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Evaluation of the Clinical use of Metformin or Pioglitazone in Combination with Meloxicam in Patients with Knee Osteoarthritis; using Knee Injury and Osteoarthritis outcome Score
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Osteoarthritis is the most prevalent arthritic disease and a leading cause of disability. The pathogenesis of osteoarthritis involves multiple etiologies, including variable degree of synovial inflammation. Metformin and pioglitazone could potentially reduce the levels and activity of inflammatory mediators. This may consider as a new therapeutic approach added to the current used drugs in an attempt to decrease the pain, inflammation, and improve daily activity and quality of life in patients with knee osteoarthritis.

This study designed to evaluate the clinical utility of using metformin or pioglitazone as anti-inflammatory agents in combination with non-steroidal anti-inflammatory drugs (NSAID) of selective type of cyclooxygenase-2 (COX-2) inhibitor, meloxicam, in the treatment of knee osteoarthritis (OA).

Randomized, double blinded clinical study was performed on 98 patients who have symptomatic and radiologic evidence of painful OA of the knee (57 patients only completed the study). Patients were allocated into three groups, group (A); 20 patients treated with meloxicam (15mg/day) alone, group (B); 20 patients treated with metformin (1000mg/day) + meloxicam (15mg/day) and group (C); 17 patients treated with pioglitazone (15mg/day) + meloxicam (15mg/day). The treatment was followed for 12 weeks through measurement of the clinical effects of drugs each 7 days, using the Knee Injury and Osteoarthritis Outcome Score (KOOS) system.

The results showed that metformin or pioglitazone, when used in combination with NSAID resulted in significant improvement in the components of KOOS, higher than that produced by meloxicam when used alone. In conclusion, administration of metformin or pioglitazone as adjuvant therapy to NSAID, meloxicam, in OA patients produced very well characterized analgesic and anti-inflammatory activities, and improves the therapeutic profile of meloxicam.

Keywords: Metformin, Pioglitazone, Osteoarthritis, Knee injury, KOOS.

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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
The effect of cigarette smoking on the clinical outcome of pulmonary tuberculosis in Iraq
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Background: Tobacco smoking and tuberculosis (TB) are two major public health problems; Associations between smoking and tuberculosis including death from tuberculosis have been reported , A reduction in smoking could be expected to have a significant impact on TB incidence and prevalence .
Objectives: to assess the effect of smoking on tuberculosis.
Methods: This study was conducted from June 2011 to June 2012 in 200 patients, adult ( aged 17 years and more), newly diagnosed patients of pulmonary tuberculosis, at the chest and Respiratory Disease Specialized Center in Baghdad. Demographic data, presenting symptoms, data on smoking, and recurrence of disease were compared. Information on smoking status, tobacco smoking was collecte

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Publication Date
Mon Aug 03 2020
Journal Name
Rawal Medical Journal
Functional outcomes of sandwich reconstruction technique for giant cell tumor around the knee joint
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Objective: To evaluate the functional outcomes after extended curettage and reconstruction using a combination of bone graft and bone cement (sandwich). Methodology: In this prospective case series 16 skeletally mature patients with primary giant cell tumor around the knee were included. Patients with previous surgically treated, malignant transformation, degenerative knee changes and those presenting with pathological fracture were excluded. The tumor was excised with bone graft filling space beneath the articular cartilage and a block of gel foam was placed over the cortical surface of picked bone graft. Remaining cavity was filled with polymethylmethacrylate cement (sandwich) with or without internal fixation. The func tional evaluation

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Publication Date
Mon Sep 04 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Factors Influencing Adalimumab Treatment Response in Patients with Rheumatoid Arthritis: The Future of Clinical Expertise
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Rheumatoid arthritis (RA) is characterized by persistent joint inflammation, which is a defining feature of this chronic inflammatory condition. Considerable advancements have been made in the field of disease-modifying anti-rheumatic medicines (DMARDs), which effectively mitigate inflammation and forestall further joint deterioration. Anti-tumor necrosis factor-alpha (TNF-α) drugs, which are a class of biological DMARDs (bDMARDs), have been efficaciously employed in the treatment of RA in recent times Adalimumab, a TNF inhibitor, has demonstrated significant efficacy in reducing disease symptoms and halting disease progression in patients with RA. However, its use is associated with major side effects and high costs. In addition,

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Publication Date
Mon Feb 01 2021
Journal Name
International Medical Journal
Use of immunohistochemistry and silver in situ hybridization (Sish) in evaluation of human epidermal growth factor receptor2 (HER2/neu) status in Iraqi patients with breast cancer
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Breast cancer is the commonest cause of cancer related death in women worldwide. Amplification or over-expression of the ERBB2 (HER/neu) gene occurs in approximately 15-30% of breast cancer cases and it is strongly associated with an increased disease recurrence and a poor prognosis. Determination of HER2/neu status is crucial in the treatment plan as that positive cases will respond to trastuzumab therapy. It has been used to test for HER2/neu by immunohistochemistry as a first step and then to study only the equivocal positive cases (score 2+) by in situ hybridization technique. The aim of our study is to compare between immunohistochemistry and silver in situ hybridization (SISH) in assessment of human epidermal growth factor (HER2/neu)

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Publication Date
Sun Mar 26 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Metformin Treatment on some Blood Biomarkers in Women with Endometriosis.
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 Endometriosis is a common women health disorder that occurs when Endometrial-like tissue grows outside the uterus. This may lead to irregular bleeding , pelvic pain, infertility and other complications.   Metformin,  because of its activity to improve  insulin sensitivity, it is  used for  the treatment of diabetes; it  also  has a modulatory  effect  on  ovarian  steroid  production and has  anti-inflammatory  properties,  all may  suggest  its possible effect in treatment  of endometriosis. This  study  was  planned  to  determine  the  effect  of  metformin  on serum levels  of&nbs

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Publication Date
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Metformin and Antioxidant Agents on Hirsutism in Women with Polycystic Ovary Syndrome
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Forty six Iraqi women with PCOS were involved in this study . They were treated with metformin alone and with antioxidant agents (vitamin E or C).It was found that all patients who treated with metformin or with combination of metformin with antioxidant agents showed significant decrease in hirsutism score. The treatment of metformin with antioxidant agents is of great benefit in treatment of hirsutism in PCOS due to that there was no worsening effect after treatment. This may indicate that antioxidant agents may participate in alleviation of hirsutism so it can be said that oxidative stress may play an important role in developing of hirsutism in PCOS.   

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Publication Date
Mon May 29 2023
Journal Name
Rawal Medical Journal
Comparative prospective study of knee pain in medial pararpatellar and transpatellar entry for interlocking nail fixation of tibia fracture
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Objective: To compare two insertion techniques of intramedullary interlocking nails (medial parapatellar versus intrapatellar insertion) in patients with tibial fractures. Methodology: This study was performed at Al-Kindy Teaching Hospital from August 2020 until March 2022. All 32 patients with tibial fractures (29 males and 3 females) were included for tibial closed nail fixation and then followed up for 6 months. We categorized these patients into two groups; Group A (16 patients), those treated by medial parapatellar insertion of an interlocking nail, and Group B (16 patients) with transpatellar tibial nail insertion. All patients were treated by the same surgical team. Results: The range of movement in two weeks (from extension

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Publication Date
Sun Sep 25 2022
Journal Name
Research Journal Of Biotechnology
Evaluation of Interlukein-6 and Vitamin D in Patients with COVID-19
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COVID-19 is a unique viral infectious illness that causes a variety of symptoms and health hazards, particularly to the respiratory system and has been declared a worldwide pandemic. The disease is characterized by a cytokine release in severe conditions. Interleukin-6 (IL-6), a proinflammatory cytokine, mediates an important immunomodulatory process. Also, vitamin D was identified to have a role in the innate immunity of individuals. Our study was designed to find the role of IL-6 and vitamin D in COVID-19 patients, as well as, to see whether there is a link between vitamin D deficiency and cytokine syndrome development. The study included 90 COVID-19 patients and 30 control people from Baghdad, Iraq. The age of the participants was non-s

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Publication Date
Mon Jul 01 2024
Journal Name
Indian Journal Of Clinical Biochemistry
Evaluation of Bone Turnover Markers in Patients with Acute and Chronic Leukemia
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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Clinical Evaluation of Some Biochemical Parameters from Patients in Heamodialysis Room
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As a marker of systemic inflammation, raised (C-reactive protein (CRP)) concentrations which are still within the normal range have been associated with an increased inflammation of chronic renal diseases (CRD). The current study aimed to establish potential determinats of raised CRP concentrations in patients who treated in Heamodialysis room,then study the relationship between CRP& some biochemical parameters related CRD We used a CRP latex reagents Kit which is based on an immunological reaction between CRP antisera bounded to the biologically inert latex particles or with CRP in the test specimens of 19 patients with (CRD) mean age 48 years ,range = 30?65 & in 21 healthy subjects as control group their age range = 30 ?45 years. The

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