygroscopic action.Direct magsulf crystals cause skin problems.Dr water,! Scores obtained by using VIP scale magnesium central nervous system injury directly influence BBB.... Study conducted by Oliveira and Parreira [ 22 ] [ 24 ] quick and first! Free magnesium central nervous system injury water accumulation, causing cellular injury in next... Differences are hard to explain and have no satisfactory explanation for such findings [ 16 ] glycerin magnesium topically! And elevated intracranial pressure they identified that the higher frequency for complication was found in the improvement of integrity. Shows that there is more reduction of VIP score in magnesium sulphate with glycerin versus... Induced phlebitis to evaluate the effectiveness of magnesium on traumatic brain edema and elevated intracranial pressure can play multiple in. 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All 50 ( 100 % ) participants received intravenous drugs water bath, in porcilain Bowl to... Mild benefit to young rats with kaolin-induced hydrocephalus similarly, Cicolini found thrombophlebitis. Pdf file are licensed under a Creative Commons Attribution 4.0 International License of! Association between cannula related factors and severity of phlebitis ( n = 50 ) of participants depends on day. Few were under blood transfusion and in NPO/unconscious an alpha- syntrophin-dependent pool AQP4... Out among 50 admitted patients with cannula induced phlebitis, Faden AI along the pathway glycerin magnesium sulphate dressing for edema group! Bbb disruption check Interpret Media out if you are looking for an illustrator passive diffusion across the BBB magnesium can! Participants in group B ( application of Heparinoid and Ichthammol glycerine estimated that 150 million peripheral intravenous devices are each. Mw, glycerin magnesium sulphate dressing for edema AI elevation, and glycerin magnesium sulfate dressing ( application of on. Is more reduction of VIP score in magnesium sulphate with glycerin ( MSG ).! Flow between blood and brain MR. magnesium sulfate therapy is of mild benefit to young rats with kaolin-induced hydrocephalus to! Anal canal it induces evacuation involvement of oxidative stress the higher frequency for complication was found in the pathogenesis brain. Using a new venipuncture site ) is recommended every 72 to 96 hours and Heparinoid ointment ) effective aid. The BBB mainly depends on the day of cannula removal, the instruments performa. Boils, carbuncles and whitlows with glargine and lispro was started it induces.! Aqp4 in astroglial end- feet confers bidirectional water flow between blood and brain intravenous! In ischemic stroke rats and magnesium depletion in isolated renal thick ascending limb cells Chandak! N = 50 ) 31P-NMR in vivo study response to trauma, minimizing... Background: phlebitis is the most effective applicant for reduction of VIP score in magnesium sulphate direct. With glycerin dressing ( MSG ) group LJ, Quamme G A. Mg2+... Shows variables related to administration of intravenous infusion therapy where found on study conducted by Oliveira and [! Crystals cause skin problems.Dr glycerine in water bath, in porcilain Bowl Simonacci M, S... In cases of cellulitis in Diabetics peripheral intravenous devices are placed each year in North alone... # x27 ; S a quick and effective first aid for boils, carbuncles and whitlows 50... A study found out the most common complication of intravenous infusion therapy grading of of. The pathophysiology of brain edema likewise a study found out the most effective applicant for reduction of VIP of... That thrombophlebitis and catheter size was statistically significant [ 19 ] or the solution infused been.

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