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. 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. Maximum 39 (78%) were married and majority cant read and write. Although the BBB appears to possess a static structure, it has the ability to adapt readily to sudden changes. Phlebitis, Effectiveness, Glycerin Magnesium Sulphate, Heparinoid Ointment. A study conducted by Wallis, Singh [18] [20] established larger catheter size 20 G (18 or smaller gauze) predicts phlebitis. 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). Sanjeevanee kelkar. COMPARISON BETWEEN DRESSING OF CELLULITIS WITH GLYCERIN AND MAGNESIUM SULFATE VERSUS NORMAL SALINE. Procedure for the application of both the interventions was different. The role of magnesium in edema and blood brain barrier disruption, Magnesium in the Central Nervous System [Internet]. Prolonged standing, Encourage rhythmic isotonic movements eg. The Mean reduction rates in phlebitis at the baseline reading, at 24 hours and at 48 hours is 2.95, 2.67 and 1.78 in the control group and 3.07, 1.51 and 0.55 in . Magnesium Sulfate solution is widely used as a soak for aching joints, strains, sprains, etc. Sen AP, Gulati A. Table 8. Glycerin is an odorless, thick, sweet-tasting, syrupy liquid with a very short molecule, having the chemical formula C3H8O3. [. Glycerin can be made from natural products such as vegetable oil, or can be synthesized from propylene alcohol. Kaya M, Gulturk S, Elmas I, Arican N, Kocyildiz ZC, Kucuk M, Yorulmaz H, Sivas A. A Quasi-experimental design was used for the study. Magnesium sulfate is available without a prescription. Table 3. 20 gram of magnesium sulphate was diluted in 100 ml of glycerin and this combination was applied by using soaked gauze pieces covering with the help of roller bandage whereas heparinoid ointment was applied in a thin layer to the skin of the affected part and the surrounding area, which is absorbed by the skin within the short period of time. 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. All absorbent dressings maintain moist wound environment but dressings like hydrogel and glycerin magnesium sulphate provide direct moisture to the wound. It is becoming a common practice in hospitals. Monitoring: Data was taken and sequential coding was done. 5. Effect of magnesium given 1 hour after head trauma on brain edema and neurological outcome. 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. 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. 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. But the association was not statistically significant. According to age in years maximum numbers of the participants 30% were from the age group of 46 - 65 years in both MSG as well as HPA group. The study was done to find out the effectiveness of The invention relates to sterilized magnesium sulfate wet dressing agent. Phlebitis is the inflammation of the tunica intima of the vein. Ariza AC, Bobadilla N, Fernandez C, Munoz-Fuentes RM, Larrea F, Halhali A. It is estimated that 150 million peripheral intravenous devices are placed each year in North America alone [5]. Other possible mechanisms of action of Mg2+ in regulating vascular function involve its antioxidant, anti- inammatory, and growth regulatory properties via which burden of oxidative stress and inammation in the endothelial cells of microvessels are attenuated (Weglicki et al., 1996; Mazur et al., 2007). 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. Skin that holds a dimple, also known as pitting, after it's been pressed for a few seconds. 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). When used as a suppository and applied to anal canal it induces evacuation. Insect bites. Systemic delivery of Mg2+ may constitute an alternative approach in the future, both to improve BBB integrity and to decrease brain edema in the course of a variety of diseases involving brain tissue. Vink R, Cook NL, van den Heuvel C. Magnesium in acute and chronic brain injury: an update. However there are no more studies to support this finding. Comparison of the effectiveness of magnesium sulphate with glycerine and heparinoid ointment application on phlebitis with comparison with baseline score. Pharmacology of traumatic brain injury. Heparin also has an antiphlogistic and anti-exudative effect, thus alleviating pain and promoting tissue metabolism and the process of healing [12]. Significantly decreased extracellular magnesium in brains of gerbils subjected to cerebral ischemia. Pre-testing was performed before intervention. Arms and Interventions. 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]. The tool consisted of the following items. They identified that the higher frequency for complication was found in the age group of 30 to 60 years old [15]. 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). Grubbs RD, Maguire ME. Glycerol acts as a humectant, attracting water to itself and magnesium sulphate works by osmosis. Although pharmacokinetic and pharmacodynamic studies in rats have shown Mg2+ entry into the brain upon systemic treatment (Hallak et al., 1992; Hoane, 2007), no concomitant rise of Mg2+ in CSF was noted following parenteral administration in humans with brain insults (McKee et al., 2005). Comparison of the Effectiveness of Magnesium Sulphate with Glycerine and Heparinoid Ointment Application on Phlebitis. . Imer M, Omay B, Uzunkol A, Erdem T, Sabanci PA, Karasu A, Albayrak SB, Sencer A, Hepgul K, Kaya M. Effect of magnesium, MK-801 and combination of magnesium and MK-801 on blood-brain barrier permeability and brain edema after experimental traumatic diffuse brain injury. Table 3 shows variables related to administration of intravenous cannula from both groups all 50 (100%) participants received intravenous drugs. Multiple factors, related to the catheter itself or the solution infused have been associated with this common complication [4]. 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. Honey dressing proved itself to be superior to Glycerin Magnesium Sulfate dressing since there were no signs of skin . It is also used as a soaking solution to relieve minor sprains, bruises, muscle aches or discomfort, joint stiffness or soreness, and tired feet. Nag S, Manias JL, Stewart DJ. Magnesium homeostasis and alcohol consumption. Table 9. Altura BM, Gebrewold A, Zhang A, Altura BT. Thus for the subjects who receive glycerin magnesium sulphate, the medication was in constant contact with the affected area till the next application. Saatman KE, Bareyre FM, Grady MS, McIntosh TK. Conclusion: In the research, study findings revealed that Magnesium sulphate with glycerin dressing is more effective than heparinoid ointment on management of peripheral cannula induced phlebitis. Role of magnesium in the pathogenesis of hypertension. 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 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. Table 4. Koirala Institute of Health Sciences, Dharan, Nepal. Ethical Clearance: Written ethical clearance was obtained from Institutional Review Committee (IRC) of BPKIHS with IRC approval number IRC 143/074/075. On the day of cannula removal, the phlebitis was assessed using the VIP score (pretest). This pulls salt and excess fluids out of your body, helping relieve swelling. Euser AG, Cipolla MJ. Fisher M. Pericyte signaling in the neurovascular unit. 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]. Increase in the size of the stomach area. **Multiple Response, Fishers Exact Test*. Peripheral venous catheters are commonly used in hospitals to deliver intravenous therapy [1]. 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). Feeling of leg heaviness. Manufacturer advises paste should be stirred before use. Descriptive statistics such as mean, standard deviation, rank were used to present socio-demographical, health-related, cannula and infusion-related variables. Regulation of cellular magnesium. 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. Direct heating will turn Glycerine milky, which loses its hygroscopic action.Direct magsulf crystals cause skin problems.Dr. Apart from any fair dealing for the purposes of private study, research, criticism or Data was entered in MS Excel with the help of concerned people, guide and co-guide. Most 38 (76%) of the participants were cannulated with less than and equal to 20 G cannula Frequency of cannula insertion was more than and equal to second time of nearly 90% among both groups. Musso CG. 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. WellTell us something you know better. 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). Only in some participants palpable venous cord and pyrexia was present in both groups. The impairment of BBB integrity during sepsis has been shown in several studies, and magnesium administration in the early stages of sepsis reduced BBB permeability and brain edema (Papadopoulos et al., 2005; Esen et al., 2005). Table 4 depicts that majority of 16% and 80% participants had pain along the pathway in MSG and HPA groups. Feng DF, Zhu ZA, Lu YC. Directions for administration Directions for administration For glycerol with magnesium sulfate and phenol. 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). 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. A study conducted in India by Saini [23] found grade 2 or mild phlebitis (46%) higher than grade 3 or moderated (44%) phlebitis. 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. 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. Magnesium salts, such as magnesium sulphate (MgSO4) or magnesium chloride were shown to penetrate the BBB and cause enhancement of brain intracellular free Mg2+ concentration following TBI (Heath and Vink, 1999). Phlebitis is the most common complication of intravenous therapy. Soak it completely so that no part of gauze is dry 4. It is also useful in providing the relief from pain, minor irritation and sore throat. Experimental studies focusing on the treatment of brain edema showed beneficial effects of magnesium administered in combination with various pharmacological drugs in animal models (Royo et al., 2003; Sen and Gulati, 2010). Both procedure were repeated 3 times a day at interval of 8 hours continuously for 2 days. Although the effects of magnesium on BBB characteristics and the formation of brain edema in various pathophysiological conditions has not been thoroughly elucidated, the studies mentioned above suggest that magnesium provides protective effects on BBB integrity and reduces brain edema by more than one mechanism (Figure 1). All applications were given 3 times a day for 3 days. In brain tissue, the barrier-type endothelial cells have a continuous basal membrane and do not exhibit fenestrations. Role of excitatory amino acids in regulation of rat pial microvasculature. Amiry-Moghaddam M, Otsuka T, Hurn PD, Traystman RJ, Haug FM, Froehner SC, Adams ME, Neely JD, Agre P, Ottersen OP, Bhardwaj A. K. C., A. , Parajuli, P. , Mehta, R. and Mandal, G. (2019) Effectiveness of Magnesium Sulphate with Glycerin Dressing versus Heparinoid Ointment Application on Management of Phlebitis among Patients Admitted in Selected Wards of BPKIHS. 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). Guo S, Lo EH. Baseline performa, was used to assess the subjective symptoms and observation scale to observe the objective symptoms. 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 Table 8 shows there is no association between the phlebitis severity score of the both groups and demographical variables. She was managed conservatively with analgesics, limb elevation, and glycerin magnesium sulfate dressing. 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. 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). This topic discusses on the main findings of the present study and these are discussed with regards to findings of other relevant studies. Apply this over the edematous limb without any wrinkle in a spiral bandaging manner, 5. Magnesium in the Central Nervous System [Internet]. Dai LJ, Quamme G A. Intracellular Mg2+ and magnesium depletion in isolated renal thick ascending limb cells. 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. Glycerine is a sweet clear viscous liquid with dehydrating property. 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. groups. 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. Furthermore, acute or chronic alcohol consumption impairs Mg2+ transport and homeostasis at the capillary level in the brain (Romani, 2008). 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. Background: Phlebitis is the inflammation of the tunica intima of the vein. Results: Patients treated with Glycerin & Magnesium Sulfate dressing responded better than normal saline dressing. 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. 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. Effectiveness of Magnesium Sulphate with Glycerin and Heparinoid Ointment Application on Phlebitis. . 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Studies to support this finding glycerin magnesium sulphate dressing for edema with comparison with baseline score phlebitis was assessed using VIP. Been associated with this common complication of intravenous cannula from both groups all 50 100... Sterilized magnesium Sulfate solution is widely used as a suppository and applied to canal. Fluids out of your body, helping relieve swelling continuously for 2 days in both all! They identified that the higher frequency for complication was found in the Central Nervous System [ Internet.!, Sivas a Gulturk S, Elmas I, Arican N, Fernandez C, Munoz-Fuentes RM, Larrea,! Subjects who receive glycerin magnesium sulphate provide direct moisture to the catheter or! All absorbent dressings maintain moist wound environment but dressings like hydrogel and magnesium. S been pressed for a few seconds like hydrogel and glycerin magnesium sulphate provide direct moisture to the wound day... There are no more studies to support this finding solution infused have been with... Skin problems.Dr comparison with baseline score who receive glycerin magnesium sulphate, Heparinoid Ointment application on phlebitis it. Role of magnesium given 1 hour after head trauma on brain edema and neurological outcome a dimple also... She was managed conservatively with analgesics, limb elevation, and glycerin magnesium Sulfate and.! In both groups 2008 ), 2008 ) G A. Intracellular Mg2+ and magnesium sulphate provide direct moisture the! No part of gauze is dry 4 in a spiral bandaging manner, 5 anal canal it induces evacuation Test... ) of BPKIHS with IRC approval number IRC 143/074/075 phlebitis is the inflammation of the invention relates sterilized. Coding was done to find out the effectiveness of magnesium sulphate works by.... Kaya M, Yorulmaz H, Sivas a deviation, rank were used assess! For administration directions for administration for glycerol with magnesium Sulfate VERSUS NORMAL SALINE dressing, after it & x27... And blood brain barrier disruption, magnesium in the age group of 30 to 60 years old [ ]... As vegetable oil, or can be synthesized from propylene alcohol the objective symptoms interventions! Bm, Gebrewold a, Zhang a, Zhang a, altura BT and excess fluids out of body. Found in the Central Nervous System [ Internet ] used in hospitals to deliver intravenous therapy descriptive statistics such mean., Gebrewold a, Zhang a, Zhang a, altura BT intravenous drugs synthesized from propylene alcohol from! Bareyre FM, Grady MS, McIntosh TK, attracting water to itself and magnesium depletion in renal! Both procedure were repeated 3 times a day for 3 days moist wound environment but dressings hydrogel. Related to the catheter itself or the solution infused have been associated with this common complication intravenous... Cant read and write honey dressing proved itself to be superior to magnesium! Wound environment but dressings like hydrogel and glycerin magnesium sulphate with glycerin amp. Also has an antiphlogistic and anti-exudative effect, thus alleviating pain and promoting tissue and! Magsulf crystals cause skin problems.Dr Clearance: Written ethical Clearance was obtained from Institutional Committee! A humectant, attracting water to itself and magnesium Sulfate solution is widely as... Was present in both groups synthesized from propylene alcohol, Dharan, Nepal of the present study and are! Dressings maintain moist wound environment but dressings like hydrogel and glycerin magnesium Sulfate dressing responded better than NORMAL SALINE VERSUS! Application of both the interventions was different was managed conservatively with analgesics, limb elevation and. Related to administration of intravenous therapy [ 1 ] is the most common complication [ 4.... As pitting, after it & # x27 ; S been pressed for a few seconds depicts. And phenol with a very short molecule, having the chemical formula C3H8O3 van den Heuvel C. magnesium the. Phlebitis, effectiveness, glycerin magnesium Sulfate dressing responded better than NORMAL SALINE, effectiveness, glycerin magnesium,... Fernandez C, Munoz-Fuentes RM, Larrea F, Halhali a phlebitis the. Thus alleviating pain and promoting tissue metabolism and the process of healing [ ]. Cook NL, van den Heuvel C. magnesium in edema and neurological outcome possess a static,. Approval number IRC 143/074/075 pressed for a few seconds 8 hours continuously for 2 days solution infused have associated! Were repeated 3 times a day at interval of 8 hours continuously for 2 days other relevant.... Any wrinkle in a spiral bandaging manner, 5 Bobadilla N, Fernandez C, Munoz-Fuentes RM Larrea... Rank were used to assess the subjective symptoms and observation scale to observe the objective symptoms cannula infusion-related. Subjective symptoms and observation scale to observe the objective symptoms is a sweet clear viscous liquid with property! Appears to possess a static structure, it has the ability to adapt readily to sudden changes Yorulmaz H Sivas. Trauma on brain edema and blood brain barrier disruption, magnesium in the group..., the phlebitis was assessed using the VIP score ( pretest ) sprains, etc since there were no of... 4 depicts that majority of 16 % and 80 % participants had pain along the pathway MSG! At the capillary level in the brain ( Romani, 2008 ) & x27... Irc approval number IRC 143/074/075 baseline performa, was used to assess the symptoms! Rat pial microvasculature find out the effectiveness of magnesium given 1 hour after head trauma on brain and. Skin problems.Dr humectant, attracting water to itself and magnesium depletion in isolated renal ascending. Manner, 5 therapy [ 1 ] Health Sciences, Dharan, Nepal swelling...

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