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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
Wed Nov 01 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effectiveness of Myoinositol alone or in Companion with Metformin in Improving Hormonal, Metabolic, and Clinical Features of PCOS Women
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Polycystic ovary syndrome (PCOS) referring to a syndrome that is recognized as a life-course disease and has both metabolic and reproductive signs; main pathophysiological cause includes insulin resistance, hyperandrogenism, and oxidative stress state. The study aimed to assess the impact of combining Myoinositol and Metformin, the main insulin-sensitizing drugs, on improving clinical, metabolic, and hormonal parameters in females with PCOS. A clinical trial that was prospective, randomized, and comparative on 54 patients (aged 18-40 y) are divided into three groups: group1 patients allocated to receive Myo-inositol(4g), group2 patients assigned to receive Metformin(1g) and group3 patients assigned to receive Myo-inositol(4g) + Metformin

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Clinical Evaluation of Melatonin Alone and in Combination with Pizotifen in the Prophylaxis of Migraine
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The treatment of migraine headache targets the neurovascular mechanism and involves the use of serotonin receptor antagonists. Some of these drugs are used for the treatment of acute attacks; while others are effective as prophylactic measures to decrease the duration and frequency of attacks. Pizotifen, a 5-HTA antagonist, is one of the prophylactic drugs for which the clinical use resulted in low outcomes in reducing migraine symptoms. Melatonin, a serotonin derived neurohormone, was reported to exert many functions like sleep induction, anti-inflammatory, neurovascular regulation, cytoprotection and modulation of neurotransmitter release.  In the view of the involvement of serotonin in the pathophysiology of migraine a

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Publication Date
Sat Sep 01 2018
Journal Name
J Of Baghdad College Of Dentistry
Serum Tumor Necrosis Factor Alpha and High Sensitive C-Reactiveprotein as Biomarkersin Periodontitis in Iraqi Patients with Osteoarthritis
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Publication Date
Mon May 22 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Comparative Biochemical Study of Glutathione, Ceruloplasmin and Trace Element in Sera of Control Group and Human Female Patients with Osteoarthritis Nodal in Iraqies Patients
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The present study conducted on 30 female patients with osteoarthritis 0A a
attending Baghdad teaching hosp ital, in addition to 30 healthy females , all subjects
were ( 35-65) years old.
Some biochemical parameters were measured in the sera of patients and healthy
group s. The parameters were Glutathione (GSH). Ceruloplasmin (Cp) and some trace
elements ,including Copper (Cu) ,Cu/ Cp ratio and Selenium (Se) were determined . The
results revealed a significant reduction in all parameters of patients sera compared to
healthy group .
The reduction in GSH and Cu/Cp ratio confirms tissue damage associated with
oxidative stress injury
A conclusion was obtained hrer ,that Cu wasn’t an important ele

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Publication Date
Thu May 18 2023
Journal Name
Journal Of Engineering
Experimental Study for Materials Prosthetic above Knee Socket under Tensile or Fatigue Stress with Varying Temperatures Effect
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The residual limb within the prosthesis, is often subjected to tensile or fatigue stress with varying temperatures. The fatigue stress and temperatures difference which faced by amputee during his daily activities will produces an environmental media for growth of fungi and bacteria in addition to the damage that occurs in the prosthesis which minimizingthe life of the prosthetic limb and causing disconfirm feeling for the amputee.

In this paper, a mechanical and thermal properties of composite materials prosthetic socket made of different lamination for perlon/fiber glass/perlon, are calculated by using tesile test device under varying temperatures ( from 20oC to 60oC), also in this paper a device for measuring rotational bendin

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Publication Date
Sat Sep 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Serum Tumor Necrosis Factor Alpha and High Sensitive C-Reactive protein as Biomarkers in Periodontitis in Iraqi Patients with Osteoarthritis
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Background: Periodontitis (PD) is well-known chronic disease affecting the periodontal ligament and alveolar bone, Osteoarthritis (OA) is a chronic joint disease with compound reasons characterized by synovial inflammation, subchondral bone remodeling, also the formation of osteophytes, that cause cartilage degradation. Chronic periodontitis and osteoarthritis are considered widely prevalent diseases and related to tissue destruction due to chronic inflammation in general health and oral health. The aim of this study is todetermine the association of chronic periodontitis and osteoarthritits in patients by analysing tumor necrosis factor alpha TNFα and high sensitive c-reactive protein (hsCRP) in the serum. Materials and Method: A tot

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Publication Date
Tue Sep 08 2020
Journal Name
Al-kindy College Medical Journal
Comparison between the Use of bupivacaine 0.5%alone and bupivacaine 0.5% with nefopam 20mg in sciatic n block ( popliteal approach) and femoral n block in patients undergoing below knee surgery
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Objective : Sciatic nerve block (popliteal approach) and femoral N block is a new technique other than general anesthesia in below knee surgery because it provides adequate muscle relaxation, with good intraoperative and post-operative analgesia. Nefopam is non opioid, non-respiratory depressant and non-sedative was mixed with local anesthetics drug to study the effects. This study was done to compare the onset and duration of sensory and onset time and duration of action of motor block following administration of either bupivacaine alone with administration of bupivacaine and Nefopam in patients undergoing below knee lower limb surgeries under ultrasound guided regional anesthesia.
Methods: 100 patients with American society of anest

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Publication Date
Wed Apr 12 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
IGF-1 , Leptin & AIP in relation to Osteoarthritis with and without Diabetes Mellitus Type2
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        IGF-1  is a protein  produced  by  the liver in  response  to  growth hormone   stimulus.One important  key in effectively  preventing  and   treating  osteo arthritis, is establishing a healthy balance of IGF-1.    Leptin is a hormone  produced   by  adipose tissue,   acting as a  sensor  of  fat  mass in  part  of   a negative   feedback   loop   that maintains  a  set  point  for  body  fat  stores.  Leptin  plays  an important  role  in &nbs

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Publication Date
Mon Jan 01 2024
Journal Name
Scripta Medica
Effect of proteolytic enzymes and insulin sensitiser in treatment of joint osteoarthritis in diabetic patients
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Background/Aim: Knee osteoarthritis is a frequently crippling chronic condition. Numerous pharmacological medications have been successfully utilised to treat knee osteoarthritis. This research aimed to compare the efficiency of metformin and serratiopeptidase in treating and preventing osteoarthritis development via distinct mechanisms. Methods: Between 1 January and 30 May 2019, a randomised-clinical-trial was done at Al-Kindy Hospital on 80 osteoarthritis patients, divided in two groups. Group I was given metformin 850 mg orally, whereas Group II was given serratiopeptidase 20 mg and metformin 850 mg orally. Parameters in these groups were compared with forty healthy normal controls. Results: Following treatment, patients in Grou

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Publication Date
Thu Sep 12 2019
Journal Name
Al-kindy College Medical Journal
The Role of Metformin in patients with Primary Hypothyroidism
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Background: Insulin resistance is present in 50% or more of patients with primary hypothyroidism. Metformin can decrease TSH levels in these patients by a complex matter, this can be of great help in clinical practice.

Objective: This study was designed to evaluate the effect of metformin in reducing TSH levels in patients with primary hypothyroidism.

Methods: Hundred patients with primary hypothyroidism, 82 females, 18 males were included in this study, everyone was followed up for two months after adding metformin 850 mg twice daily in addition to thyroxin.

Results: 36 patients (36%) have a normal baseline TSH and no change after 2 months, 64 pa

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