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Category: Volume 08 Issue 11 November 2020
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Title: A Study of Serum Magnesium Levels in Acute Exacerbation of Chronic Pulmonary Disease on Admission and at the Time of Discharge

Authors: Dr Tamizh Selvan.R, Prof. Dr Ramakrishna Rao. M, Prof. Dr Periyasamy S

 DOI: https://dx.doi.org/10.18535/jmscr/v8i11.64

Abstract

Background:  COPD is one of the most common disease affecting the elderly population in the world. The course of the disease is characterized by frequent exacerbations. Many factors play role in exacerbation of COPD. One such factors is serum magnesium in the body. The objective of the study is to ascertain the correlation between serum magnesium levels during acute exacerbation of COPD.

Aim and Objective: Estimating serum magnesium levels in acute exacerbation of COPD. To correlate the relation of magnesium levels in patients of acute exacerbation of COPD at the time of admission and at the time of discharge.

Material and Methods: This study was done among 100 patients presented with acute exacerbation of COPD in emergency department of Rajah Muthiah Medical College and Hospital from November 2018 to June 2020. Patients detailed history, clinical examination and necessary investigation were done for the patients. Patients admitted with AECOPD above 40 years was included in the study, and patients with conditions causing hyper or hypomagnesemia were excluded.

Statistical Methods: The data was analyzed using SPSS version 23.0 and Microsoft excel 2019.

Results: Mean serum magnesium level at the time of admission was 1.287 mg/dl (SD±0.33) and the time of discharge was 2.009 mg/dl (SD± 0.2955). The association of serum magnesium level and acute exacerbation of COPD was found to be statistically significant with p value less than .05.

Conclusion: Patients presented with acute exacerbation of COPD had hypomagnesemia. So magnesium was modifiable and independent risk factor for COPD exacerbation.

Keywords: COPD, acute exacerbation, serum magnesium, asthma, Anthonisens criteria.

References

  1. John J. Reilly, Jr., EdwinK. Silverman, Steven. D. Shapiro: Chronic Obstructive Pulmonary Diseases, Harrison’s Internal Medicine 19th edition, 2015. 1700
  2. Chunk Yip, M.D., COPD: State of the art – Common Medical Diseases (II) the Eleventh Health Conference.36-43.
  3. Thomas L. Petty. The History of COPD. International Journal of COPD 2006:1(1): 3-4.
  4. Aziz et al, Serum magnesium levels and acute exacerbation of COPD,:123-124.
  5. Sajjad Rajab et al., relationship between serum magnesium levels and acute exacerbation of COPD,,2009:63-65
  6. Nagomi- Obradovic L et al., Evaluation of magnesium in serum and urine in patients with pulmonary diseases. Clin Lab. 2005;51(11- 12):647-52.
  7. Douglas seaton, Anthony Seaton, Leitch-Crofton & Douglas’s Respiratory Diseases, 5 Edition Vol.1 Epidemiology 7 Risk Factors of Chroni bronchitis & Emphysema.617-623.
  8. F. Murray &J.Nadel. Text Book of Respiratory Medicine 1994.Chronic bronchitis & Emphysema.1342.
  9. American Thoracic society, standard for the diagnosis and care of patients with chronic obstructive pulmonary disease. Am.j. Respir. Crit. Care Med. 1995;152: S77-S121
  10. Bhattacharya SN, Bhagatnagar JK, Kumar S, Jain PC. Chronic bronchitis in rural population. Indian J. of Chest Dis. 1975; 17: 1-7.
  11. Pandey MR, Domestic smoke pollution and chronic bronchitis in a rural community of Hill region of Nepal. Thorax 1984; 39: 337-339.
  12. Behera D, Jindal SK, Respiratory symptoms in Indian women using domestic cooking fuels. Chest 1991; 100: 358- 388.
  13. F. Tolsa, Y. Gao, J.U. RajDevelopmental change in magnesium sulfate-induced relaxation of rabbit pulmonary arteriesJ Appl Physiol, 87 (5) (1999), pp. 1589-1594
  14. J. Dominguez, M. Barbagallo, G. Di Lorenzo, et al.Bronchial reactivity and intracellular magnesium: a possible mechanism for the bronchodilating effects of magnesium in asthma Clin Sci (London), 95 (2) (1998), pp. 137-142.
  15. Dhingra, F. Solven, A. Wilson, D.S. McCarthy Hypomagnesemia and respiratory muscle power Am Rev Respir Dis, 129 (3) (1984), pp. 497-498
  16. H. Spivy, E.M. Skobelof, R.M. Levin. Effect of Mg chloride on rabbit bronchial smooth muscle, Ann Emerg Med, 19 (1990), pp. 1107-1112
  17. Del Castillo, L. Engbeak. The nature of the neuromuscular block produced by Mg. J Physiol, 124 (1954), pp. 370-384
  18. Bois. Effect of Mg deficiency on mast cells and urinary histamine in rats. Br J Exp Pathol, 44 (1963), pp. 151-155
  19. S. Alamoudi. Hypomagnesaemia in chronic, stable asthmatics: prevalence, correlation with severity and hospitalization Eur Respir J, 16 (3) (2000), pp. 427-431
  20. Nagorni-Obradović, S. Ignjatović, V. Bosnjak-Petrović, M. Mitić-Milikić. Evaluation of magnesium in serum and urine in patients with pulmonary diseases. Clin Lab, 51 (11-12) (2005), pp. 647-652
  21. David Holmes et al., low magnesium levels a cause for concern among COPD patients. Respir Med 2008; 11-12
  22. Douglas seaton, Anthony Seaton, Leitch-Crofton th& Douglas’s Respiratory Diseases, 5 Edition Vol.1 Epidemiology 7 Risk Factors of Chroni bronchitis & Emphysema.617-623.
  23. F. Murray &J.Nadel. Text Book of Respiratory Medicine 1994.Chronic bronchitis & Emphysema.1342
  24. American Thoracic society, standard for the diagnosis and care of patients with chronic obstructive pulmonary disease. Am.j. Respir. Crit. Care Med. 1995;152: S77-S121
  25. Bhattacharya SN, Bhagatnagar JK, Kumar S, Jain PC. Chronic bronchitis in rural population. Indian J. of Chest Dis. 1975; 17: 1-7.
  26. Pandey MR, Domestic smoke pollution and chronic bronchitis in a rural community of Hill region of Nepal. Thorax 1984; 39: 337-339.
  27. Behera D, Jindal SK, Respiratory symptoms in Indian women using domestic cooking fuels. Chest 1991; 100: 358- 388.
  28. Kasper DL, Fauci AS, Hauser S, et al, editors. Harrison’s principles of internal medicine, 19th [monograph on the Internet]. New York: The McGraw-Hill Companies, Inc.; 2015.

Corresponding Author

Dr Ramakrishna Rao M

Professor, Department of General Medicine, Rajah Muthiah Medical College and Hospital, Chidambaram, India, 608002