scholarly journals The role of magnesium in the treatment of alcohol withdrawal with delirium

2021 ◽  
Vol 17 (8) ◽  
pp. 47-50
Author(s):  
O.O. Havrylov ◽  
M.L. Gomon

Background. The role of magnesium in the treatment of alcohol withdrawal with delirium is indefinite, although it is well known about its participation in the pathogenesis of this severe condition. The study was aimed to reveal the benefits and disadvantages of the sedation with added magnesium sulfate in comparison with traditional sedative therapy. Materials and methods. In our study, we tested 40 treated patients, which were randomized in two groups. We controlled the level of sedation by the Richmond agitation-sedation scale. The target level of sedation was between 0 and –2 points. We maintained this level in all the patients. In all groups, we evaluated the following values: duration of delirium, mean arterial pressure, pulse, the level of serum magnesium, cortisol and serotonin, laboratory indicators of kidneys, and liver condition. In the control group, we carried out the sedation with 10–20 mg of diazepam every 4–6 hours with infusion of barbiturates as needed. The treatment in the research group was identical with addition of magnesium sulfate 50 mg/kg every 8 hours. Results. The results of the study demonstrated that the duration of delirium is significantly lower in the research group in comparison with the control (p < 0.05). We found hypomagnesemia in almost half of the patients. The indicators of haemodynamics such as mean arterial pressure and pulse were significantly lower in both groups on the third day (p < 0.05). We found 4 cases (20 %) of hypotension in the research group and 2 cases (10 %) in the control group. The study of the dynamics of serum cortisol and serotonin showed the significant difference on the third day in both groups (p < 0.05). We found no difference in these laboratory parameters on the third day between groups (p ≥ 0.05). There was no significant difference between the laboratory indicators of kidneys and liver condition in both groups (p ≥ 0.05). Conclusions. The use of magnesium sulfate allowed decreasing the duration of delirium but had an excessive effect on haemodynamics. Such biomarkers as serum cortisol and serotonin didn’t verify the effect of magnesium sulfate.

2019 ◽  
Author(s):  
Wei Tan ◽  
Dong-chen Qian ◽  
Meng-meng Zheng ◽  
Xuan Lu ◽  
Yuan Han ◽  
...  

Abstract Background: The infusion of magnesium sulfate is well known to reduce arterial pressure and attenuate hemodynamic response to pneumoperitoneum. This study aimed to investigate whether different doses of magnesium sulfate can effectively attenuate the pneumoperitoneum-related hemodynamic changes and the release of vasopressin in patients undergoing laparoscopic gastrointestinal surgery. Methods: Sixty-nine patients undergoing laparoscopic partial gastrectomy were randomized into three groups: group L received magnesium sulfate 30 mg/kg loading dose and 15 mg/kg/h continuous maintenance infusion for 1 h; group H received magnesium sulfate 50 mg/kg followed by 30 mg/kg/h for 1 h; and group S (control group) received same volume 0.9% saline infusion, immediately before the induction of pneumoperitoneum. Systemic vascular resistance (SVR), cardiac output (CO), mean arterial pressure (MAP), heart rate (HR), central venous pressure(CVP), serum vasopressin and magnesium concentrations were measured. The extubation time, visual analogue scale were also assessed. The primary outcome is the difference in SVR between different groups. The secondary outcome is the differences of other indicators between groups, such as CO, MAP, HR, CVP, vasopressin and postoperative pain score. Results: Pneumoperitoneum instantly resulted in a significant reduction of cardiac output and an increase in mean arterial pressure, systemic vascular resistance, central venous pressure and heart rate in the control group (P < 0.01). The mean arterial pressure (T2 – T4), systemic vascular resistance (T2 – T3), central venous pressure(T3-T5) and the level of serum vasopressin were significantly lower (P < 0.05) and the cardiac output (T2 – T3) was significantly higher (P < 0.05) in group H than those in the control group. The mean arterial pressure (T4), systemic vascular resistance (T2), and central venous pressure(T3-T4) were significantly lower in group H than those in group L (P < 0.05). Furthermore, the visual analog scales at 5 min and 20 min, the level of vasopressin, and the dose of remifentanil were significantly decreased in group H compared to the control group and group L (P < 0.01). Conclusion: Magnesium sulfate could safely and effectively attenuate the pneumoperitoneum-related hemodynamic instability during gastrointestinal laparoscopy and improve postoperative pain at serum magnesium concentrations above 2 mmol/L.


2019 ◽  
Author(s):  
Wei Tan ◽  
Dong-chen Qian ◽  
Meng-meng Zheng ◽  
Xuan Lu ◽  
Yuan Han ◽  
...  

Abstract Background: The infusion of magnesium sulfate is well known to reduce arterial pressure and attenuate hemodynamic response to pneumoperitoneum. This study aimed to investigate whether different doses of magnesium sulfate can effectively attenuate the pneumoperitoneum-related hemodynamic changes and the release of vasopressin in patients undergoing laparoscopic gastrointestinal surgery. Methods: Sixty-nine patients undergoing laparoscopic partial gastrectomy were randomized into three groups: group L received magnesium sulfate 30 mg/kg loading dose and 15 mg/kg/h continuous maintenance infusion for 1 h; group H received magnesium sulfate 50 mg/kg followed by 30 mg/kg/h for 1 h; and group S (control group) received same volume 0.9% saline infusion, immediately before the induction of pneumoperitoneum. Systemic vascular resistance (SVR), cardiac output (CO), mean arterial pressure (MAP), heart rate (HR), central venous pressure(CVP), serum vasopressin and magnesium concentrations were measured. The extubation time, visual analogue scale were also assessed. The primary outcome is the difference in SVR between different groups. The secondary outcome is the differences of other indicators between groups, such as CO, MAP, HR, CVP, vasopressin and postoperative pain score. Results: Pneumoperitoneum instantly resulted in a significant reduction of cardiac output and an increase in mean arterial pressure, systemic vascular resistance, central venous pressure and heart rate in the control group (P < 0.01). The mean arterial pressure (T2 – T4), systemic vascular resistance (T2 – T3), central venous pressure(T3-T5) and the level of serum vasopressin were significantly lower (P < 0.05) and the cardiac output (T2 – T3) was significantly higher (P < 0.05) in group H than those in the control group. The mean arterial pressure (T4), systemic vascular resistance (T2), and central venous pressure(T3-T4) were significantly lower in group H than those in group L (P < 0.05). Furthermore, the visual analog scales at 5 min and 20 min, the level of vasopressin, and the dose of remifentanil were significantly decreased in group H compared to the control group and group L (P < 0.01). Conclusion: Magnesium sulfate could safely and effectively attenuate the pneumoperitoneum-related hemodynamic instability during gastrointestinal laparoscopy and improve postoperative pain at serum magnesium concentrations above 2 mmol/L.


2019 ◽  
Author(s):  
Wei Tan ◽  
Dong-chen Qian ◽  
Meng-meng Zheng ◽  
Xuan Lu ◽  
Yuan Han ◽  
...  

Abstract Background The infusion of magnesium sulfate is well known to reduce arterial pressure and attenuate hemodynamic response to pneumoperitoneum. This study aimed to investigate whether different doses of magnesium sulfate can effectively attenuate the pneumoperitoneum-related hemodynamic changes and the release of vasopressin in patients undergoing laparoscopic gastrointestinal surgery. Methods Sixty-nine patients undergoing laparoscopic partial gastrectomy were randomized into three groups: group L received magnesium sulfate 30 mg/kg loading dose and 15 mg/kg/h continuous maintenance infusion for 1 h; group H received magnesium sulfate 50 mg/kg followed by 30 mg/kg/h for 1 h; and group S (control group) received same volume 0.9% saline infusion, immediately before the induction of pneumoperitoneum. Systemic vascular resistance (SVR), cardiac output (CO), mean arterial pressure (MAP), heart rate (HR), serum vasopressin and magnesium concentrations were measured. The extubation time, visual analogue scale were also assessed. The primary outcome is the difference in SVR between different groups. The secondary outcome is the differences of other indicators between groups, such as CO, MAP, HR, vasopressin and postoperative pain score. Results Pneumoperitoneum instantly resulted in a significant reduction of cardiac output and an increase in mean arterial pressure, systemic vascular resistance, and heart rate in the control group (P < 0.01). The mean arterial pressure (T2 – T4), systemic vascular resistance (T2 – T3) and the level of serum vasopressin were significantly lower (P < 0.05) and the cardiac output (T2 – T3) was significantly higher (P < 0.05) in group H than those in the control group. The mean arterial pressure (T4) and systemic vascular resistance (T2) were significantly lower in group H than those in group L (P < 0.05). Furthermore, the visual analogue scales at 5 min and 20 min, the level of vasopressin, and the dosage of remifentanil were significantly decreased in group H compared to the control group and group L (P < 0.01). Conclusion Magnesium sulfate could safely and effectively attenuate the pneumoperitoneum-related hemodynamic instability during gastrointestinal laparoscopy and improve postoperative pain at serum magnesium concentrations above 2 mmol/L.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Wei Tan ◽  
Dong-chen Qian ◽  
Meng-meng Zheng ◽  
Xuan Lu ◽  
Yuan Han ◽  
...  

Abstract Background The infusion of magnesium sulfate is well known to reduce arterial pressure and attenuate hemodynamic response to pneumoperitoneum. This study aimed to investigate whether different doses of magnesium sulfate can effectively attenuate the pneumoperitoneum-related hemodynamic changes and the release of vasopressin in patients undergoing laparoscopic gastrointestinal surgery. Methods Sixty-nine patients undergoing laparoscopic partial gastrectomy were randomized into three groups: group L received magnesium sulfate 30 mg/kg loading dose and 15 mg/kg/h continuous maintenance infusion for 1 h; group H received magnesium sulfate 50 mg/kg followed by 30 mg/kg/h for 1 h; and group S (control group) received same volume 0.9% saline infusion, immediately before the induction of pneumoperitoneum. Systemic vascular resistance (SVR), cardiac output (CO), mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), serum vasopressin and magnesium concentrations were measured. The extubation time, visual analogue scale were also assessed. The primary outcome is the difference in SVR between different groups. The secondary outcome is the differences of other indicators between groups, such as CO, MAP, HR, CVP, vasopressin and postoperative pain score. Results Pneumoperitoneum instantly resulted in a significant reduction of cardiac output and an increase in mean arterial pressure, systemic vascular resistance, central venous pressure and heart rate in the control group (P <  0.01). The mean arterial pressure (T2 – T4), systemic vascular resistance (T2 – T3), central venous pressure(T3-T5) and the level of serum vasopressin were significantly lower (P <  0.05) and the cardiac output (T2 – T3) was significantly higher (P <  0.05) in group H than those in the control group. The mean arterial pressure (T4), systemic vascular resistance (T2), and central venous pressure(T3-T4) were significantly lower in group H than those in group L (P <  0.05). Furthermore, the visual analog scales at 5 min and 20 min, the level of vasopressin, and the dose of remifentanil were significantly decreased in group H compared to the control group and group L (P <  0.01). Conclusion Magnesium sulfate could safely and effectively attenuate the pneumoperitoneum-related hemodynamic instability during gastrointestinal laparoscopy and improve postoperative pain at serum magnesium concentrations above 2 mmol/L. Trial registration The study was retrospectively registered at Chinese Clinical Trial Registry; the registration number is ChiCTR-IPD-17011145, principal investigator: D.Y. Q., date of registration: April 13, 2017.


2019 ◽  
Author(s):  
Wei Tan ◽  
Dong-chen Qian ◽  
Meng-meng Zheng ◽  
Xuan Lu ◽  
Yuan Han ◽  
...  

Abstract Background: The infusion of magnesium sulfate is well known to reduce arterial pressure and attenuate hemodynamic response to pneumoperitoneum. This study aimed to investigate whether different doses of magnesium sulfate can effectively attenuate the pneumoperitoneum-related hemodynamic changes and the release of vasopressin in patients undergoing laparoscopic gastrointestinal surgery. Methods: Sixty-nine patients undergoing laparoscopic partial gastrectomy were randomized into three groups: group L received magnesium sulfate 30 mg/kg loading dose and 15 mg/kg/h continuous maintenance infusion for 1 h; group H received magnesium sulfate 50 mg/kg followed by 30 mg/kg/h for 1 h; and group S (control group) received same volume 0.9% saline infusion, immediately before the induction of pneumoperitoneum. Systemic vascular resistance (SVR), cardiac output (CO), mean arterial pressure (MAP), heart rate (HR), central venous pressure(CVP), serum vasopressin and magnesium concentrations were measured. The extubation time, visual analogue scale were also assessed. The primary outcome is the difference in SVR between different groups. The secondary outcome is the differences of other indicators between groups, such as CO, MAP, HR, CVP, vasopressin and postoperative pain score. Results: Pneumoperitoneum instantly resulted in a significant reduction of cardiac output and an increase in mean arterial pressure, systemic vascular resistance, central venous pressure and heart rate in the control group (P < 0.01). The mean arterial pressure (T2 – T4), systemic vascular resistance (T2 – T3), central venous pressure(T3-T5) and the level of serum vasopressin were significantly lower (P < 0.05) and the cardiac output (T2 – T3) was significantly higher (P < 0.05) in group H than those in the control group. The mean arterial pressure (T4) , systemic vascular resistance (T2) and central venous pressure(T3-T4) were significantly lower in group H than those in group L (P < 0.05). Furthermore, the visual analogue scales at 5 min and 20 min, the level of vasopressin, and the dosage of remifentanil were significantly decreased in group H compared to the control group and group L (P < 0.01). Conclusion: Magnesium sulfate could safely and effectively attenuate the pneumoperitoneum-related hemodynamic instability during gastrointestinal laparoscopy and improve postoperative pain at serum magnesium concentrations above 2 mmol/L.


2021 ◽  
Vol 20 (3) ◽  
pp. 631-636
Author(s):  
Rafida M ◽  
AH Safitri ◽  
Nurina Tyagita

Objective:Averrhoa bilimbi fruit contains potassium and flavonoid expected to play a role in lowering blood pressure. This study aim to examine the effect of Averrhoa bilimbi fruit extract on blood pressure and mean arterial pressure in NaCl-induced hypertensive rats. Materials and methods: This research employs pre- and post-test randomized control group design and uses 15 rats which are divided into 3 groups. On day 6, all groups are pretreated with NaCl 8% solution to induce hypertension for 14 days. On day 20, the control, furosemide and bilimbi groups are respectively treated with distilled water, 0.72mg/200gBW furosemide, and 150mg/200gBW Averrhoa bilimbi fruit extract for 7 days. The (systolic and diastolic) blood pressure and mean arterial pressure of each group are evaluated on day 20 and 27. The results are analyzed with Repeated Anova. Results: The mean systolic and diastolic blood pressure of the control, furosemide and bilimbi group before treatment are (128.4±11.8/88.0±7.8mmHg); (142.8±13.6/85.4±16.7mmHg); and (144.8±15.1/98.0±14.9mmHg) respectively. The mean systolic and diastolic blood pressure of the control, furosemide and bilimbi group after being treated are (88.0±11.8/60.8±7.8mmHg); (98.0±13.6/71.0±16.7mmHg); and (85.4±15.1/65.0±14.9mmHg) respectively. The mean arterial pressure of the control, furosemide and bilimbi groups are (69.4±8.2mmHg); (79.6±14.8mmHg); (71.4±15.0mmHg) respectively. There is a statistically significant difference in the blood pressure and the mean arterial pressure among the groups (p=0.000). Averrhoa bilimbi fruit extract has an effect on the blood pressure and the mean arterial pressure of NaCl-induced hypertensive rats. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.631-636


2020 ◽  
Vol 5 (2) ◽  
pp. 49-55
Author(s):  
Hafiko Andresni ◽  
Zahtamal Zahtamal ◽  
Winda Septiani ◽  
Mitra Mitra ◽  
Lita Lita

ABSTRACT Toilet training is an effort to train children to be able to control and urinate (BAK) and defecate (BAB). Toilet training is one of the main tasks of children at toddler age. Toilet training is one of the main tasks of children in toddler age which is very important to be done to create independence in children in controlling BAK and BAB and children know the parts of the body and their functions. Data in 2012 shows that ± 60% of parents do not teach toilet training to children from an early age. The aim of the study was to find out the effectiveness of toilet training education on maternal behavior and toilet skills in toddler age training (18-36 months). The study was conducted in July-August 2018. This type of quantitative research used the design of the Quasy pretest and posttest experiment with non-equivalent control group design. Samples were 36 mothers and 36 children with purposive sampling technique. Data analysis used Paired t test, Wilcoxon test, Man-Whitney test an Independent t test. The results showed that toilet training education through lecture methods, modules and maze games was more effective than toilet training education through lecture and leaflet methods on children's knowledge and abilities. Conversely, for the role of mothers in supervision there is no significant difference in effectiveness. Health education is recommended in health promotion programs to increase maternal knowledge, the role of mothers and the ability of toilet training children independently. Keywords: Toilet training, Lecture method, Module, Maze game, Leaflet, Knowledge, Role of mother, Children's ability.


2021 ◽  
pp. 037957212110254
Author(s):  
Harleen Kaur ◽  
Neerja Singla ◽  
Rohini Jain

Objective: India is the second country after China having the highest population prevalence of diabetes. Several research studies investigating diabetes have been done, but not much work has been done on prediabetes. The purpose of this study was to investigate the effect of nutrition and lifestyle modification on prediabetic females. Methods: A total of 120 prediabetic females from Ludhiana city were divided into 2 matched groups: control group (n = 60) and experimental group (n = 60). Impact of nutrition intervention for dietary and lifestyle modification (for 3 months) was assessed on the anthropometric, dietary, biochemical parameters, and diabetes risk score of the experimental group and control group (no intervention). Results: All the selected 120 subjects completed the study (experimental group = 60; control group = 60). There was significant difference in the changes between the 2 groups throughout the study. The fasting blood glucose and glycated hemoglobin A1c levels of the experimental group subjects reduced significantly ( P ≤ .01). However, no change was observed among the control group subjects. The lipid profile of the experimental group showed a significant improvement ( P ≤ .01). Conclusion: Nutrition counselling of the prediabetics regarding dietary and lifestyle modification is recommended so as to improve their metabolic control, thus preventing them from being diabetics.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. Lombardo ◽  
A. Vigezzi ◽  
G. Ietto ◽  
C. Franchi ◽  
V. Iori ◽  
...  

AbstractPatients afflicted with melanoma show lower vitamin D serum levels (VDSL) than the healthy population. This hypothesis agrees with its well-known antiproliferative features. An observational study was carried out to collect VDSL in patients suffering from melanoma. Our aim was to identify a potential connection between low VDSL and the risk to incur melanoma. Furthermore, we studied the association between VDSL at the diagnosis of melanoma and other germane prognostic factors. The population held in regard was composed of 154 patients with a diagnosis of melanoma between 2016 and 2019. These patients were retrospectively collected from our follow-up storage. We compared VDSL to clinical and pathological parameters (age, sex, tumour location, Breslow’s depth, Clark’s level, histological subtype, ulceration, et aliqua). Moreover, we recruited a control group with negative melanoma history. Mean and median of VDSL were significantly lower in the melanoma group. Instead, we found a negative association between melanoma and VDSL > 30 ng/L (OR 0.11; p < 0.0001). No correlation between VDSL and both Breslow’s depth and Clark’s level was discovered, but the VDSL comparison between thin (depth ≤ 1 mm) and thick tumours (depth > 1 mm) revealed a statistically significant difference (21.1 ± 8.2 ng/L vs 17.8 ± 8.1; p = 0.01). Moreover, VDSL were significantly lower in melanomas with mitotic rate ≥ 1/mm2 (22.1 ± 8.3 ng/L; p < 0007). Nevertheless, no connection was found between VDSL and both ulceration and positive sentinel nodes (p = 0.76; p = 0.74). Besides, our study revealed no association between VDSL and histological subtype (p = 0.161). Lower VDSL correlate with thick and high mitotic rate tumours. Future prospective studies would investigate if appropriate upkeep of suitable VDSL can decrease the risk of primary and recurrent melanoma diagnosis.


2014 ◽  
Vol 15 (2) ◽  
pp. 83-88
Author(s):  
Dusko Kornjaca ◽  
Vladimir Zivkovic ◽  
Nevena Barudzic ◽  
Vladimir Jakovljevic ◽  
Dragan Djuric

ABSTRACT Vibroacoustics, a scientific field that has been intensively studied for the last thirty years, uses the properties of sound waves (infrasound, ultrasound, noise and music) to induce vibrations that, like a sound wave, may have both useful and harmful effects. Th e aim of this study was to examine the effects of vibroacoustically induced microvibrations on arterial blood pressure and markers of oxidative stress in the blood. Th e experiments were performed on Wistar male rats that had a 180-200 g body mass and were divided into control and experimental groups (6 rats in each). In the experimental group, microvibrations were induced using the Vitafon vibroacoustic apparatus (Vitafon, St. Petersburg, Russian Federation), which delivers sound waves of varying frequencies by a process called “phoning”. Up to 60 minutes of phoning time was delivered to the kidney and liver using 4 diff erent regimens that included a 5-minute stabilisation time; up to four 10-minute phoning regimens, with 5-minute breaks between each single regimen, at a 30 Hz-18000 kHz frequency range;, and 2.8 μm-12.3 μm microwave amplitudes. After the completion of a phoning regimen, animals were sacrificed and the oxidative stress markers were measured in blood samples (O2-, H2O2, nitrites, lipid peroxidation index, superoxide dismutase, catalase, and glutathione) and compared with the values of markers in the control group. Systolic arterial pressure was analysed after the acute application of up to four diff erent regimens of vibroacoustic microvibrations. Systolic arterial pressure decreased significantly during the administration of the second regimen in comparison to the control group. Systolic arterial pressure returned, almost completely, to the initial value after the administration of the third and fourth regimens. Th ere was no significant change in diastolic arterial pressure after the acute administration of up to four different regimens, although the pressure decreased slightly after the first and second regimens and returned to the initial value during the administration of the third and fourth regimens. Analysis of oxidative stress markers showed a statistically significant change in the catalase level. No statistically significant differences were found in the other oxidative stress markers analyzeanalysed. Further research is needed to clarify the physiological effects of low compared to high frequencies of vibroacoustically induced microvibrations and their possible therapeutic significance.


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