steoarthritis (OA) is a chronic degenerative joint disease that doubled in prevalence since the mid of 20th century most commonly due to obesity and aging. Osteoarthritis can affect any joint in the body. The pathogenesis of OA is multifactorial influenced by range of biochemical and mechanical factors.

 Oxidative stress is described to play an important role in many diseases including OA. Accumulating evidences suggested the beneficial effect of anti-oxidants for reducing OA severity. Curcumin is a well-known antioxidant agent that acts by different mechanisms in modulating oxidative stress status. This study was designed to evaluate the antioxidant effect of curcumin as adjuvent therapy to a non-steroidal anti-inflammatory drug, meloxicam, in the management of knee osteoarthritis. This prospective open-labelled randomized controlled study was carried out on forty-two eligible patients who were allocated in two groups, serum superoxide dismutase 3 (SOD3) and glutathione reductase (GR) were measured at baseline and after 3 months of the study. Pain and physical function assessment were evaluated by oxford knee score (OKS). Results illustrated highly significant improvement in pain and physical function scores when curcumin used as adjuvant to meloxicam, also curcumin supplementation resulted in significant increase in SOD3 serum level and only a modest decrease in GR serum level when compared to meloxicam alone. In conclusion, this study demonstrated benefit of curcumin when used in combination with meloxicam over using meloxicam alone in modulating antioxidant parameters in blood, in addition to significantly improving pain and physical function after 3 months of treatment.

Background: Osteoarthritis (OA) is one of the most prevalent chronic degenerative arthritis diseases and a major cause of pain and physical disability among elderly patients. It can affect any joint in the body but most commonly, hip and knee joints. The etiology of the disease is multifactorial, OA affected by a range of mechanical and biochemical factors. Various studies provided compelling evidence that low-grade inflammation and synovitis are playing a pivotal role in its pathogenesis along with oxidative stress. Unfortunately, there is no cure for the disease; thus, most current treatments are prescribed for alleviating symptoms only. Curcumin, a natural polyphenolic compound, has been used for centuries in ayurvedic medicine that gained an increasing surge of interest to explore its potential properties. Many in vitro and in vivo studies reported powerful anti-inflammatory and antioxidant capacity for treating various pathological conditions, including OA, curcumin has shown chondroprotective potential on osteoarthritis disease. Aim of the Study: This study was designed to evaluate the anti-inflammatory effect of curcumin as an additive therapy to a non-steroidal anti-inflammatory drug, meloxicam, in the management of knee osteoarthritis. Patients and Method: This prospective open-labeled randomized controlled trial was conducted among patients with mild to moderate knee OA. Sixty-two patients were enrolled in this study; only 42 patients completed the study. Patients were assigned randomly into two groups; group (A) 21 patients treated with meloxicam alone (15 mg/day), group (B) 21 patients treated with a combination of meloxicam (15 mg/day), and curcumin (1600 mg/day) for 12 weeks. Inflammatory biomarkers (IL-1β, IL-6, and TNF-α) serum levels were evaluated at the time of enrolment and after 12 weeks of treatment. Results: Results gained from this study showed that treatment of knee OA patients with a combination of meloxicam and curcumin has a better effect on overall pain and physical function in addition to a remarkable decrease in serum pro-inflammatory biomarkers (IL-1β, IL-6, TNF-α) level (-39%, -24%, -30%) respectively after 12 weeks of treatment in respect to baseline levels. However, this reduction was significant only for IL-6. While those patients treated with meloxicam alone demonstrated no significant reduction. Conclusion: Curcumin represents a safe and effective anti-inflammatory product that exhibits a synergistic effect when used in combination with meloxicam, resulting in pain and physical activity improvement, which its anti-inflammatory effect may reflect

 Pelargonium graveolens (P. graveolens), commonly known as rose geranium it is native to the southern parts of Africa (1) . Phytochemical studies show that this plant is rich in flavonoids, terpenoids, volatile oil, tannins, and glycosides. It has an important pharmacological activities including antibacterial, antifungal, and antidiabetic and antioxidant activity. This is a novel study of Pelargonium graveolens cultivated in Iraq. In this study, the preliminary tests indicate the presence of active constituents in the leaves including terpenoids, flavonoids, alkaloids and tannin. This study also involved studying the antibacterial activity of Pelargonium graveolens hexane and ethanol leaves extracts and was performed on gram negative bacteria species (Escherichia coli) and one gram positive bacteria (Staphylococcus aureus). The antibacterial study was performed by ager well diffusion method. The ethanol extract shows good results against examined bacteria while hexane extract shows no antibacterial activity against examined bacteria.