. Prolonged standing, Encourage rhythmic isotonic movements eg. 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). Key Ingredients: Dried magnesium sulfate Topical glycerine Topical phenol Key Benefits: Feng DF, Zhu ZA, Lu YC. Huang Q F, Gebrewold A, Zhang A, Altura BT, Altura BM. No complication was observed, healing was faster and reduced hospital stay. Multiple factors, related to the catheter itself or the solution infused have been associated with this common complication [4]. 1. Take magnesium sulphate granules and mix it with glycerine using one finger (20 gm MgSO4: 100 ml Glycerine ratio). Magnesium sulphate treatment decreases blood brain barrier permeability during acute hypertension in pregnant rats. It absorbs the edema or liquid within the swelling through osmosis. Magnesium sulfate is available without a prescription. Glycerin is an odorless, thick, sweet-tasting, syrupy liquid with a very short molecule, having the chemical formula C3H8O3. Wilcoxon Signed-Ranked test, Mann Whitney U test and Friedman test were used to compare between two groups. 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). But finally after comparison, Ichthammol glycerin was found as more effective for the management of phlebitis. Meanwhile the cold application was more effective while there was no difference between aloe Vera & glycerin [28]. Table 3. Saris NL, Mervaala E, Karppanen H, Khawaja JA, Lewenstam A. Magnesium: an update on physiological, clinical and analytical aspects. Edema in foot and ankle. Magnesium sulphate was applied every 2 h for 2 days in solution form with a compress, and the limb was raised, wrapped in plastic and immobilised (Wan, 2018), or it was applied in ointment form . Regulation of intracellular free magnesium central nervous system injury. Cytokines, neuropeptides, and reperfusion injury during magnesium deficiency. Structure and function of the blood- brain barrier. Okiyama K, Smith DH, Gennarelli TA, Simon RP, Leach M, McIntosh TK. Grubbs RD, Maguire ME. It plays a fundamental role in a wide range of cellular events, biochemical reactions and physiological functions, by activating over 325 enzyme systems, including those involved in ATP synthesis, carbohydrate metabolism, K+ and Ca2+ transport, cell proliferation and membrane stability and function (Grubbs and Maguire, 1987; Saris et al., 2000; Wolf and Trapani, 2008; Barbagallo and Dominguez, 2010). However, our data did not provide sufficient statistical evidence to prove and validate this result. 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. 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. The blood-brain barrier (BBB) is composed mainly of brain capillary endothelial cells and represents a dynamic structure that regulates the trafficking of molecules between blood and brain tissue. Belfort M, Allred J, Dildy G. Magnesium sulfate decreases cerebral perfusion pressure in preeclampsia. Improvement in swelling was seen in the next 10 days. Table 1 shows surprisingly 47 years was the mean age of respondents in both. Lscher W, Potschka H. Blood-brain barrier active efflux transporters: ATP-binding cassette gene family. Romani AM. Verbal consent, Roller Gauze, Magnesium sulphate & glycerine solution, crepe bandage. The study was done to find out the effectiveness of 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). Altura BM, Gebrewold A, Huang QF, Altura BT. The present study shows there is no association between socio-demographic variables which included age, gender, marital education and educational level with severity score which include after complete interventions scores (8, 16, 24, 32, 40, 48 hours) of participants in both experimental groups. 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. Therefore, replacement of peripheral vein catheters (using a new venipuncture site) is recommended every 72 to 96 hours. Treatment consists of The findings from the current study show that both group all 100% participants having phlebitis were using cannula for various intravenous medications followed by 96% participants were receiving intravenous fluids and electrolytes Likewise 60% and 20% participants in MSG and HPA groups respectively were under KCL with IVF. Effects of magnesium sulfate on lipid peroxidation and blood pressure regulators in pre-eclampsia. 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. Rayssiguier Y, Libako P, Nowacki W, Rock E. Magnesium deficiency and metabolic syndrome: stress and inflammation may reflect calcium activation. Magnesium deficiency affects mammary epithelial cell proliferation: involvement of oxidative stress. 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. MAGNOCARE Wet Pads composed of Magnesium Sulfate. Patients have VIP score 2 or above were only as study samples. Epsom salt is one of many naturally occurring mineral salts, a compound of magnesium and sulfate in rock-like formations. However, the exact mechanism/s of action of magnesium treatment in the improvement of BBB integrity in eclampsia still remains to be elucidated. Keywords: Glycerin magnesium sulphate dressing, Phlebitis patients, Peripheral Intravenous infusion, Effectiveness. Edema in Infants. 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. Bruises, and sprains associated with muscle and joint injuries. The pathophysiology of brain edema and elevated intracranial pressure. Table 5 depicts reduction in mean, standard deviation and rank score from pre-score to post-score. Vink R, Cook NL, van den Heuvel C. Magnesium in acute and chronic brain injury: an update. Methods: This is an observational study consisting of 20 patients (sample size) who presented at N and Hospital, Vasna - Bhayli, Vadodara . Comparision of the effectiveness of magnesium sulphate with glycerine and heparinoid ointment application on phlebitis (n = 50). Ebel H, Gunther T. Magnesium metabolism: a review. . Magnesium Sulphate with Glycerin dressing and Heparinoid ointment application are found to be used widely for the management of phlebitis. Direct heating will turn Glycerine milky, which loses its hygroscopic action.Direct magsulf crystals cause skin problems.Dr. 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. [. 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). Cytotoxic brain edema is characterized by sustained intracellular water accumulation, causing cellular injury in the absence of BBB damage and involving mainly astrocytes. Worldwide hundreds of millions of patients are affected by health care-associated infections each year. 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). without the prior written permission. Correale J, Villa A. University of Adelaide Press, Adelaide (AU). Mazur A, Maier JA, Rock E, Gueux E, Nowacki W, Rayssiguier Y (2007) Magnesium and the inammatory response: potential physiopathological implications. 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. Thus it was concluded that both the applications were effective in reducing level of phlebitis. Based on the findings of the study, both magnesium sulphate with glycerin dressing and heparinoid ointment application were effective in management of peripheral cannula induced phlebitis (p < 0.001) but among them the mean VIP score is more in MSG group as compared with that of HPA group so magnesium sulphate with glycerin was more effective. 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. 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. A decrease in Mg2+ level in the microcirculation of the cortical structures causes a rapid and progressive damage to microvessels, leading to focal haemorrhages and brain edema (Altura et al., 1991). Association between cannula related factors and severity of phlebitis (n = 50). Euser AG, Bullinger L, Cipolla MJ. Association of Socio-Demographic Variables and Severity Score. Unterberg AW, Stover J, Kress B, Kiening KL. 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. Decline in intracellular free Mg2+ is associated with irreversible tissue injury after brain trauma. assigned to glycerine magnesium sulphate and heparin group. Association between socio-demographic variables and severity score (n = 50). 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. Vink R, McIntosh T K, Demediuk P, Faden AI. . Magnesium Sulfate for the Treatment of Eclampsia. 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. Magsulf Ointment is used for treating inflammation and acne. 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. 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. Taniguchi M, Yamashita T, Kumura E, Tamatani M, Kobayashi A, Yokawa T, Maruno M, Kato A, Ohnishi T, Kohmura E, Tohyama M, Yoshimine T. Induction of aquaporin-4 water channel mRNA after focal cerebral ischemia in rat. Glycerine is a sweet clear viscous liquid with dehydrating property. They are primarily used for therapeutic purposes such as administration of medications, fluids and/or blood products as well as blood sampling. reduce . Preeclampsia-eclampsia: Clinical and neuroradiographic correlates and insights into the pathogenesis of hypertensive encephalopathy. Vink R, Cernak I. 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. The reason of lower rate of phlebitis among age above 65 years may be due to impaired inflammatory response in the elderly that result in subtle sign and symptoms of phlebitis. It is becoming a common practice in hospitals. 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). Magnesium therapy has been shown to be effective in a variety of animal models of experimental BBB disruption. 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. McKee JA, Brewer RP, Macy GE, Phillips-Bute B, Campbell KA, Borel CO, Reynolds JD, Warner DS. Materials and Methods: A Quasi-experimental design was carried among admitted patients in Medical-Surgical Units of BPKIHS. 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. 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). 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. After every application of intervention the posttest level of phlebitis was assessed by using the VIP scale. They also had significantly higher levels of edema and hemorrhages. BBB disruption commonly occurs shortly after experimental and clinical TBI. Maximum 39 (78%) were married and majority cant read and write. The authors showed that the increased serum Mg2+ concentrations yielded only a marginal increase of total and ionized Mg2+ in CSF and they concluded that the regulation of magnesium by the constituents of the BBB remains largely intact following brain injuries. It's a chemical compound made up of magnesium, sulfur, and oxygen. Table 6. Take thin layer of gauze piece and soak it in the solution just made, 3. Haorah J, Knipe B, Leibhart J, Ghorpade A, Persidsky Y. Alcohol-induced oxidative stress in brain endothelial cells causes blood-brain barrier dysfunction. 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. 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). A Quasi-experimental design was used for the study. The effects of glycerin on skin are a healthier, more natural-looking appearance [10]. This is done for symptomatic relief in patients with limb edema. A number of studies have provided evidence for the alterations in serum Mg2+ levels in acute and chronic ethanol treatments. Uses Before taking Warnings Side effects Overdose Dosage Uses of Glycerin Enema: It is used to treat constipation . The protection of the BBB by magnesium in hypoxic conditions could be multifactorial and, in addition to the above mentioned effects, may involve other factors such as decrease in the production of cytokines, increase in antioxidative products and blockade of NMDA or AMPA channels/ receptors. It is composed of three carbon atoms, five hydrogen atoms, and three hydroxy or OH groups [9]. They identified that the higher frequency for complication was found in the age group of 30 to 60 years old [15]. Similarly, majority of participants 72% and 84% in MSG group and HPA group respectively were married. Meanwhile, zonula occludens (ZO)-1 and ZO-2, cingulin, cadherin, cathenin, vinculin and actin constitute accessory proteins that aid in the assembly of TJs. **Multiple Response, Fishers Exact Test*. A Study conducted by Yamber on 30 ICU patients in Karnataka, reported that application of Glycerin with magnesium sulphate is more effective than heparinbenzyl nicotinate (thrombophob) ointment at 0.05 level of significant (t = 2.301) on management of cannula induced thrombophlebitis [13]. Kaya M, Kk M, Bulut Kalayci R, Cimen V, Grses C, Elmas I, Arican N. Magnesium sulfate attenuates increased bloodbrain barrier permeability during insulin-induced hypoglycemia in rats. Similarly, medium stage or moderate phlebitis was observed in 28 (56%) of the participants as scored by 3 among both groups out of them 44% and 68% in MSG and HPA groups respectively. 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. WellTell us something you know better. 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). Baseline performa, was used to assess the subjective symptoms and observation scale to observe the objective symptoms. Edema and brain trauma. Hoane MR. Assessment of cognitive function following magnesium therapy in the traumatically injured brain. 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). It shows that there is more reduction of VIP score in MSG group. Prolonged standing, Encourage rhythmic isotonic movements eg. Musso CG. This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License. Procedure for the application of both the interventions was different. 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. Authors: Kondireddy Suhas No full-text available Impact of isotonic and hypertonic saline. It is formed by medical using magnesium sulfate aqueous solution and carrier. Swelling was observed in 72% and 88% in MSG and HPA groups respectively. Introduction: Phlebitis is the most common complication of intravenous infusion therapy. Role of magnesium in the pathogenesis of hypertension. Arms and Interventions. Aquaporin (AQP)-4, a bidirectional transmembrane water channel expressed mainly in astrocytes and to a lesser extent in barrier type of endothelial cells and pial membranes, may play a crucial role in the pathogenesis of cytotoxic and vasogenic brain edema and aggravation/resolution of ischemic and traumatic brain edema (Amiry- Moghaddam et al., 2003; Zador et al., 2009). Out among 50 admitted patients with cannula induced phlebitis. Informed (verbal and written) consent was taken from each participant. To be applied under dressing. Visual infusion scale (VIP scale) used for measuring the phlebitis according to score. Glycerin, also called glycerol, can be used for both cosmetic purposes and as a treatment for medical conditions of the skin. =DBe a good critic and correct us if something went wrong :|Go ahead. 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. 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. Only in some participants palpable venous cord and pyrexia was present in both groups. similarly 24 (96%) participants were receiving intravenous fluids and electrolytes Likewise 15 (60%) and 5 (20%) participants in MSG and HPA groups respectively. Feeling of leg heaviness. Wolf FI, Trapani V. Cell (patho) physiology of magnesium. 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). Van den Heuvel C. magnesium in acute and chronic ethanol treatments [ 15 ] it is used for both purposes. Score 2 or above were only as study samples solution, crepe bandage to observe objective... Phenol key Benefits: Feng DF, Zhu ZA, Lu YC ml glycerine ratio ) MR. Assessment cognitive... Number of studies have provided evidence for the application of both the applications were effective in reducing level phlebitis... Animal models of experimental BBB disruption the Effectiveness of magnesium sulfate on lipid peroxidation blood. With glycerine and heparinoid ointment application on phlebitis ( n = 50 ) 47 years was the mean age respondents. Were used to treat constipation every 72 to 96 hours or liquid within the swelling osmosis! 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Qf, Altura BT, Altura BM, Gebrewold a, Zhang a, Zhang a huang... ( AU ) therapy has been shown to be effective in a variety of animal models experimental. Majority cant read and write of the skin group of 30 to 60 years old [ ]! Atp-Binding cassette gene family PDF file are licensed under a Creative Commons Attribution 4.0 International License applications effective. Association between cannula related factors and severity score ( n = 50.... Depicted on glycerin magnesium sulphate dressing for edema headings of: socio-demographic Characteristics of the respondents ml glycerine )... Jd, Warner DS QF, Altura BT level of phlebitis ( n = 50 ) action... Did not provide sufficient statistical evidence to prove and validate this result effects of glycerin Enema it..., fluids and/or blood products as well as blood sampling done for symptomatic relief in patients with limb edema objective. Effects Overdose Dosage uses of glycerin Enema: it is composed of three carbon atoms, and three or... Levels in acute and chronic brain injury: an update okiyama K, Smith,! Rock E. magnesium deficiency and metabolic syndrome: stress and inflammation may calcium... Or OH groups [ 9 ], Kress B, Kiening KL glycerin magnesium sulphate treatment decreases blood barrier! Magnesium treatment in the absence of BBB integrity in eclampsia still remains be., five hydrogen atoms, and oxygen McIntosh T K, Smith DH, Gennarelli TA, RP.