Systemic and local antiinflammatory effect of magnesium chloride in experimental arthritis

Abstract Objective Despite some knowledge gaps in scientific evidence, MgCl2 is largely used for pain relief in musculoskeletal diseases. Mg salts were shown to provide analgesia postoperatively in orthopedic surgery and low Mg levels were linked to arthritis development and severity. We determined the anti-inflammatory activity of MgCl2 in an acute arthritis model. Methods Mice received 0.1 mg/25μL Zymosan (Zy) or saline into the knees. Joint pain was evaluated using von Frey test; cell influx, and interleukin (IL)-1 level were assessed in joint lavage at 6 h. Synovia were excised for histopathology and analysis of immunoexpression of nuclear factor kappa B (NFκB) and tumor necrosis factor (TNF)-α. Groups (n = 6/group) received either 90 mg/kg MgCl2/100 μL or saline per os (systemic) or 500 μg/25 μL MgCl2 or saline intra-articularly (i.a.) 30 min prior to Zy. Results MgCl2 given either systemically or locally significantly reduced cell influx (p = 0.0012 and p = 0.0269, respectively), pain (p = 0.0005 and p = 0.0038, respectively), and intra-articular IL-1 level (p = 0.0391), as compared to saline. Systemic MgCl2 significantly decreased NFκB (p < 0.05) immmunoexpression, as compared to saline. Conclusion MgCl2 given systemically or locally displayed anti-inflammatory activity in a severe acute arthritis model reducing cell influx, pain, and cytokine release. MgCl2 operates at least partially via inhibiting NFκB activation. This is the first in vivo demonstration that MgCl2 decreases cytokine release in arthritis, prompting reduction of inflammation and pain relief.

Electrochemical Studies of Magnesium Coated with Modified Chitosan and Electrosprayed as an Anticorrosive Protection Method in Bone Repair / Estudios Electroquímicos del Magnesio Recubierto con Quitosano Modificado y Electrorociado como Proceso de Protección Anticorrosiva en la Reparación de Hueso

ABSTRACT Magnesium (Mg) is essential for the metabolic reactions of the human body and is known for its biocompatibility, its mechanical and physical properties are similar to human bone, which is why it is considered to have high potential in biomedical applications such as temporary and resorbable implants. Through surface modifications, the high tendency to corrosion of Mg could be controlled, such as biodegradable membranes that prevent the passage of chloride ions present in the human organism. To prepare the membrane, solutions of chitosan modified with gelatin and/or glutaraldehyde are used and by means of the electrospray method applied to protect the Mg. To simulate body fluid conditions a Kokubo saline solution (BFK) was prepared. The study focuses on evaluating the corrosion rate of Mg with a coating made of a chitosan electrosprayed membrane, applying electrochemical measurements of electrochemical impedance spectroscopy and linear polarization resistance. The key additive to improve the behavior of the membranes was observed with the use of gelatin, where the membrane with the best results lowing corrosion rates is the Mg CH+GE+GL system, which it was observed with very good physical integrity in the images of morphological analyzes of the surface after 30 days of exposure.

RESUMEN El magnesio (Mg) es esencial para las reacciones metabólicas del cuerpo humano y es conocido por su biocompatibilidad, sus propiedades mecánicas y físicas son similares a las del hueso humano, por lo que se considera que tiene un alto potencial en aplicaciones biomédicas como implantes temporales y reabsorbibles. Mediante modificaciones superficiales se podría controlar la alta tendencia a la corrosión del Mg, como por ejemplo membranas biodegradables que impidan el paso de iones cloruro presentes en el organismo humano. Para preparar la membrana se utilizan soluciones de quitosano modificado con grenetina y/o glutaraldehído y mediante el método de electrorociado se aplican para proteger el Mg. Para simular las condiciones de los fluidos corporales se preparó una solución salina de Kokubo. El estudio se enfoca en evaluar la velocidad de corrosión del Mg con un recubrimiento hecho de una membrana electrorociada con quitosano, aplicando técnicas electroquímicas de espectroscopia de impedancia electroquímica y resistencia de polarización lineal. El aditivo clave para mejorar el comportamiento de las membranas se observó con el uso de gelatina, donde la membrana con mejores resultados bajando los índices de corrosión es el sistema Mg CH+GR+GL, el cual se observó con muy buena integridad física en las imágenes de análisis morfológicos de la superficie después de 30 días de exposición.

Postoperative serum magnesium levels as a predictor for the need for calcium replacement after total thyroidectomy: a prospective study

ABSTRACT Objective: Our aim was to assess the ability of serum magnesium (Mg), measured on the first postoperative day (Mg1PO), to predict the need for calcium (Ca) replacement in patients undergoing total thyroidectomy (TT). Subjects and methods: Eighty patients undergoing TT, with Mg1PO and PTH dosage in the first (PTH1h) and eighth (PTH8h) hours after TT, were evaluated for the need for Ca replacement. Data were evaluated by uni/multivariate logistic regression and Receiver Operating Characteristic (ROC) curve. Results: 32 patients (40%) required Ca replacement. Median PTH1h, PTH8h and Mg1PO were higher in the no replacement group: 17 versus (vs) 3 pg/mL (p < 0.001), 18.2 vs 3.0 pg/mL (p < 0.001) and 2 vs 1.6 mg/dL (p < 0.001), respectively. Mg1PO was the isolated predictor for this replacement (odds ratio = 0.0004, 95% confidence interval: 0.000003-0.04; p = 0.001), with the cut-off value of 1.8 mg/dL showing sensitivity and specificity of 78.1% and 87.5%, respectively. Conclusions: In this group of patients, serum Mg1PO was the isolated predictor for the need for Ca replacement.

A Rare Case Report of “Torsades De Pointes” Induced by Fluconazole-Levetiracetam Combined Therapy

Drugs used to treat cardiovascular disease as well as those used in the treatment of multiple other conditions can occasionally produce exaggerated prolongation of the QT interval on the surface electrocardiogram and the morphologically distinctive polymorphic ventricular tachycardia that results is known as «torsade de pointe». «Torsade de pointe» (TDP) is a characteristic polymorphic ventricular arrhythmia associated with delayed ventricular repolarization as evidenced on the surface electrocardiogram by QT interval prolongation. It typically occurs in self-limiting bursts, causing dizziness and syncope, but may occasionally progress to ventricular fibrillation and sudden death. This rare case report showed the potential higher risk of the occurrences of «Tdp» when levetiracetam (KEPPRA) was used in combination therapy with fluconazole, which is already a known medication with the risk of causing polymorphic ventricular arrhythmia.

Status of Serum Magnesium in Different Stages of CKD Patients: A Tertiary Care Hospital Study in Bangladesh

Background: In chronic kidney disease (CKD), renal regulatory mechanisms may be insufficient to balance intestinal magnesium absorption hence insufficient to maintain homeostasis. But related data are relatively sparse and not readily available, especially in Bangladesh context. Aim of the study: The aim of the study was to assess the pattern of serum magnesium level in different stages of CKD patients. Material & Methods: This descriptive cross-sectional study was conducted in the Department of Medicine and the Department of Nephrology, Dhaka Medical College Hospital (DMCH) for nine months’ period. Approval for the study was taken from the ethical review committee of DMC before the commencement of the study. Diagnosed patients of chronic kidney disease (CKD) were approached for the inclusion of the study. Informed written consent was taken from each patient. All patients were subjected to detailed history taking, physical examination, and relevant investigations. For the study purpose, serum magnesium was done for all patients. Results: After compiling data from all participants, statistical analysis was performed using the statistical package for social science (SPSS) version 22 for windows, and a p < 0.05 was considered statistically significant. Mean age of the patients was 53 years with male predominance (male 64% vs female 36%). Of all, 6.7% of cases had hypomagnesemia and 55.3% had hypermagnesemia. The mean serum magnesium level was 2.68±0.81 mg/dl. Assessment of serum magnesium in a different stages of CKD showed that hypermagnesemia is associated with higher staging (p<0.05), and there is a negative correlation between lower e-GFR with serum magnesium ((r=-0.753, p<0.01). Conclusion: Nearly two-third of CKD patients were found with altered magnesium level in the form of hypomagnesemia or hypermagnesemia in this study. Serum magnesium was found increased in higher stages of CKD. That means serum magnesium level increases along with higher stage of the disease. Urinary magnesium excretion also decreases when eGFR of patient decreased.

To evaluate the serum magnesium levels in fresh myocardial infraction patients and to compare them with normal healthy individuals – A comparative study

Background: Now-a-days, myocardial infarction (MI) is one of the most prevalent disorders. Lack of blood supply causes MI/heart attacks. Ischemia or a lack of oxygen causes heart tissue damage and is ultimately fatal. Several studies demonstrated the association of magnesium deficiency with MI. Aim and Objectives: The aim of the study was to evaluate the levels of serum magnesium in MI patients and to compare them with normal healthy individuals. Materials and Methods: The present study assessed magnesium levels in 50 MI and another 50 without MI, healthy participants serve as a control. All the study participants were recruited from Government Medical College, Amritsar. Results: In normal individuals (n = 50), the Mean ± standard deviation (SD) of serum magnesium was 1.994 ± 0.28 mg/dl and SE. of 0.04, while in MI patients Mean ± SD was 1.13 ± 0.49 mg/dl and SE of 0.07. The mean of magnesium was significant (t = 10.8, P < 0.001) high in MI patients as compared to the control. Conclusion: Thus, it concludes that magnesium can be used as a diagnostic investigation tool for assessing patients suffering from MI.

Effect of magnesium sulfate with ketamine infusions on intraoperative and postoperative analgesia in cancer breast surgeries: a randomized double-blind trial

Abstract Background Opioids are the cornerstone in managing postoperative pain; however, they have many side effects. Ketamine and Magnesium (Mg) are NMDA receptor antagonists used as adjuvant analgesics to decrease postoperative opioid consumption. Objective We assumed that adding Mg to ketamine infusion can improve the intraoperative and postoperative analgesic efficacy of ketamine infusion alone in cancer breast surgeries. Methods Ninety patients aged between 18 and 65 years and undergoing elective cancer breast surgery were included in this prospective randomized, double-blind study. Group K received ketamine 0.5 mg.kg-1 bolus then 0.12 mg.kg-1.h-1 infusion for the first 24 hours postoperatively. Group KM: received ketamine 0.5 mg.kg-1 and Mg sulfate 50 mg.kg-1, then ketamine 0.12 mg.kg-1.h-1 and Mg sulfate 8 mg.kg-1.h-1 infusions for the first 24 hours postoperative. The primary outcome was the morphine consumption in the first 24 hours postoperative, while the secondary outcomes were: intraoperative fentanyl consumption, NRS, side effects, and chronic postoperative pain. Results Group KM had less postoperative opioid consumption (14.12 ± 5.11 mg) than Group K (19.43 ± 6.8 mg). Also, Group KM had less intraoperative fentanyl consumption. Both groups were similar in postoperative NRS scores, the incidence of side effects related to opioids, and chronic neuropathic pain. Conclusion Adding Mg to ketamine infusion can safely improve intraoperative and postoperative analgesia with opioid-sparing effect in cancer breast surgery.

Hypomagnesemia � An overlooked parameter in type 2 diabetes mellitus

Background: Diabetes Mellitus refers to a group of common metabolic disorders that share the phenotype of Hyperglycemia. It is the leading cause of morbidity and mortality throughout the world with an estimated worldwide prevalence of 439 million by 2030 and 19% of world抯 DM patients are Indians. Magnesium is an important co-factor for various enzymes involved in Insulin secretion and is involved in sodium-potassium ATPase pump. 25%-38% of Type 2 DM patients had Hypomagnesemia, which has also contributed in developing microvascular complications such as Diabetic Retinopathy (DR) and Diabetic Nephropathy (DN). Various studies have suggested that Magnesium supplementation in Type 2 DM patients with Hypomagnesemia have shown beneficial effects on insulin sensitivity and glucose metabolism. Aim and objectives: To study the prevalence of Hypomagnesemia in Type 2 DM patients and to study the association of Hypomagnesemia with microvascular complications such as DR and DN. Materials and methods: It is a hospital based Observational study carried out in 2022 for a period of 1 year including 60 patients fulfilling the ADA criteria for diagnosing T2DM and patients with Diabetic Retinopathy and Diabetic Nephropathy, and excluding patients with Malabsorption, Chronic diarrhoea, Renal Failure on diuretic therapy, Sepsis, Pancreatitis. Serum Magnesium levels of 1.6 mg/dl � 2.6 mg/dl is considered as normal range. Serum Magnesium were measured using Xylidyl blue colorimetric method. Results: The Mean age of the patients in our study was 55.89 years. Among 60 patients diagnosed with Diabetes Mellitus, 42 patients had Hypomagnesemia, 18 patients had Normomagnesemia (p- value: <0.0001). Patients with an HbA1c levels > 7% had Hypomagnesemia when to compared to patients with HbA1c <7% with a significant p value of 0.009. Hypomagnesemia was also associated with Diabetic Retinopathy and Diabetic Nephropathy with a significant p-value of 0.013 and 0.009 respectively. Conclusion: In our study, it has shown that patients with uncontrolled T2DM had Hypomagnesemia, which is also associated with micro-vascular complications of T2DM such as DR and DN.

Assessment of serum magnesium and correlation with glycemic control and complication in type 2 diabetes mellitus – A cross-sectional study in a tertiary care hospital in eastern zone of India

Background: Diabetes mellitus (DM) is an expanding global health problem. Type 2 DM (T2DM) patients account about 90% of total DM patients. Magnesium is important for different physiological mechanism. Hypomagnesemia is common in T2DM patient. Magnitude of hypomagnesemia is related with glycemic control and is associated with complications of T2DM. Aims and Objectives: Our aim of the study was to assess the prevalence of hypomagnesemia in patients of T2DM patients and to find their correlation with glycemic control and complications of T2DM patients in rural population of eastern zone of India. Materials and Methods: The hospital-based cross-sectional study includes 99 male and female DM patients between 15 and 60 years age. Fasting blood sugar, postprandial blood sugar, HbA1c, serum total magnesium, and urine albumin creatinine ratio were measured. Data were entered into Microsoft Excel spreadsheet and then analyzed by SPSS (version 25.0; SPSS Inc.) and GraphPad Prism (version 5.0). P < 0.05 was considered statistically significant. Results: From our study, we observed that hypomagnesemia is common in T2DM patients. The magnitude of hypomagnesemia is correlated with glycemic control (P < 0.0001). Moreover, hypomagnesemia is associated with diabetic kidney diseases (P < 0.05). Conclusion: It can be concluded that serum magnesium should be monitored in all T2DM patients and should be managed appropriately because hypomagnesemia may induce complications in T2DM patients.

A study of serum magnesium levels in acute myocardial infarction and its association with clinical outcome

Background: Cardiovascular disease is one of the leading causes of mortality, morbidity, and increased health-care cost. Magnesium has been implicated in the pathogenesis of acute myocardial infarction (AMI) and its complications. Magnesium ions are considered essential for the maintenance of functional integrity of myocardium. The serum magnesium concentration was found to have great significance in AMI. The present study was undertaken to evaluate the prognostic value of serum magnesium in AMI. Aim and Objectives: The aim of the study was (1) to evaluate serum magnesium levels in patients of AMI on 1st and 7th day post-myocardial infarction and (2) to evaluate validity of serum magnesium as prognostic indicator of Ami. Materials and Methods: This observational cross-sectional study was conducted in the Medicine Department, Guru Nanak Dev Hospital attached to Govt. Medical College, Amritsar. A total of 40 patients of AMI were enrolled in this study. Serum magnesium levels were done for all the patients and its correlation with clinical outcome was observed. Results: On day 1, mean serum magnesium levels in patients with ST-segment elevation myocardial infarction were 1.638 ± 0.19 whereas mean serum magnesium levels in patients with Non-ST-segment elevation myocardial infarction were 2.315 ± 0.321. Mean serum magnesium levels in patients with arrhythmias were 1.73 ± 0.35 on day 1 and 2.14 ± 0.25 on day 7 (P < 0.05). Mean serum magnesium levels at day 1 in patients having mortality are 1.452 ± 0.078 as compared to 2.105 ± 0.399 in rest of surviving patients. It was inferred from this study that patients with AMI with low serum magnesium levels are more prone to develop complications such as arrhythmias and death as compared to patients of AMI with normal serum magnesium levels. Conclusion: Magnesium is an underestimated cation and has been implicated in the pathogenesis of AMI and its complications. Patients of AMI with low serum magnesium levels are found to be more prone to develop arrhythmias as compared to those with normal serum magnesium levels. Hence, it can be concluded that measurement of serum magnesium level is of prognostic significance in AMI.

Comparison of serum calcium, serum magnesium, serum sodium and serum potassium in patients of preeclampsia and normal pregnant women-a cross-sectional study

Background: Preeclampsia is a clinical condition in which the patient is suffering from hypertension and proteinuria, which may be associated with pathological edema. There are multiple systems involved in pre-eclampsia which is the main culprit to complicate the pregnancy. In developing nations, approximately 4–18% of pregnancies are complicated by preeclampsia which is a major cause of morbidity and mortality globally. It does not affect pregnant females only, but may be life-threatening for growing fetuses too. If we consider the mortality in all pregnant females, about 10–15% of maternal deaths are due to pre-eclampsia. Aims and Objectives: The main objective of this study is to compare the serum calcium, magnesium, sodium and potassium level in preeclampsia patients and normal pregnant women. Materials and Methods: After taking written consent from the patients, randomly 50 pregnant females diagnosed by a gynecologist as suffering from preeclampsia were selected and for the control group 50 pregnant females who came for routine checkups were selected. 5 ml of blood was collected in the clot activator tube. The samples were analyzed for serum calcium, magnesium, sodium, and potassium on a fully automated biochemistry analyzer ”Erba XL 640” in HiTech, clinical biochemistry laboratory, B.J medical college, Ahmedabad. Results: The result showed a decreased level of serum calcium, magnesium, sodium, and potassium in the study group compared to the control group. The S. calcium level was (7.624 ± 0.84) and (8.52 ± 0.80) mg/dl in the study and control groups respectively. The S. magnesium level in the study and control were (1.47 ± 0.25) and (1.79 ± 0.18) mg/dl, respectively. S. sodium levels were (131.46 ± 6.96) and (139.92±7.86) mEq/L in the study and control groups, respectively. And the level of S. potassium in the study and control groups was (3.39 ± 0.52) and (3.67 ± 0.38) mEq/L, respectively. All the parameter values are significantly lower in a study group in comparison to control group patients (P < 0.001). Conclusion: From our study, we have concluded that the serum level of some parameters such as calcium, magnesium, sodium, and potassium was significantly decreased in patients suffering from preeclampsia. We can also conclude that these parameters can be used as a biomarker for the diagnosis of preeclampsia.

The effects of magnesium sulfate added to epidurally administered local anesthetic on postoperative pain: a systematic review

Abstract Background This study evaluated the efficacy of epidurally administered magnesium associated with local anesthetics on postoperative pain control. Methods The study protocol was registered in PROSPERO as CRD42021231910. Literature searches were conducted on Medline, Cochrane, EMBASE, CENTRAL, and Web of Science for randomized controlled trials comparing epidural administration of magnesium added to local anesthetics for postoperative pain in elective surgical adult patients. Primary outcomes were the time to the first Postoperative (PO) Analgesic Request (TFAR), 24-hour postoperative opioid consumption, and Visual Analog Scale (VAS) scores at the first six and 24 postoperative hours. Secondary outcomes included Postoperative Nausea and Vomiting (PONV), pruritus, and shivering. Quality of evidence was assessed using GRADE criteria. Results Seventeen studies comparing epidural were included. Effect estimates are described as weighted Mean Differences (MD) and 95% Confidence Intervals (95% CI) for the main outcomes: TFAR (MD = 72.4 min; 95% CI = 10.22-134.58 min; p < 0.001; I2= 99.8%; GRADE: very low); opioid consumption (MD = -7.2 mg (95% CI = -9.30 - -5.09; p < 0.001; I2= 98%; GRADE: very low). VAS pain scores within the first six PO hours (VAS) (MD = -1.01 cm; 95% CI = -1.40-0.64 cm; p < 0.001; I2= 88%; GRADE: very low), at 24 hours (MD = -0.56 cm; 95% CI = -1.14-0.01 cm; p= 0.05; I2= 97%; GRADE: very low). Conclusions Magnesium sulfate delayed TFAR and decreased 24-hour opioid consumption and early postoperative pain intensity. However, imprecision and inconsistency pervaded meta-analyses, causing very low certainty of effect estimates.

Progress in antenatal magnesium sulfate exposure for neuroprotection in preterm infants / 中华围产医学杂志

Magnesium sulfate has been administered to pregnant women at imminent risk of preterm delivery for fetal neuroprotection, but its adverse effects and target population have not been fully studied. This paper summarizes the current protocols according to the existing guidelines and the latest research progress, including the gestational age at intervention, dose, duration of therapy and the need for re-administration, hoping to provide a reference for the clinical use of magnesium sulfate for fetal neuroprotection in China.

The Case Control Study of Serum Magnesium level In Pulmonary Tuberculosis and Its Correlation with the Stage of Pulmonary Tuberculosis

Background: In 2016, 6.3 million cases of PTB were reported by WHO. Magnesium is extremely essential for life and is present as intracellular ion in all living cells and tissues¹. Some workers have found serum Magnesium level to decrease in cases of PTB, which rises towards normal with specific treatment. Objectives: 1. To estimate and compare serum Magnesium levels in cases and controls 2. To measure correlation between Magnesium levels and severity of PTB Materials and Methods: This was a prospective case control study, conducted on 30 PTB patients and 30 controls who met the inclusion and exclusion criteria of the study. This study was done in S.Nijalingappa Medical College, Bagalkot, Karnataka during the period September 2021 to January 2022. All patients were clinically evaluated and underwent relevant investigations. Results: There was significant decrease in Serum Magnesium in cases and more decreased in moderately advanced and far advanced disease. Conclusion: The study concludes that there is significant reduction in Serum Magnesium in PTB and it further decreases as the severity of PTB increases, hence necessitating early treatment of PTB and need for Magnesium supplementation in PTB patients.

Niveles de fertilización con calcio, magnesio y azufre en genotipos de arveja voluble (Pisum sativum L.) en Nariño

Nariño es el principal productor de arveja de Colombia. En su cultivo, se fertiliza con nitrógeno, fósforo y potasio, pero no se conoce el efecto de otros nutrimentos. Esta investigación tuvo como objetivo evaluar el efecto de diferentes niveles de calcio, magnesio y azufre sobre los componentes de rendimiento de arveja voluble, en los municipios de Gualmatán, Pupiales y Puerres, en suelos Andisoles y, en Ipiales y Potosí, en suelos Inceptisoles. En cada localidad, se utilizó un diseño de bloques completos al azar, con arreglo en parcelas divididas y tres repeticiones, donde el factor A correspondió a cinco genotipos de arveja y el factor B, a cinco niveles de fertilización con calcio, magnesio y azufre. Los resultados indicaron respuesta positiva de los rendimientos a la aplicación de estos elementos. El nivel de fertilización 112,5-50-25 kg.ha-1 de Ca, Mg y S, respectivamente, presentó mayor rendimiento que el nivel establecido por la información del análisis de suelos o testigo en Gualmatán, Pupiales y Potosí, mientras que, en Puerres, hubo respuesta al nivel más alto, 135-60-30, de los mismos elementos. Los otros niveles de fertilización fueron similares al testigo. En Ipiales, la variedad Sureña presentó rendimientos similares para todos los niveles de fertilización. San Isidro presentó su mayor rendimiento, con el nivel 112,5-50-25 kg.ha-1, de calcio magnesio y azufre. Las líneas con gen afila L3 y L18 igualaron los rendimientos de las variedades comerciales Sureña, Alcalá y San Isidro, en Potosí y en Pupiales.

Nariño is the main pea producer in Colombia. The crop is fertilizer with nitrogen, phosphorus, and potassium, but the effect of other nutrients is unknown. The objective of this research was to evaluate the effect of different levels of calcium, magnesium, and sulfur on the performance components of voluble pea in the municipalities of Gualmatán, Pupiales, and Puerres on Andisols, and in Ipiales and Potosí on Inceptisols soils. A randomized complete block design was used with divided plots and three replications, where factor A corresponded to five pea genotypes and factor B to five levels of fertilization with calcium, magnesium, and sulfur. The results indicated positive response of the yields to the application of these elements. The level of fertilization 112.5-50-25 kg.ha-1 of Ca, Mg, and S respectively, presented a higher yield than the level established by information from the soil analysis or control in Gualmatán, Pupiales and Potosí, while in Puerres there was a response at the highest level 135-60-30 of the same elements. The other levels of fertilization were similar to the control. In Ipiales Sureña variety presented similar yields for all fertilization levels. San Isidro presented its highest yield with a level of 112.5-50-25 kg.ha-1 of calcium, magnesium and sulfur. The lines with the L3 and L18 genes matched the yield of the commercial varieties Sureña, Alcalá and San Isidro in Potosí and Pupiales.

Prevalence of Hypomagnesaemia Among Type 2 Diabetic Patients Admitted to a Tertiary Care Hospital

Background: Magnesium (Mg) is one of the dominant intracellular cations. It catalyzes more than 300 intracellular reactions and has multiple functions in areas of energy production, intracellular calcium regulation, protein synthesis and degradation, and neurotransmitter release. To estimate the prevalence of hypomagnesaemia among patients with type 2 diabetes attending a tertiary care Hospital.Material & Methods:A cross-sectional study was carried out at the Bangladesh Institute of Research and Rehabilitation in Diabetes (BIRDEM), which treats patients with Diabetes Mellitus from all over the country. A total of 754 patients were included and analyzed in this study. All patients with type 2 diabetes who were referred to the BIRDEM during the period from the first of July 2020 to the end of June 2021 and had their serum Mg assessed were included in the study.Results:Out of 754 patients with type 2 diabetes, 150 patients (19.89%) (95% CI, 16.8%-21.4%) were hypomagnesaemic. Female gender, hypertension, statin therapy, HbA1c between 7-7.9% or ? 9% and patients with diabetes duration more than five years were independent risk factors for hypomagnesaemia. No association between hypomagnesaemia and age distribution, smoking history, neuropathy and retinopathy was found. In comparison with individuals enrolled in the National Vitamin D study, diabetic patients in this study had a much higher prevalence of hypomagnesaemia (19% vs. 0.7%) with odd’s ratio of 32 (95% CI, 21-48.2).Conclusions:The present study has shown that an apparently-healthy elderly population may have a magnesium deficiency that may need to be identified and treated for optimizing clinical care. Further multicentric studies with a greater sample size should be done in this field, which will benefit the elderly population.

A study on association of serum magnesium, serum uric acid levels and microalbuminuria in patients with type 2 diabetes mellitus

Background: Microalbuminuria is multifactorial and it is an important marker for diabetic nephropathy. The aim of thestudy was to assess the incidenceand association of serum magnesium levels, serum uric acid levels and microalbuminuria in patients with type 2DM. Methods:This study was a cross-sectional study conducted for a period of 2 years from October 2015 to September 2017, where the patients diagnosed as type 2 DM admitted in AJIMS were taken up for the study. All the patients’ blood sample was sent for estimation of serum magnesium, serum uric acid, FBS, PPBS, HBA1C and urine spot albumin:creatinine ratio. Results:In our study, out of 100 patients with type 2 diabetes, 79 patients had microalbuminuria. Out of these, 83.3% (N=75) was having hypomagnesemia (p<0.000) associated with microalbuminuria. Hyperuricemia was seen in 63% (N=63) of the population but 79.4% (N=50) hyperuricemics were associated with microalbuminuria(p<0.000).Conclusions:There was a significant microalbuminuria in patients with type 2 DM, with reduced serum Mg levels and elevated serum uric acid levels ascompared with patients who had serum Mg and uric acid levels withinthe normalrange.

Ensayo clínico: efecto del sulfato de magnesio sobre los niveles séricos de lactato en el seno coronario / Clinical trial: effect of magnesium sulfate on serum levels of lactate in the coronary sinus

Resumen: Introducción: Se han propuesto varios métodos para controlar la inflamación y preservar el miocardio durante la circulación extracorpórea (CEC), entre ellos podemos mencionar la administración de electrolitos, tales como el magnesio (Mg2+). Objetivo: Comparar el efecto del uso de sulfato de magnesio (MgSO4) prepinzamiento aórtico (pre-PAo) vs placebo sobre los niveles séricos de lactato en el seno coronario en pacientes sometidos a revascularización miocárdica (RVM) multivaso con CEC. Material y métodos: Se realizó un ensayo clínico controlado en 52 pacientes sometidos a RVM multivaso con CEC, aleatorizados para recibir placebo (grupo I) o MgSO4 (grupo II) pre-PAo, y se tomaron muestras sanguíneas del seno coronario en dos tiempos diferentes: T0: pre-PAo y T1: previo al cierre de tórax, cuantificándose el lactato sérico. Para su análisis, se utilizó t de Student y χ2. Una p < 0.05 fue significativa. La información se procesó en SPSS v-22.0. Resultados: Los niveles séricos de lactato en el seno coronario postpinzamiento aórtico (pos-PAo) fueron menores en el grupo II (2.967 ± 0.86 vs 2.154 ± 1.14) mostrando diferencias significativas (p = 0.006). Conclusión: El uso de MgSO4 pre-PAo disminuye los niveles séricos de lactato en el seno coronario en pacientes sometidos a RVM multivaso con CEC.

Abstract: Introduction: Several methods have been proposed to control inflammation and to preserve the myocardium during cardiopulmonary bypass (CABG), including the administration of electrolytes such as magnesium (Mg2+). Objective: To compare the effect of using magnesium sulfate (MgSO4) or a placebo before aortic clamping (AoC) on the serum levels of lactate in the coronary sinus in patients undergoing myocardial multivessel revascularization (MRV) with CABG. Material and methods: A clinical assay was conducted with 52 patients undergoing MRV multivessel with CEC; the patients were randomized to receive a placebo (group I) or MgSO4 (group II) before AoC, and blood samples were taken from the coronary sinus to quantify serum lactate at two different times: T0: pre-AoC and T1: before closing the chest. Statistical analysis was performed on Student's t-test and χ2. A p < 0.05 was considered statistically significant. The data were processed with SPSS v-22.0. Results: Serum levels of lactate in the coronary sinus post-AoC were lower in group II (2.967 ± 0.86 vs 2.154 ± 1.14), with significant differences (p = 0.006). Conclusion: The use of MgSO4 before AoC reduces serum lactate levels in the coronary sinus in patients undergoing MRV multivessel with CABG.

Reporte de seis casos de eclampsia en un hospital rural de la selva de Chiapas / Six Cases of Reports of Eclampsia in a Rural Hospital from the Chiapas Jungle

Resumen La eclampsia es un síndrome relativamente raro e impredecible de la enfermedad hipertensiva inducida por el embarazo, caracterizado por un estado convulsivo tónico-clónico que puede o no cursar con hipertensión previa o daño orgánico. Complica aproximadamente 3 de cada 1,000 embarazos, con alta incidencia en pacientes de zonas rurales y bajo nivel socioeconómico, mujeres con preeclampsia, primigestas adolescentes y multíparas mayores de 35 años de edad. Presentamos el reporte de 6 casos de eclampsia que sucedieron en un hospital rural del estado de Chiapas, ubicado en el corazón de la Selva Lacandona. La mayoría fueron primigestas adolescentes en trabajo de parto, quienes rebasaban las 40 semanas de gestación. Todas fueron manejadas con medidas de soporte y neuroprotección con sulfato de magnesio, 5 de ellas fueron referidas a segundo nivel a la unidad de cuidados intensivos para recibir una atención integral, con un tiempo promedio de estancia de 2 días. Ninguna presentó un nuevo cuadro convulsivo. No se registraron resultados perinatales adversos ni muerte materna. El síndrome preeclampsia-eclampsia es un problema de alto impacto en el embarazo y un reto para los 3 niveles de atención, pero sobre todo para la atención en el medio rural y zonas indígenas de todo México, ya que, debido a costumbres arraigadas, las pacientes omiten el control prenatal, además de habitar en lugares con difícil acceso a hospitales o clínicas.

Abstract Eclampsia is a relatively rare and unpredictable syndrome of pregnancy-induced hypertensive disease, characterized by a tonic-clonic seizure state which may or may not present hypertension or end-organ damage. It complicates approximately 3 out of 1000 pregnancies, with a high incidence in patients of low socioeconomic status and rural areas, women with pre-eclampsia, primiparous teen or multiparous women over 35 years old. We present the report of 6 cases of eclampsia that occurred in a first level rural hospital of attention in the state of Chiapas, located in the heart of the Lacandon Jungle. Most of them occurred in primiparous teen patients during labor, which exceeded 40 weeks of gestation. All were promptly managed with support measures and magnesium sulfate neuroprotection, 5 of them referred to the second level of the intensive care unit for more comprehensive care, the average length of stay was 2 days. No one presented a new seizure. No adverse perinatal outcomes or maternal death were recorded. The pre-eclampsia-eclampsia syndrome is a problem with a high impact on pregnancy and a challenge for all three levels of care, but especially for care in rural areas and indigenous areas throughout Mexico, since, due to entrenched customs, patients omit prenatal control, in addition to living in places with difficult access to hospitals or clinics.

Comparison Of Magnesium Sulphate With Dexamethasone As Adjuvant To Local Anaesthetics For Supraclavicular Brachial Plexus Block

Background:Background and objectives: Brachial plexus block is routinely performed method of regional nerve block. Different adjuvantshave been used to hasten the onset and prolong the duration of peripheral nerve blocks. In this study we compared dexamethasone and magnesium sulphate as an adjuvant to combination of bupivacaine and lignocaine in supraclavicular brachial plexus block with regards to comparison of time required for onset and duration of sensory and motor block, duration of post-operative analgesia and requirement of rescue analgesics in first 24 hours postoperatively. Material And Methods:This prospective, observational, comparative study was performed on 60 patients of ASA class I, II and III in the age group of 18 to 70 years, weighing 40 to 70 kilogram and undergoing lower arm, elbow, forearm and hand surgeriesdivided in to 2 equal groups D and M. Group D received dexamethasone 8mg and group M received magnesium sulphate 500mg along with bupivacaine(0.5%) and lignocaine(2%).Result:Onest of sensory and motor blockade was significantly faster in group D compared to group M (p-0.001, p<0.001 respectively). Duration of sensory and motor blockade and duration of postoperative analgesia was prolonged in group D compared to group M (p-0.008, p-0.034).Conclusion:Addition of dexamethasone or magnesium sulphate as adjuvant in supraclavicular block prolongs postoperative analgesia. Dexamethasone provided quicker onset and longer duration of analgesia with lesser consumption of rescue analgesic in comparison to magnesium sulphate.