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Article
Effects of Metformin on Sperm Parameters in Mice: as a model for human being

Authors: Muhammad –Baqir M-R Fakhrildin --- Mohammad 0. Selman --- Ahmed. Kh. Rashid
Journal: Iraqi Journal of Embryos and Infertility Researches المجلة العراقية لبحوث الأجنة والعقم ISSN: eISSN: 26166984 / pISSN: 22180265 Year: 2016 Volume: 6 Issue: 1 Pages: 45-60
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Metformin is anti-hyperglycemic effect due to decrease of hepatic glucose production. Another effect, leading decrease insulin resistance, regarded a safe drug, treatment of choice for overweight.Objective:To investigate the effects of 3 concentration of MF administered orally to male mice on sperm parameters as model for human being.Materials and Methods:In current study, 80 male mice were taken with age ranging between 1.5-2 month and weights ranging between 25-30 grams males classified into four groups of a control group (G1) and treated group (G2, G3 and G4) doses of MF were employed, 0.2, 0.4, 0.6 mg/mice daily to groups, given orally for 6 weeks and then the animals were scarified.ResultsResults have revealed a significant difference (P < 0.05) in sperm concentration for 3 groups compared to G1 group. Progressive motility (%) appeared with significant difference (P< 0.05) for G3 group as compared to other treated and G1 group. Furthermore, the result illustrated a significant decreased (P< 0.05) in the abnormal sperm morphology for G3 group compared with treated and control. However, sperm agglutination (%) confirmed that the G3 group exhibited highly statistical significant decrease (p≤0.001) compared to G1, G2 and G4.ConclusionsFrom results of the present study, it was concluded that the administration of MF doses reduce sperm concentration .while, 0.4mg dose improve certain sperm parameters.


Article
Comparison between The Efficacy of Combined Metformin – Letrazole with Metformin – Clomiphene Citrate in Polycystic Ovarian Syndrome

Author: Shiemaa' Mohsen Mohammad Al-Khafaje
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2016 Volume: 9 Issue: 2 Pages: 2462-2469
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Adding Metformin to clomiphene citrate in clomiphene –resistant PCOS patients increases ovulatory response. However because of anti-estrogenic effects of clomiphene it may be associated with lower pregnancy rate. Offsetting the ovulation rate benefit, Letrazole is an aromatase inhibitor which induce ovulation without antiestogenic effects.Aim of Study: is to induce ovulation& increase the pregnancy rate and live birth rate in patient with PCOS using a new era of therapy with less side effects, less complications and better patient compliance.Materials and Methods: The study is a single – blind randomized clinical trial , 120 ovarian cycle were studied in 60 clomiphene – resistant patients with PCOS , who were chosen among 115 PCOS patients attending infertility clinic in Samawa city – Iraq during the years 2011 – 2012 Infertile women with PCOS were randomly divided into Metformin –Letrazole (29 patients) and Metformin – clomiphene groups (30 patients) after an initial 6 – 8 weeks of metformin.They received either Letrazole (5mg) from2nd to 7th day orclomiphene citrate (100mg)daily from 5th to 9th day of menstrualcycle . Estradiol (E2) level , number of follicles and endometrial thickness were measured on the day of HCG administration .The pregnancy rate of both groups also estimated.Results: Mean total E2 and E2per mature follicle were significantly higher in clomiphene group without a difference in mean number of follicles ≥ 18mm and ovulation rate .Endometrialthickness was significantly higher in Letrazole group .Thepregnancy rate in Letrazole group (10 patients, 34.50%) as compared with clomiphene group (5 patients 16.6%) did not show significant difference, whereas full – termpregnancies were higher in Letrazole group (10 patients 34.5%) versus 3 patients (10%).Conclusion: In clomiphene resistant PCOS, the combination of Letrazole and Metformin leads to higher full term pregnanciesas compared with clomiphene and Metformin .


Article
EFFECT OF BETAHISTINE AND METFORMIN ON LIPID PROFILE IN OBESE FEMALES IN IRAQ: A RANDOMIZED, PLACEBO-CONTROLLED CLINICAL TRIAL

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Abstract

Background:Obesity has become a major worldwide health problem and therefore, the associated morbidity, mortality and both medical and economical costs are expected to increase as well. Obesity increases cardiovascular risk via risk factors such as triglycerides (TG), high LDL cholesterol, low HDL cholesterol, elevated plasma glucose and insulin concentrations. Objective:To investigate the effect of metformin and betahistine along with lifestyle change on lipid profile in obese women in Iraq.Methods:This study was carried out on 78 female patients with age range of 18-50 years who were allocated into three groups: Group 1: treated with oral metformin 850 mg twice daily with lifestyle change for 12 weeks. Group 2: treated with betahistine 32 mg 3 times daily with lifestyle change for 12 weeks. Group 3: treated with placebo 500 mg twice daily with lifestyle change for 12 weeks to serve as control. Complete history was taken, in addition to clinical examination to meet inclusion criteria. Serum transaminases (ALT+AST) and estimated glomerular filtration rate (GFR) were estimated at baseline to exclude hepatic or renal abnormalities.Results:Each metformin and betahistine, along with lifestyle intervention highly significantly reduced total cholesterol level, LDL-C level, TG and VLDL level, and increased plasma level of HDL after 12 weeks in obese women with disturbed lipid profile compared to pre-treatment values, and the changes elicited by metformin and betahistine (plus lifestyle change) were highly significant compared to placebo (lifestyle change alone).Conclusion:The results obtained in this study clearly demonstrated the beneficial effect of using metformin or betahistine to obese women with dyslipidemia and confirmed the role of pharmacotherapy in targeting the lipid metabolism changes accompanying obesity.Keywords:Obesity, dyslipidemia, lifestyle change, betahistine, metformin


Article
Effects of Metformin and Metformin Plus Glibenclamide on Glucose-6-Phosphatase Status and Some Biochemical Parameters in Type 2 Diabetic Patients

Authors: Zainab S. Hallab --- Alaa H. Jawad --- Perry H. Saifullah
Journal: Al-Nahrain Journal of Science مجلة النهرين للعلوم ISSN: (print)26635453,(online)26635461 Year: 2016 Volume: 19 Issue: 2 Pages: 18-24
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

This research was done to assess the effects of anti diabetic drugs (metformin and metformin plus glibenclamide) on Glucose-6-phosphatase activity, serum leptin concentration, Fasting plasma glucose (FPG), Glycated hemoglobin (HbA1c%) and lipid profile in type 2 diabetic patients. The study involved 64 patients suffering from type 2 diabetes mellitus. They were divided into 3 groups. The first group involves 23 newly diagnosed diabetic patients, who did not take any hypoglycemic agents. The second group involves 21 patients on metformin monotherapy, whereas the third group involves 20 patients on metformin plus glibenclamide combination therapy. Another group which involved 20 apparently healthy subjects was used as control group. Age, Body mass index (BMI), FPG, HbA1c %, lipid profile, Glucose-6-phosphatase activity and serum leptin concentration have been determined. The results showed that the activity of Glucose-6-phosphatase was lower in metformin and metformin plus glibenclamide groups when compared with newly diagnosed group and closer to that of control group, leptin concentration was lower in metformin group than that in metformin plus glibenclamide group and these two groups were lower than newly diagnosed group, the levels of FPG, HbA1C% were reduced in metformin and metformin plus glibenclamide groups when compared with newly diagnosed group and metformin alone produce a non-significant favorable effect on all lipids profile parameters, while metformin plus glibenclamide showed a significant reduction in Total Cholesterol (TC) and Low Density Lipoprotein LDL-C. In conclusion, using metformin as a mono therapy or combination with glibenclamide can reduce Glucose-6-phosphatase activity, FPG and HbA1c% levels in type 2 diabetic patients and metformin monotherapy reduced leptin levels more than metformin combination with glibenclamide in type 2 diabetic patients patients so Glucose-6-phosphatase activity and serum leptin concentration can be used as an indicator for the choice of treatment in those diabetic patients.

أجريت هذه الدراسة لتقييم آثار العقاقير المضادة لمرضى السكري على فعاليه الجلوكوز-6- فوسفاتيز، تركيز هرمون اللبتين, مستوى السكر في بلازما الدم، نسبه التراكمي للسكر ومستوى الدهون في مرضى السكري من النوع الثاني. وشملت الدراسة 64 مريضا يعانون من داء السكري من النوع الثاني. تم تقسيمهم إلى ثلاث مجاميع اعتمادا على نوع العلاج المستخدم, تشمل المجموعة الأولى 23 مريضا تم تشخيصهم حديثا من دون اخذ أي نوع من العلاج وتشمل المجموعة الثانية 21 مريضا تمت معالجتهم بعقار الميتفورمين، والمجموعة الثالثة تشمل 20 مريضا تمت معالجتهم بعقار الميتفورمين مع الجلايبينكلامايد تم استخدام مجموعة أخرى التي شملت 20 شخصا أصحاء كمجموعة تحكم العمر، مؤشر كتلة الجسم، مستوى السكر، نسبة التراكمي للسكر، مستوى الدهون، فعاليه الجلوكوز-6- فوسفاتيز وتركيز هرمون الليبتين تم تحديدهم. أظهرت النتائج أن فعاليه الجلوكوز-6- فوسفاتيز كان أقل في المجموعات التي تتناول العلاج بالمقارنة مع المجموعة التي تم تشخيصها حديثا وأقرب إلى قيم المجموعة الضابطة، وكان تركيز هرمون الليبتين أقل في مجموعة الميتفورمين من مجموعه الميتفورمين مع الجلايبينكلامايد وكانت هاتين المجموعتين أقل من المجموعة التي تم تشخيصها حديثا. مستويات السكر، ونسبه التراكمي للسكر انخفضت في المجموعات التي تتناول العلاج بالمقارنة مع المجموعة التي تم تشخيصها حديثا. الميتفورمين وحده إحدث تأثير إيجابي غير كبير على جميع الدهون، في حين أن استخدام الميتفورمين مع الجلايبينكلامايد أدى الى انخفاض كبير في مستوى TC و LDL-C. في الختام، استخدام الميتفورمين كعلاج أحادي أو بالاشتراك مع الجلايبينكلامايد يمكن أن يقلل من فعاليه الجلوكوز-6-فوسفاتيز، مستوى السكر في الدم ونسبة التراكمي للسكر في مرضى السكر من النوع الثاني و الميتفورمين وحده يخفض مستويات هرمون الليبتين أكثر من الميتفورمين مع الجلايبينكلامايد في مرضى السكري من النوع الثاني لذلك فعاليه الجلوكوز-6- فوسفاتيز وتركيز هرمون الليبتين يمكن أن يستخدم كمؤشر لاختيار العلاج في هذا النوع من المرضى.


Article
Effect of Metformin Treatment on some Blood Biomarkers in Women with Endometriosis.
فعاليه دواء الميتفورمين في بعض المؤشرات الحيويه في الدم على النساء اللاتي يعانين من داء بطانه الرحم الهاجره

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Abstract

Endometriosis is a common women health disorder that occurs when Endometrial-like tissue grows outside the uterus. This may lead to irregular bleeding , pelvic pain, infertility and other complications. Metformin, because of its activity to improve insulin sensitivity, it is used for the treatment of diabetes; it also has a modulatory effect on ovarian steroid production and has anti-inflammatory properties, all may suggest its possible effect in treatment of endometriosis. This study was planned to determine the effect of metformin on serum levels of interleukin- eight(IL-8), Tumor necrosis factor-alpha (TNF –α) and estradiol (E2) production , and related symptomatic changes that accompany with endometriosis (pelvic pain, dysmenorrhea and menorrheaga) after three months of study. Blood samples were obtained from those taking metformin and measure the serum levels of (IL-8) , TNF –α and (E2) were measured before and after three months of taking a metformin .Metformin therapy resulted in a significant reduction in the clinical symptoms of endometriosis (pelvic pain and dysmenorrhea) and insignificant changes in menorrhagia. Metformin therapy resulted in a significant reduction in the serum levels of IL-8, TNF- α while insignificant reduction in estradiol E 2 in the study group after 3 months of treatment .In conclusion the results of this study, demonstrated that metformin may be a well-tolerated treatment for endometriosis that relieved pain and reduces menstrual disorders and serum levels of the inflammatory markers (IL-8 and TNF-α) are decreased in study group treated with metformin after 3 months due to its anti- inflammatory effects.

بطانة الرحم الهاجره هو من اكثر الامراض شيوعا لدى النساء و الذي يحدث نتيجه أنسجة تشبه بطانة الرحم تنمو خارج الرحم و هذا قد يؤدي إلى اضطراب الدوره الشهريه ,آلام الحوض والعقم ومضاعفات اخرى. الميتفورمين يستخدم لعلاج مرض السكري الذي يحسن الحساسية للانسولين و لديه أيضا خصائص مضادة للالتهابات وتأثير على الإنتاج الستيرويد المبيض، لهذا ااحتمال ان يكون له دور فعال في علاج البطانة الرحم الهاجره .لدراسه ما إذا كان استخدام الميتفورمين فعالا على بطانة الرحم الهاجره من خلال تقييم استخدام الميتفورمين 1500ملغ يوميا لمده ثلاث اشهر على مستويات الانترلوكين– 8 و عامل نخر الورم ألفا وانتاج الستيرويد في الدم والتغييرات في الأعراض التي تحدث مع بطانة الرحم (ألم الحوض، عسر و غزاره الطمث )بعد ثلاثة أشهر من اخذ العلاج .تشمل جمع عينات من نساء من مختلف الاعمار وعددهم 30 يعانين من داء بطانه الرحم الهاجره و وينقسمون الى:1-نساء مصابين بالمرض ويستخدمن العلاج التقليدي(حبوب منع الحمل, هرمون البروجيسترون, عقار الدانازول Danazol, مثيل محرر هرمونات التناسل Gn-RH-Agonists) .2- نساء مصابين بالمرض يستخدمن العلاج التقليدي اضافه الى 1500 ملغ من الميتفورمين.تشمل اخذ عينات من الدم قبل وبعد ثلاثه أشهر من اخذ الميتفورمين واجراء بعض التحاليل المختبريه على العينات التي تشمل مستوى الانترلوكين 8(interleukin-8), عامل نخر الورم (tumor necrosis factor alpha ) و الاستروجين E2 ومقارنة النتائج . أدى العلاج الميتفورمين في المرضى الذين يعانون من التهاب بطانة الرحم في انخفاض كبير في عسر الطمث وآلام الحوض أسفرت أيضا عن انخفاض كبير في ل IL-8 و TNF-aلمستويات مصل - لمجموعة الدراسة بعد 3 أشهر من العلاج ,.مما يشير إلى أنها قد يكون لها الإمكانات العلاجية للميتفورمين كما عقار للالتهاب البطاني الرحمي.

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