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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 Apr 01 2015
Journal Name
Iraqi Postgraduate Medical Journal
Can the automated pump be an alternative to tourniquet in knee arthroscopy ?
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ABSTRACT: BACKGROUND: Arthroscopic knee surgeries are performed in very large numbers worldwide, and in spite of relatively low complication rate, but the total number is significant. Some of these complications are due to tourniquet use and can be serious. OBJECTIVE: Is to asses if automated pump (with or without) dilute epinephrine saline irrigation can replace the tourniquet use in soft tissue arthroscopic knee surgeries. PATIENTS AND METHODS: 36 patients (9 females 25 % and 27 males 75 %) were included in this prospective experimental nonrandomized study, and were necessitated soft tissue arthroscopic knee surgeries. Patients were divided into two groups, in group A (patients) tourniquet and automated pump were used. In group B (18 pati

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Publication Date
Tue Feb 25 2020
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Evaluation of Hepatocyte Growth Factor in Iraqi Patients with Acute Myeloid Leukemia: Its Correlation with Clinical Parameters and Response to Induction Therapy
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BACKGROUND: Hepatocyte growth factor (HGF) is a proangiogenic factor that exerts different effects over stem cell survival growth, apoptosis, and adhesion. Its impact on leukemogenesis has been established by many studies. AIM: This study aimed to determine the effect of plasma HGF activity on acute myeloid leukemia (AML) patients at presentation and after remission. PATIENTS AND METHODS: This was a cross-sectional prospective study of 30 newly-diagnosed, adult, and AML patients. All patients received the 7+3 treatment protocol. Patients’ clinical data were taken at presentation, and patients were followed up for 6 months to evaluate the clinical status. Plasma HGF levels were estimated by ELISA based methods in the pa

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Publication Date
Fri Jan 01 2016
Journal Name
International Archives Of Medicine
The role of MRI in the diagnosis of intra articular knee derangement: A prospective study
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Publication Date
Sat Jun 19 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Role of Ginkgo biloba Extract as Monotherapy in Improving the Outcomes of Patients with Metabolic Syndrome: A Pilot Comparative Study with Metformin
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The present study evaluates the effects of Ginkgo biloba extract as monotherapy on the glycemic status, insulin resistance (IR), body mass index (BMI), and visceral adiposity index (VAI), in addition to the inflammatory markers, oxidative status and leptin level in patients with metabolic syndrome in comparison with metformin.

The study is a randomized, double-blind pilot study conducted during the period May to September, 2020. Fifty patients were recruited in the study and they were allocated into two groups (25 per each group): Ginkgo biloba and Metformin groups, they received (120 mg Ginkgo biloba extract/ capsule) and (500 mg Metformin/ capsule) respectively; orally as a single dose for 90 days. Blood samples were taken at z

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Publication Date
Mon Aug 21 2017
Journal Name
Biomedical And Pharmacology Journal
Gene Expression and Clinical Manifestations in Iraqi Patients with Acromegaly
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Publication Date
Sun Jul 30 2023
Journal Name
Al-rafidain Journal Of Medical Sciences
Correlation of Kidney Injury Molecule-1 and Nephrin Levels in Iraqi Patients with Diabetic Nephropathy
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Diabetic nephropathy is characterized by persistent microalbuminuria and metabolic changes that decline renal functions. Researchers have been prompted to explore new biomarkers such as KIM-1 and nephrin that may enhance the identification of disease. Objective: To Evaluate biomarker levels of kidney injury molculre-1 (KIM-1) concentration and nephrin as early and sensitive markers of nephropathy in type 2 diabetic patients. Method: One hundred T2DM patients were included in a cross-sectional study at the specialized center for endocrinology and diabetes, Baghdad. The first group includes 50 diabetic nephropathy (DN) patients, and the second group includes 50 T2DM patients without DN. Biochemical and clinical parameters were reported for pa

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Publication Date
Sun Jul 30 2023
Journal Name
Iraqi Journal Of Science
Integration of Sunflower and Sorghum Water Extracts Applied Alone or in Combination With Reduced Doses of Chevalier for Weed Control in Wheat
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      Field trial was conducted with the aim of utilizing extract of allelopathic crop to reduce the use of synthetic herbicides in wheat fields. Sorghum extract at 12 L /ha, sunflower extract at 12 L /ha, combination of sorghum and sunflower extracts at 12 L /ha and chevalier at 25, 50 and 100% of recommended dose were applied alone or in combination with each other. Weed free and weedy check treatments were included for comparison. The experiment was conducted in a randomized complete block design with three replications. The results showed that the recommended  dose of chevalier  treatment recorded lowest means of weed density 15.7, 23.7, 25.3 and 27.9 weeds m-2and weeds dry weight 13.4, 16.4, 23.3 and 29.2 g m-2 and gave

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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)
Evaluation of the Anti-Inflammatory Effect of Pioglitazone in Experimental Models of Inflammation in Rats
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         The antidiabetic thiozolidinediones (TZDs) a class of peroxisome proliferators-activated receptor (PPAR) ligands has recently been the focus of much interest for their possible role in regulation of inflammatory response. The present study was designed to evaluate the anti-inflammatory activity of pioglitazone in experimental models of inflammation in rats. The present study was conducted to evaluate the anti inflammatory effect of TZDs (pioglitazone 3mg/Kg) on acute, sub acute and chronic model of inflammation by using egg-albumin and formalin–induced paw edema in 72 rats, relative to reference drugs Dexamethasone 5mg/Kg and Piroxicam 5mg/Kg. In each inflammation model, 24 rats wer

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation the Role of Clinical Pharmacist on Prevents or Reduced the Medication Error in Emergency Department
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Objective: To identify the role and importance of the clinical pharmacist in the Emergency Department on prevent
or reduced the medication error.
Methodology: We collected the medical file of 3400 patients, 1400 patient's file in (A) hospital, and 1000 patient's
file in each of (B and C) hospital, who admitted to the ED, at primary weekdays between 8 am to 2 pm, and
recorded all the intervention made by clinical pharmacist through an active search in clinical charts, with analysis
of the daily medical prescription. The potential severity of harm of the medication error judged by two reviewers,
a permanent emergency physician, and clinical pharmacist based on the National Coordinating Council (NCC) of
Medication Error

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Publication Date
Sat Oct 01 2022
Journal Name
Baghdad Science Journal
Violation of the Hormonal Spectrum in Polycystic Ovaries in Combination with Insulin Resistance. What is the Trigger: Insulin Resistance or Polycystic Ovary Disease?
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Polycystic ovary syndrome (PCOS) is the main cause of female infertility. The role of insulin resistance in the development of polycystic ovary is actively discussed here. The study included patients with PCOS without insulin resistance (n = 48) and with insulin resistance (n = 39). The comparison groups were patients with no history of PCOS: a control group without insulin resistance (n = 46) and a group of patients with insulin resistance (n = 45). The following parameters were determined in patients: FSH, LH, TSH, T3f, T4f, PRL, E2, 17-OHd, Pr, AMH, Test total, Testf, DHEAS, DHEASs, SHBG, ACTH, cortisol, IRI, IGF-1, C-peptide, and glucose level. The HOMA-IR index and the LH / FSH ratio and t

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