Muhammad Ajmal Khan, Javed Iqbal, Abdul Rashid.
Magnesium Sulphate infusion; A novel approach to treatment of Tetanus.
Professional Med J Jan ;10(4):271-4.

Objectives: The effective control of seizure needs continuous use of muscle relaxant. Role of magnesium sulphate infusion in this context is new in the management of tetanus seizures and needed to be studied. Study Design: Prospective Observational Setting: DHQ. Hospital Faisalabad. Tetanus Ward. Patients and Methods: All patients during nine months (May 2002 to Jan 2003) were treated according to our protocol using adequate doses of magnesium sulphate (titrating it with deep tendon reflexes). Results: Total 32 cases were collected with median age 33. Male to female ratio was 2:1. Average incubation period was 15 days. Twenty one patients recovered from the illness. Mortality was more in females (18.75 %) as compared to males (15.62 %). The highest risk factor in female resistant to therapy was tetanus due to septic abortions. Eleven patients were found refractory to the treatment and required ventilatory support and I.C.U. coverage, ultimately expired. Conclusion: Magnesium sulphate infusion was found helpful in the reduction of spasm in tetanus patients. It minimized the nursing monitoring and proved to be cost effective therapy.

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