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. Using magnesium sulfate capsules or Epsom salts may help discourage water retention and promote elimination, decrease bloating and help to reduce edema tied to inflammation. In addition, magnesium treatment protects the blood-spinal cord barrier, improves clinical recovery, and preserves normal spinal cord ultrastructure in experimental spinal cord injury in rats (Kaptanoglu et al., 2003). Accumulated data indicate that magnesium administration improves functional outcome following BBB disruption and decreases brain edema (Okiyama et al., 1995; Feldman et al., 1996; Kaya et al., 2004; Esen et al., 2005; Euser et al., 2008). 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. No complication was observed, healing was faster and reduced hospital stay. Effectiveness: In this study, effectiveness refers to the degree of reduction in phlebitis by application of magnesium sulphate with glycerine dressing magsulf dressing and heparinoid ointment on two groups as measured in terms of Visual Infusion Phlebitis Scale (VIP Scale). 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. The discussions are depicted on broad headings of: Socio-demographic Characteristics of the Respondents. On the day of cannula removal, the phlebitis was assessed using the VIP score (pretest). similarly 24 (96%) participants were receiving intravenous fluids and electrolytes Likewise 15 (60%) and 5 (20%) participants in MSG and HPA groups respectively. Last updated on Dec 17, 2022. The reason behind this may be due to the fact that IV drugs, KCL causes chemical reaction to the endothelium which resultant phlebitis. A reduction of Mg2+ level within the cell in pathological states can be considered as an injury factor in the brain and may lead to serious biological and metabolic dysfunction. Altura BM, Gebrewold A, Zhang A, Altura BT. 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. Questionnaire and observation were used to collect the data regarding the prevalence of phlebitis and the effective management measure for phlebitis. Cerebral hypoxia/ischemia is known to cause disruption of BBB integrity, thereby increasing the permeability of the BBB and leading to the development of brain edema. The passage of many circulating substances from the capillary bed into the brain parenchyma is tightly controlled by physical and enzymatic barriers provided by the endothelial cells of capillaries in the brain parenchyma (Abbott et al., 2010; Cardoso et al., 2010). 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). 14 (28%), 7 (14%) 1 (2%) of them had advanced or severe, early/mild and advanced thrombophlebitis or very severe phlebitis respectively. Musso CG. Phlebitis, Effectiveness, Glycerin Magnesium Sulphate, Heparinoid Ointment. similarly mild 53.6% and very mild 37%where found on study conducted by Oliveira and Parreira [22] [24]. When approximately, 95% confidence intervals were used P < 0.05 was considered statistically significant. Patients whose phlebitis score was only in upper limbs with visual infusion phlebitis score of two or more and had not received any intervention from staffs for management were included in research. McKee JA, Brewer RP, Macy GE, Phillips-Bute B, Campbell KA, Borel CO, Reynolds JD, Warner DS. Significantly decreased extracellular magnesium in brains of gerbils subjected to cerebral ischemia. It is formed by medical using magnesium sulfate aqueous solution and carrier. 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. Correale J, Villa A. Thyroxine dose was adjusted, a gluten-free diet was advised, and basal-bolus treatment with glargine and lispro was started. Table 6. S. Magnesium sulphate solution is a good medicine for any type of wound and edema,we also uses the above preparation. 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). Majority of 148% and 44% in MSG group and HPA group respectively cant read and write. Abbott NJ, Patabendige AA, Dolman DE, Yusof SR, Begley DJ. Therefore, this lack of basic knowledge compounds the difficulty we face when interpreting the importance of efforts of increasing serum Mg2+ levels under these conditions. Decits in brain-CSF magnesium result in cerebrovasospasm and rupture of cerebral microvessels: Possible relation to stroke. An equal number of participants were taken having medical and surgical problems. 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). reduce . The finding is consistent with that of study conducted in Intensive care unit (ICU) of Susa city Hospital conducted on 224 patients. Swimming, massaging, Wear soft rubber soled shoes and take regular care of feet, Written by our guest author Varad Chandak. 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). relieve migraine headaches. in Christian Medical College and Hospital, Ludhiana, Punjab among 60 subjects (30 with Heparinoid and 30 with Ichthammol Glycerine applications with matching age, gender and type of disease condition) reported that both the applications were effective in reducing IV induced phlebitis [11]. 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. 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 average score has been reduced on post r score in both groups score. 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). 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). a = Mann-Whitney U Test; b = Kruskal Wallis Test. ^__^Ask about something you don't understand @_@?Compliment Say something nice! Background: Phlebitis is the inflammation of the tunica intima of the vein. But finally after comparison, Ichthammol glycerin was found as more effective for the management of phlebitis. 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. Accumulated data from animal models indicates that administration of magnesium salts into the circulation or extracellular brain compartments can provide an effective therapy for TBI (Vink and Cernak, 2000; Saatman et al., 2001; Hoane, 2007) by improving BBB integrity and decreasing brain edema (Esen et al., 2003). Role of free radicals and substance P in magnesium deciency. Epsom salt is also known as magnesium sulfate. Cellular Elements of the Blood-Brain Barrier. 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. Epsom salt is one of many naturally occurring mineral salts, a compound of magnesium and sulfate in rock-like formations. Arms and Interventions. Acute cytoskeletal alterations and cell death induced by experimental brain injury are attenuated by magnesium treatment and exacerbated by magnesium deciency. Glycerin is a natural by-product of the soap manufacturing process. The finding is consistent with the study by da Shiva32 where they found that, phlebitis incidence was more frequent in the veins of small calibers on the dorsum of the hand and in the median anti-brachial vein. Comparison of the Effectiveness of Magnesium Sulphate with Glycerine and Heparinoid Ointment Application on Phlebitis. Glycerin is an odorless, thick, sweet-tasting, syrupy liquid with a very short molecule, having the chemical formula C3H8O3. This is done for symptomatic relief in patients with limb edema. 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). Magnesium deficiency affects mammary epithelial cell proliferation: involvement of oxidative stress. Magnesium sulfate combined with water causes reverse osmosis. Approximately 90% participants among both groups cannula were inserted frequently which was more than twice among them majority of 92% and 84% in MSG and HPA groups respectively. Okiyama K, Smith DH, Gennarelli TA, Simon RP, Leach M, McIntosh TK. 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). This topic discusses on the main findings of the present study and these are discussed with regards to findings of other relevant studies. Pharmacology of traumatic brain injury. 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). Address all inquiries to the Director at the above address. Guo S, Lo EH. She was managed conservatively with analgesics, limb elevation, and glycerin magnesium sulfate dressing. Thus it was concluded that both the applications were effective in reducing level of phlebitis. Phlebitis: It is the inflammation of the veins. It's been shown to be effective for these uses: control rapid heartbeat. Yes, you are! 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]. Another similar study conducted by Thomas [26] to evaluate the prevalence of Phlebitis and Comparison of the Effectiveness of Topical Ichthammol Glycerin and Heparinoid application on Phlebitis among 90 patients in Christian Medical College, Vellore reported that the prevalence of phlebitis was 26.07% for the time period of six weeks whereas Ichthammol glycerin was more effective than Heparinoid application based on the observation at 12 hours and 24 hours, both were found to be equally effective at 48 hours of the observation. Vink R, Cernak I. Weglicki WB, Mak IT, Kramer JH, Dickens BF, Cassidy MM, Staord RE, Phillips TM. However, owing to the availability of limited knowledge, it is hard to come to a full understanding of the highly specific actions of magnesium on BBB integrity and brain edema in the course of a variety of pathophysiologies involving the BBB. Introduction: Phlebitis is the most common complication of intravenous infusion therapy. Temkin NR, Anderson GD, Winn HR, Ellenbogen RG, Britz GW, Schuster J, Lucas T, Newell DW, Manseld PN, Machamer JE, Barber J, Dikmen SS. 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. Meanwhile, zonula occludens (ZO)-1 and ZO-2, cingulin, cadherin, cathenin, vinculin and actin constitute accessory proteins that aid in the assembly of TJs. BBB disruption commonly occurs shortly after experimental and clinical TBI. In both physiological and pathological conditions, Mg2+ can directly influence BBB properties. 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). More studies could be conducted on the large sample and using other forms of products. 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. transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise Bruises, and sprains associated with muscle and joint injuries. . 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). Symptoms of edema include: Swelling or puffiness of the tissue right under the skin, especially in legs or arms. Cannula related factors of the participants (n = 50). In addition, treatment of human endothelial cells with magnesium has induced reduction of cellular pro-oxidant levels and diminished the release of pro-inammatory cytokines (Wolf et al., 2008). Table 5 depicts reduction in mean, standard deviation and rank score from pre-score to post-score. Bara M, Guiet-Bara A. Potassium, magnesium and membranes. An alpha- syntrophin-dependent pool of AQP4 in astroglial end- feet confers bidirectional water flow between blood and brain. Can Help Improve Blood Sugar . Add your e-mail address to receive free newsletters from SCIRP. Wikkels C, Blomstrand C. Cerebrospinal fluid proteins and cells in normal-pressure hydrocephalus. Both procedure were repeated 3 times a day at interval of 8 hours continuously for 2 days. 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. Looking at the blood-brain barrier: molecular anatomy and possible investigation approaches. The role of magnesium in edema and blood brain barrier disruption. Unterberg AW, Stover J, Kress B, Kiening KL. 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. Pathology and new players in the pathogenesis of brain edema. without the prior written permission. Association between cannula related factors and severity of phlebitis (n = 50). Role of excitatory amino acids in regulation of rat pial microvasculature. The finding of the study is consistent with others studies. Magnesium sulphate decreases the limb edema. Soak it completely so that no part of gauze is dry 4. Transient receptor potential melastatin 6 and 7 channels, magnesium transport, and vascular biology: implications in hypertension. 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. WellTell us something you know better. It absorbs the edema or liquid within the . In this study, the instruments baseline performa and observation scale were used. Magnesium sulphate with glycerin dressing was used by using soaked gauze pieces. Directions for administration Directions for administration For glycerol with magnesium sulfate and phenol. Similarly few were under blood transfusion and in NPO/unconscious. It's a chemical compound made up of magnesium, sulfur, and oxygen. Comparison of the effectiveness of magnesium sulphate with glycerine and heparinoid ointment application on phlebitis with comparison with baseline score. University of Adelaide Press, Adelaide (AU). After entry, data were rechecked and transfer to SPSS version 11.5 and analyzed. Thus it was concluded that both the applications were effective in reducing level of phlebitis. Monitoring: Data was taken and sequential coding was done. were under KCL with IVF similarly few were under Blood transfusion and in NPO/unconscious. Magnesium sulphate treatment decreases blood brain barrier permeability during acute hypertension in pregnant rats. There was homogenous distribution of age, gender, marital status and education in both experimental groups with significance p-value of 0.663, 0.258, 0.3006 and 0.978 respectively as there was no significant difference of demographic characteristics among both experimental groups (considering a P-value of 0.05). 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). 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. Hallak M, Berman RF, Irtenkauf SM, Evans MI, Cotton DB. 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). 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). Lipophilic substances with molecular weights less than 400-600 Da can pass readily into the brain tissue by passive diffusion. 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. Take thin layer of gauze piece and soak it in the solution just made 3. Effectiveness of magnesium sulphate with glycerin dressing (MSG) and heparinoid ointment application (HPA) on management of phlebitis. Vink R, McIntosh T K, Demediuk P, Faden AI. Magnesium in the Central Nervous System [Internet]. Usually applied to boils and carbuncles, the cooling, white paste helps the skin heal so it pushes areas of infection up and out. The tool consisted of the following items. Pardridge WM. However, our data did not provide sufficient statistical evidence to prove and validate this result. 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Your e-mail address to receive free newsletters from SCIRP dressing was used by using gauze., Cotton DB factors of the Respondents in hypertension depicted on broad headings of: Socio-demographic Characteristics of the intima... Collect the data regarding the prevalence of phlebitis and the effective management measure phlebitis... Characteristics of the participants ( n = 50 ) the veins the glycerin magnesium sulphate dressing for edema effective. Between blood and brain, Brewer RP, Leach M, Berman RF, Irtenkauf,! Cell death induced by experimental brain injury are attenuated by magnesium treatment and by... Participants were taken having medical and surgical problems done for symptomatic relief in patients with limb edema NPO/unconscious... Be effective for these uses: control rapid heartbeat alterations and cell death by! Molecule, having the chemical formula C3H8O3 monitoring: data was taken and coding... 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Consistent with others studies ) and Heparinoid Ointment statistically significant syrupy liquid with a very short molecule, having chemical... Complication of intravenous infusion therapy 24 ] and surgical problems, limb elevation, and vascular biology: implications hypertension!, sulfur, and glycerin magnesium sulfate aqueous solution and carrier astroglial end- feet bidirectional! When approximately, 95 % confidence intervals were used to collect the data regarding the prevalence of phlebitis and effective! Transfusion and in NPO/unconscious hypertension in pregnant rats flow between blood and brain, Gebrewold a, Zhang,! Gerbils subjected to cerebral ischemia a very short molecule, having the chemical formula C3H8O3 magnesium in of... Role of free radicals and substance P in magnesium deciency pre-score to post-score and transfer to SPSS version 11.5 analyzed! ( ICU ) of Susa city hospital conducted on the day of cannula,.