ascorbic-acid and Ulcer

Chronic foot ulcers are associated with a high risk of osteomyelitis, poor quality of life, amputations and disability. Few strategies improve their healing, and amputation rates in high-risk foot services are usually over 30 %. We conducted a randomised, inactive-placebo controlled, double-blind trial of 500 mg of slow-release vitamin C in sixteen people with foot ulcers in the Foot Wound Clinic at Westmead Hospital. Nine were randomised to control and seven to vitamin C. When serum vitamin C results become available at 4 weeks, all people with deficiency were offered both vitamin C and glucosamine tablets for the next 4 weeks. Patients without baseline deficiency continued their original assigned treatment. The primary outcome was percentage ulcer healing (reduction in ulcer size) at 8 weeks. Fifty percentage of subjects had baseline vitamin C deficiency, half having undetectable levels. Healing at 8 weeks was significantly better in the vitamin C group (median 100 v. -14 %, P = 0·041). Healing without amputation occurred in all patients in the vitamin C group. In contrast, 44 % of controls had not healed their ulcer at the end of the study period. Vitamin C improved healing of foot ulcers. Further studies are needed to determine whether there is a threshold effect for serum vitamin C above which therapy is ineffective and whether there are better or lesser responding subgroups. Because of its low cost and ease of access and administration, we recommend offering vitamin C therapy to all people who have chronic foot ulcers and potentially suboptimal vitamin C intake. Trial registration number: ACTRN12617001142325.

Topics: Ascorbic Acid; Diabetic Foot; Humans; Ulcer; Vitamins; Wound Healing

Topics: Ascorbic Acid; Dietary Supplements; Humans; Jaw Fractures; Male; Middle Aged; New Zealand; Periodontal Diseases; Scurvy; Ulcer; Vitamin D

To report the presence of an asymptomatic cilium in the subconjunctival area and an adjacent sterile scleral ulcer, together as a complication of subtenon injection of steroids, and the resolution of the ulcer despite the in situ cilium.. Medical management of a 51-year-old man, who was a known case of ankylosing spondylitis, with a 3-mm scleral ulcer located in the inferior palpebral area with one adjacent fully embedded cilium at the probable site of subtenon injection given for suspected acute iridocyclitis.. On altering the medication, the ulcer resolved completely. This occurred despite the in situ cilium, which did not act as a nidus for infection or inflammation.. The presence of cilia did not adversely affect the outcome of treatment of the adjacent ulcer. Therefore, if there is no exposure of the entrapped cilium through the conjunctiva, as was in this case, conservative management of the ulcer and not trying to remove the cilium seems to be a good alternative as opposed to reports in literature, which warrant its removal in most cases.

Topics: Anti-Bacterial Agents; Ascorbic Acid; Carboxymethylcellulose Sodium; Chloramphenicol; Cilia; Conjunctival Diseases; Drug Therapy, Combination; Eye Foreign Bodies; Humans; Iatrogenic Disease; Injections, Intraocular; Iridocyclitis; Male; Middle Aged; Scleral Diseases; Spondylitis, Ankylosing; Steroids; Tetracycline; Ulcer; Vitamins

The rhizomes of Nardostachysjatamansi, the plant commonly known as Jatamansi have been described in Ayurveda for their soothing and sedative action on the central nervous system. In the present study, the anti-stress effect of hydroethanolic extract (70%) of N. jatamansi (NJE) was evaluated in reference to its antioxidant property. Wistar rats were divided into four groups: naive, stressed, and T-200 and T-500 stressed with oral pre-treatment of NJE 200 and 500 mg/kg, respectively. Restraint of rats in metallic chambers for 4 h at 4 degreesC was followed by sacrifice and assessment of stress-induced alterations in biochemical parameters, incidence and severity of ulcers. Lipid peroxidation (LPO) and NO levels in stomach and LPO, NO levels and catalase activity in brain, plasma corticosterone level and adrenal ascorbic acid were measured. In vitro antioxidant activity of NJE was studied by measuring the free radical scavenging activity. NJE showed potent antioxidant activity and significantly reversed the stress-induced elevation of LPO and NO levels and decrease in catalase activity in the brain. It inhibited the incidence of gastric ulcerations and reversed the alterations in biochemical parameters/markers of stress-induced gastric ulceration. NJE also significantly altered stress-induced increase in adrenal and spleen weights and decrease in level of ascorbic acid in adrenal gland. Elevation of plasma corticosterone level was negated dose- dependently. The findings suggest that the NJE possesses significant anti-stress activity, which may be due to its antioxidant activity.

Topics: Adrenal Glands; Animals; Antioxidants; Ascorbic Acid; Brain; Catalase; Corticosterone; Dose-Response Relationship, Drug; Free Radicals; Lipid Peroxidation; Male; Nardostachys; Nitric Oxide; Phytotherapy; Plant Extracts; Rats; Rats, Wistar; Restraint, Physical; Spleen; Stomach; Stress, Psychological; Ulcer

Reflux-induced injury and oxidative stress result in esophageal inflammation and the potential for progression to intestinal metaplasia and adenocarcinoma. Proton-pump inhibitors represent the standard medical approach, but anti-inflammatories and antioxidants offer novel therapeutic possibilities.. Six weeks after an esophagojejunostomy reflux procedure, female Wistar rats (n = 100) were randomized to receive either an antioxidant (vitamin C, 8 mg or 28 mg/day), a cyclooxygenase-2 (COX-2) inhibitor (rofecoxib, 1 mg/day), or no therapy. After sacrifice 16 weeks later, esophageal injury was scored using pathologic and image analysis scoring.. Esophagitis was present in all 63 animals completing the study and severe in 27 (43%). No animal developed metaplasia or tumor. The extent of inflammation and esophageal ulceration were not significantly different between experimental groups.. In this model of reflux injury, antioxidants and COX-2 inhibitors failed to ameliorate the severe inflammation induced. Further experimental designs should evaluate these novel approaches in less severe experimental models.

Topics: Animals; Antioxidants; Ascorbic Acid; Cyclooxygenase 2 Inhibitors; Dose-Response Relationship, Drug; Esophagitis, Peptic; Esophagus; Female; Inflammation; Jejunum; Lactones; Models, Animal; Random Allocation; Rats; Rats, Wistar; Sulfones; Ulcer

Topics: Ascorbic Acid; Cardiac Surgical Procedures; Esophageal Stenosis; Female; Humans; Middle Aged; Postoperative Complications; Tablets; Ulcer

Topics: Ascorbic Acid; Female; Humans; Immunity, Cellular; Male; Mouth Diseases; Mouth Mucosa; Neutrophils; Periodontitis; Recurrence; Stomatitis, Aphthous; Ulcer

Topics: Adenosine Diphosphate; Adenosine Triphosphatases; Adenosine Triphosphate; Aerobiosis; Aniline Compounds; Animals; Ascorbic Acid; Cattle; Depression, Chemical; Dinitrophenols; Electron Transport; Enzyme Activation; Ethers; Hydroxybutyrates; Hydroxylation; In Vitro Techniques; Ketoglutaric Acids; Kinetics; Malates; Mitochondria, Liver; Mitochondrial Swelling; NAD; Oligomycins; Oxidative Phosphorylation; Oxidoreductases; Oxygen Consumption; Phenols; Phenylenediamines; Polarography; Quinolines; Rats; Rotenone; Serum Albumin, Bovine; Stimulation, Chemical; Succinates; Time Factors; Ulcer; Uncoupling Agents

Topics: Animal Feed; Animals; Ascorbic Acid; Esophageal Diseases; Female; Male; Stomach Ulcer; Temperature; Ulcer; Zea mays

Topics: Ascorbic Acid; Collagen Diseases; Corrinoids; Cystitis; Cystitis, Interstitial; Drug Therapy; Humans; Lupus Erythematosus, Systemic; Pyridoxine; Scleroderma, Systemic; Ulcer; Vitamin B 12

Topics: Ascorbic Acid; Carbohydrate Metabolism; Cornea; Ulcer; Vitamins

Topics: Ascorbic Acid; Cornea; Corneal Ulcer; Eye Diseases; Penicillins; Ulcer; Vitamins