Total Serum Magnesium Research Articles

English

BACKGROUND Mineral metabolism is frequently disturbed in thyroid dysfunctions. Among thyroid dysfunctions, hypothyroidism is one of the most common form resulting from the deficiency of thyroid hormones. Studies done on serum calcium, phosphorus and magnesium in hypothyroid patients earlier have conflicting results. Hence the present study has been undertaken to study the levels of serum calcium, phosphorus, and magnesium among hypothyroid patients and analyse their correlation with thyroid stimulating hormone (TSH). METHODS The case control study was conducted in the Department of Biochemistry in Trichy SRM Medical College Hospital and Research Centre for a period of 6 months from 2017 January to July 2017. The study was undertaken involving 50 hypothyroid cases and 50 healthy volunteers as controls after proper ethical clearance and informed consent of all the study subjects. Serum calcium, phosphorus and magnesium were measured along with tri-iodothyronine (FT3), tetra-iodothyronine (FT4) and TSH among all study subjects. Statistical analysis of data was done using statistical package for social sciences (SPSS) software. RESULTS The mean value of serum total calcium and total magnesium was lower among hypothyroid cases and phosphorus value was increased as compared to controls. (P < 0.001) Statistically significant negative correlation was observed between serum calcium, magnesium and TSH among hypothyroid cases. Statistically significant positive correlation was observed between serum phosphorus and TSH among hypothyroid cases. CONCLUSIONS Among hypothyroid patients the values of serum calcium, magnesium and phosphorus is significantly altered. Thyroid disorders have an important role in bone and mineral metabolism. Thus, monitoring of these minerals among hypothyroid patients in regular follow up may effectively improve the clinical manifestations in them. Hence, monitoring of mineral status of the hypothyroid patients on follow-up will be of benefit to the patients. KEYWORDS Hypothyroidism, Calcium, Phosphorus, Magnesium, Minerals

Effect of phototherapy on serum magnesium level in newborn with hyperbilirubinemia

Objective To screen neonates with hyperbilirubinemia who received phototherapy to determine the effect of phototherapy on the serum magnesium level. Background Hyperbilirubinemia is one of the most prevalent problems in neonates. Phototherapy remains the main primary management in neonatal jaundice. However, it has many adverse effects, and hypomagnesemia is one of them. Patients and methods A prospective hospital-based comparative study was conducted on 70 eligible neonates admitted in Neonatal Intensive Care Units of Menoufia University Hospital receiving phototherapy from May 2019 to February 2020. Serum bilirubin and magnesium (total and ionized) were determined before starting phototherapy, and it was considered as control. Then serum bilirubin and magnesium were measured after 48 h of phototherapy and after termination of phototherapy. The plasma magnesium level was measured spectrophotometrically using ready-for-use kit supplied by Quimica Clinica Aplicada S.A. Company. Results The total serum magnesium level before phototherapy was 2.7 ± 0.3, 2.1 ± 0.30 mg/dl 48 h after phototherapy, and 1.85 ± 0.28 mg/dl after termination of phototherapy. Serum ionized magnesium level before phototherapy was 0.58 ± 0.02, 0.53 ± 0.02 mmol/l 48 h after phototherapy, and 0.51 ± 0.01 mmol/l after termination of phototherapy. So, there was a significant decrease in serum magnesium level (total and ionized) after phototherapy. Conclusion Our study concluded that there was a significant negative correlation between the duration of phototherapy and serum magnesium level (total and ionized).

Prognostic indicators at presentation for canine parvoviral enteritis: 322 cases (2001-2018).

To evaluate clinicopathological prognostic indicators associated with survival based on hematology and serum biochemistry profile findings at presentation of dogs with canine parvoviral enteritis (CPE). Secondary objectives were to describe the signalment, history, physical examination findings, and progression of disease while in hospital and correlate them to survival. Retrospective study from medical records of dogs diagnosed with CPE between 2001 and 2018. University teaching hospital. Three hundred twenty-two dogs diagnosed with CPE that received in-hospital treatment. None. Of 322 hospitalized dogs, 294 dogs (91%) survived infection with a median hospitalization time of 79hours. Multivariable analysis showed that glucose (P=0.04), total magnesium (P=0.011), and the dichotomized variable of a low HCT (P=0.033) on presentation were significantly associated with survival. For every 1mmol/L (18mg/dL) decrease in glucose concentration, cases had 1.85 lower odds of survival. For every 0.1mmol/L (0.2mEq/L) increase in total magnesium concentration, cases had 2.50 lower odds of survival. Cases with a low HCT had 10.69 lower odds of survival. On univariable analyses, non-survivors had a lower median body weight (P=0.006) and presented more commonly for diarrhea (P=0.015). At least 1 episode of diarrhea (P=0.003) and hematochezia or melena (P<0.001) in hospital were negatively associated with outcome, in addition to the persistence of diarrhea (P=0.026) and hyporexia (P=0.018) in hospital for 5 to 6 days. Survival rates of 91% were achieved with in-hospital treatment in this cohort of dogs. Negative biochemical prognostic indicators affecting survival include a low HCT, decreased blood glucose concentrations, and increased total serum magnesium concentrations at presentation.

Ionized or Total Magnesium levels, what should we measure in critical ill patients?

Monitoring and measuring magnesium (Mg) values are essential to prevent the development of numerous complications in perioperative medicine and critically ill patients. Although previous studies suggest that measuring free ionized magnesium (iMg) is more useful for estimating Mg status, clinicians currently rely on measurement of total serum magnesium to determine if supplemental magnesium is needed. In this review, we analyzed the recent literature to decide whether it is better to measure ionized serum Mg or total serum Mg when assessing magnesium status, whether iMg predicts clinical outcome, and what are the difficulties in measuring serum iMg levels in intensive care patients and perioperative medicine.

Bone involvement in Gaucher disease type 1: a differential diagnosis of multiple fractures in a young patient. Case report

Gaucher disease type 1 (GD1) is a rare inherited disease caused by mutations in the GBA1 gene, which encodes the lysosomal enzyme glucocerebrosidase, leading to decreased enzyme activity and the consequential accumulation of its substrate, glucosylceramide, within macrophages. Bone involvement in GD1 may include avascular necrosis, bone infarcts, fragility fractures, lytic or sclerotic bone lesions and osteomyelitis. Bone pain can manifest as an acute and very painful bone crisis or a chronic pain that might vary in intensity, usually caused by fractures or avascular necrosis with progressive collapse of bone and joints. Hence, this report aims to describe a case of Gaucher disease type 1 and discuss its diagnosis, bone involvement and management, since late diagnosis or inadequate therapy can lead to clinical worsening, irreversible mobility impairment and increased morbidity. AGR, a 32-year-old male patient, was admitted to the Rheumatology Service with a previous history of diffuse bone pain, episodic hyperemia in the lower limbs since the age of 9 and two low-impact fractures. He had an initial non-confirmed diagnostic hypothesis of chronic recurrent multifocal osteomyelitis and was taking dipyrone and tramadol to reduce pain. His physical examination evinced overweight (body mass index: 29.7 kg/m2) and hepatosplenomegaly. Laboratory tests shown thrombocytopenia, with platelet count 103,000/mm3 (reference value [RV]: 140,000-450,000/mm3), serum phosphorus 4.7 mg/dL (RV: 2.7-4.5 mg/dL), C-reactive protein 88.8 mg/dL (RV: &lt; 5 mg/dL) and ferritin 1336 ng/mL (RV: 30-400 ng/mL). Biochemical and bone turnover markers were normal, including serum total calcium and magnesium, parathyroid hormone, 25-OH vitamin D, alkaline phosphatase, procollagen type-I N-terminal propeptide and C-terminal telopeptide of type I collagen. Conventional radiographies and magnetic resonance imaging were performed and confirmed previous fractures in the right humerus and the right acetabulum. They also showed sclerotic lesions in the left femur and Erlenmeyer flask deformities in the distal femurs and the proximal tibias. Bone scintigraphy indicated a bone infarct area in the left tibia. Areal bone mineral density (BMD) evaluated by bone densitometry showed a left total femur Z-score of +4.3 and left femoral neck Z-score of +4.5. Differently, the bone microarchitecture and volumetric BMD, evaluated by a high-resolution peripheral quantitative computed tomography (HR-pQCT) at distal radius and distal tibia, demonstrated an impairment of cortical compartment with lower cortical thickness and lower cortical volumetric BMD, possibly contributing to the low-impact fractures. Considering the compatible radiological findings, associated with hepatosplenomegaly and thrombocytopenia, Gaucher disease type 1 became the major hypothesis. It was confirmed after enzymatic dosage, which showed low residual glucocerebrosidase activity and high serum chitotriosidase. Enzyme replacement therapy was started with taliglucerase alfa, a recombinant enzyme preparation that aims to supply the lacking glucocerebrosidase in lysosomes. After 6 months of treatment, patient reported a significant improvement in bone pain and general quality of life. Therefore, clinicians should be alert to young patients with multiple low-impact fractures and further evaluate other possible bone involvement, as GD1 may be a differential diagnosis. Since it needs specific treatment, early diagnosis can be crucial to avoid permanent bone damage and morbidity.

Continuous Observation of Serum Total Magnesium Level in Patients Undergoing Hemodialysis

Background: Magnesium is an indispensable cation and plays an important physiological role in the body. Most previous studies focused on the single measurement of serum magnesium in patients undergoing hemodialysis. However, scant studies focused on continuous observations of serum magnesium levels. Objective: To provide continuous observations of serum magnesium levels in patients on maintenance hemodialysis (MHD). The levels of magnesium in patients initiating hemodialysis are also recorded and analyzed in the present study. Methods: In this retrospective study, we serially investigated the measurements of serum total magnesium in MHD patients and patients initiating hemodialysis. Our data were followed up for one year. We provided real-time update on the levels of serum magnesium in patients on hemodialysis. Results: On January 1, 2019, a total of 356 end-stage renal disease patients were receiving hemodialysis in our hospital. On December 31, 2019, the number had increased to 383. We found that serum total magnesium levels were in the normal range before initiating hemodialysis. With the initiation of hemodialysis, the levels of serum total magnesium increased. In patients on MHD, hypermagnesemia was very common. Hypomagnesemia was rare when 0.5 mmol/L magnesium dialysate was used. We did not find proton pump inhibitor associated hypomagnesemia. Conclusion: We find that serum total magnesium levels are in the normal range before initiating hemodialysis. However, in patients on MHD, hypermagnesemia is common when 0.5 mmol/L magnesium dialysate is used. Hypomagnesemia is very rare. Hypomagnesemia in patients on MHD is an indicator of poor condition.

Magnesium Deficiency Questionnaire: A New Non-Invasive Magnesium Deficiency Screening Tool Developed Using Real-World Data from Four Observational Studies.

Due to the high estimated prevalence of magnesium deficiency, there is a need for a rapid, non-invasive assessment tool that could be used by patients and clinicians to confirm suspected hypomagnesemia and substantiate laboratory testing. This study analyzed data from four large observational studies of hypomagnesemia in pregnant women and women with hormone-related conditions across Russia. Hypomagnesemia was assessed using a 62-item magnesium deficiency questionnaire (MDQ-62) and a serum test. The diagnostic utility (sensitivity/specificity) of MDQ-62 was analyzed using area under the receiver operating characteristic curve (AUROC). A logistic regression model was applied to develop a shorter, optimized version of MDQ-62. A total of 765 pregnant women and 8836 women with hormone-related conditions were included in the analysis. The diagnostic performance of MDQ-62 was “fair” (AUROC = 0.7−0.8) for women with hormone-related conditions and “poor” for pregnant women (AUROC = 0.6−0.7). The optimized MDQ-23 (23 questions) and MDQ-10 (10 questions) had similar AUROC values; for all versions of the questionnaire, there was a significant negative correlation between score and changes in total serum magnesium levels (p < 0.0001 for all comparisons; correlation coefficients ranged from −0.1667 to −0.2716). This analysis confirmed the value of MDQ in identifying women at risk of hypomagnesemia.

Alteration of serum calcium and magnesium level in transfusion dependent thalassemic patients with combined iron chelator therapy

Background: Regular blood transfusion and iron chelation is the primary treatment of thalassemia patientsto maintain their life. Iron chelatormay alter serum total calcium and magnesium level in TDT patients.&#x0D; Objective: To evaluateany alteration of serum total calcium and magnesium level in transfusion dependent thalassemia patients treated with iron chelator.&#x0D; Method: The present cross sectional study was carried out in the department of Physiology, BSMMU, Dhaka between September 2017 to February 2019. Thirty cases of TDT, aged 5-40 year were included in the study group. Age and sex matched 30 healthy subjects were also studied as control. All the TDT patients were selected from the outpatient Department of Hematology and Transfusion Medicine, BSMMU, Dhaka. Serum total calcium, magnesium and ferritin levels were measured by colorimetric method. For statistical analysis independent sample t test and Chi-Square test and Pearson correlation coefficient test were used.&#x0D; Result: The mean serum total calcium and magnesium levels were significantly (p&lt;0.05) lower and serum ferritin level was significantly (p&lt;0.001) higher in study group compared to that of control. Again, in this study group 6.7 % TDT patients had hypocalcemia and 13.3% TDT patients had hypomagnecemia.&#x0D; Conclusion: This study may conclude that low serum total calcium and magnesium level may be associated with TDT patients treated by combined deferoxamine (DFO) &amp; deferiprone (DFP) iron chelator.&#x0D; J Bangladesh Soc Physiol. 2020, June; 15(1): 17-22

Whole Blood Ionized Magnesium, a Novel Nutrition Biomarker for Magnesium Intake

Abstract Objectives Most studies used serum magnesium concentration and total urine magnesium as nutrition biomarkers of magnesium, but whether these biomarkers are sensitive to changes in dietary intake of magnesium is uncertain. Whole blood ionized magnesium (iMg2+) is the free bioactive form of magnesium in the body, and therefore it could be more sensitive to the changes in magnesium intake. Thus, we aimed to compare the responses of iMg2+, serum magnesium concentration, and total urine magnesium following an oral dose of magnesium. Methods Healthy adults participated in a randomized, single-blind, placebo-controlled crossover trial. They were randomly assigned to 300 mg of magnesium chloride (MgCl2, ReMag®) or placebo, taken with a low-magnesium breakfast after 8-hours of fasting. Timed blood and urine samples were obtained beginning 15-minutes before breakfast, and then at 0, 0.5, 1, 2, 4, 6, 8, and 24-hours timepoints following breakfast. Pharmacokinetic analyses included area under the curve (AUC), the maximum concentration (Cmax), and the time to maximum concentration (Tmax) for iMg2+, serum magnesium concentration, and total urine magnesium. Data were analyzed using paired t-test and Wilcoxon signed-rank test, and reported as mean ± standard deviation, or as median and range, depending on normality. Results Seventeen participants were included in the data analyses. Responses were observed following MgCl2 compared to placebo for iMg2+ (AUC = 1.51 ± 0.96 vs. 0.84 ± 0.82, and Cmax = 1.38 ± 0.13 vs. 1.32 ± 0.07, both P &amp;lt; 0.05). We saw no response following MgCl2 versus placebo for serum magnesium concentration (AUC = 27.00 [0, 172.93] vs. 14.55 [0, 91.18], and Cmax = 2.38 [1.97, 4.01] vs. 2.24 [1.98, 4.31]), and for total urine magnesium (AUC = 201.74 ± 161.63 vs. 139.30 ± 92.84, and Cmax = 26.12 [12.91, 88.63] vs. 24.38 [13.51, 81.51]), both P &amp;gt; 0.05. Conclusions The response of iMg2+ to a single oral dose of magnesium was more pronounced than the responses of serum magnesium concentration and total urine magnesium. Therefore, iMg2+ may be a more sensitive nutrition biomarker for magnesium intake. Funding Sources Funding for this study was provided through an unrestricted educational grant from Think Healthy Group Inc.

SAT-LB309 Amphotericin B Induced Hypocalcemia in a Patient With Severe Hypercalcemia Due to Acute T-Cell Leukemia/Lymphoma

SAT-LB309 Amphotericin B Induced Hypocalcemia in a Patient With Severe Hypercalcemia Due to Acute T-Cell Leukemia/Lymphoma

Total serum and intraerythrocyte magnesium concentrations in hemodialysis patients using different dialysate solutions.

Beside routinely used 0.5 mmol/L dialysate-magnesium, higher dialysate-magnesium (1.0 mmol/L) was recently introduced. The aim of this study was to evaluate the impact of different dialysate-magnesium on serum and intraerythrocyte levels of magnesium (Mg) before and after dialysis. The study included 43 patients receiving chronic hemodialysis, divided into two groups based on dialysate-magnesium (0.5 or 1.0 mmol/L) used prior to study initiation and during 12 months of follow-up. Blood samples were taken at the mid-week dialysis; total serum Mg was measured colorimetrically and intraerythrocyte Mg by atomic absorption spectrophotometry. Hypermagnesiemia-associated complications were observed for 12 months. Total serum Mg was 1.14 ± 0.19 mmol/L before and 0.95 ± 0.16 mmol/L after dialysis in patients using lower dialysate-Mg (p < 0.001), whereas it was 1.47 ± 0.25 mmol/L before and 1.49 ± 0.18 mmol/L after dialysis in patients using higher dialysate-Mg (p = 0.926). Intraerythrocyte Mg was 1.98 ± 0.34 mmol/L before and 1.97 ± 0.28 mmol/L after dialysis in the lower dialysate-Mg group (p = 0.939), while it was 2.09 ± 0.37 mmol/L before and 2.19 ± 0.48 mmol/L after dialysis in the higher dialysate group (p = 0.067). After 12 months total serum Mg decreased in both the groups, remaining lower in 0.5 mmol/L dialysate-Mg group. No hypermagnesiemia-related symptoms occur during 12 months of follow-up in both the groups. In patients using lower dialysate-Mg total serum Mg remains within the reference range and shows postdialytic decline, while in higher dialysate-Mg group it exceeded reference range before and after dialysis without significant intradialytic change. The intraerythrocyte values remain within reference range with both dialysates used. No clinical signs and symptoms of hypermagnesiemia occur during longer administration of higher dialysate-magnesium despite high total serum Mg level.

The effect of hemodialysis on serum magnesium concentration in hemodialysis patients.

In recent years, the concentration of magnesium in dialysis patients has drawn an increasing amount of attention. Both hemodialysis and peritoneal dialysis may affect magnesium metabolism, but studies in this area are very limited. This study aimed to investigate the serum magnesium concentrations in hemodialysis patients and examine the factors related to the serum magnesium concentration, and to explore the effect of hemodialysis with conventional hemodialysis solution (magnesium ion concentration 0.5 mmol/L) on blood magnesium concentration. In this single-center, retrospective study, linear regression models were established to explore the factors related to serum magnesium concentration in hemodialysis patients. Serum magnesium concentration was also compared before and after hemodialysis treatment. The data of 148 hemodialysis patients were collected and analyzed. The mean value of pre-hemodialysis total serum magnesium concentration was 1.11±0.14 mmol/L. The prevalence of hypermagnesemia was 73.65%, and 2 patients had hypomagnesemia (1.35%). Data analysis indicated that total platelet count, serum phosphorus level, serum creatinine, plasma albumin, and total serum cholesterol level were significantly related to serum magnesium concentration. After hemodialysis treatment, the serum magnesium concentration was significantly lower when conventional hemodialysis was used. After hemodialysis, the average decrease in the serum magnesium concentration was 0.14 mmol/L. Most patients who received hemodialysis had mild hypermagnesemia when routine dialysate was supplied. Serum magnesium concentration is related to patients' nutritional status. Hemodialysis treatment can decrease the total serum magnesium concentration.

Alterations in Serum Magnesium Levels in Hyperbili-rubinemic Neonates Before and After Phototherapy

Background: Bilirubin binds to cell membrane phospholipids, including N-methyl D-aspartate receptor, and causes excessive activation that can lead to neurotoxic effects. Since magnesium is an important inhibitor of this receptor, a comparison can be made between the physiological effects of magnesium and the neurological effects of bilirubin. This study aimed to compare changes in serum magnesium levels before and after phototherapy in hyperbilirubinemic newborns.Methods: This retrospective cross-sectional study examined full-term newborns with hyperbilirubinemia. These newborns were admitted between 2012 and 2014 to the Neonatal Unit of Children’s Medical Center in Tehran, Iran. Based on the amount of bilirubin upon admission, participants were divided into three groups of mild (20 mg/dl). The total serum magnesium levels were measured before and 12-24 h after phototherapy.Results: A total of 143 newborns were included in this study. A significant difference was observed between serum magnesium levels before (2.42±0.46 mg/dl) and after (2.07±0.32 mg/dl) phototherapy (P<0.001). This difference was observed in all etiologies of icterus.Conclusion: The magnesium level decreased significantly after the completion of jaundice treatment for all causes of the condition. These findings raise the hypothesis that an increase in the level of extracellular magnesium is a defense mechanism that reduces the neurotoxic effects of bilirubin.

Circulating Ionized Magnesium as a Measure of Supplement Bioavailability: Results from a Pilot Study for Randomized Clinical Trial.

Oral supplementation may improve the dietary intake of magnesium, which has been identified as a shortfall nutrient. We conducted a pilot study to evaluate appropriate methods for assessing responses to the ingestion of oral magnesium supplements, including ionized magnesium in whole blood (iMg2+) concentration, serum total magnesium concentration, and total urinary magnesium content. In a single-blinded crossover study, 17 healthy adults were randomly assigned to consume 300 mg of magnesium from MgCl2 (ReMag®, a picosized magnesium formulation) or placebo, while having a low-magnesium breakfast. Blood and urine samples were obtained for the measurement of iMg2+, serum total magnesium, and total urine magnesium, during 24 h following the magnesium supplement or placebo dosing. Bioavailability was assessed using area-under-the-curve (AUC) as well as maximum (Cmax) and time-to-maximum (Tmax) concentration. Depending on normality, data were expressed as the mean ± standard deviation or median (range), and differences between responses to MgCl2 or placebo were measured using the paired t-test or Wilcoxon signed-rank test. Following MgCl2 administration versus placebo administration, we observed significantly greater increases in iMg2+ concentrations (AUC = 1.51 ± 0.96 vs. 0.84 ± 0.82 mg/dL•24h; Cmax = 1.38 ± 0.13 vs. 1.32 ± 0.07 mg/dL, respectively; both p < 0.05) but not in serum total magnesium (AUC = 27.00 [0, 172.93] vs. 14.55 [0, 91.18] mg/dL•24h; Cmax = 2.38 [1.97, 4.01] vs. 2.24 [1.98, 4.31] mg/dL) or in urinary magnesium (AUC = 201.74 ± 161.63 vs. 139.30 ± 92.84 mg•24h; Cmax = 26.12 [12.91, 88.63] vs. 24.38 [13.51, 81.51] mg/dL; p > 0.05). Whole blood iMg2+ may be a more sensitive measure of acute oral intake of magnesium compared to serum and urinary magnesium and may be preferred for assessing supplement bioavailability.

Effect of combined calcium, magnesium, vitamin C and E supplementation on seminal parameters and serum oxidative stress markers in fructose-induced diabetic Wistar rats

Context Deleterious effects of diabetes on seminal quality, serum metals and antioxidants have been confirmed. Objective This study evaluated the effect of combined calcium, magnesium, vitamin C and E supplementation on seminal parameters, serum total antioxidant capacity (TAC), nitric oxide (NO), malonyldialdehyde (MDA), calcium and magnesium in fructose-induced diabetic rats. Materials and methods Thirty rats were grouped into non-diabetic controls, diabetic controls, diabetic rats given vitamin E + C, calcium + magnesium and vitamin E + C + calcium + magnesium. The analytes were evaluated using standard methods. Statistical significance was set at p < .05. Results The diabetic controls had significantly higher MDA (p = .036) but lower (p = .0001) TAC, calcium, magnesium, sperm count, and %motility than the non-diabetic controls. The Vitamin C + E group showed the greatest improvement as they had the highest values of seminal parameters compared to other supplemented groups. Conclusion Combined Vitamin C + E supplementation may provide better ameliorative benefits than a combination of Vitamin C, E, calcium and magnesium in diabetics.

Prophylactic administration of oral calcium carbonate during plateletpheresis: A bicentric prospective study

BACKGROUND:Administration of anticoagulant citrate and dextrose (ACD-A) chelates ionized calcium in blood and causes hypocalcemia in plateletpheresis donors. The aim of the study was to observe the effects of oral calcium (Ca) supplementation during plateletpheresis on various parameters related to calcium metabolism.MATERIALS AND METHODS:This study was performed between January 2014 and December 2014 on 200 plateletpheresis donors. They were divided into two groups. In group A donors (n=100), no prophylactic oral calcium supplementation was given. In group B (n=100) donors, 2000 mg of calcium was given one hour before the start of the procedure, 500 mg was given at the start of the procedure and 500 mg calcium was given just before the end of procedure. Biochemical parameters like serum total calcium (T Ca), serum total magnesium (T Mg) and ionized calcium level (iCa) were measured before and after the procedure. Relative risk of citrate toxicity was measured between the two groups.RESULTS:There was a significant fall in total calcium (pre 9.02 mg/dl, post 8.23 mg/dl,), ionized calcium level (pre 1.14 mmol/L, post 0.91 mmol/L) and total magnesium (pre 1.92 mg/dl, post 1.79 mg/dl) amongst the donors who did not receive prophylactic calcium supplementation. Despite calcium intake, in prophylactic calcium intake group, we did observe a significant drop in total magnesium (pre 2.04 mg/dl, post 1.94 mg/dl) and ionized calcium level (pre 1.25 mmol/L, post 1.12 mmol/L, p<0.01). We did observe a drop in total calcium level, however, this observation was not statistically significant. The risk (RR=5.44) of citrate toxicity was higher among group A donors.CONCLUSION:Prophylactic oral calcium carbonate supplementation would help in to reduce the risk of citrate toxicity. Therefore, we suggest for prophylactic oral administration of 3000 mg elemental calcium carbonate in three divided doses to make PP procedures uneventful.

Age and Muscle Function Are More Closely Associated With Intracellular Magnesium, as Assessed by 31P Magnetic Resonance Spectroscopy, Than With Serum Magnesium.

Total serum magnesium is a common clinical measurement for assessing magnesium status; however, magnesium in blood represents less than 1% of the body’s total magnesium content. We measured intramuscular ionized magnesium by phosphorus magnetic resonance spectroscopy (31P-MRS) and tested the hypothesis that this measure better correlates with skeletal muscle function and captures more closely the effect of aging than the traditional measure of total serum magnesium. Data were collected from 441 participants (age 24–98 years) in the Baltimore Longitudinal Study of Aging (BLSA), a study of normative aging that encompasses a broad age range. Results showed that intramuscular ionized magnesium was negatively associated with age (β = −0.29, p < 0.001, R2 = 0.08) and positively associated with knee-extension strength (β = 0.31, p < 0.001, and R2 = 0.1 in women; and β = 0.2, p = 0.003, and R2 = 0.04 in men), while total serum magnesium showed no association with age or strength (p = 0.27 and 0.1, respectively). Intramuscular ionized magnesium was significantly lower in women that in men (p < 0.001), perhaps due to chronic latent Mg deficiency in women that is not otherwise detected by serum magnesium levels. Based on these findings, we suggest that intramuscular ionized magnesium from 31P-MRS is a better clinical measure of magnesium status than total serum magnesium, and could be measured when muscle weakness of unidentified etiology is detected. It may also be used to monitor the effectiveness of oral magnesium interventions, including supplementation.

Cistus salviifolius Toxicity in Cattle.

Toxicity related to consumption of Cistus sp. pl. has been described in ruminants in some countries. This report describes the clinical and pathological findings of Cistus salviifolius toxicosis in 3 beef cattle herds located in 2 different areas of Sicily, Italy. Outbreaks were observed after grazing in poor winter pasture where C. salviifolius was abundant. Mean morbidity and mortality were 29% and 21%, respectively. Most of the affected animals (6 to 36 months old) showed anorexia, weight loss, and pollakiuria culminating in recumbency and death. Occasionally, abortion and neurological signs were observed. In animals with acute signs, there was a moderate decrease of sodium and chloride concentrations in serum. Animals with chronic signs showed an increase of serum urea, creatine phosphokinase (CPK), aspartate transaminase (AST), lactate dehydrogenase (LDH), and phosphorus and a decrease in total serum protein, calcium, chloride, and magnesium concentrations. Moderate anemia and slight neutropenia, lymphocytosis, and eosinophilia were detected in all groups. At necropsy, the main lesion was severe distention of the urinary bladder with turbid hemorrhagic urine and crystalluria. Histologically, chronic cystitis, interstitial nephritis, eosinophilic enteritis, and nonsuppurative necrotizing hepatitis were observed. To our knowledge, this is the first report of C. salviifolius toxicosis in cattle in Italy.

Total Serum Magnesium Levels and Calcium-To-Magnesium Ratio in Sickle Cell Disease.

Background and Objectives: Imbalance of calcium/magnesium ratio could lead to clinical complications in sickle cell disease (SCD). Low levels of magnesium have been associated with sickling, increased polymerization and vaso-occlusion (VOC) in sickle cell due to cell dehydration. The K-Cl cotransport plays a very important role in sickle cell dehydration and is inhibited by significantly increasing levels of magnesium. The study evaluated total serum magnesium levels and computed calcium/magnesium ratio in SCD patients and “healthy” controls. Materials and Methods: The study was a case-control cross-sectional one, involving 120 SCD patients (79 Haemoglobin SS (HbSS)and 41 Haemoglobin SC (HbSC)) at the steady state and 48 “healthy” controls. Sera were prepared from whole blood samples (n = 168) and total magnesium and calcium measured using a Flame Atomic Absorption Spectrometer (Variant 240FS manufactured by VARIAN Australia Pty Ltd., Melbourne, VIC, Australia). Calcium/magnesium ratios were calculated in patients and the controls. Results: The prevalence of hypomagnesemia and hypocalcaemia among the SCD patients was observed to be 39.17% and 52.50% respectively, higher than the controls (4.17% and 22.92%, for hypomagnesemia and hypocalcaemia, respectively). Level of magnesium was significantly lower in the SCD patients compared to their healthy counterparts (p = 0.002). The magnesium level was further reduced in the HbSS patients but not significantly different from the HbSC patients (p = 0.584). calcium/magnesium ratio was significantly higher in the SCD patients (p = 0.031). Although calcium/magnesium ratio was higher in the HbSC patients compared to those with the HbSS genotype, the difference was not significant (p = 0.101). Conclusion: The study shows that magnesium homeostasis are altered in SCD patients, and their levels are lower in HbSS patients. Although calcium/magnesium ratio is significantly higher in SCD patients compared with controls, there is no significant difference between patients with HbSS and HbSC genotypes. Magnesium supplementation may be required in sickle cell patients.

Blood metabolite concentrations and body condition score in relation to postpartum resumption of ovarian cyclicity in crossbred cows

Apparently healthy crossbred cows (20) of first to fourth parity with normal calving history and free from any immediate post-parturient complications were selected to study the body condition score (BCS) and certain blood metabolite for establishment of cyclicity during postpartum periods. The cows were divided equally into 2 groups– Gr A (cows exhibited oestrus within 60 days postpartum (cyclic)) and Gr B (cows did not exhibit oestrus within 60 days postpartum (non-cyclic)). The study revealed that the BCS, level of serum total protein, cholesterol, BUN, calcium, phosphorus and magnesium differed significantly at different days of postpartum, i.e. day 0, 15, 30, 45, 60 and between the groups. The BCS, level of serum glucose, total protein, cholesterol, BUN, calcium, phosphorus and magnesium had a positive relation with respect to the postpartum cyclicity of the crossbred cows.