Acid In Management Research Articles

Assessment of Cefuroxime and Cefuroxime Clavulanic Acid Prescription Practices for Infection Management in Routine Indian Healthcare Settings: Expert Insights

Background: Cefuroxime axetil has shown effectiveness as part of intravenous/oral sequential therapy for community-acquired pneumonia (CAP) treatment, although some countries currently lack dosage recommendations for this regimen. In addition, the perspectives of clinicians were not studied. So, this study evaluated the prescription practice of cefuroxime, and cefuroxime+ clavulanic acid in the management of infections in routine Indian settings. Methods: The cross-sectional survey, titled ‘Cefuroxime & Cefuroxime+Clavulanic acid in Management of Infections: Expert Perspective (CARE) Study’, utilized a 20-item, multiple-response questionnaire to gather expert opinion from specialists regarding the clinical use of cefuroxime and cefuroxime + clavulanic acid in managing infections. The survey encompassed questions about current prescription practices, clinical observations, preferences, and experiences related to the use of these antibiotics in routine settings. Results: Among the 164 clinicians surveyed, 78% of the respondents indicated that cefuroxime was highly effective in managing lower respiratory tract infections. Additionally, 91% of the experts stated that the combination of cefuroxime and clavulanic acid was very effective in managing infections. The majority of clinicians recommended cefuroxime + clavulanic acid as the initial therapy for complicated urinary tract infections (88%), as well as first-line therapy for uncomplicated skin and soft tissue infections (45%) and community-acquired pneumonia (58%). According to 40% of the clinicians, cefuroxime + clavulanic acid was recommended as the initial therapy for 21-30% of patients suspected of methicillin-resistant Staphylococcus aureus infection. Most respondents (88%) preferred cefuroxime + clavulanic acid as the antibiotic for managing Pseudomonas aeruginosa infection. Conclusion: The survey has emphasized the critical role of cefuroxime and cefuroxime + clavulanic acid as antibiotics in managing diverse infections. Clinicians' recognition of their efficacy and preference for combination therapy has underscored the importance of antibiotic stewardship in optimizing patient care.

Ascorbic acid in cancer management – time for a second look

Introduction and aim. Over the past decades, the hypotheses that ascorbic acid (AA) can play a role as an anti-neoplastic therapy have generated many conflicting reports. Despite the controversies, mounting evidence has shown that AA has the potential to play a role as an anti-neoplastic agent. Recent studies have unraveled its pharmacokinetics and various mechanism of action on cancer cells. This has spawned different preclinical studies with reports of good activities against various cancers. Material and methods. A review of the literature regarding ascorbic acid in the management of cancer was performed using the PubMed database. The research was limited to abstracts and available full-text articles. Analysis of the literature. Clinical trials have also demonstrated its safety and tolerability across different dosages. AA has been noted as a multitargeting agent that acts as a pro-oxidative cytotoxic agent, anti-cancer epigenetic regulator and immune modulator. AA has also been shown act synergistically with standard chemotherapy regimens in different cancers. Despite its potentials, phase III clinical trials are seriously lacking. The recent phase III VITALITY study shows that AA may play a role as an adjunct targeted therapy for ras-mutated cancers. Therefore, there is need to for more standardized clinical trials to help identify cancer subtypes and AA combination regimens that can show the most benefits. In this review, the pleiotropic mechanism of action of AA was explored as well as various preclinical and clinical studies in cancer therapy. In addition, recommendations were also made for effective strategies towards an AA and standard cancer regimens in treatment as well as future directions. Ascorbic acid has been shown to induce cell death in various cancer types through different mechanisms of action. Several clinical trials and case reports have shown its efficacy in combination chemotherapy, and the pharmacological route of action can be either intravenous or oral. However, it can impair the actions of some drugs when given in combination. Also, dosage should be determined for maximal pharmacologic action. Conclusion. Ascorbic acid has the potential to provide safe and cost-effective antineoplastic treatment option especially in combination therapy. Its potential needs to be further investigated through clinical trials.

Therapeutic review: The role of tranexamic acid in management of traumatic brain injury, nontraumatic intracranial hemorrhage, and aneurysmal subarachnoid hemorrhage.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. To summarize current literature evaluating tranexamic acid in the management of intracranial bleeding associated with traumatic and nontraumatic brain injuries and implications for clinical practice. Intracranial hemorrhage, regardless of etiology, is associated with high morbidity and mortality. Tranexamic acid is an antifibrinolytic with anti-inflammatory properties shown to reduce mortality in trauma patients with extracranial injuries. In traumatic brain injury, a large randomized trial found no difference in outcomes when tranexamic acid was compared to placebo; however, subgroup analyses suggested that it may reduce head injury-related mortality in the context of mild-to-moderate injury if treatment occurs within 1 hour of symptom onset. More recent out-of-hospital data have disputed these findings and even suggested harm in severely injured patients. In spontaneous, nontraumatic intracranial hemorrhage, treatment with tranexamic acid did not result in a difference in functional status; however, rates of hematoma expansion, even though modest, were significantly reduced. In aneurysmal subarachnoid hemorrhage, tranexamic acid may prevent rebleeding, but has not led to improved outcomes or reduced mortality, and there is concern for increased incidence of delayed cerebral ischemia. Overall, tranexamic acid has not been shown to result in increased risk of thromboembolic complications across these classes of brain injury. Despite its favorable safety profile overall, tranexamic acid does not seem to improve functional outcomes and cannot be routinely recommended. More data are needed to determine which head injury subpopulations are most likely to benefit from tranexamic acid and which patients are at increased risk for harm.

Effect on Vitamin D supplements and Fatty Acids in management of cardiovascular diseases

Effect on Vitamin D supplements and Fatty Acids in management of cardiovascular diseases

Usefulness of Ursodeoxycholic Acid in Management of Gallstone Disease in Children

Objective − The aim of the study is to assess the usefulness of ursodeoxycholic acid in management of gallstone disease in children. Materials and Methods − The prospective study aimed to assess the management of gallstone disease in children. We analyzed all new cases of cholelithiasis during the period from January 2016 to March 2020. Forty-eight new cases of cholelithiasis were enrolled in the study. The diagnosis was established by ultrasound examination due to different complaints in previously healthy patients, or during regular follow-up visits in patients with a chronic disease. A Student t-test, Fisher’s test and χ2-test were used in the statistical processing, where appropriate. Results − A 6-month course of treatment with ursodeoxycholic acid was conducted in 72.9% of cases (N=35). In 27.1% (N=13) of patients this treatment was not administered. Successful dissolution of gallstones was observed in 31.4% (N=11) of treated patients (N=35), over a period of 1 to 6 months. In the group of nontreated patients (N=13), successful dissolution of gallstones was achieved in 38.5% (N=5). Cholecystectomy was performed in 10.4% (N=5) patients, and 1 patient underwent endoscopic retrograde cholangiopancreatography. No early complications, relapse or postcholecystectomy syndrome were observed in the 12-month follow-up period. Conclusion − Management of cholelithiasis in children can often be a challenge. In a selected patient group, conservative treatment may be successful. Use of ursodeoxycholic acid can lead to dissolution of gallstones in patients with preceding dehydration. The effectiveness of ursodeoxycholic acid, except in children with dehydration, was higher

Efficacy of Combination of Iron Pyrophosphate and Folic Acid in Management of Iron Deficiency- A Retrospective Study

Background: Iron deficiency is the most common cause of anemia, especially in reproductive-aged women. If not treated, it leads to weakness, fatigue, menorrhagia, amenorrhea in females and can cause serious consequences such as heart problems and complications in pregnant ladies such as premature births and low birth weight babies. Thus, it is necessary to prescribe iron supplementation in iron-deficient women to avoid complications in the later stage. Objective: The objective of this study was to evaluate the efficacy of the combination of ferric pyrophosphate and folic acid in reproductive-aged women who suffered from iron deficiency. Methods: Electronic medical records of 100 reproductive-aged women deficient in iron were analyzed. The baseline hemoglobin and iron parameters were noted. They were prescribed a 30 mg tablet combination of ferric pyrophosphate and folic acid, and the parameters were noted at 4 weeks, 8 weeks, and 12 weeks. The data was statistically analyzed by SPSS version 26.0. Results: The hemoglobin (hemoglobin, total erythrocytes, mean corpuscular volume, red cell distribution width, haematocrit) and iron parameters (serum iron, ferritin, transferrin saturation, serum transferrin) showed significant improvement in week 4, which continued till week 12. The RDW levels showed much improvement after week 4 till week 12. Conclusion: Our study concluded that the combination of ferric pyrophosphate and folic acid in tablet form significantly improves the hemoglobin and iron parameters within 4 weeks and showed further improvement until 12 weeks without any complaint of side effects.

Gut-Liver Axis Modulation: A Potential Role of Probiotics and Omega-3 Fatty Acids in Management of NAFLD

Gut-Liver Axis Modulation: A Potential Role of Probiotics and Omega-3 Fatty Acids in Management of NAFLD

Comparison between topical ciprofloxacin in treatment of acute suppurative otitis media versus oral amoxicillin/clavulanic acid combination + topical ciprofloxacin

Background Acute suppurative otitis media is a disease widespread at childhood. Aim The study is to compare between topical ciprofloxacin in treatment of acute suppurative otitis media versus oral amoxicillin/clavulanic acid combination +topical ciprofloxacin. Patients and methods This is a prospective, randomized (computer-generated randomization), open-label, controlled study on 50 patients who presented to the outpatient clinic with acute suppurative otitis media (ASOM). Results In this study, topical ciprofloxacin treatment was found to be effective for an acute suppurative otitis media as was the combination treatment. Conclusion Topical ciprofloxacin was found to be as effective as the combination of topical ciprofloxacin ear drops and oral amoxicillin/clavulanic acid in management of discharging acute suppurative otitis media.

Role of intravenous zoledronic acid in management of giant cell tumor of bone- A prospective, randomized, clinical, radiological and electron microscopic analysis

BackgroundThe primary treatment of Giant cell tumor of bone is surgical management. Bisphosphonates are antiresorptive drugs which inhibit osteoclast mediated bone resorption and shown to have inhibitory effect on various tumors. The present study aims to establish clinical, ultrastructural and radiological response of intravenous zoledronic acid on giant cell tumor of bone. MethodologyDesign - Prospective randomized controlled study. A group of 30 patients of GCT bone were randomized into two equal groups. Patients in control group did not receive any adjuvant therapy before surgery. Patients in bisphosphonate group received three doses of intravenous zoledronic acid at four weeks interval prior to definitive surgery. The evaluation was done based on size of swelling, VAS score, plain radiograph, MRI and histopathological and Transmission electron microscopic examination findings. ResultsSignificant reduction in VAS score (from mean 5.33 to 1.8), increased mineralization particularly at periphery of lesion in plain radiograph, statistically significant increase in mean apoptotic index, P value < 0.0001 (mean 41.46 in bisphosphonate group and 6.06 in control group) was noted in bisphosphonate group. No significant change in tumor volume is noted in MRI. No significant side effects were noted. DiscussionOne distinctive feature of pathogenesis of GCT bone is osteoclastogenesis which causes extensive bone destruction. Use of intravenous Zoledronic acid counteracts this bone destruction. Further, possible antiangiogenic effect of intravenous bisphosphonates inhibits tumor growth and provides symptomatic improvement. ConclusionIV Zoledronic acid alleviates pain, produce sclerosis and induce apoptosis hence decrease the rate of tumor progression and decrease the rate of local bone destruction, hence they are useful adjuvant to surgery in GCT.

Low Level Laser Therapy and Omega-3 in the Management of Recurrent Aphthous Sto matitis

Introduction: In view of the importance and prevalence of Recurrent Aphthous Stomatitis(RAS) there is an urgent need for searching about an effective therapy that is less expensive, easyto use and readily available with no side effects. Low Level Laser Therapy (LLLT ) and Omega-3were considered as possible treatment options of RAS.Aim of the work: The aim of the current study was to compare the usefulness of LLLT with orwithout omega-3 versus omega-3 alone in treatment of RAS and evaluate the immune-modulatoryeffect of systemically administered omega-3.Materials and method: 45 patients were suffering from RAS were randomly assigned intoeither GӀ: (LLL T), GӀӀ: (omega-3) and GӀӀӀ: (omega-3 plus LLL T). The comparison was assessedclinically via calculating: The reduction in ulcer surface area by using Visual Basic Program, theeffectiveness indices (EI ) of pain improvement at day 1 and day five, average duration of ulcerepisodes, and the number of new ulcer outbreaks at base line and then monthly for the following 6months. Immunologically via: Measuring the amount of IL2, determination of CD4+CD25+ high Tregulatory cells in blood samples at base line (BL), 3 and 6 months.Results: GӀ showed significant reduction in ulcer surface area and significant decrease in painsensation, without significant change in all other parameters. GӀӀ showed no significant changein the degree of pain sensation in spite of reduction in ulcer surface area in addition to significantchange in all other parameters. GӀӀӀ showed significant improvement in all clinical parameterswhich is compatible with the changes occurred in the immunologic parameters. At BL nosignificant deference was observed in between the three groups. For the follow up measurements:The reduction in ulcer surface area and (EI ) of pain improvement showed significant differencecomparing GӀӀ with GӀ and GӀӀӀ in favor of the last mentioned two groups with no differencein between both of them, regarding the monthly clinical variables and immunologic parametersshowed significant difference comparing GӀ with GӀӀ and GӀӀӀ in favor of the GӀӀ and GӀӀӀ with nodifference in between both of them.Conclusions: Using LLLT with omega - 3 fatty acid in management of RAS gave the mostfavorable clinical and immunologic results. The used Visual Basic Program was effective incalculating the difference of ulcers surface areas and the digital data enabled fair statistical analysis.

Evaluation of Omega-3 fatty acids in management of trigeminal neuralgia

Background: Trigeminal neuralgic (TN) pain has been known as the world's worst pain. Omega-3 fatty acids have been recently studied extensively in neuralgic pain. Carbamazepine has been known to be the first drug of choice in treating TN pain. In the present study, the potential benefits of omega-3 fatty acids in addition to the carbamazepine were assessed. Objective: The objective of the study was to evaluate the role of omega-3 fatty acids in the neuralgic pain along with carbamazepine in treating neuralgic pain. Materials and Methods: The present study was undertaken on 114 patients with TN pain. The patients were divided in two groups. The group I consisted of patients who were on carbamazepine only, and group II comprised patients who were on carbamazepine and omega-3 fatty acids. The pain was assessed using Brief Pain Inventory questionnaire, which is the most widely used questionnaire for chronic pain. The patients were evaluated on the day of reporting and on subsequent follow-up at 2 weeks, 6 weeks, and 15 weeks interval. The data obtained was subjected to statistical analysis to assess the additional benefits of omega-3 fatty acids in TN pain. Results: The results obtained showed that the intensity of pain reduction and life quality was better in patients receiving carbamazepine and omega-3 fatty acids by the end of the 15th week compared to the patients receiving carbamazepine alone. Conclusion: The present study demonstrates the reduction in neuropathic pain on long-term usage of omega-3 fatty acids, signifying that omega-3 fatty acids may offer better relief in neuralgic pain.

Efficacy of fecal microbiota transplantation and 5-aminosalicylic acid in management of experimental colitis in mice

Efficacy of fecal microbiota transplantation and 5-aminosalicylic acid in management of experimental colitis in mice

MANAGEMENT OF ACUTE ALUMINUM PHOSPHIDE TOXICITY IN RAT MODEL WITH A NOVEL INTERVENTION, A TRIAL OF BORIC ACID

Aluminum phosphide (AlP) or rice tablet is a cheap pesticide. When it comes in contact with acid (gastric acid) or moisture, it releases phosphine (PH3) gas. The heart, lungs, liver are the main targets in acute Aluminum phosphide (AlP) poisoning. Most deaths occur due to cardiovascular toxicity. Recently, boric acid has been proposed theoretically as an antidote for AlP poisoning. With the formula B (OH)3, boric acid can accept electrons as it is a Lewis acid with an empty p orbital. The aim of the present study was to investigate the possible protective role of boric acid in management of aluminum phosphide poisoning and its possible use as an effective antidote to reduce ALP poisoning mortality. Forty albino rats, all of which were adults and males were equally divided into four groups, group 1: control (given distilled water), group 2: given boric acid only (100mg/kg nontoxic dose), group 3: given aluminum phosphide (12.5 mg/kg), group 4: given aluminum phosphide followed by boric acid. Rats in group 1 and 2 was killed by cervical dislocation, while rats in group 3 and 4 were left to die, then all were dissected out. Fixation in situ was performed by perfusion technique then the chest and the abdomen were carefully incised to reveal the heart and the liver. The liver and the heart were washed with saline then quickly dissected, excised then blotted for histological preparation. Blood samples were collected from each rat (immediately after death) for measuring liver enzymes (SGOT, SGPT, ALK (alkaline phosphatase) and cardiac troponin. Rats treated with ALP followed by boric acid showed significant increase in their survival time, marked improvement in histopathological changes and also showed significant improvement in biochemical parameters including liver and cardiac markers (SGOT, SGPT, and cardiac troponin) compared with rats intoxicated with AlP. Conclusion: This study may increase the hope of using boric acid as a new effective antidote for ALP poisoning and opens the door of opportunity for larger experimental and then clinical trials to reevaluate the role of boric acid in acute ALP poisoning.

Ultrasound-Guided Hyaluronic Acid Injection for the Management of Morton's Neuroma.

Morton's neuroma is one of the common causes of forefoot pain. In the present study, hyaluronic acid injection was performed on patients to determine the efficacy and adverse effects of hyaluronic acid in management of Morton's neuroma. Eighty-three patients with Morton's neuroma in their third intermetatarsal space with definite Mulder's click were included in the study. Those with severe forefoot deformities such as forefoot cavus or hallux valgus on plain X-rays were excluded. Ultrasound-guided hyaluronic acid injections were performed on all patients weekly for 3 weeks. Pain during walking using visual analogue scale (VAS) and AOFAS Forefoot Scale were prospectively evaluated preinjection, and at 2, 4, 6, 12 months postinjection. Significant improvement in VAS and AOFAS Forefoot Scale were seen overall at 2 months after hyaluronic acid injections ( P < .05). Then, there were almost no changes after 4 months, continuing until 12 months. The mean VAS was decreased from 73.1 initially to 23.0 at 12 months and AOFAS Forefoot Scale was increased from 32.2 to 86.5. There were no complications which occurred. In the present study, ultrasound-guided hyaluronic injection was clinically effective for pain relief and functional improvement for at least 12 months in patients with Morton's neuroma. However, numbness associated with Morton's neuroma should be addressed more cautiously since it may persist without much improvement. Level IV, retrospective case series.

Efficiency of Tranexamic Acid in Management of Surgical Orthopedic Bleeding in Patients with Haemophilia

Haemophilia is an inherited bleeding disorder (gonosomala recessive, related to chromosome X, with transmission from carrying women to male descendents) characterised from the clinic point of view by important bleeding, secondary to some minimum and biologic traumas by deficiency of trombo-plastino-formation, consecutive to either a deficit of factor VIII (haemophilia A), or the factor IX (haemophilia B). The most characteristic manifestation of hemophilia is intra-articular � hemarthrosis. Its repetitive character leads to irreversible lesions of the articular structures, inducing lesions of the synovium with degenerative effects over the articular cartilage and destructive effects for the subchondral bone tissue. In time, these lesions require orthopaedic surgery to improve the locomotor activity. Managing an efficient hemostasis is vital during surgery, due to high risk of bleeding triggered by coagulopathy and surgery. Numerous studies carried out underlined the efficiency of the tranexamic acid (TXA) in reducing bleeding, in different surgery branches, by inhibiting the enzymatic degradation of fibrin. In orthopaedic surgery, the tranexamic acid is frequently used in case of hip and knee arthroplasties, reducing the bleeding and blood transfusion necessary to the treatment of posthaemorrhagic anemia. This paper wants to assess the efficiency of the tranexamic acid in realization of hemostasis to another category of patients, haemophiliac patients with indication of total hip and knee endoprosthesis.

Role of Estimation of Serum Ferritin, Vitamin B12 and Folic Acid in Management of Beta Thalassemic Children

Objective: To estimate the levels of serum Ferritin, Vitamin B12 and Folic acid in beta thalassemic children. Introduction: Beta thalassemia is the most common genetically transmitted haematological disorder in Indian children. In thalassemia, there is ineffective erythropoiesis which can be either due to excess iron accumulation, or low vitamin B12 and folate status. Study Design: The case-control study was carried out at G.G.S. Medical College and Hospital, Faridkot in department of Biochemistry in collaboration with department of Paediatrics. Materials and methods: In this case-control study, 50 children with with beta thalassemia major in the age group of 4 to 8 years were studied for estimation of serum ferritin, vitamin B12 and folic acid. The control group consisted of 50 age and sex matched healthy children. Results: The study group had much higher serum ferritin levels as compared to healthy controls (p&lt; 0.001). On other hand, the thalassemic children had much lower vitamin B12 level in comparison with healthy controls (p&lt; 0.001). The folic acid levels were also much lower in thalassemic children as compared to healthy controls (p&lt; 0.001). Conclusion: Biochemical screening for levels of serum ferritin, vitamin B12 and folic acid is of paramount importance in management of thalassemic children. Supplementation of vitamin B12 and folic acid could be helpful to improve erythropoiesis in thalassemic children who have proven deficiency of these vitamins, though further studies are needed to establish this hypothesis.

Tranexamic acid in epistaxis: a systematic review

The role of tranexamic acid in the management of epistaxis remains unclear. There is uncertainty about its safety and about the contraindications for its use. We performed a systematic review of the use of systemic and topical tranexamic acid in epistaxis and a comparative review of its use in other specialties. This review assesses and summarises the existing evidence for the efficacy and safety of tranexamic acid in the management of epistaxis. Systematic review. MEDLINE and EMBASE were searched for 'epistaxis' and equivalent MESH terms, combined with the Boolean operator 'OR' and 'tranexamic acid'. The Cochrane library and society guidelines were reviewed for evidence regarding the use of tranexamic acid in other specialties. All five relevant RCTs were included in the review and were evaluated according to the recommendations of the Cochrane Handbook for Systematic Reviews. Three RCTS pertained to spontaneous epistaxis; of these, one trial found no benefit of oral tranexamic acid in acute epistaxis, one trial found no significant benefit of topical tranexamic acid, but the largest of the trials showed significant benefit of topical tranexamic acid in acute epistaxis management. Two RCTs examined oral tranexamic acid for prophylaxis of recurrent epistaxes in patients with hereditary haemorrhagic telangiectasia; both showed significant reduction in severity and frequency. Tranexamic acid, as a WHO 'essential medicine', is a powerful, readily available tool, the use of which in epistaxis has been limited by uncertainty over its efficacy and its safety profile. This systematic review summarises the existing evidence and extrapolates from the wealth of data for other specialties to address the clinical question - does TXA have a role in epistaxis management?

Uterine balloon tamponade in combination with topical administration of tranexamic Acid for management of postpartum hemorrhage.

While uterine balloon tamponade is an effective modality for control of postpartum hemorrhage, the reported success rates have ranged from the level of 60% to the level of 80%. In unsuccessful cases, more invasive interventions are needed, including hysterectomy as a last resort. We developed a modified tamponade method and applied it to two cases of refractory postpartum hemorrhage after vaginal delivery. The first case was accompanied by uterine myoma and low-lying placenta. After an induced delivery, the patient had excessive hemorrhage due to uterine atony. Despite oxytocin infusion and bimanual uterine compression, the total blood loss was estimated at 2,800 mL or more. The second case was diagnosed as placental abruption complicated by fetal death and severe disseminated intravascular coagulation, subsequently. A profuse hemorrhage continued despite administration of uterotonics, fluid, and blood transfusion. The total blood loss was more than 5,000 mL. In each case, an intrauterine balloon catheter was wrapped in gauze impregnated with tranexamic acid, inserted into the uterus, and inflated sufficiently with sterile water. In this way, mechanical compression by a balloon and a topical antifibrinolytic agent were combined together. This method brought complete hemostasis and no further treatments were needed. Both the women left hospital in stable condition.

Efficacy of α-glycyrrhizic acid in management of early autoimmune hepatitis

Efficacy of α-glycyrrhizic acid in management of early autoimmune hepatitis

Nicotinic Acid Treatment for Retinal Vein Occlusion

Objectives: To evaluate the effect of nicotinic acid in management of retinal vein occlusions (CRVO or BRVO). Materials and Methods: This prospective nonrandomized pilot study included 20 patients (21 eyes) with CRVO or BRVO that received nicotinic acid (3 g/day) for 3 months. A complete ophthalmologic examination uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), testing for a relative afferent pupillary defect (RAPD), slit-lamp examination, gonioscopy, intraocular pressure (IOP) measurement, fundoscopy and fundus photography was performed. Results: Four patients did not appear for follow-up and hypersensitivity reaction to nicotinic acid and severe hyperglycemia happened in two patients. Therefore, the results of treatment in 16 eyes of 15 are reported. These patients had a mean age of 59.56 ± 11.12 years. The average length of follow-up was 8.6 ± 2.7 months. The mean BSCVA was 1.56 ± 0.66 before treatment, 1.38 ± 0.72 (p >0.05) at one month and 0.88 ± 0.69 (p<0.01) at three months. The last BSCVA of all 16 eyes averaged 0.97 ± 0.73 (p<0.01). All patients had reduction of hemorrhagic events, cotton wool spots, edema in macula and disc, venous tortuosity, and dilation on basis of fundus photographs 3 months after treatment. Conclusion: Nicotinic acid usage provides enough time for development of collateral vessels, by induction of vasodilatation. Nicotinic acid use is tolerable and is related with mild systemic side effects.