Nitroglycerin Ointment Research Articles

Rethinking the Role of Nitroglycerin Ointment in Ischemic Vascular Filler Complications

Soft tissue dermal fillers, both temporary and permanent, are used frequently in facial rejuvenation. As the use of fillers increases, ischemic complications including skin necrosis are becoming more prevalent. In the literature, topical nitroglycerin paste has been recommended in the early treatment of patients presenting with ischemia. The purpose of this study was to evaluate the vascular perfusion effects of topical nitroglycerin paste in an animal model using indocyanine green (ICG) imaging. After Animal Research Committee approval, a rabbit ear model was used to create filler-associated skin ischemia. Ischemia was confirmed to occur after intra-arterial occlusion. Four commonly used soft tissue fillers were injected intra-arterially: Radiesse (Merz USA, Greensboro NC), Restylane (Galderma, Ft. Worth, TX), Juvederm Ultra (Allergan, Irvine CA), Belotero (Merz USA, Greensboro NC) (0.1 ml). A total of 15 ears were used, 1 control and 4 experimental per product. Thirty minutes after occlusion, nitroglycerin ointment USP, 2%(Nitro-Bid) was applied topically to the experimental ears. Vascular perfusion was evaluated with the SPY System (Novadaq Inc.) using ICG imaging. Perfusion images were obtained at baseline, immediately after, and 30 minutes after intra-arterial filler injection, and at 30, 60, 90, and 120 minutes after application of topical nitroglycerin ointment. In this rabbit ear model, no statistically significant improvement in perfusion was noted after topical application of nitroglycerin paste with ICG imaging. In addition, the skin of the rabbit ear post-nitroglycerin ointment appeared to have more of a congested appearance than the controls. Ischemic filler complications are becoming increasingly prevalent. Practitioners often treat these complications with topical nitroglycerin paste based on the knowledge that topical nitroglycerin causes vasodilation. In filler-induced tissue ischemia, however, filler product is present within arterioles. Theoretically, applying nitroglycerin paste, at least early, may not improve perfusion and could worsen ischemia with dilation of vessels and further propagation of product into the smaller arterioles and capillaries. In addition, nitroglycerin paste has systemic effects, including hypotension and dizziness, which may not be tolerated by some patients. Therefore, the authors caution the use of topical nitroglycerin paste in patients presenting with filler-associated ischemia. Further studies in the best treatment algorithms for patients presenting with ischemic complications need to be performed.

Excision Hemorrhoidectomy: New Methods to Improve the Outcomes of an Old Technique

Context: Hemorrhoidal disease is the most common anorectal disorder that requires surgical intervention. Hemorrhoids require treatment when they result in symptoms such as bleeding or prolapse. Surgical intervention is indicated for significant prolapse, and a number of accepted and viable methods are available for treating prolapsing hemorrhoids that do not reduce spontaneously (Grade III and IV). Excision hemorrhoidectomy remains the gold standard treatment for Grade III and IV hemorrhoids despite great interest in alternative procedures such as stapled hemorrhoidopexy and Doppler-guided hemorrhoidal artery ligation with mu- copexy. A large body of evidence demonstrates that excision hemorrhoidectomy is an eective, safe, and aordable procedure. Nevertheless, the main drawback of excision hemorrhoidectomy remains its notorious association with significant postoperative pain. Evidence Acquisition: A comprehensive literature search was conducted through MEDLINE and the Cochrane database of system- atic reviews. Only prospective case-controlled studies, review articles, and meta-analyses were considered. Results: Many strategies have been put forward in the literature to address the issue of pain after excision hemorrhoidectomy. These strategies can be broadly categorized into surgical techniques (e.g., LigaSure hemorrhoidectomy) and pharmacological adjuncts (e.g., intradermal methylene blue and chemical sphincterotomy with glyceryl trinitrate ointment). In recent years, meta-analyses and randomized controlled trials have been performed to evaluate their eects. Conclusions: This article evaluates the evidence behind these strategies and outlines the new methods available to improve the outcomes of an old technique.

Notice of Retraction: Jamal SA, et al. Effect of Nitroglycerin Ointment on Bone Density and Strength in Postmenopausal Women: A Randomized Trial. JAMA. 2011;305(8):800-807.

Notice of Retraction: Jamal SA, et al. Effect of Nitroglycerin Ointment on Bone Density and Strength in Postmenopausal Women: A Randomized Trial. JAMA. 2011;305(8):800-807.

Microbiological quality control of non-sterile compounded medicines prepared in a Portuguese hospital centre

ObjectivesThis work aimed to evaluate the quality of non-sterile formulations compounded at Centro Hospitalar Cova da Beira (Covilhã, Portugal) immediately after preparation and up to the defined ‘beyond-use date’.MethodsMicrobiological quality...

Effect of botulinum toxin A and nitroglycerin on random skin flap survival in rats.

A suitable pharmacological substitute for the well-established surgical delay technique for random skin flaps to increase viability has been elusive. To evaluate the effects of nitroglycerin and botulinum toxin type A on random flap survival in a rat model. The present controlled experimental study was performed in the four groups of rats. One week after intervention in each group, the flap was raised and kept in situ, and flap necrosis was evaluated through follow-up. Group 1 received intradermal botulinum toxin type A (BTX-A) and topical nitroglycerin 2%; group 2 received BTX-A and topical Vaseline (Unilever, USA); group 3 received topical nitroglycerin and intradermal normal saline; and group 4 received topical Vaseline and intradermal normal saline. BTX-A reduced the area of necrosis compared with control (24% versus 56% respectively; P<0.001). Nitroglycerin application was associated with a trend toward improved flap viability (42% versus 56%; P=0.059). The combination of topical nitroglycerin and BTX-A, compared with Vaseline and BTX-A, was associated with decreased flap necrosis (16.1% versus 24%, respectively), although it was not statistically significant (P=0.45). BTX-A was effective in reducing distal flap necrosis. The effect of BTX-A was significantly more pronounced than nitroglycerin ointment.

Topical Nitroglycerin for Osteoporosis: Old Drug New Application

ABSTRACT Osteoporosis is a progressive bone disease characterized by a decrease in the bone mass and density, which can lead to an increased risk of fracture. Multiple treatments have been formulated for it like calcium, vitamin D supplements, bisphosphonates, raloxifene, hormone replacement therapies, teriparatide and calcitonin. However, all of these have their own shortcomings. Topical nitroglycerin is a cost-effective, novel medication that not only increases bone formation but also decreases its resorption, and also has the potential to decrease vertebral fractures more than that provided by the existing treatments. Therefore, it could be the answer to the need of an efficacious, cost-effective, affordable, safe and a convenient form of therapy for the prevention of post-menopausal bone loss and osteoporosis as a whole. Therefore, we recommend that individuals with osteoporosis be treated with topical nitroglycerin ointment (15 mg/day). How to cite this article Malhotra J, Garg R, Agrawal P, Agarwal A, Singh O. Topical Nitroglycerin for Osteoporosis: Old Drug New Application. J South Asian Feder Obst Gynae 2016;8(1):1-3.

Effect of Glyceryl Trinitrate Ointment on Pain Control After Hemorrhoidectomy: A Meta-analysis of Randomized Controlled Trials.

Hemorrhoidectomy is associated with postoperative pain and prolonged wound healing. Glyceryl trinitrate has been shown to decrease muscle spasm and increase anodermal blood flow. A meta-analysis of randomized controlled trials was conducted to evaluate the efficacy of topical glyceryl trinitrate application in pain relief after hemorrhoidectomy. PubMed, EMBASE, Cochrane Library, Scopus, and ClinicalTrials.gov registries were searched for studies published before August 2015. Individual effect sizes were standardized, and a meta-analysis was conducted to calculate a pooled effect size using random effects models. Pain was assessed using a visual analog scale on days 1, 3, 7, and 14 after operation. Secondary outcomes included time taken to resume routine activities, wound healing at 3 weeks after operation, complication, and headache incidence. A total of 12 trials with 1095 patients were reviewed. Significant pain reduction was observed on days 1, 3, 7, and 14 after hemorrhoidectomy in the glyceryl trinitrate groups. Glyceryl trinitrate-treated patients appeared to resume routine activities earlier than those in the control group (weight mean difference -7.52; 95% confidence interval: 16.13-1.08). The wound healing rates 3 weeks after operation were significant higher in the glyceryl trinitrate-treated groups than in the control group (risk ratio 1.79; 95% confidence interval: 1.38-2.33). However, the incidence of headache significantly increased in the glyceryl trinitrate group (risk ratio 3.68; 95% confidence interval: 1.62-8.34). Topical application of glyceryl trinitrate effectively relieves pain and promotes wound healing after hemorrhoidectomy; however, the substantial headache incidence may limit extensive application.

PD22-09 RESURFACING THE PENIS OF THE HYPOSPADIAS CRIPPLE

You have accessJournal of UrologyTrauma/Reconstruction: Urethral Reconstruction (including Stricture) III1 Apr 2015PD22-09 RESURFACING THE PENIS OF THE HYPOSPADIAS CRIPPLE Mina Fam and Moneer Hanna Mina FamMina Fam More articles by this author and Moneer HannaMoneer Hanna More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1451AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES After the creation of a neourethra in patients with multiple failed hypospadias repairs (hypospadias cripples), resurfacing the penis with healthy skin is a significant challenge because local tissue is often scarred. Without adequate coverage of healthy skin, there is an increased risk of repair breakdown and poor cosmetic results. In our series, the use of a healthy scrotal fascio-cutaneous flap as well as the use of tissue expanders served as a reliable means of resurfacing the penis after complex repairs where there is a lack of healthy local tissue. METHODS We retrospectively reviewed 203 patients referred after multiple unsuccessful hypospadias repairs from 1989 to 2013. 58/203 patients did not have adequate healthy local penile skin to resurface the penis after urethroplasty. Scrotal skin was used to resurface the penis in 54/58 patients. Of these 54 patients, 50 had a scrotal fascio-cutaneous rotational flap and 4 had a Cecil two-stage repair. 6/58 underwent tissue expansion of the dorsal penile skin over a 12-16 week period prior to penile resurfacing. 2/58 patients underwent scrotal skin resurfacing and subsequent tissue expansion for their reconstructions. RESULTS Patient age ranged from 4-38 years old and the number of prior operations ranged from 3-24 operations. Follow-up ranged from 6 months to 22 years. 56/58 (96.5%) patients had successful resurfacing of the penis with scrotal skin, tissue expanders or a combination of both approaches. 5/54 (9.3%) patients who underwent penile resurfacing with scrotal skin developed post-operative cyanosis of the flap. 3/5 patients with cyanosis were salvaged with nitroglycerine ointment. After long-term follow up, 10/54 (18.5%) patients with scrotal skin resurfacing underwent flap revision due to minor complications such as scarring, presence of a “dog ear” and penoscrotal webbing. 6/10 patients who underwent flap revision required simultaneous depilation of a hairy flap. All 6 patients who underwent tissue expansion had successful skin flap reconstruction without complication. CONCLUSIONS A rotational scrotal fascio-cutaneous flap is typically well-vascularized and therefore lends to successful penile resurfacing after urethroplasty. In select cases, local expansion of dorsal penile skin provides a skin flap with excellent texture and pigmentation to resurface the penis. In our experience, the use of scrotal skin flaps, tissue expansion of the dorsal penile skin or a combination of both serve as reliable approaches in resurfacing the penis in almost any hypospadias cripple lacking healthy local skin. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e479 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mina Fam More articles by this author Moneer Hanna More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Nitroglycerine Ointment for Prevention of Osteoporosis in Postmenopausal North Indian Women

Nitroglycerine Ointment for Prevention of Osteoporosis in Postmenopausal North Indian Women

Successful Use of 0.2 % Glyceryl Trinitrate Ointment for Anal Fissures in Erbil City , Iraq

Abstract Aim of the study: To assess the clinical efficacy of 0.2% glyceryl trinitrate ointment in the management of acute and chronic anal fissures. Patients and Methods: A prospective clinical study conducted on consecutive patients presented to the surgical clinic of Erbil teaching Hospital, Erbil city with acute and chronic anal fissures, from June 2009 till August 2012.These patients were treated with topical 0.2% glyceryl trinitrate (GTN) paste in soft white paraffin three times a day. Patients were examined at regu- lar intervals to evaluate the fissure status, adverse reactions, symptomatic control and recurrence. One hundred and fifty nine patients with acute and chronic anal fissures were evaluated in the study. Fifty one of them were lost to follow-up and 108 were remaining (94.7%)Results: At the end of complete course (6-8 weeks), pain was completely relieved in 80.9 % and partially better in 7.4%, bleeding was absent in 83.7%, anal tone became normal in 80%, and in 80.3 % had heal-ing. The course was completed or taken for longer duration in patients 62.9%. GTN was stopped before end of the course in 40 patients (37%) due to differ-ent causes, side effects mainly headache 60 %, non compliance 95%, or no response at all 50%.

PS-198 Topical Glyceryl Trinitrate Ointment To Aid Umbilical Artery Cannulation In Neonates

Background and aims Umbilical artery cannulation is a common neonatal procedure that is often challenging because umbilical arteries constrict after birth. We aimed to determine whether the topical application of a vasodilating ointment prior to cannulation increases success and decreases the time taken to cannulate. Methods Discarded umbilical cords were collected immediately after delivery and two 3 cm sections proximal to the baby were used for the study. 0.1mL topical Glyceryl Trinitrate (GTN) ointment (0.2% w/w) was applied to the surface of one section for 5 min prior to cannulation, whereas the second section acted as the control. After ointment removal, medical staff blinded to intervention attempted to cannulate one artery in each section. We assessed cannulation success, time to cannulate, and correct treatment identification for each participant. Results 14 experienced (9 Fellows, 5 Consultants) and 9 junior (Registrars) medical staff attempted 46 cannulations. Experienced participants successfully cannulated 100% of treated and control sections with no significant difference in mean (SD) time to cannulate (98 (75)s and 97(51)s respectively, p = 0.97). Junior participants cannulated 89% and 67% of treated and control sections respectively (p = 0.69), and mean (SD) time to cannulate was 132 (78)s and 106 (53)s respectively (p = 0.42). GTN treated arteries were correctly identified by 43% of experienced and 22% of junior participants (p = 0.47). Conclusions This study suggests that topical application of GTN does not increase successful cannulation of umbilical arteries by experienced staff. More participants or prolonged GTN application time may be needed to confirm these findings in junior staff.

Topical nitroglycerin ointment for treatment of acute hypertension in hospitalized inpatients.

Hypertension in the hospital setting is common; however, guidelines provide limited guidance specific to the inpatient setting. Acute antihypertensive treatment options can be limited in this setting by monitoring requirements of intravenous medications and patients' inability to take oral medications. A possible treatment choice used to treat acute hypertension is nitroglycerin ointment. Nitroglycerin is not approved by the Food and Drug Administration for this condition, and limited evidence exists to support this indication. To evaluate the statistical and clinical effectiveness of nitroglycerin ointment as a treatment option for acute hypertension based on a 20 mm Hg or greater reduction in systolic blood pressure. A retrospective chart review at a large tertiary community teaching hospital was performed on all adult noncardiac inpatients with an episode of acute hypertension that resulted in the administration of nitroglycerin ointment. Seventy-two patients met inclusion criteria with a total of 112 applications of nitroglycerin ointment. Of the 112 applications, systolic blood pressure decreased 20 mm Hg or more in 42% of occurrences with a median decrease of 16 mm Hg. Study results suggest possible efficacy of nitroglycerin ointment for the treatment of acute hypertension in noncardiac hospitalized patients.

Addition of intrarectal local analgesia to periprostatic nerve block improves pain control for transrectal ultrasonography-guided prostate biopsy: a systematic review and meta-analysis.

To evaluate the efficacy and safety of combined intrarectal local analgesia and periprostatic nerve block versus periprostatic nerve block alone for pain control during transrectal ultrasound-guided prostate biopsy. We comprehensively searched PubMed, Embase and the Cochrane Library trials. Studies comparing the two techniques were identified and pooled for cumulative analysis. The outcome measurements included visual pain scales of three consecutive procedures of transrectal ultrasound-guided prostate biopsy, as well as short-term postoperative complication rates. There were 18 studies that were finally eligible for the quantitative analysis involving 2076 participants. Combined modalities significantly reduced the pain associated with probe manipulation (weighted mean difference -2.06, 95% confidence interval -2.77 to -1.35, P < 0.001), anesthesia infiltration (weighted mean difference -1.45, 95% confidence interval -2.20 to -0.70, P < 0.001) and needle biopsy (weighted mean difference -0.55, 95% confidence interval -0.76 to -0.34, P < 0.001). Subgroup analyses assessing different local analgesics showed that local anesthetics are generally more effective than myorelaxant and non-steroidal anti-inflammatory drugs. Lidocaine-prilocaine cream proved the most effective in pain control regardless of the origin of pain. No significant difference of short-term postoperative complications (fever, dysuria, acute urinary retention, hematuria, hematospermia and rectal bleeding) was found between the two techniques. The only side-effect associated with local analgesics was headache reported in studies using glyceryl trinitrate ointment. Combined modalities show better analgesic efficacy than periprostatic nerve block alone for transrectal ultrasound-guided prostate biopsy without increased morbidities. Among the various local analgesics, lidocaine-prilocaine cream seems to offer the best overall efficacy.

Comparaing the effect of Nitroglycerin and Clobetazol Ointments on Prevention of Superficial Intravenous Catheter Induced Phlebitis

Background: Although intravenous injection is nowadays one of the common invasive procedures in medical care, but like any other procedure, it has a lot of side effects. Phlebitis is the most common complication and one of the therapeutic aims is to prevent it. Aim: The aim of this study was to compair the effect of Clobetasol with Nitroglycerin ointment on the prevention of superficial IV Catheter induced phlebitis. Methods: This clinical trial study was conducted on 144 patients admitted in men surgery ward in Arak Valiasr hospital in 1392. Patients were randomly allocated into three groups: Group A (Clobetasol), Group B (NTG) and Group C (Control). Severity of phlebitis was measured using the standard visual rating scale. In intervention groups, after venipuncture, ointment were administered on the distal portion of IVcatheter and the area was dressed. The venipuncture area was assessed 24, 48 and 72 (hrs) after venipuncture. Data were analyzed by chi-square, Fisher's exact and Kruskal-Wallis statistical tests and using spss19. Results: There was no significant difference among three groups in terms of severity of catheter induced phlebitis in the first and second measurements. In the third measurement there was a significant difference among intervention and control groups (P < 0/007) and the severity of catheter induced phlebitis was reduced more in NTG group comparing Clobetasol group. Conclusion: The use of Nitroglycerin in prevention of superficial, IVcatheter induced phlebitis is more effective than Clobetasol. It is suggested that Nitroglycerin can be administered to prevent phlebitis in patients who need to have IVcatheter for a long time (over 48 hours).

Hemodynamic Effects of Nitroglycerin Ointment in Emergency Department Patients

BackgroundNitroglycerin ointment is commonly used in the treatment of emergency department (ED) patients with suspected acute heart failure (AHF) or suspected acute coronary syndrome (ACS), but its hemodynamic effects in this population are not well described. ObjectiveOur objective was to assess the effect of nitroglycerin ointment on mean arterial pressure (MAP) and systemic vascular resistance (SVR) in ED patients receiving nitroglycerin. We hypothesized that nitroglycerin ointment would result in a reduction of MAP and SVR in the acute treatment of patients. MethodsWe conducted a prospective, observational pilot study in a convenience sample of adult patients from a single ED who were treated with nitroglycerin ointment. Impedance cardiography was used to measure MAP, SVR, cardiac output (CO), stroke volume (SV), and thoracic fluid content (TFC) at baseline and at 30, 60, and 120 min after application of nitroglycerin ointment. Mixed effects regression models with random slope and random intercept were used to analyze changes in hemodynamic parameters from baseline to 30, 60, and 120 min after adjusting for age, sex, and final ED diagnosis of AHF. ResultsSixty-four subjects with mean age of 55 years (interquartile range, 48–67 years) were enrolled; 59% were male. In the adjusted analysis, MAP and TFC decreased after application of nitroglycerin ointment (p = 0.001 and p = 0.043, respectively). Cardiac index, CO, SVR, and SV showed no change (p = 0.113, p = 0.085, p = 0.570, and p = 0.076, respectively) over time. ConclusionsAmong ED patients who are treated with nitroglycerin ointment, MAP and TFC decrease over time. However, other hemodynamic parameters do not change after application of nitroglycerin ointment in these patients.

Efficacy of combination of 0.2% GTN and lignocaine ointments in wound healing and pain relief after Milligan Morgan hemorrhoidectomy – A comparison with lignocaine and 0.2% GTN ointments separately

ObjectiveTo compare the analgesic efficacy and rate of wound healing of combination of 0.2% Glyceryl Trinitrate and 2% lignocaine ointments with 0.2% Glyceryl Trinitrate and 2% lignocaine ointment separately after Milligan Morgan hemorrhoidectomy. DesignRandomized control trial. Place and duration of studyCombined Military Hospital, Kharian, Malir and Bannu. November 2007 to August 2011. Patients and methodsPatients undergoing Milligan Morgan hemorrhoidectomy were randomized into 3 groups by using computer generated table. Group A received combination of 0.2% Glyceryl Trinitrate and 2% lignocaine ointment, Group B 2% lignocaine and Group C received 0.2% Glyceryl Trinitrate ointment. These ointments were given on twice daily basis. Pain scores were measured on a 100 mm Visual Analog Scale. Pain scores and quantity of oral analgesics used were compared daily until the 7th post-operative day. The time required for complete healing (in weeks) was also compared. ResultsOut of 210 patients, 192 (67 Group A, 64 Group B and 61 Group C) completed the study. Demographic data were comparable in all three groups. There were statistically significant reductions in pain scores and quantity of analgesics used from the first to the fourth post-operative days in Group A. The time required for complete healing was also significantly reduced in the combination group. There were no significant side effects in any group. ConclusionThe combination of 0.2% GTN and 2% lignocaine showed better pain relief resulting in less use of oral analgesics and faster healing of the wound after Milligan Morgan hemorrhoidectomy.

Minimally invasive method for determining the effective lymphatic pumping pressure in rats using near-infrared imaging

The ability to quantify collecting vessel function in a minimally invasive fashion is crucial to the study of lymphatic physiology and the role of lymphatic pump function in disease progression. Therefore, we developed a highly sensitive, minimally invasive research platform for quantifying the pumping capacity of collecting lymphatic vessels in the rodent tail and forelimb. To achieve this, we have integrated a near-infrared lymphatic imaging system with a feedback-controlled pressure cuff to modulate lymph flow. After occluding lymphatic flow by inflating a pressure cuff on the limb or tail, we gradually deflate the cuff while imaging flow restoration proximal to the cuff. Using prescribed pressure applications and automated image processing of fluorescence intensity levels in the vessels, we were able to noninvasively quantify the effective pumping pressure (P(eff), pressure at which flow is restored after occlusion) and vessel emptying rate (rate of fluorescence clearance during flow occlusion) of lymphatics in the rat. To demonstrate the sensitivity of this system to changes in lymphatic function, a nitric oxide (NO) donor cream, glyceryl trinitrate ointment (GTNO), was applied to the tails. GTNO decreased P(eff) of the vessels by nearly 50% and the average emptying rate by more than 60%. We also demonstrate the suitability of this approach for acquiring measurements on the rat forelimb. Thus, this novel research platform provides the first minimally invasive measurements of P(eff) and emptying rate in rodents. This experimental platform holds strong potential for future in vivo studies that seek to evaluate changes in lymphatic health and disease.

Topical Nitroglycerin: A New and Safe Treatment Option for Osteoporosis

ABSTRACT Osteoporosis is a progressive bone disease characterized by a decrease in the bone mass and density, which can lead to an increased risk of fracture. Multiple treatments have been formulated for it like calcium, vitamin D supplements, bisphosphonates, raloxifine, hormone replacement therapies, teriparatide and calcitonin. However, all of these have their own shortcomings. Topical nitroglycerin is a cost-effective, novel medication that not only increases bone formation but also decreases its resorption, and also has the potential to decrease vertebral fractures more than that provided by the existing treatments. Therefore, it could be the answer to the need of an efficacious, cost-effective, affordable, safe and a convenient form of therapy for the prevention of post-menopausal bone loss and osteoporosis as a whole. Therefore, we recommend that individuals with osteoporosis be treated with topical nitroglycerine ointment (15 mg/day). How to cite this article Agrawal P, Agarwal A, Singh O, Bansal M. Topical Nitroglycerin: A New and Safe Treatment Option for Osteoporosis. J South Asian Feder Menopause Soc 2014;2(1):20-22.

Effect of topical nitric oxide donor (0.2 % glyceryl trinitrate) on wound healing in diabetic wistar rats

Cutaneous wound healing activity of 0.2 % glyceryl trinitrate (GTN) ointment was evaluated in diabetic wistar rats. Streptozotocin (STZ)-induced diabetic rats were divided in four groups (N = 6) and anaesthetized by ketamine 75 mg/kg and xylazine 10 mg/kg. Two groups were operated for excision wound (EW). One group served as control and another as 0.2 % GTN ointment treatment group. EW groups were studied for wound closure rate and re-epithelization. Remaining two groups were divided into control and treatment group. Rats in these two groups were inflicted with incision wound (IW) and dead space wound (DW) in the same animal. IWs were studied for wound tensile strength while DWs were studied for granulation tissue weight, hydroxyproline content and histological changes in granulation tissue. EW showed significantly higher re-epithelization in treatment group compared to control (61.10 ± 2.98 vs 27.36 ± 6.68; P = 0.01) but there was no difference in wound closure rate between the groups. 0.2 % GTN did not affect tensile strength of IW, granulation tissue weight or hydroxyproline content. This suggests that topical NO does not have any effect on collagen secretion and maturation by fibroblasts in incisional wound model. In conclusion, NO donor may useful in the wounds where wound contraction has a minor role in wound closure e.g., diabetic foot ulcers.

Hemodynamic Effects of Nitroglycerin Ointment in Emergency Department Patients With Symptoms of Acute Heart Failure

Hemodynamic Effects of Nitroglycerin Ointment in Emergency Department Patients With Symptoms of Acute Heart Failure