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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
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Psychological Problems of Patients with Colorectal Cancer
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Objective: Assessment the psychological problems in patients with colorectal cancer, and to find out the
relationship between socio-demographic characteristics such as (age, sex, marital status, educational level,
and occupation) and psychological problems for those patients.
Methodology: A descriptive design is employed through the present study from 1
st July 2011 to 25
th December
2011 in order to study the quality of life in colorectal cancer patients with psychological problems.
A purposive (non probability) sample is selected for the study which includes (60) patients diagnosed with
colorectal cancer were treated in Mosul Oncology and Nuclear Medicine hospital or the patients who visited
the outpatient cl

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Publication Date
Sun Nov 04 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Patients’ Compliance with Essential Hypertension
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Objective:
This study aims to asses the patients' compliance with essential hypertension in respect to antihypertensive
medications, follow-up, dietary pattern and health habits, to identify the associated long-term complications, and
to find out the relationship between patient's compliance, and demographic characteristics such as age, gender,
level of education, and duration of disease.
Methodology:
A descriptive study was carried out in Nasiriyah Teaching Hospital to achieve presented objectives .
Results:
The results of the study revealed that there were a significant association between educational level and total
patient's compliance, a significant association was found between the duration of disease and

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Publication Date
Wed Oct 18 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Patients’ Compliance with Essential Hypertension
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Objective:
This study aims to asses the patients' compliance with essential hypertension in respect to antihypertensive
medications, follow-up, dietary pattern and health habits, to identify the associated long-term complications, and
to find out the relationship between patient's compliance, and demographic characteristics such as age, gender,
level of education, and duration of disease.
Methodology:
A descriptive study was carried out in Nasiriyah Teaching Hospital to achieve presented objectives .
Results:
The results of the study revealed that there were a significant association between educational level and total
patient's compliance, a significant association was found between the duration of disease and

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Publication Date
Tue Oct 14 2025
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Illness Perceptions and Response to Treatment with Romiplostim in Iraqi Patients with Refractory Immune Thrombocytopenia Purpura: A Cross-Sectional Study
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Background: Immune thrombocytopenia is an immune-related disorder that causes an impairment in platelet production and stimulates platelet destruction, causing variable bleeding symptoms. Objective: This study focuses on refractory immune thrombocytopenic purpura patients on romiplostim treatment and their level of illness perception related to treatment response. Method: A cross-sectional study was conducted from May 1st, 2025, to August 1st, 2025. Brief Illness Perception Questionnaires were administered to 84 patients with ITP to collect the data. The study took place at the Hematology and Bone Marrow Transplant Center, Medical City, Baghdad, Iraq. Results: The romiplostim response rate is 21 (25.0%), while the partial response rate is 4

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Publication Date
Wed Nov 07 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Factors Associated with Prehospital Delay of Patients with Acute Myocardial Infarction
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Objective(s): to assess the factors which are associated with the prolonged prehospital delay of patients with
acute myocardial infarction.
Methodology: A descriptive study was conducted at the Coronary Care unit (CCU) in Al-Yarmok Teaching
Hospital, Ibn AL-Nafis Hospital for Cardiovascular Diseases, AL-Kadumia Teaching Hospital, Baghdad Teaching
Hospital, and AL-Kindy Teaching Hospital during the period of the study from February 2
nd
, 2009 to October 30th
,
2009. A random sample of (160) paƟent who were admiƩed to the hospitals were selected one by one. A
questionnaire was constructed for the purpose of the study, which is comprised of four parts that include (1)
sociodemographic data; (2) prehospital d

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Publication Date
Wed May 12 2021
Journal Name
Annals Of The Romanian Society For Cell Biology
The Effect of Rehabilitation Exercises Preceded by Reflexology Technique in the Rehabilitation of Patients with Frozen Shoulder: Experimental Research
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Shoulder immobilization is one of the injuries that lead to disability and loss of movement in the joint within a short time, which called the researchers to find appropriate therapeutic means to rehabilitate this injury. They prepared a rehabilitation program accompanying the reflexology technique to rehabilitate the injury of the immobilized shoulder of the small degree and improve the range of movement and muscle strength working on the shoulder joint The sample was selected from the male patients aged (40-50) years. The muscle strength test was used using the force sensor, the shoulder range test from the flexion and extension position and the visual analog test to measure the level of pain. The study concluded that the pre-rehabilitati

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Publication Date
Mon Jan 01 2024
Journal Name
Iraqi Journal Of Hematology
Evaluation of Vitamin D level in thalassemia patients: The experience of a single center
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Publication Date
Mon Dec 01 2014
Journal Name
Iraqi Journal Of Science
Detection of human leukocyte antigen and celiac disease auto antibodies in serum of patients with multiple sclerosis
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To determine the important pathogenic role of celiac disease in triggering several autoimmune disease, thirty patients with Multiple Sclerosis of ages (22-55) years have been investigated and compared with 25 healthy individuals. All the studied groups were carried out to measure anti-tissue transglutaminase antibodies IgA IgG by ELISA test, anti-reticulin antibodies IgA and IgG, and anti-endomysial antibodies IgA and IgG by IFAT. There was a significant elevation in the concentration of anti-tissue transglutaminase antibodies IgA and IgG compared to control groups (P≤0.05), there was 4(13.33%) positive results for anti-reticulin antibodies IgA and IgG , 3(10%) positive results for anti-endomysial antibodies IgA and IgG . There were 4 pos

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Publication Date
Wed Dec 30 2020
Journal Name
Al-kindy College Medical Journal
Measurement of plasma fibrinogen and D-dimer in a sample of Iraqi patients with solid malignant tumors
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Background: Multifactor affect the pathogenesis of thrombosis in solid malignancy; however, a significant role is attributed to the cancer cells ability to interact with and activate the host hemostatic system. [1] 

Hemostasis is highly correlated to tumor growth, angiogenesis and metastasis, modulation of these pathways reflects interesting and promising treatment options in the future. [1]

Most patients with cancer frequently suffer from chronic compensated DIC and have abnormal laboratory coagulation tests without clinical manifestations of thrombosis, which is a subclinical hypercoagulable state that can be detected by varying degrees of activation of blood clotting. The results of laboratory tests in th

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Publication Date
Mon Dec 01 2014
Journal Name
Iraqi Journal Of Science,
Detection of human leukocyte antigen and celiac disease auto antibodies in serum of patients with multiple sclerosis
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To determine the important pathogenic role of celiac disease in triggering several autoimmune disease, thirty patients with Multiple Sclerosis of ages (22-55) years have been investigated and compared with 25 healthy individuals. All the studied groups were carried out to measure anti-tissue transglutaminase antibodies IgA IgG by ELISA test, anti-reticulin antibodies IgA and IgG, and anti-endomysial antibodies IgA and IgG by IFAT. There was a significant elevation in the concentration of anti-tissue transglutaminase antibodies IgA and IgG compared to control groups (P≤0.05), there was 4(13.33%) positive results for anti-reticulin antibodies IgA and IgG , 3(10%) positive results for anti-endomysial antibodies IgA and IgG . There were 4 pos

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