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. The tool consisted of the following items. Magnesium sulphate with glycerin dressing was used by using soaked gauze pieces. Finally, data will be preserved for at least five years. Almost equal number of participants were from both gender 24 (48%) and 26 (52%) from male and female gender respectively. Purpose of intravenous cannula in the participants (n = 50). 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. Vink R, McIntosh TK, Demediuk P, Weiner MW, Faden AI. Stretched or shiny skin. 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). Royo NC, Shimizu S, Schouten JW, Stover JF, McIntosh TK. A study conducted in India by Saini [23] found grade 2 or mild phlebitis (46%) higher than grade 3 or moderated (44%) phlebitis. COMPARISON BETWEEN DRESSING OF CELLULITIS WITH GLYCERIN AND MAGNESIUM SULFATE VERSUS NORMAL SALINE. 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. Socio-demographic characteristics of the participants (n = 50). Association of Socio-Demographic Variables and Severity Score. Effectiveness of Magnesium Sulphate with Glycerin and Heparinoid Ointment Application on Phlebitis. The above-mentioned beneficial effects of magnesium on BBB integrity may be related to its ability to scavenge free radicals. to be significant. 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. 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. Decline in intracellular free Mg2+ is associated with irreversible tissue injury after brain trauma. ALL comments that are not spam will be published on the website. 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). 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. 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. Cover it well with crepe bandage, you can cover this by stockings, Avoid static isometric activities eg. This topic discusses on the main findings of the present study and these are discussed with regards to findings of other relevant studies. 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). Where you type create something beautiful! This is express yourself space. Chaon A, Lisott E, Eblen-Zajjur A. Magnesium sulphate reduces cell volume in physiological conditions but not in the cytotoxic oedema during global brain ischemia. In this way, the BBB is equipped with regulating means that enable the maintenance of neuronal homeostasis. However there are no more studies to support this finding. 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). Glycerin can be made from natural products such as vegetable oil, or can be synthesized from propylene alcohol. 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). 25 participants in Group B (application of Heparinoid ointment). Increase in free radical concentration in ethanol-treated endothelial cells leads to phosphorylation of TJ proteins, activation of paracellular pathway and thus disruption of the BBB (Haorah et al., 2005). Add your e-mail address to receive free newsletters from SCIRP. After entry, data were rechecked and transfer to SPSS version 11.5 and analyzed. Incidence rate of phlebitis was associated with male sex, between 21 to 40 years of age, small Gauze catheter size, inmserted at fore arm, IV drug administration and blood product transfusion [7]. When regulating its own activities, the mature BBB receives support from at least three different cell types: 1) pericytes which share the same basement membrane with endothelial cells; 2) astrocytes which envelope 99% of the abluminal face of endothelial cells; and 3) neurons (Guo and Lo, 2009; Correale and Villa, 2009). Table 1 Results of investigations in case 1 and case 2 The finding is consistent with that of study conducted in Intensive care unit (ICU) of Susa city Hospital conducted on 224 patients. 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. 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). These enzymes are important for the survival of various cell types including endothelial cells of the BBB. Thyroxine dose was adjusted, a gluten-free diet was advised, and basal-bolus treatment with glargine and lispro was started. WellTell us something you know better. 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. 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). Billard JM. Lscher W, Potschka H. Blood-brain barrier active efflux transporters: ATP-binding cassette gene family. Zador Z, Stiver S, Wang V, Manley GT (2009) Role of aquaporin-4 in cerebral edema and stroke. Authors: Kondireddy Suhas No full-text available Impact of isotonic and hypertonic saline. However, our data did not provide sufficient statistical evidence to prove and validate the result. 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. McKee JA, Brewer RP, Macy GE, Phillips-Bute B, Campbell KA, Borel CO, Reynolds JD, Warner DS. Heath DL, Vink R. Improved motor outcome in response to magnesium therapy received up to 24 hours after traumatic diffuse axonal brain injury. Wolf FI, Trapani V, Simonacci M, Boninsegna A, Mazur A, Maier JA. The difference between pre and post-treatment score was found to be significant. An equal number of participants were taken having medical and surgical problems. Magnesium therapy has been shown to be effective in a variety of animal models of experimental BBB disruption. 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). Symptoms of edema include: Swelling or puffiness of the tissue right under the skin, especially in legs or arms. Results: The study findings revealed significantly reduction of phlebitis score after 48 hours of treatment with both interventions. Magnesium homeostasis and alcohol consumption. Vink R, Cook NL, van den Heuvel C. Magnesium in acute and chronic brain injury: an update. Peripheral vascular catheter insertion sites should be monitored at a minimum of each shift using a recognized Visual Infusion Phlebitis (VIP) scale for measuring degrees or severity of phlebitis [3]. In: Aquaporins- Handbook of experimental pharmacology 190 (Beitz E, eds), Springer, Heidelberg, pp 159-70. 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. 1. Pathology and new players in the pathogenesis of brain edema. Yes, you are! It's been shown to be effective for these uses: control rapid heartbeat. primary physiological response to trauma, thus minimizing the barrier to wound healing an facilitates tissue repair. If left untreated may lead to infection or thrombus formation. M . Edema and brain trauma. Insect bites. It shows that there is more reduction of VIP score in Magnesium sulphate with glycerin (MSG) group. Sanjeevanee kelkar. 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). Likewise a study found out the most effective applicant for reduction of phlebitis in comparison of Heparinoid and Ichthammol glycerine. The average score was reduced on post-treatment score in both groups. Magnesium sulfate combined with water causes reverse osmosis. Although the BBB appears to possess a static structure, it has the ability to adapt readily to sudden changes. This is done for symptomatic relief in patients with limb edema. Out of 100 hospitalized patients at any given time, 7 in developed and 10 in developing countries will acquire at least one health care-associated infection [6]. Nurses need to have adequate knowledge and skill regarding cannula induced phlebitis management and its complication prevention. The mean VIP score is more in MSG group as compared with that of HPA group. Out among 50 admitted patients with cannula induced phlebitis. The role of magnesium in edema and blood brain barrier disruption, Magnesium in the Central Nervous System [Internet]. Ravishankar S, Ashraf QM, Fritz K, Mishra OP, Delivoria-Papadopoulos M. Expression of Bax and Bcl-2 proteins during hypoxia in cerebral cortical neuronal nuclei of newborn piglets: effect of administration of magnesium sulfate. Swelling was observed in 72% and 88% in MSG and HPA groups respectively. No complication was observed, healing was faster and reduced hospital stay. 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. Similarly, there was no significant association between magnesium sulphate with glycerin dressing and heparinoid ointment application on management of phlebitis with selected socio-demographic variables and cannula related factors. Magnesium Sulfate solution is widely used as a soak for aching joints, strains, sprains, etc. 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). Check Interpret Media out if you are looking for an illustrator. 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. Descriptive statistics such as mean, standard deviation, rank were used to present socio-demographical, health-related, cannula and infusion-related variables. Feeling of leg heaviness. Maximum 39 (78%) were married and majority cant read and write. 2. Barbagallo M, Dominguez LJ. 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 . Both procedure were repeated 3 times a day at interval of 8 hours continuously for 2 days. 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