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Omeprazole, a Proton pump inhibitor, is widely prescribed in patients with chronic gastroesophageal reflux. Patients continue to use omeprazole for long period of time even without the supervision of the doctor. The authors report a 50-year-old male patient with a 5-year history of omeprazole use, who complained of chest discomfort. ECG on admission showed atrial fibrillation. Laboratory findings showed hypomagnesaemia, hypocalcaemia, and hypokalemia. The case report emphasizes the importance of patient education regarding the use and adverse drug reactions of the prescribed medications.
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Introduction: In developing nations, the increased prevalence of type 2 diabetes mellitus (T2DM) has resulted in significant morbidity and socioeconomic consequences. Hypomagnesemia has been associated with insulin resistance and related micro- vascular consequences due to its ability to trigger hyperglycemia. Although many research articles on glycemic control have been published in recent years, the latest therapeutic approaches may not be feasible to all. As a result, prioritising preventative and primary care research becomes critical. Aim and objective: The study is aimed at estimating serum magnesium concentration and glycated hemoglobin (HbA1c) levels in patients with Type 2 Diabetes mellitus. This will help us evaluate how glycemic control in Diabetes can influence serum Magnesium levels. Method: The study consists of 50 consenting patients who came for routine blood investigations. Those patients having high random blood sugar were selected and divided into two groups based on their age. i.e. 25-50, 51-75. Other parameters con- sidered were age, gender and diet. After an overnight fasting, blood of the consenting patient was collected. Magnesium was measured by Cobas 6000 using the calorimeter end-point method. The other blood sample was transferred into an EDTA test tube which was used to estimate HbA1c level. Result: Participants were divided into two groups based on their age. i.e. 25-50, 51-75. The mean serum magnesium levels were 1.46 mg/dL for group 1 and 1.3 mg/dL for group 2. The mean HbA1c levels for group 1 were 7.65 and and 8.36 for group 2 respectively. According to Pearson’s correlation coefficient, inverse correlation was found between HbA1c levels and Serum magnesium levels. Conclusion: Magnesium insufficiency has been linked to a higher incidence of diabetic due to poor glycemic management in people with diabetes. To avoid such problems and maintain glycemic control, dietary supplements may be recommended. Large-scale clinical research is also required.
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RESUMEN Introducción: El síndrome de Gitelman es una tubulopatía caracterizada por alcalosis metabólica hipopotasémica, hipomagnesemia e hipocalciuria. Sus efectos musculoesqueléticos son comunes, pudiendo provocar desarrollo de condrocalcinosis. Caso clínico: Paciente con condrocalcinosis de larga data asociada a hipomagnesemia crónica en tratamiento con calcio y magnesio. Tras la suspensión del tratamiento debido a una intervención quirúrgica presentó debilidad generalizada, alcalosis metabólica, hipopotasemia, hipomagnesemia e hipocalciuria con diagnóstico final de síndrome de Gitelman. Tras la instauración de tratamiento, mejoró clínica y analíticamente manteniendo cifras iónicas estables. Discusión y conclusiones: Resulta fundamental un adecuado diagnóstico de este tipo de tubulopatías, ya que un tratamiento adecuado evita complicaciones asociadas.
ABSTRACT Introduction: Gitelman syndrome is a renal tubule disease that involves hypokalaemic metabolic alkalosis, hypomagnesaemia and hypocalciuria. The musculoskeletal effects of Gitelman syndrome are common, including the development of chondrocalcinosis. Clinical case: A female patient with long-standing chondrocalcinosis associated with chronic hypomagnesaemia on treatment with calcium and magnesium. After the suspension of the treatment due to surgery, she presented with a generalised weakness, metabolic alkalosis, hypokalaemia, hypomagnesaemia and hypocalciuria, with final diagnosis of Gitelman syndrome. After re-introducing the treatment, she improved clinically, with electrolytes remaining stable. Discussion and conclusions: A proper diagnosis of this type of tubular diseases is essential because an adequate treatment avoids associated complications.
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Humans , Female , Middle Aged , Chondrocalcinosis , Diagnosis , Gitelman Syndrome , Rheumatology , Therapeutics , DiseaseABSTRACT
Goats are considered as an important animal not in present scenario but also from ancient time. Due to increasing frugal interest of goat farming globally, profound animal husbandry practices are attaining importance under the target of obtaining quality products along with good animal health and welfare. During the transition phase of life, noticeable alterations in the endocrine and metabolic status of the dairy ruminants were registered. Among small ruminants i.e. goat’s hypocalcaemia, hypoglycemia/Pregnancy toxemia and hypomagnesaemia are the common metabolic disorders which normally precipitated during metabolic anxiety phase. The present study was conducted during the period of 1st January 2019 to 31st December 2019. During this period we had registered total 957 goats at Kalsi, Chakrata areas of district Dehradun, Chorgalia, Kotabagh, Kaladhungi areas of district Nainital and Shetlai, Pantnagar, Bazpur areas of district Uddham Singh Nagar beside this we had also included the concerned cases from Government Veterinary Hospital Outpatient departments (OPDs) of the above said areas in Uttarakhand. In the present study, we had performed a prevalence study over common occurring metabolic diseases of goats like hypocalcaemia, hypoglycemia/pregnancy toxemia and hypomagnesaemia. Besides this, we had also studied the dissemination pattern of common occurring metabolic diseases on the basis of their age groups and parity
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Background: Prevalence of hypomagnesaemia is significantly higher in diabetic patients with microvascular complications compared to diabetics with no microvascular complications. The aim of this study is to measure levels of serum magnesium in patients with newly diagnosed type 2 diabetes mellitus and study its association with the presenting microvascular complications.Methods: This was hospital based, one year cross-sectional study carried out in Department of Medicine, IGMC Shimla in patients with newly diagnosed type 2 diabetes mellitus. Total 53 patients were enrolled in this study who presented in medicine OPD or admitted in medicine ward.Results: Serum Magnesium value of the patients ranged from 1.20-3.0 mg/dl with mean value of 1.9±0.3 mg/dl. Fourteen patients (26.4%) had hypomagnesaemia. A total of 34 (64.2%) patients presented with complications of diabetes in which proteinuria was present in 34 (64.2%), retinopathy in 4 (7.5%) and neuropathy in 1 (1.9%). Fourteen (41.2%) patients with hypomagnesaemia presented with complications of diabetes (p value=0.003). 34 (64.2%) patients presented with proteinuria out of which 14 (41.2%) patients had hypomagnesaemia while 20 (58.8%) had normomagnesaemia (p=0.03). One (1.9%) patient had neuropathy and hypomagnesaemia was also present in this patient (p=0.6). Four patients (7.5%) presented with retinopathy out of which 3 (5.7%) had hypomagnesaemia while 1 (1.9%) had normomagnesaemia.Conclusions: Hypomagnesaemia is associated with microvascular complications of diabetes. Also there is statistically significant relationship between proteinuria and hypomagnesaemia in patients with newly diagnosed type 2 diabetes mellitus.
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@#Proton pump inhibitors (PPIs) are the mainstay of therapy for all gastric acid related diseases and are commonly used in current clinical practice. Although widely regarded as safe, PPIs have been associated with a variety of adverse effects, including hypomagnesaemia. The postulated mechanism of PPI-related hypomagnesaemia involves inhibition of intestinal magnesium absorption via transient receptor potential melastin (TRPM) 6 and 7 cation channels. PPI-induced hypomagnesaemia (PPIH) has become a well recognized phenomenon since it was first reported in 2006. Clinical concerns arise from growing number of case reports presenting PPIH as a consequence of long-term PPI use, with more than 30 cases published to date. In this article, we report 2 cases of PPIH associated with the use of pantoprazole. Both patients presented with severe hypomagnesaemia and hypocalcaemia. One of them had associated hypokalemia and cardiac arrhythmia. A casual relation with PPIs postulated and supported by resolution of electrolyte abnormalities after discontinuation of PPIs.
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Proton Pump Inhibitors , HypokalemiaABSTRACT
Introduction:Low serum magnesium levels in hospitalized patients, including those with cardiovascular ailments, have been reported by many studies. On the other hand, magnesium therapy is advocated but has not yet been conclusively proved. In our earlier study, an association between waterborne magnesium and hypomagnesemia in healthy subjects was reported. The present study was aimed at the contribution of waterborne magnesium among filtered and non-filtered water users in hospitalized patient. Methods:Present study was carried out at SMIMER, Surat. Ethical committee approval was taken. On informed consent, subjects from ICCU and general ward of Medicine unit were selected. Demographic and clinical information was collected. Serum magnesium, cardiac profile, and renal profile were analyzed. Patients with conditions such as kidney, liver, brain, and other critical illness were excluded. The results were expressed as Mean and SD, and appropriate statistical tools were applied to arrive at conclusions. Results:Among total 557 subjects including 185 healthy subjects, 93 ICCU and 279 non-ICCU patients, the incidence of hypomagnesemia (serum Mg < 1.7 mg/dl) was 18%, 36%, and 42% was observed respectively. A significant difference (p < 0.01) in serum magnesium between filtered and non-filtered water users in healthy (1.77 ± 0.36 vs 2.01 ± 0.48), ICCU (1.35 ± 0.44 vs 1.72 ± 0.55), and in non-ICCU patients (1.51 ± 0.59 vs 1.77 ± 0.51) was found. No significant difference was observed in other parameters. Conclusion:Significant hypomagnesaemia was observed among users of filtered water as compared to nonfiltered water users in all groups (ICCU, non-ICCU and healthy), strongly suggestive of contribution of waterborne magnesium in maintaining normal status in the population and inadequate levels may be correlated to a higher incidence of myocardial infarction as evident from the present study wherein a 42% prevalence of hypomagnesaemia in ICCU patients was found.
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Objective To investigate the clinical,biochemical and genetic features of hereditary hypomagnesaemia with secondary hypocalcaemia.Methods Two boys came from different Chinese families.They were hospitalized at the Peking University First Hospital between 2014 and 2016 at the age of 9 years and 1 year and 2 months because of epilepsy and psychomotor retardation.Clinical investigation,laboratory examination,and medical imaging were performed for the etiological study.Whole-genome sequencing was used for the genetic analysis of the patients.Mutations of TRPM6 gene were confirmed by means of Sanger sequencing.Results Patient 1 presented with recurrent seizures and psychomotor retardation from the age of 3 months.Vision loss and psychomotor regression were noticed from the age of 9 years,accompanied with hypertension.Serum magnesium and total calcium were significandy decreased to 0.13-0.15 mmol/L and 1.43-2.00 mmol/L,respectively in patient 1.Serum potassium was reduced to 1.85-3.25 mmol/L.Blood parathyroid hormone was also decreased.On the TRPM6 gene of patient 1,2 novel non-sense mutations,c.2771G ＞ A (p.Trp924Ter) and c.115C ＞ T (p.Gln39Ter) were identified.Patient 2 presented with seizures and psychomotor retardation at the age of 2 weeks.Both of his serum magnesium (0.17-0.35 mmol/L) and serum total calcium (1.32-1.34 mmol/L) were significantly decreased.Blood parathyroid hormone was decreased.Two novel mutations (c.1239G ＞ A,p.W413X and c.146G ＞ A,p.C49Y) were found in the TRPM6 gene of patient 2.Severe hypomagnesaemia,hypocalcaemia and TRPM6 gene mutations confirmed the diagnosis of hereditary hypomagnesaemia with secondary hypocalcaemia in the 2 patients.After the large-dose supplement of magnesium sulfate,progressive clinical improvements were observed in the 2 patients.However,because of the severe brain damage,patient 1 still had psychomotor retardation.Patient 2 completely recovered.Conclusions Hereditary hypomagnesaemia with secondary hypocalcaemia is a severe inherited metabolic disease.Early diagnosis and large-dose magnesium supplement are the key to the good prognosis of the patients.In this study,2 Chinese children with the clinical onset of epilepsy and psychomotor retardation are reported.The diagnosis is made by way of blood biochemical assay and gene analysis.Four novel mutations on their TRPM6 gene are identified.
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Background: Pre eclampsia occurs in 3-5% of pregnancies and is an important cause of fetal and maternal morbidity and mortality worldwide. Objectives: The aim of the study was to evaluate changes in serum magnesium in healthy young women, normal pregnancy and in preeclampsia in their third trimester. Materials and Methods:The study population consisted of 120 subjects divided into three groups with each group comprising of 40 subjects. Serum magnesium level was estimated by fully automatic analyzer in healthy non pregnant women (Group-1), normotensive primigravida (Group2) and preeclamptic primigravida in third trimester (Group-3). The results were analysed using statistical test ANOVA. At p value < 0.05, results were considered significant. Results:The mean serum magnesium levels were 2.71 + 0.24 mg/dL, 1.90 + 0.21 mg/dL and 1.64 + 0.26 mg/dL respectively in healthy young women, normal pregnancy and in preeclampsia. There was a significant decrease in the serum magnesium levels in the normal pregnancy as compared to those in the nonpregnant women and the level is significantly decreased further in preeclampsia. Conclusion: Decreased serum magnesium levels in pregnancy may be associated with increased risk of developing preeclampsia. Changes in the serum levels of magnesium can be used as an effective marker in the early diagnosis of pre eclampsia
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A 29 years old female presented to us in the metabolic clinic of the University of Port Harcourt Teaching Hospital (UPTH) on account of a week history of easy fatigability, weakness, and lower extremity muscle cramps associated with numbness and tingling sensation in the peri-oral area, fingers and toes. Two weeks prior to the onset of her presenting symptoms, she had visited a local pharmaceutical shop on account of a distressing epigastric discomfort and was subsequently placed on daily oral omeprazole 20mg daily for a month by a pharmacist. She had been on the omeprazole medication for two weeks before her present symptoms manifested. Her past medical history was not suggestive of hypoparathyroidism nor pancreatitis. She was married with three children and has an uneventful family, social and obstetric histories. On examination, she was a healthy well-oriented young female with positive Trousseau’s, Chvostek’s and epigastric tenderness signs. Further Laboratory evaluation revealed she had low plasma magnesium, low plasma albumin-corrected calcium, and low serum parathyroid hormone levels, while other laboratory parameters were essentially normal. A diagnosis of omeprazole-induced electrolyte disorders (hypomagnesaemia and hypocalcaemia) associated with hypoparathyroidism was made following the review of her clinical examination and laboratory findings. She was subsequently managed with oral magnesium supplements following the withdrawal of the omeprazole medication (replaced with oral ranitidine), monitored weekly, and full recovery was achieved after three weeks.
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Objective To investigate the clinical features and disease-causing mutations of familial hypomagnesaemia with hypercalciuria and nephrocalcinosis.Methods In February 2016,a 24 year old female patient with left kidney stone and nephrocalcinosis in bilateral kidneys was admitted to our hospital.One month prior to this admission,she had been treated by PCNL to remove the most part of left kidney stone in otherhospital.Mter admission,She was found hypomagnesaemia (serum magnesium 0.65 mmol/ L) and hypercalciuria (24h urine calcium 364.0 mg) but with normal renal function (serum creatinine 101.5μmol/L).And the remained part of left kidney stone was removed by flexible ureteroscope.As she was considered probably with an autosomal recessive FHHNC,an analysis of CLDN16 and CLDN19 gene mutations was performed using her and her parents'peripheral white blood cells.Results Mutation analysis revealed this patient had two heterozygous mutations in the CLDN16.One is an one-base deletion mutation in the 123th codon in exon 2:368delA.The other is a missense mutation in the 139th codon in exon 2:416C →T which resulted in an amino acid change Ala139Val.Her parents respectively had one of each heterozygous mutation.In the six months follow-up,an oral administration with hvdrochlorothiazide,potassium citrate,and calcium magesium supplements significantly reduced her hypomagnesaemia (serum magnesiun 1.0 mmol/L) and hypercalciuria (24-h urine calcium 156.0 mg),and no stone recurrence and aggravation of nephrocalcinosis and renal dysfunction occurred.Conclusions We diagnosed a patient with FHHNC who had a novel compound heterozygous mutation of CLDN16.This rare disease should be suspected if there are three constant clinical features of hypomagnesaemia,hypercalciuria and nephrocalcinosis,and verified with CLDN16 and CLDN19 gene test.Currently the option for treatment of FHHNC is symptomatic treatment until severe deterioration of renal function.The hydrochlorothiazide,potassium citrate,and calcium magesium supplements may have considerable effects on hypomagnesaemia and hypercalciuria.
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Persistent hypocalcaemia usually is a presentation of hypoparathyroidism. When it is coupled with low parathormone levels the diagnosis seems almost certain. However, the fact that hypomagnesaemia can give rise to both hypocalcaemia and low parathormone levels gives us points to ponder. This case depicts a young woman soon after childbirth presenting with carpopedal spasm and biochemical abnormalities. Subsequent correction of hypomagnesaemia readjusts calcium, potassium and parathormone levels.
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Background: Hypomagnesaemia may have negative impact on glucose homeostasis and insulin sensitivity. This study was done to compare serum Mg levels in type 2 diabetic patients with non diabetic healthy control subjects and to assess the correlation between serum Mg levels and glycemic control in Egyptian patients. Methods: 60 type 2 diabetic patients attending the outpatient clinic of diabetes at Kasr Al Aini hospital faculty of medicine Cairo University and 30 healthy age matched control subjects were enrolled. Fasting blood sugar, fasting insulin, fasting lipids, Hb A1C and serum Mg were measured. Weight, height and blood pressure were recorded. BMI, IR (HOMA), were calculated. The data was analyzed and expressed in terms of mean ± SD. Pearson correlation was performed to establish the relationship between Mg and metabolic variables in type 2 diabetic patients. Results: serum Mg levels were significantly reduced in type 2 diabetic patients compared to the control group with mean ±SD (1.29 ± 0.31 mg/dl) versus (2.41 ± 0.13 mg/dl) with P value < 0.001. There were highly significantly negative correlations between serum Mg levels and HbA1c, fasting glucose and insulin resistance with (r = -0.969, -0.894, -0.653) respectively, P value < 0.001. The best cut off point of Mg was ≤ 2.0 mg/dl in differentiating cases from controls using ROC curve analysis. Conclusion: hypomagnesaemia is closely linked to type 2 diabetes mellitus and it is strongly correlated to glycemic control. We recommend to measure serum Mg in type 2 diabetes and patients who need supplementation should be considered.
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INTRODUCCIÓN: con el empleo de anticuerpos monoclonales anti-receptor del factor de crecimiento epidérmico (EGFR), se reportan efectos adversos, entre ellos hipomagnesemia e hipocalcemia. El nimotuzumab, anti-EGFR de producción nacional, tiene otras particularidades en su mecanismo de acción. OBJETIVO: analizar si la administración de este fármaco causa hipomagnesemia e hipocalcemia secundaria, como el resto de los anti-EGFR. MÉTODOS: los pacientes del estudio provienen del ensayo clínico controlado: Uso del anticuerpo monoclonal nimotuzumab en el tratamiento de pacientes con carcinoma de células escamosas de cabeza y cuello, en estadios avanzados. De cada uno de los dos grupos de tratamiento del ensayo fueron seleccionados, mediante muestreo simple aleatorio, 12 pacientes. Se registraron las variables demográficas y antropométricas; se realizaron las determinaciones de calcio y magnesio, utilizando muestras de suero obtenidas durante el ensayo clínico y conservadas a 86 °C. La información fue procesada automatizada; paquete estadístico SPSS 15.0. Para determinar cambios en las concentraciones de Ca y Mg se utilizaron, respectivamente, los test de Friedman y de rangos con signos de Wilcoxon. En la comparación entre grupos se empleó el test de Wilcoxon-Mann-Whitney. RESULTADOS: los dos grupos de sujetos mostraron características semejantes. En el grupo tratado con nimotuzumab, las medias de las concentraciones de Mg fueron de 2,06; 2,17 y 2,11 mg/dL, al inicio, a las 3 sem y al final del tratamiento (p= 0,72). No existieron diferencias al comparar los cambios en las concentraciones de Mg y Ca entre ambos grupos (p= 0,07 y p= 0,86). CONCLUSIÓN: no existen evidencias para plantear que el nimotuzumab produzca hipomagnesemia e hipocalcemia secundarias, en cursos de tratamiento de 200 mg semanales por 6 sem.
INTRODUCTION: some adverse effects have been reported with the use of monoclonal antibodies against Epidermal Growth Factor Receptor (EGFR), including hypomagnesaemia and hypocalcaemia. Nimotuzumab is a Cuban anti-EGFR antibody with a particular mechanism of action, so it is important to know if Nimotuzumab causes these adverse effects. OBJECTIVE: assess whether the administration of this drug causes hypomagnesemia and secondary hypocalcemia, like other anti-EGFR. METHODS: patients on this study came from the controlled clinical assay: Use of Monoclonal Antibody Nimotuzumab in Treatment of Patients with Squamous-Cell Carcinoma of the Head and Neck In Advance Stages. 12 patients were taken by simple random sampling from each group of treatment of clinical assay (total 24). Demographic and anthropometric variables were recorded and mensuration of calcium and magnesium were done from serum samples obtained during clinical assay and preserved at 86 °C. Information was processed using statistical package SPSS 15.0. Friedman test and Wilcoxon test were used to assess changes in Ca and Mg concentrations. Wilcoxon-Mann-Whitney test was used to compare the groups. RESULTS: both groups of subjects had similar characteristics. In the group of patients treated with nimotuzumab, Magnesium concentrations mean were 2.06, 2.17 and 2.11 mg/dL, at the beginning, after three weeks and at the end of treatment, respectively (p=0.72). There were not differences in Mg and Ca concentration changes along the study between groups (p= 0.07 y p= 0.86). CONCLUSIONS: there are not evidences to establish that nimotuzumab causes hypomagnesaemia and secondary hypocalcaemia in treatment of 200 mg a week during six weeks.
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Humans , Magnesium , Medical Oncology/methods , Antibodies, Monoclonal/therapeutic use , BiomarkersABSTRACT
Background: Diabetes mellitus is one of the most common metabolic disorder and leading cause of death and disability in the world. The incidence of diabetes is increasing globally and in India. Magnesium depletion has a negative impact on glucose homeostasis and insulin sensitivity in patients with type 2 diabetes. Hypomagnesaemia can lead to development of complications in diabetes. Hence there is need for the study to explore the status of magnesium in type 2 diabetes. Objectives: To estimate and compare the serum magnesium levels in type 2 diabetes patients with age/sex matched non diabetic controls. Methods: A case control study was done in randomly chosen 100 type 2 diabetic patients and 100 non diabetic age/sex matched controls. Estimation of serum magnesium was done by enzymatic end point method. Results: 37% of diabetic patients had low serum magnesium levels (Mg2+ level ≤1.5 mg/dL) and 9 % of controls had low serum magnesium levels. The mean serum magnesium levels were 1.96 ± 0.54 mg/dL and 2.375 ± 0.449 mg/dL in diabetics and controls respectively (P value <0.0001 highly significant). Hypomagnesaemia (Mg2+ level ≤1.5 mg/dL) was correlating with retinopathy (P = 0.041 significant). Conclusion: This study demonstrated that low serum Mg2+ status is common in type 2 diabetes mellitus patients when compared to non-diabetic controls. It may be prudent in clinical practice to periodically monitor plasma Mg2+ concentration in diabetic patients. If plasma Mg2+ is low, an intervention to increase dietary intake of magnesium may be beneficial to prevent the complications.
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Objective To approach the efficacy of magnesium sulfate(MgSO4 )supplemantation to prevent junctional ectopic tachycardia(JET)during the early postoperative period in infant patients after sur-gery for congenital heart disease.Methods A total of 325 infant patients undergoing cardiac surgery with cardiopulmonary bypass were randomly divided into two groups:the trial group (n =162,50 mg /kg 25%MgSO4 )and the placebo group(n =163,normal saline).The serum magnesium concentrations were meas-ured at five time points.Continuous electrocardiographic documentation by Holter monitor was performed for 24 hours after cardiac sugery.Results At T3 time point(1 hour after 50 mg /kg 25% magnesium sulfate and equivalent saline applied in intravenous infusion),the concentration of serum magnesium in trial group was higher than that of the placebo group[(1.79 ±0.33)mmol /L vs.(0.92 ±0.18)mmol /L],and the differ-ence between two groups was significant(P =0.001 ).At T4 and T5 time points(after magnesium sulfate and equivalent saline applied 12 and 24 hours respectively),the concentrations of serum magnesium in trial group were throughout higher than those of the placebo group [T4:(1.24 ±0.2)mmol /L vs.(0.83 ±0.17 ) mmol /L;T5:(1.20 ±0.16)vs.(0.80 ±0.19)mmol /L,P =0.024,P =0.035,respectively].The overall incidence of JET was 5.2%(17 /325),the placebo group had a significantly greater occurrence of JET than that of the trial group,the difference was significant between two groups [9.2%(15 /163 )vs.1.2%(2 /162),P =0.013 ].The onset time of JET in placebo group was earlier than that of the trial group (P =0.019).A total of 14 of 17 cases(82.4%)with JET had hypomagnesaemia,the cases with JET had a signif-icant longer period of mechanical ventilation and CICU stay.Conclusion Positively supplementation with magnesium sulfate during the early postoperative period in infant patients after surgery for congenital heart diseaae could reduce the incidence of JET.Hypomagnesaemia is related to JET.
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Proton pump inhibitors (PPIs) are widely used though an association with hypomagnesaemia and hypocalcaemia has only been described since 2006. Patients typically present after years of stable dosing with musculoskeletal, neurological or cardiac arrhythmic symptoms, but it is likely that many cases are under-recognised. Magnesium levels resolve rapidly on discontinuation of PPI therapy and hypomagnesaemia recurs rapidly on rechallenge with any agent in the class. The cellular mechanisms of magnesium homeostasis are increasingly being understood, including both passive paracellular absorption through claudins and active transcellular transporters, including the transient receptor potential channels (TRPM6) identified in the intestine and nephron. PPIs may alter luminal pH by modulating pancreatic secretions, affecting non-gastric H+K+ATPase secretion, altering transporter transcription or channel function. A small reduction in intestinal absorption appears pivotal in causing cumulative deficiency. Risk factors have been associated to help identify patients at risk of this effect but clinical vigilance remains necessary for diagnosis.
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Humans , Absorption , Claudins , Diagnosis , Fatigue , Homeostasis , Hydrogen-Ion Concentration , Intestinal Absorption , Intestines , Magnesium , Nephrons , Phenobarbital , Proton Pump Inhibitors , Risk Factors , Transcytosis , Transient Receptor Potential ChannelsABSTRACT
Aim: The aim of this study was to compare the serum magnesium levels of patients with breast cancer and apparently healthy people without the disease. Study Design: This is a cross-sectional prospective study. Place and Duration of Study: The study was carried out at the Department of Surgery, Central Hospital, Benin City and Department of Chemical Pathology, University of Benin Teaching Hospital Benin city, Nigeria, between July, 2011 and October 2012. Methodology: A total of 60 female participants from Central Hospital, Benin City, Nigeria were recruited for this study. 30 of the women (50%) had breast cancer and 30 women (50%) without the disease served as control. Venous blood was obtained from participants and serum magnesium level was determined using standardized laboratory methods. Results: The results showed a statistically significant reduction in serum magnesium level of patients with breast cancer compared with those without the disease. Conclusion: We demonstrated from this present study that the participants with breast cancer have reduced serum magnesium level compared to those without the disease (control) and it is advisable to cautiously add magnesium as an adjuvant therapy in the management of breast cancer.
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Gestational diabetes mellitus (GDM) is a strong predictor of postpartum prediabetes and transition to overt type 2 diabetes (T2DM). Although many reports indicate that low magnesium is correlated with deteriorated glucose tolerance, the association between postpartum serum magnesium level and the risk for T2DM in women with a history of GDM has not been evaluated. We analyzed postpartum serum magnesium levels and development of prediabetes and T2DM in women with prior GDM according to American Diabetes Association (ADA) criteria using the Korean National Diabetes Program (KNDP) GDM cohort. During a mean follow-up of 15.6+/-2.0 months after screening, 116 women were divided into three groups according to glucose tolerance status. Ultimately, eight patients (6.9%) were diagnosed with T2DM, 59 patients (50.9%) with prediabetes, and 49 patients (42.2%) with normal glucose tolerance (NGT) after follow-up. The T2DM group had the lowest serum magnesium level (0.65 [0.63-0.68] mM/L) in the postpartum period, but there was no significant difference between the prediabetes group (0.70 [0.65-0.70] mM/L) and the NGT group (0.70 [0.65-0.70] mM/L) (P=0.073) Multiple logistic regression analysis showed that postpartum HOMA-IR was a significant predictor of both prediabetes and T2DM. Moreover, we found that postpartum serum magnesium level was also a possible predictor for T2DM development. Serum magnesium level in the postpartum period may be a possible predictor for T2DM development in women with a history of GDM.