Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Archana Dambal

"Journal of clinical and diagnostic research is a welcome change in publishing practices. It aims to reach out to the grass-root level researchers who do not lack in experience, clinical material and ideas, but lack in their knowledge in English language and statistics. The journal achieves it's aim by supporting in these exact domains.
It also gives due credit to all research designs like descriptive and qualitative studies while many journals ignore these important study designs. The rigorous review process does not allow any compromise in quality
It is indexed in many indexing agencies and the articles are available under creative commons licence free of cost
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It's wide scope welcomes articles across various specialities in medicine. In an era when there is an unscientific insistence on speciality specific research by regulatory bodies in medical education, JCDR supports collaborative research across specialities. I wish the publisher all the best in his future endeavors."



Dr. Archana Dambal
Department of General Medicine,
Belgaum Institute of Medical Sciences,Belgaum, Karnataka,INDIA,
On 30 Nov 2018




Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
For authors, the manuscripts can be uploaded online through an easily navigable portal, on other hand, reviewers appreciate the systematic handling of all manuscripts. The way JCDR has emerged as an effective medium for publishing wide array of observations in Indian context, I wish the editorial team success in their endeavour"



Dr Bhanu K Bhakhri
Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dematolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2012 | Month : June | Volume : 6 | Issue : 5 | Page : 848 - 850

The Role of Magnesium Sulphate in Tuberculous Meningitis

Manmohan Krishna Pandey, Purnima Mittra, Pradeep Kumar Maheshwari, Rupali Mehrotra,

1. Assistant Professor, Deptt. of Medicine, Rohilkhand Medical College. Bareilly-243001 (INDIA). 2. Assistant Professor, Department of Pathology, Rohilkhand Medical College.Bareilly-243001 (INDIA). 3. Prof. & Head, Neurology Divison, P.G. Department of Medicine, S.N.M.C., Agra-282003 (INDIA). 4. Senior Resident, Deptt. of Medicine, ERA’s Lucknow Medical College, Sarfarazganj, Hardoi Road, Lucknow- 226003 (INDIA).

Correspondence Address :
Dr P.K.Maheshwari Prof.& Head, Neurology Divison, P.G.Department of Medicine, S.N.M.C.,Agra-282003 (INDIA) Phone: 9997026852 E-mail: pkmaheshwari2011@gmail.com

Abstract

Context: Magnesium sulphate (MgSO4) has been studied for its beneficial role in traumatic brain injury (TBI) and ischaemic cerebral infarcts as it decreases the oxidative stress and increases the cerebral perfusion. The present study was done for evaluating its role in tuberculous meningitis (TBM).

Aims: To study the role of intravenous magnesium sulphate in tuberculous meningitis.

Methods and Material: The present study had 40 cases of tuberculous meningitis which comprised of 20 cases of group A(n-20) as contols for the study group B (n-20). The study group (Group B) was given intravenous magnesium sulphate 2 gm six hourly for 7 days additionally than the control group (Group A) which was treated with steroids and anti-tubercular drugs. The outcome was measured by using the Barthel Index (BI) and the Modified Rankin Scale (MRS) on the first day, the seventh day and after six weeks. The cases with arteritis in the two groups were compared separately.

Statistical analysis: The results were analyzed by using the SPSS software and the unpaired t-test with p-values.

Results: The means of the changes in the MRS and the BI of the Groups A and B were not statistically significant. When the means of the changes in the BI and the MRS were compared in the arteritis cases of the two groups separately, they were found to be statistically significant with a p value <0.05.

Conclusions: Magnesium sulphate had a statistically significant role in TBM with tuberculous arteritis and it had a statistically nonsignificant role in TBM without arteritis.

Keywords

Tuberculous Meningitis, Magnesium Sulphate, Barthel Index, Modified Rankin Scale, Arteritis

How to cite this article :

Manmohan Krishna Pandey, Purnima Mittra, Pradeep Kumar Maheshwari, Rupali Mehrotra,. THE ROLE OF MAGNESIUM SULPHATE IN TUBERCULOUS MENINGITIS. Journal of Clinical and Diagnostic Research [serial online] 2012 June [cited: 2019 Sep 22 ]; 6:848-850. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2012&month=June&volume=6&issue=5&page=848-850&id=2218

Introduction
Magnesium has an important role in the homeostatic regulation of the pathways which are involved in brain injuries (1). During the normal physiological processes, magnesium acts as a non-competitive inhibitor of the NMDA receptors (2) and it thereby regulates the calcium influx (3). In TBI, there is a depletion of magnesium and its homeostatic control on the NMDA receptors is lost, leading to a massive influx of calcium, causing neuronal degeneration and cell death (1). The therapy with magnesium sulphate reduces the oxidative stress after a traumatic brain injury TBI in humans (4). In subarachnoid haemorrhage patients who underwent temporary cerebral artery occlusion for the clipping of the cerebral aneurysms, the treatment with magnesium sulfate dilated the leptomeningeal arteries and enhanced the collateral blood flow and the tissue oxygenation (5). Magnesium sulphate is a potent cerebral vasodilator due to calcium channel antagonism in the vascular smooth muscle cells and its effects on the myosin-binding proteins that regulate muscle contraction (6),7]. Consequently, magnesium sulphate typically increases the cerebral perfusion (8),(9),(10). Various studies are available on the role of magnesium sulphate in TBI and cerebrovascular accidents, but no study is available on its role in TBM.This study was designed to study the neuroprotective role of magnesium sulphate in TBM.

Material and Methods

The study was done at a tertiary care centre of north India between 2008-2009 on patients with tubercular meningitis who were admitted in the Department of Medicine or were referred from other departments. This study was approved by the Medical College Ethical Committee. After taking the informed consent of the patients and after explaining about the prognosis and the side effects to the patients and their relatives, the patients were asked for a detailed clinical history.

A diagnosis for definite TBM was made in cases where the CSF smear or culture was positive for AFB or where the PCR was positive for AFB. In the absence of the above criteria, the diagnosis of the most probable TBM was based on the clinical features (history and examination) which was suggestive of meningitis, while the cerebrospinal fluid examination was suggestive of predominant lymphocyte cells, rise in the protein levels with low CSF sugar or ratio of CSF sugar to simultaneously measured blood sugar value less than 60% and head CT scan suggestive of exudates, hydrocephalus and arteritis.

An unmarked, sealed envelope which contained directives for group A and B were prepared in advance and they were drawn at random. Group A (n=20) was given the standard therapy only and Group B (n=20) was given the standard therapy plus intravenous magnesium sulphate (2 gm, 6 hourly which was diluted with 100 ml of normal saline for 7 days). All the patients were followed for a minimum period of 6 weeks and often for longer, whenever it was possible after their discharge. A clinical assessment of the neurological state of the all the patients was done by using the Barthel Index (BI) (11) and the Modified Rankin Score (MRS) (12) on days 1, 7 and 42. The parameters of BI are feeding, bathing, grooming, dressing, bladder and bowel control, toilet use, transfer (bed to chair and back), mobility and stairs. The parameters of MRS include the degree of disability and the level of assistance which the patients need.

Results

The maximum number of cases were in the 2nd to 3rd decades of life [Table/Fig 1]. The common symptoms in both the groups were fever (85%), headache (74%) and vomiting (62%). The presence of infarction was further confirmed by doing a CT scan or MRI of the brain (if the CT scan was inconclusive). There was no significant difference between the groups in the clinical presentation, as the symptoms and signs were found to be equally distributed among the groups [Table/Fig 2]. The means of MRS and BI of the two groups on the 1st, 7th, and the 42nd day signified the progressive clinical improvement in both the groups [Table/Fig-3]. The mean of the MRS change in Group A from day 1 to day 7 and that from day 1 to day 42 was 0.89 + 0.59 and 1.5 + 0.69 respectively. Though there was more change of MRS in Group B, the mean fall from days 1–7 was 1.17 + 0.55 and that from days 1–42 was 1.80 + 0.70 as compared to Group A, but it was not statistically significant [Table/Fig 4].

The change of MRS in Group B with arteritis was more as compared to that in Group A with arteritis and it was statistically significant [Table/Fig-5]. The mean of the BI change in Group A from the 1st to the 7th day and that from the 1st to the 42nd day was 11 + 15.44 and 17.25 + 22.03 respectively. Though there was more change in BI in Group B, the mean of the change from days 1–7 was 13 + 13.22 and that from days 1–42 was 32 + 25.31 as compared to Group A, but it was not statistically significant [Table/Fig 6]. The changes of BI in Groups A (n=5) and B (n=7) who had arteritis.were compared and it was found that the change of the Barthel Index in Group B was more as compared to that in Group A. This was statistically significant [Table/Fig 7].

Discussion

The present study showed the significant role of magnesium sulphate (MgSO4) in cases of TBM with vasculitis and it has proved its neuroprotective role. The outcome was measured in terms of BI and MRS. The changes in BI and MRS were not statistically significant in the two study groups. In the cases of TBM with vasculitis among the two groups, the changes in BI and MRS were statistically significant (p ≤0.05), thus establishing the bene- ficial effect of magnesium sulphate in TBM with arterits. The incidence of cerebral infarction which is secondary to TBM is reportedly 6%–47% (13). It can lead to a permanent neurological disability in the survivors of TBM. Magnesium sulphate may be a cost effective neuroprotective therapy as it decreases the morbidity which is associated with cerebral infarcts. The limitations of the present study were its small sample size and the non availability of a radiological follow-up with CT/MRI of the brain sequentially. Further studies with larger sample size are needed for establishing the role of MgSO4 in TBM with vasculitis. This study was supported by various animal and human studies which were available, on the role of magnesium sulphate in the central nervous system. A decline in the ionized magnesium concentrations in rat brain was observed after a brain injury, that correlated with the neurological outcome and the behavioural deficits in rats (14). A significant positive and linear correlation was established between the ionized magnesium levels which were measured at 24 h after the injury and the motor outcome at 1 and 2 weeks (15). Many studies in rats have shown that the treatment with magnesium after a brain injury had neuron-protective effects on the motor and the behavioural outcome [1,16-18] in a dose-dependent manner [19,20]. The cortical damages were attenuated

Conclusion

after the treatment with magnesium in rats (21). Magnesium, which was administered at 24 hours, improved the motor outcome and the behavioural parameters in rats with brain injuries (22),(23). Magnesium reversed the persistent motor and cognitive deficits with the reduction of the post-traumatic stress and anxiety after brain injuries in rats.

In conclusion, the present study showed that MgSO4 was beneficial in TBM with vasculitis, but further studies with larger sample sizes are needed for establishing its role.

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Alborch E, Salom JB, Perales AJ, Torregrosa G, Miranda FJ, Alabadi JA, et al. Comparison of the anticonstrictor action of dihydropyridines (nimodipine and nicardipine) and MG2_ in isolated human cerebral arteries. Eur J Pharmacol. 1992;229:83–89.
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Belfort MA, Moise KJ. Effect of magnesium sulfate on the maternal brain blood flow in preeclampsia: a randomized, placebo-controlled study. Am J Obstet Gynecol. 1992;167:661– 66.
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Lysakowski C, Von Elm E, Dumont L, Junod J, Tassonyi E, Kayser B, et al. Effect of magnesium, high altitude and acute mountain sickness on the blood flow velocity in the middle cerebral artery. Clin Sci. 2004; 106:279 –85. AUTHOR(S): 1. Dr. Manmohan Krishna Pandey 2. Dr. Purnima Mittra 3. Dr. Pradeep Kumar Maheshwari 4. Dr. Rupali Mehrotra PARTI CULARS OF CONTRIBUTORS: 1. Assistant Professor, Deptt. of Medicine, Rohilkhand Medical College. Bareilly-243001 (INDIA). 2. Assistant Professor, Department of Pathology, Rohilkhand Medical College.Bareilly-243001 (INDIA). 3. Prof. & Head, Neurology Divison, P.G. Department of Medicine, S.N.M.C., Agra-282003 (INDIA). 4. Senior Resident, Deptt. of Medicine, ERA’s Lucknow Medical College, Sarfarazganj, Hardoi Road, Lucknow- 226003 (INDIA). NAME, ADRESS, E-MAIL ID OF THE CORESPONDING AUTHOR: Dr P.K.Maheshwari Prof.& Head, Neurology Divison, P.G.Department of Medicine, S.N.M.C.,Agra-282003 (INDIA) Phone: 9997026852 E-mail: pkmaheshwari2011@gmail.com Financial OR OTHER COMPETING INTERESTS: None. Date of Submission: Apr 09, 2012 Date of Peer Review: May 12, 2012 Date of Acceptance: May 25, 2012 Date of Publishing: Jun 22, 2012
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Scardo JA, Hogg BB, Newman RB. The favorable hemodynamic effects of magnesium sulfate in preeclampsia. Am J Obstet Gynecol. 1995;173: 1249–53.
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Mahoney FI, Barthel D. Functional evaluation: the Barthel Index. Maryland State Med Journal 1965; 14:56-61.
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Bonita R, Beaglehole R. Modification of the Rankin Scale: Recovery of the motor function after a stroke. Stroke 1988 Dec; 19(12):1497–500.
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Date of Submission: Apr 09, 2012
Date of Peer Review: May 12, 2012
Date of Acceptance: May 25, 2012
Date of Publishing: Jun 22, 2012

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