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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 Jan 01 2024
Journal Name
Medical Research Archives
Genetic Polymorphism for the Gene Encoding Endoplasmic Reticulum Aminopeptidase-1 (ERAP-1) in Iraqi Patients with Ankylosing Spondylitis
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Ankylosing spondylitis (AS) is a common, highly heritable inflammatory arthritis affecting primarily the spine and pelvis. This study was aimed to investigate the relationship between the rs27044 polymorphism in Endoplasmic reticulum aminopeptidase-1 (ERAP-1) with the susceptibility and severity of AS correlated with some biochemical markers such as hematological parameter (Erythrocytes sedimentation rate (ESR)) and immunological parameters (C-reactive protein (CRP), Human leukocyte antigen-B27 (HLA-B27), Interlukin-6 (IL-6) and Interlukin-23 (IL-23)), and oxidative stress parameters (Glutathione (GSH) and Malondialdehyde (MDA)) in a sample of Iraqi population. A total of 60 blood samples were collected from AS patients requited Rhe

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Publication Date
Thu Jun 13 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Association of the MDR1 Variants (rs2032582 and rs2032583) with Steroid Response in Iraqi Children with Idiopathic Nephrotic Syndrome
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Background: Several studies linked the development of steroid-resistant nephrotic syndrome (SRNS) to genetic variations in the multidrug resistance 1 (MDR1) gene, though a disparity in findings was underlined among children with different ethnic origins. Objective: This study examined the relationship between MDR1 variants (rs2032582 and rs2032583) and the risk of developing SRNS in Iraqi patients with idiopathic nephrotic syndrome (INS). Methods: This case-control study included children with steroid-sensitive INS (SSNS; n=30) and SRNS (n=30) from the Babylon Hospital for Maternity and Pediatrics. Sanger sequencing was used to determine the participants’ genotypes. Results: The rs2032582 genotypes and alleles were not associated

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Publication Date
Sun Jul 02 2023
Journal Name
Journal Of Pakistan Association Of Dermatologists
The frequency of acute radiodermatitis and associated risk factors among patients with breast cancer treated by radiotherapy
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Background: Acute radiodermatitis is a common side effect during and after radiotherapy course in breast cancer patients treated by radiotherapy. This study assess the frequency of acute radiodermatitis and record the predictive factors for acute radiodermatitis. Patients and Methods: A descriptive case series study conducted at Baghdad, Iraq from August 2020 to September 2021. 70 female scheduled for radiotherapy sessions enrolled in this study. sociodemographic data were recorded and Skin examination before radiotherapy and weekly till the end of the radiotherapy sessions was done to report the frequency, risk factors, clinical picture and grades of acute radiodermatitis based on The National Cancer Institute’s Common Terminology Crite

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Publication Date
Sun May 05 2024
Journal Name
Review Of Clinical Pharmacology And Pharmacokinetics - International Edition
Emergency department presentation and management of patients with acute decompensated heart failure at the Baghdad Teaching Hospital
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Acute decompensated heart failure (ADHF) is a leading cause of hospital admission and many factors are known to precipitate decompensation. We aimed to assess the decompensating factors of heart failure and the management of patients admitted to the emergency department (ED). A total of 107 patients were examined, all diagnosed with ADHF in the ED of the Baghdad Teaching Hospital, from June 2017 to December 2017, and presenting with decom¬pensation (pulmonary oedema, peripheral oedema, and fatigue). The mean patient age was 62.5 ± 9.8 years (range: 43–85 years); the majority of them were in their 7th decade (37.4%), and men were slightly more than women. Hy¬pertension was the most commonly associated comorbidity (68.2%), follow

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of Clinical And Experimental Dentistry
In vitro bond strengths post thermal and fatigue load cycling of sapphire brackets bonded with self-etch primer and evaluation of enamel damage
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Background: This in vitro study compares a self-etch primer (SEP) to an etch-and-rinse (EaR) for bonding sapphire brackets by evaluation of the enamel etch-pattern, shear bond strength, amount of remnant adhesive and enamel surface damage following thermal and fatigue cyclic loading. Material and Methods: Ceramic (sapphire) brackets were bonded to 80 extracted human premolars using two enamel etching protocols: conventional EaR using 37% phosphoric acid (PA) gel (control), and a SEP (Transbond Plus). Each group was subdivided into two subgroups (n=20 teeth) according to the time of bracket debonding: after 24 h water storage or following 5000 thermo-cycles plus 5000 cycles fatigue loading, to determine the shear bond strength (SBS), adhesiv

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Publication Date
Sun Oct 01 2023
Journal Name
Asian Pacific Journal Of Cancer Prevention
Immunohistochemical study of the expressed cluster differentiation markers proteins type 20 and 56 in breast tissues from a group of Iraqi patients with breast cancers
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Publication Date
Thu Sep 01 2016
Journal Name
Injury Prevention
The effectiveness of injury prevention program on reducing the incidence of lower limb injuries in adolescent male soccer players
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The highest incidence of injury is seen in adolescent playing pivoting sports such as soccer, basketball, and handball. Objective: To examine the effectiveness of a neuromuscular prevention program in reducing knee and ankle injuries in adolescent male soccer players.

Publication Date
Fri Dec 03 2021
Journal Name
Rawal Medical Journal
Functional outcome of interlocked intramedullary nailing fixation in management of closed tibia shaft fractures
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Objective: To assess prospectively functional outcome of interlocked intramedullary nailing fixation in management of closed tibia shaft fractures. Methodology: This prospective study included 134 patients with closed shaft tibia fractures with age 18-60 years and isolated closed fracture of shaft of tibia. The fractures were fixed by interlocking intramedullary nail. At follow-up after 12 months postoperatively, the functional outcome was assessed radiographically for the sign of union and clinically according to Klemm-Borner criteria. Results: The mean age was 38.55 years. Out of 134 patients, 55.2% were male. The cause was road traffic accident in 44.8%, majority of the fracture occur in the mid-shaft (41.8%), and oblique fracture was th

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Scopus
Publication Date
Tue Sep 08 2020
Journal Name
Al-kindy College Medical Journal
Outcome of En Bloc Resection of Osteoidosteoma
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Background: Osteoid osteomaa benign tumor is unusual before the age of 5 or after age 30 and is more prevalent in men. The main symptom is pain, which is typically severe and responsible for nocturnal awakenings. The conditons usually diagnosed through radiological imagine and confirmed by Histopathology.
Objectives: To assess the effectiveness and the complications that had been risen during the surgical procedure of osteoid osteoma using en bloc resection.
Methods: (10) Patients diagnosed with osteoid osteomawere treated with enbloc surgical reseaction were included in this study.the study took place at Al Yarmouk teaching hospital.the from April 2017-october 2018 and included 10 patients..(7) male, (3) females.The mean age of th

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Publication Date
Mon May 17 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
Efficacy of Five Organic Acids Combination on T2- Mycotoxicosis in Rats
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Mycotoxins are secondary by-products of mold metabolism and are accountable for human and animal mycotoxicosis. The most serious trichothecenic mycotoxin is the fungal T-2 mycotoxin. T-2 mycotoxin impaired nutrient absorption, metabolism, and then, eliciting severe oxidoreductive stress. Diet plays a key role beyond the supply of nutrients in order to promote animal and human health. Organic acids have been commonly used to exert antioxidative stress capacity in the liver and gut ecosystem. This study is planned to explore, the competence of using (X-MoldCid®) during chronic T-2 mycotoxicosis course in rat. Rats were allocated into 4 main groups, (CN-Gr), negative control and was allowed for the free access to the normal rats chow and the

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