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.

Frequency of Hypomagnesaemia in Children with Hypocalcemic Seizures

Aim: To determine the frequency of hypomagnesaemia in children with hypocalcemic seizures. Study Design: Cross sectional descriptive study. Place and Duration: Department of Pediatrics, Liaquat University Hospital, Jamshoro / Hyderabad. From November 2017 to April 2018. Methodology: Children (06 months to 06 years age and of either gender) having Two or more than two hypocalcemic seizures within 12 hours duration were included in the study . The children with hypocalcemic seizure were assessed for magnesium deficiency (hypomagnesaemia). The evaluation of hypomagnesaemia was done according to the cut off / reference values for hypomagnesaemia (<1.8 mg/dl). The data was collected on pre-structured proforma (attached). Results: Total 147 children with hypocalcemic seizures were taken in this study, among them 49 (33.3%) patients had found low magnesium level and 98 (54.4%) patients had normal magnesium level. Conclusion: Seizures associated with hypocalcaemia is one of the common type of convulsion in children. In our study, a positive relation was found between low levels of serum magnesium and hypocalcemic seizures.

New Insight of Methylenetetrahydrofolate Reductase (MTHFR) C677T Gene Polymorphisms, and Serum Electrolytes in Cardiac Syndrome X Patients

Background: Cardiac Syndrome X (CSX) is a condition affecting the cardiovascular system with a significant degree of morbidity. Diagnosis and treatment are challenging when the cause is unclear. Subsequently, a molecular marker for screening of people with CSX is highly recommended. The present study evaluated the association between MTHFR C677T gene polymorphism among Sudanese patients with CSX. Materials and Methods: A total of 100 subjects were enrolled. Venous blood sample was collected from each participant in Ethylene Diamine Tetracetic Acid (EDTA) containers. DNA was extracted from blood samples using guanidine chloride method and MTHFR mutation was detected by PCR-restriction fragment polymorphism (PCR-RFLP). Statistical package for social sciences (SPSS) was used to analyze data. Results: Most patients 30(60%) were females, their age ranged between 30-60 with mean age 44.98±7.34 SD. MTHFR 677CT genotype frequency was statistically significant (P≤0.014), where 10(20%) had 677CT and 1(2%) had 677TT among patients group respectively compared to control individuals who had only 2(4%) 677CT. T alleles were significantly more frequent among our participant than C alleles. There is insignificant slightly decreased (2.4 ±2.8, and 2.5±3.2) in serum magnesium levels among patients compared to control respectively, as well as random blood glucose. Elevated mean levels of total cholesterol, and HDL among patients (182 ±18.1, and 49.7±7.1) vs (180 ±20.3, and 46.6 ±11.3) among control group, all findings were statistically non-significant. Slightly decrease in magnesium level (2.2 ±2.1, vs 2.9 ±0.8) among heterozygous CT genotypes compared to homozygous genotypes. Conclusion: MTHFR C677T is linked to CSX in the Sudanese population, and serum magnesium level was slightly decreased among heterozygous MTHFR C677T. Furthermore, the mutation could be used as a disease molecular screening technique.

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.

Study of effect of serum magnesium concentration on clinical outcome of critically sick patients in medical intensive care unit

Background: Deficiency of magnesium is common and often ignored. It is associated with cardiac irregularity, cardiac insufficiency, seizure and electrolyte imbalance. As this element has multiple functions in our body it is important in the pathophysiology of several critical illnesses in intensive care unit (ICU). Hence the present study was undertaken to determine the usefulness of admission serum magnesium levels with regards to patient outcome considering mortality, need and duration of ventilator support, and acute physiologic assessment and chronic health evaluation 2 (APACHE 2) score.Methods: Demographic data such as age and sex were recorded. Patients were assessed for presenting complaints, history of other diseases and habits through an interview with the patients or care giver. These findings were recorded on a predesigned proforma patients was followed up for the outcomes such as mortality, need of ventilator support, duration of ICU stay and APACHE 2 score.Results: Regarding comparison between outcome of patients between two groups, 44% patients with magnesium level <1.7 mg/dl have improved and 72% patient didn’t improve. 44% patients with magnesium level >1.7 mg/dl have improved and 28% patient didn’t improve.Conclusions: From present observational study we can conclude that hypomagnesaemia is more common in patients more than 50 years of age and with male predominance. Pneumonia with septicaemia and cerebrovascular accident (CVA) was commonly associated with hypomagnesaemia. In present study we have observed that hypomagnesaemia is associated with high APACHE 2 score, poor outcome and more requirement of ventilatory support.

Hypomagnesemia and Poor Glycemic Control Among Palestinian Type 2 Diabetic Patients: A Cross-Sectional Study

Background: Hypomagnesemia has been shown to have a significant impact on both glycemic control and diabetes complications in type 2 Diabetes Mellitus (T2DM) patients. This study aims to assess the prevalence of hypomagnesemia in T2DM patients and find the association between serum magnesium levels and outcomes relevant to glycemic control and diabetic complications.Methods: A cross-sectional study was conducted and included 373 patients (222 males and 151 females). Serum magnesium levels were measured by the Colorimetric Endpoint Method using the Cobas C501system. Hypomagnesemia was determined to be a serum magnesium level <1.6 mg/dL. In addition, the following data were also obtained; patients' characteristics, anthropometric measurements, smoking status, HbA1c, co-morbidities, and therapeutic management. Results: Patients' mean age was 56.2 ±10.8 years, 24.6% were smokers, and most were overweight or obese. About 60% have a history of hypertension, and the majority have had diabetes for more than ten years. Their mean HbA1c level was 8.5±2. The prevalence of hypomagnesemia was 11% (95% CI: 8%-14.6%). It was found to be significantly higher among females (adjusted OR: 2.7, 95%CI: 1.2%-5.8%), patients with HbA1c ≥ 8% (adjusted OR: 2.4, 95%CI: 1.1%-5.5%), and patients with a history of diabetic retinopathy (adjusted OR: 2.7, 95%CI: 1.1%-7.1%). Conclusions: the study showed that hypomagnesemia is more prevalent in females and is associated with diabetic retinopathy and poor glycemic control. Having a sufficient magnesium level may be associated with better glycemic control and a reduced occurrence of complications.

Plasmatic Magnesium Deficiency in 101 Outpatients Living with Type 2 Diabetes Mellitus

(1) Background: Magnesium deficiency is usually associated with type 2 diabetes mellitus (T2DM). Individuals living with T2DM with hypomagnesemia show a more rapid disease progression and have an increased risk for diabetes complications. (2) Methods: This is a cross-sectional and descriptive study in the National Institute of Nutrition and Food Technology of Tunis in Tunisia, including all adult outpatients (≥18 years old) with a diagnosis of T2DM from 1 September 2018 to 31 August 2019. The aim of this study was to evaluate the prevalence of plasmatic magnesium deficiency in a Tunisian population of T2DM and to study the relationship between magnesium status and intake, glycemic control and long-term diabetes-related complications. (3) Results: Among the 101 T2DM outpatients, 13 (12.9%) presented with a plasmatic magnesium deficiency. The mean age was 56 ± 7.9 years with a female predominance (62%, n = 63). The mean of the plasmatic magnesium level was 0.79 ± 0.11 mmol/L (0.5–1.1), and the mean of 24 h urinary magnesium excretion was 87.8 ± 53.8 mg/24 h [4.8–486.2]. HbA1c was significantly higher in the plasmatic magnesium deficiency group than the normal magnesium status group (10% ± 1.3 vs. 8.3% ± 1.9; p = 0.04), with a significant difference in participants with a poor glycemic control (HbA1c > 7%) (100%, n = 13/13 vs. 53%, n = 47/88; p = 0.001). A weak negative relationship was also found between plasmatic magnesium and HbA1c (r = −0.2, p = 0.03). Peripheral artery disease was more commonly described in individuals with low plasmatic magnesium levels than in individuals with normal levels (39%, n = 5 vs. 0%, n = 0; p < 0.001). The mean plasmatic magnesium level in participants without diabetic nephropathy and also peripheral artery disease was significantly higher compared to individuals with each long-term diabetes-related complication (0.8 mmol/L ± 0.1 vs. 0.71 mmol/L ± 0.07; p = 0.006) and (0.8 mmol/L ± 0.1 vs. 0.6 mmol/L ± 0.08; p < 0.001), respectively. (4) Conclusions: Hypomagnesemia was identified in individuals with T2DM, causing poor glycemic control and contributing to the development and progression of diabetes-related microvascular and macrovascular complications.

Serum magnesium and zinc levels- A predictor of cardiovascular risk in hemodialysis patients

Cardiovascular disease is one of the leading causes of mortality in haemodialysis patients. Several studies have demonstrated the relation of zinc and magnesium in cardiovascular disease. In present study we aimed to measure serum zinc and magnesium levels and correlate with the Framingham score to calculate the cardiovascular risk.Present study was prospective, cross sectional type, conducted in chronic kidney disease patients undergoing haemodialysis.Serum magnesium, zinc, cholesterol, urea, creatinine, HDL cholesterol, systolic BP are measured and Framingham score was calculated. And zinc and magnesium values were correlated with Framingham score. The study is conducted in 100 CKD patients undergoing hemodialysis. Out of 100 CKD patients undergoing hemodialysis, 59% had high risk,28% had intermediate risk, and 13% had low risk of developing cardiovascular disease according to their Framingham risk score. In these patients, zinc and magnesium levels were found and correlated with Framingham risk score. Out of 100 patients undergoing hemodialysis, 37 patients were hypomagnesemic, 43 patients were normomagnesemic, 20 patients were hypermagnesemic. In this, a positive correlation was found between development of hypomagnesemia and duration of hemodialysis. Magnesium level was correlated with Framingham risk score. In this hypomagnesemic patients, 67% patients have low risk, 8% have intermediate risk, 24% patients have high risk of developing heart disease. Out of 100 patients, 86 patients have normal zinc level, 14 patients have increased zinc level. Zinc levels was not altered during dialysis. These patients already have risk of developing heart disease independent of zinc level.In our study, magnesium level of haemodialysis patients was reduced and it is associated with duration of haemodialysis. Zinc levels were not altered in the patients.