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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
Sun Oct 21 2018
Journal Name
Al-kindy College Medical Journal
Evaluation of the clinical examination in thediagnosis of acute medial collateral ligament injury of the knee joint in comparism with examination under general anesthesia
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Background: Tear of MCL of the knee is a frequent problem among knee ligaments injuries.Injuries to the MCL are usually caused by contact on the outside of the knee and are accompanied by sharp pain on the inside of the knee. Contrary to most other knee ligaments the medial collateral ligament (MCL) has an excellent ability to heal, being fairly large and well vascularised structure. The vast majority of isolated medial ligament injuries heal without significant long-term problems

Objectives: is to compare between the early clinical examination, and assessment under general anesthesia (GA), and to find out the best methods to assess the MCL tear especially in suspected cases.

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Pharmaceutical Negative Results
The diagnostic value of Paraoxonase (PON 1) enzyme activity in the diagnosis of knee joint osteoarthritis: case control study
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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
HLA Typing in Iraqi Patients with Obesity and Primary Osteoarthritis.
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Background: Osteoarthritis (OA) is a degenerative joint disease. It is one of the major causes of disability in developed and developing countries. Human leukocyte antigen (HLA) as part of immune system has a role in the disease process.Objectives: To investigate whether there is an association between HLA class II-DRB and OA.Methods: A case control study with 26 patients with osteoarthritis and 22 apparently healthy obese control persons matching in ethnicity were enrolled in this study during the period between October 2012 till March 2013. Direct interview was done with each patient and HLA typing was done by molecular method using Sequence Specific Primer (PCR-SSP) method using One Lambda Kit-USA. Results: The results showed that fem

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Publication Date
Tue Jun 30 2015
Journal Name
Al-kindy College Medical Journal
Magnetic resonance imaging findings of knee injury
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Background: Since its introduction to musculoskeletal imaging in the early 1980, magnetic resonance imaging (MRI) has revolutionized diagnostic imaging of the knee. It is therefore become the examination of choice in the evaluation of internal joint structures of the knee like menisci, cruciate ligaments, and articular cartilage.Objectives: to describe the MRI finding in various knee injuries.Patients and methods: A cross sectional study was done on 130 patients with history of knee injury in MRI unit at institute of radiology and al-Shaheed Ghazi Al-Hariri Hospital in medical city complex - Baghdad, from October 2011 to February 2013 includes 103 men, 27 women; the mean age was 33.86 years. MR imaging studies of the knee performed using

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Publication Date
Thu Apr 03 2025
Journal Name
Iraqi Journal Of Community Medicine
The Rational Use of Collagen in Osteoarthritis: Review article
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Osteoarthritis is a degenerative disease affecting joints that is chronic and disables the movement of patients with increasing pain and decreasing their quality of life with age. Available treatments are only symptomatic with no cure. Recent methods for managing osteoarthritis involve using pharmacological, non-pharmacological treatments or both for improving physical function in patients and alleviating pain. Clinical trials were conducted to reveal the extent of benefits obtained from different nutraceuticals and food supplements, such as collagen with growing use and fairly good results in the treatment of osteoarthritis. The goal of this study is to review the current information about the rational use of collagen in osteoarthritisKeyw

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Publication Date
Thu Feb 01 2018
Journal Name
Research Journal Of Pharmaceutical,biological And Chemical Sciense
correlation of serum tumor necrosis factor alpha and high sensitive c-reactive protein with clinical periodontal parameters in osteoarthritis patients
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Publication Date
Tue May 01 2018
Journal Name
International Journal Of Medical Research & Health Sciences
Estimation of Serum Matrix Metalloproteinases-1 Levels in Iraqi Female Patients with Osteoarthritis
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This study was established to investigate the correlation between the expression of matrix metalloproteinases (MMP-1) and the pathogenesis of osteoarthritis (OA). Blood samples were collected from 55 female patients with inflammatory OA and controls for estimation of serum (MMP-1) levels. In the current study, there is significant increase (p<0.001) in the mean of serum MMP-1 levels in osteoarthritis females (4027.73 ± 1345.28 pg/ml) than that in control females (798.76 ± 136.79 pg/ml). It was concluded that MMP-1 may be associated with the pathogenesis of osteoarthritis.

Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Comparative study of anterior knee pain after patelloplasty with and without circumferential denervation in a total knee arthroplasty
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Background: The anterior knee pain is an important chief complaint of the patients with knee osteoarthritis due to patellofemoral pathology. The pain receptors denervation can be achieved by circumferential denervation of the patellar area by a process of electrocautery.

Objectives: The aim of current study is to assess the pain after total knee arthroplasty (TKA) by patelloplastywith and without circumferential denervation via electrocautery at a minimum follow up with 1 year separately for each patient.

Type of the study:Cross- sectional study.

Methods: Thirty five patients,with mean age of about (62.8) years, were enrolled in this pros

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Publication Date
Wed May 17 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Evaluation Interleukin ─ 8 and High Sensitivity C - Reactive Protein in Sera of Control Group and Human Female Patients with Osteoarthritis Nodal in Iraqi's Patients
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       The present study conducted on 30 female patients with osteoarthritis OA a attending Baghdad teaching hospital, in addition to 30 healthy females, all subjects were (35-65) year's old .Parameters were measured in the sera of patients group and healthy groups were interleukin -8 (IL-8) and high sensitivity C-reactive protein (hs-CRP).The results revealed a higher significant in all parameters of patients sera compared to healthy groups. Conclusion was obtained that IL-8 and hs- CRP were a markers or player inflammatory disease like osteoarthritis nodal  

 

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Publication Date
Wed Dec 01 2010
Journal Name
Al Mustansiriyah Journal Of Pharmaceutical Sciences
Evaluation ofAaspirin, Clopidogrel or Their Combination In Hypertensive Patients
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The objective of this study is to evaluate the effect of aspirin, clopidogrel or their combination on different parameters in hypertensive patients.Platelets adhesion, activation, and aggregation are central to thrombus formation, which follows atherosclerotic plaque disruption and causes acute coronary syndromes. Aspirin and clopidogrel exert their antiplatelet effects by inhibiting thromboxane A2 production and adenosine diphosphate–induced platelet aggregation pathways, respectively. This study was designed to evaluate the possible effects of aspirin and clopidogrel given either alone or in combination in patients with essential hypertension on blood pressure and other parameters in addition to lipid profile using a randomized

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