Evaluation of C-reactive protein and magnesium level in migraine patients on pre and post prophylactic treatment

Migraine affects the day to day life of the sufferers with the symptoms of photophobia and phonophobia with pulsatile or non-pulsatile headache lasting from 1 to 4 hours. Prophylactic treatment or anti-migraine drugs were given to migraineurs to overcome the complications. C-reactive protein (CRP) and Magnesium level of symptomatic migraineurs, which act as biomarkers for the inflammatory cerebrovascular diseases before and after the treatment with Sodium Divalproex, Flunarizine and Propranolol. The evaluation of C-reactive protein and magnesium levels are noted along with symptoms when they first walk into the clinic. Treatment provided with Sodium Divalproex, Flunarizine and Propranolol for one month. After 1 month, the same tests are being performed. During the test at first instance, the values of pain scale were 31%, CRP value for negative were 20% and positive were 80% and pre-test of Serum magnesium level was 8.8% and at the second visit the pain scale reduced to 10.25%; CRP level was negative 25% and positive was 75%; Serum Magnesium was 9.35%. So, the significant values are being measured by the statistics, which we applied and found P=0.05. The patients who visited first didn’t come for the second visit. So, the results might vary and the patients who visited for the second time after one-month treatment, some got effective results while others remained ineffective. The reason for being ineffective is that they might have adapted to their current regimen.

Hypomagnesaemia in children under five years of age having acute diarrhea.

Objective: To determine the frequency of hypomagnesaemia in children under five year of age having acute diarrhea. Study Design: Descriptive Cross Sectional study. Setting: Department of Pediatric Medicine, Rashid Latif Medical College / Arif Memorial Teaching Hospital, Lahore. Period: August 2019 to January 2020. Material & Methods: A total of 96 children aged between 6 months to five years having acute diarrhea and duration of illness <14 days were enrolled. All the patients were subjected to measurement of serum magnesium level. The proportion of hypomagnesaemia was analyzed in acute diarrhea. The effect modifier and confounding variables were controlled through stratification of data on duration of illness less as < 14 days and more than 14 days, age as < 2 year or > 2 year and weight as < 2SD or > 2SD on weight for age chart. Chi square test was applied considering p value < 0.05 as significant. Results: Our study comprised of 96 patients having acute diarrhea, of these 96 study cases, 62 (64.6%) were boys and 34 (35.4%) were girls. Mean age of our study cases was 19.25±15.71 months. Mean weight of study cases was 9.56±3.01 kg. Mean duration of illness was 5.74 ± 3.26 days. Mean Serum Magnesium level was 1.63 ± 0.32 mg/dl (ranging from 1.0 mg/dl to 2.8 mg/dl). Hypomagnesaemia was present in 47 (49%) cases. Conclusion: High frequency of hypomagnesaemia was observed in children under 5 years of age having acute diarrhea. Duration of illness had significant impact on hypomagnesaemia. Serum magnesium levels must be regularly monitored in children with acute diarrhea.

Calcium Pyrophosphate Crystal Deposition in a Cohort of 57 Patients with Gitelman Syndrome

Objective Gitelman syndrome (GS) is the most frequent salt-wasting genetic tubulopathy and a source of hypokalaemia and hypomagnesemia. Chondrocalcinosis (CC) is a frequent feature of GS. The aim of our study was to determine the prevalence, distribution patterns, clinical phenotypes and risk factors of CC in GS. Methods This prospective study of a cohort of 57 patients with GS included a systematic screening for CC by peripheral joint radiography, cervical spine computerized tomography (CT) and joint ultrasonography. The prevalence of cervical C1-C2 CC by CT was compared between 33 GS patients and sex- and age-matched controls. Clinical and biochemical features were analysed to identify factors associated with CC. Results Mean age of patients was 46.5 ± 12.4 years, 66.7% were women, and 93.0% carried SLC12A3 mutations. Mean serum magnesium level was 0.60 ± 0.30 mmol/l. CC was observed in 79% of patients, with the highest prevalence at the cervical spine (81.8%) followed by the knee (52.6%), wrist (50.9%), ankle (38.6%), temporomandibular joint (36.4%), shoulder (33.3%), hip (22.8%), elbow (14.0%) and sclero-choroid (12.1%). Prevalence of CC at the C1-C2 level was higher in the GS cohort than control group (72.7% vs 9.1%) (adjusted odds ratio 21.0, 95% CI 2.8–156.1, p= 0.003). Independent factors associated with CC were low serum magnesium level and age. Conclusion GS was associated with widespread CC, favoured by aging and hypomagnesemia. The C1-C2 level was the most affected site. Follow-up of this unique cohort will help understanding the clinical consequences of CC, especially the precise characterization of pyrophosphate arthropathy.

Assessment of Magnesium Levels in Ischemic Cerebral Stroke Patients and Its Correlation with Severity of Neurological Disability – A Longitudinal Observational Study from Sri Amritsar, Punjab

BACKGROUND World Health Organization (WHO) clinically defines a stroke as ‘the rapid development of clinical signs and symptoms of a focal neurological disturbance lasting more than 24 hours or leading to death with no apparent cause other than vascular origin’. Hypo magnesia (ionized form) leads to neuromuscular hyperirritability, tremors, increased vascular resistance, coronary vasospasm and hypertension. Magnesium deficiency triggers vasoconstriction enhancing vascular endothelial injury and hence leads to atherosclerosis. In the present study, we wanted to evaluate serum magnesium levels in ischemic cerebral stroke patients and correlate its severity with the neurological disability using modified Rankin scale (mRS) and Canadian neurological scale. METHODS It was a longitudinal observational study, undertaken in the Department of Medicine in Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar from December 2018 to June 2020. 60 patients with acute ischemic cerebral stroke fulfilling the inclusion criteria were selected. 5 ml venous sample for serum magnesium level was taken within 24 hours and on day 5 of admission. Presence or absence of hypomagnesemia in patients after acute cerebral ischemic stroke was recorded during the hospital stay of patients, receiving standard management protocol of ischemic stroke. The correlation co-efficient of serum magnesium level with modified Rankin scale and Canadian neurological scale was calculated. RESULTS The mean age of patients was 61.6 ± 1.6 years, 42 (70 %) patients were male and 18 (30 %) were females and there was male preponderance. The mean serum magnesium level was measured as 1.78 ± 0.2 mg/dL, it was observed that the mean value for mRS was 3.93 ± 0.75 and Canadian neurological scale was 7.11 ± 2.01 within 24 hours and on the 5th day the mean value for mRS was 3.5 ± 1.09 and Canadian neurological scale was 8.02 ± 2.97. The present study observed a statistically significant correlation between mRS score and serum magnesium level as well as Canadian neurological scale and serum magnesium levels. CONCLUSIONS It was concluded through the results of this study that low levels of magnesium in the body can cause more severe stroke. KEYWORDS Stroke, Serum Magnesium, Hypomagnesemia, Modified Rankin Scale, Canadian Neurological Scale

Serum Magnesium Level as a Biomarker to Predict the Risk of Labor Epidural Anesthesia Associated Fever

Background: Labor epidural anesthesia-associated fever（LEAF) is the biggest problem for labor epidural anesthesia. This study aimed to evaluate the clinical value of serum magnesium levels to predict the LEAF.Methods: Finally, overall 528 singleton term-pregnant women who underwent labor epidural anesthesia in Fujian Provincial Maternity and Children's Health Hospital, affiliated hospital of Fujian Medical University from January 2019 to June 2019, were analyzed retrospectively. Using venous blood samples, the serum magnesium level was detected. The relationship between the serum magnesium level and LEAF was interpreted, and the optimal cut-off values of the serum magnesium level to predict LEAF were calculated. Results: Overall, 65（12.30%）participants had LEAF. And a higher rate of the bulging membrane, gestational hypertension, NICU admission, and the different mode of delivery was significantly associated with LEAF. Also, the serum magnesium level demonstrated higher significantly in LEAF presence than absence (p<0.05). What is more, it indicated that the area under the receiver operating characteristic curve (AUC) for the serum magnesium level was 0.825, and an optimal cut-off of the serum magnesium level was 0.855 mg/dl. Furthermore, it demonstrated that the serum magnesium level had the highest OR (OR= 7.49; 95% CI (4.58-14.35) ). The bulging membrane is an independent risk factor LEAF presence (OR = 1.55; 95% CI (1.01-2.43 ).Conclusions: Serum magnesium may reduce the incidence of LEAF. Serum magnesium can provide a suitable biomarker to predict LEAF and offer a useful target for LEAF treatment.

A Study on Some Serum Biological Constituents during Different Days of Normal Oestrous Cycle of Manipuri Pony Mares

Background: The aim of this study was to estimate the serum biochemical (glucose, cholesterol, total protein, calcium, phosphorus and magnesium) and hormonal constituents (estrogen and progesterone) in female Manipuri pony mares during the different days of oestrous cycle. Methods: A total of 50 numbers of blood samples were collected from 10 numbers of apparently healthy, non-pregnant on the different days of oestrous cycle i.e. day 0, 4, 8, 14 and 18 by using commercial diagnostic kits. Result: The mean serum levels of glucose, cholesterol and phosphorus were found to be non-significant on the different days of oestrous cycle whereas the mean serum level of total protein and calcium was found significantly different (P less than 0.01). The serum magnesium level differed significantly (P less than 0.05) amongst the different days of oestrous cycle. Both estrogen and progesterone were also found to be significant (P less than 0.01) between the different days of oestrous cycle. The results showed significant influence on serum biochemical and hormonal assay during different days of oestrous cycle in female Manipuri pony.