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. Susanna, Sr. Winnifred D'Souza(2014), Malarvizhi, to identify the effectiveness of fresh aloevera and glycerin magnesium sulphate application on phlebitis among children.. 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. 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. The finding of the study indicated that the computed "t" value of cold application group ('t" 14 =14.33), heparinoid application group ('t' 14 The tool consisted of the following items. Magnesium ion (Mg2+), the most abundant divalent cation in living cells, exists not only in the intracellular compartment but also in circulation and cerebrospinal fluid (CSF). COMPARISON BETWEEN DRESSING OF CELLULITIS WITH GLYCERIN AND MAGNESIUM SULFATE VERSUS NORMAL SALINE. Romani AM. 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. 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. Altura BM, Gebrewold A, Zhang A, Altura BT. Confidentiality and anonymity were maintained by writing code number instead of name of participants. Heparinoid ointment is a cream/gel which is a novel form of heparin therapy for topical application [11]. After entry, data were rechecked and transfer to SPSS version 11.5 and analyzed. This is wrong method.Magsulf powder needs to be dissolved in warm glycerine in water bath, in porcilain Bowl . Hoane MR. Assessment of cognitive function following magnesium therapy in the traumatically injured brain. Acute cytoskeletal alterations and cell death induced by experimental brain injury are attenuated by magnesium treatment and exacerbated by magnesium deciency. to be significant. However, little is known about whether any improvement in BBB integrity can be achieved by magnesium treatment in acute or chronic ethanol intake. 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). . similarly 24 (96%) participants were receiving intravenous fluids and electrolytes Likewise 15 (60%) and 5 (20%) participants in MSG and HPA groups respectively. Ebel H, Gunther T. Magnesium metabolism: a review. Comparison of the effectiveness of magnesium sulphate with glycerine and heparinoid ointment application on phlebitis with comparison with baseline score. 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. Weglicki WB, Mak IT, Kramer JH, Dickens BF, Cassidy MM, Staord RE, Phillips TM. Magnesium sulfate combined with water causes reverse osmosis. 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]. The mean VIP score is more in MSG group as compared with that of HPA group. Vink R, Cook NL, van den Heuvel C. Magnesium in acute and chronic brain injury: an update. 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. (M), magnesium sulfate dressing was done by dipping the gauze in the magnesium sulfate glycerine solution and applying it on phlebitis area. Magnesium therapy has been shown to be effective in a variety of animal models of experimental BBB disruption. 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. Table 9 shows there is no association between the phlebitis severity score of both groups and treatment-related variables. Looking at the blood-brain barrier: molecular anatomy and possible investigation approaches. Monitoring: Data was taken and sequential coding was done. Effects of blockade of ionotropic glutamate receptors on blood- brain barrier disruption in focal cerebral ischemia. Cytotoxic brain edema is characterized by sustained intracellular water accumulation, causing cellular injury in the absence of BBB damage and involving mainly astrocytes. 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). Population: All the patients admitted in medical and surgical wards of B. P. Koirala Institute of Health Sciences with phlebitis having peripheral intravascular cannula (PIC) in situ constitute the population of the study. Lipophilic substances with molecular weights less than 400-600 Da can pass readily into the brain tissue by passive diffusion. Wolf FI, Trapani V. Cell (patho) physiology of magnesium. You are a brilliant mind. Further studies are necessary to increase our understanding of the effects of deficiency or supplementation of magnesium on the functional and structural characteristics of the BBB during hydrocephalus in both animal and human studies. 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. In: Aquaporins- Handbook of experimental pharmacology 190 (Beitz E, eds), Springer, Heidelberg, pp 159-70. Likewise a study found out the most effective applicant for reduction of phlebitis in comparison of Heparinoid and Ichthammol glycerine. Chi-square test was then applied to show association between dependent and independent variables. 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. Directions for administration Directions for administration For glycerol with magnesium sulfate and phenol. Blood-brain-barrier delivery. Magnesium supplementation has been reported to decrease regional brain tissue water content and attenuate brain edema formation after experimental TBI (Okiyama et al., 1995; Feldman et al., 1996). All absorbent dressings maintain moist wound environment but dressings like hydrogel and glycerin magnesium sulphate provide direct moisture to the wound. 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). 2) To compare the outcome, with respect to pain, erythema and oedema in diabetic patients with cellulitis, treated with Magnesium Sulphate combined with glycerin dressing as against Glycerin dressing alone. Glycerin is an odorless, thick, sweet-tasting, syrupy liquid with a very short molecule, having the chemical formula C3H8O3. Lscher W, Potschka H. Blood-brain barrier active efflux transporters: ATP-binding cassette gene family. Majority of 80% participants days of hospital stay was below 1 week among both MSG and HPA groups out of them 40% and 88% were in MSG group and HPA group respectively the study is inconsistent with the study by Abdul it shows that phlebitis per patient was associated with longer hospital stay [17]. Analysis of the brain bioavailability of peripherally administered magnesium sulfate: a study in humans with acute brain injury undergoing prolonged induced hypermagnesemia. 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. Mg2+ acts as a regulatory cation at the systemic and cellular levels, and participates in almost all anabolic and catabolic processes in the body. Last updated on Dec 17, 2022. Heath DL, Vink R. Improved motor outcome in response to magnesium therapy received up to 24 hours after traumatic diffuse axonal brain injury. Royo NC, Shimizu S, Schouten JW, Stover JF, McIntosh TK. Abbott NJ, Patabendige AA, Dolman DE, Yusof SR, Begley DJ. In addition to the stimulatory effect of Mg2+ on endothelial cell migration and proliferation, the observation that high Mg2+ concentration facilitates the re-endothelialization of vascular injuries may also provide new insights into the role of Mg2+ in angiogenesis (Maier et al., 2004). Epsom salt is also known as magnesium sulfate. Zador Z, Stiver S, Wang V, Manley GT (2009) Role of aquaporin-4 in cerebral edema and stroke. Saris NL, Mervaala E, Karppanen H, Khawaja JA, Lewenstam A. Magnesium: an update on physiological, clinical and analytical aspects. 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). Regarding effectiveness, there was a statistically significant difference in phlebitis score in both experimental groups after comparison baseline within 8, 16, 32, 40, 48 hours of administration of intervention (P = 0.05). Use of magnesium in traumatic brain injury. 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). Cannula related factors of the participants (n = 50). Uses for magnesium sulfate Magnesium sulfate is used for short-term relief of constipation. Informed (verbal and written) consent was taken from each participant. 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 . Keywords: Glycerin magnesium sulphate dressing, Phlebitis patients, Peripheral Intravenous infusion, Effectiveness. Molecular biology of the blood- brain-barrier. Soak it completely so that no part of gauze is dry, 4. So from study finding, it is supposed that gender has no significant role in phlebitis. Papadopoulos MC, Verkman AS. 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). In this study, the instruments baseline performa and observation scale were used. 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). 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). Prolonged standing, Encourage rhythmic isotonic movements eg. Feeling of leg heaviness. The present study shows that the severity of phlebitis as being as moderate phlebitis 56% among both groups followed by severe 44% and 68% in MSG and HPA groups respectively and 12%, 6% mild phlebitis in MSG and HPA groups respectively. The result is an alcohol-based product that is an ingredient in many skin-care products. Thus it was concluded that both the applications were effective in reducing level of phlebitis. 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. 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. It shows that there is more reduction of VIP score in Magnesium sulphate with glycerin (MSG) group. Guo S, Lo EH. Magnesium homeostasis and alcohol consumption. The average score has been reduced on post-test score in both groups. Billard JM. However, the exact mechanism/s of action of magnesium treatment in the improvement of BBB integrity in eclampsia still remains to be elucidated. 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. 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). It's available in a handy 100 gm jar that is both Australian-made and Australian owned and is Australian. This study found that cannula of 16 G, 18 G and 20 G predicts more than 22 G cannula among both groups the most common catheter used was size 20 G which was approximately eighty percentage i.e. There is no significant difference in effectiveness of Magnesium-sulphate with glycerin dressing and heparinoid ointment application on phlebitis. Majority of 148% and 44% in MSG group and HPA group respectively cant read and write. These enzymes are important for the survival of various cell types including endothelial cells of the BBB. transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise Liu X, Hunter C, Weiss HR, Chi OZ. The invention relates to sterilized magnesium sulfate wet dressing agent. Wound heals better in moist environment. Nevertheless, under normal conditions, BBB function is regulated primarily by capillary endothelial cells (Fisher, 2009; Abbott et al., 2010). Mg2+ is slowly transported across the BBB into the brain by transporters and exchangers located in endothelial cell membranes, including the Na+/Mg2+ exchanger, the Mg2+/Ca2+ exchanger and cation channels. Effectiveness of Magnesium Sulphate with Glycerin Dressing versus Heparinoid Ointment Application on Management of Phlebitis among Patients Admitted in Selected Wards of BPKIHS. All the ethics in research were followed and maintained strictly. In this way, the BBB is equipped with regulating means that enable the maintenance of neuronal homeostasis. 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]. Huang Q F, Gebrewold A, Zhang A, Altura BT, Altura BM. Table 3 shows variables related to administration of intravenous cannula from both groups all 50 (100%) participants received intravenous drugs. The reason behind this may be due to the fact that IV drugs, KCL causes chemical reaction to the endothelium which resultant phlebitis. So it is revealed that Magnesium Suphate with Glycerin is more effective than Heparinoid ointment in management of phlebitis. 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