Abstract Asthma is a complex disease defined by chronic airway inflammation and airflow limitation causing variable respiratory symptoms which include shortness of breath (SOB), wheezing, chest tightness and cough. Asthma guidelines advocate adding a second long acting bronchodilator to medium doses of inhaled corticosteroids (ICS) rather using high doses of ICS alone to control moderate to severe persistent asthma. The aim of this study was to evaluate the clinical outcomes of three medication regimens indicated for Iraqi patients suffering from persistent asthma. This study was interventional randomized clinical study conducted on a sample of adult Iraqi asthmatic patients in Baghdad City. The study composed of three visits distributed over eight weeks; baseline visit followed by first follow up and second follow up visits after four and eight weeks respectively. The study enrolled 78 adult patients with moderate to severe persistent asthma as diagnosed by specialist physician according to patient history and baseline pulmonary function test (PFT) and allocated them randomly to three groups (each group included 26 patients) to receive equivalent medium doses of budesonide inhaler in addition to either formoterol inhaler, oral modified release aminophylline tablets or tiotropium inhaler (first, second and third group respectively). Sixty four patients completed this study. The mean ages of patients were above 35 years with slightly more male predominance. The study groups developed significant increase of peak expiratory flow rate (PEFR) and forced vital capacity (FVC) values at the first follow up visit compared to baseline values (p<0.001). Thereafter, the first and third groups achieved significant higher values at the second follow up visit compared to first follow up visit (p<0.001), while second group produced no change. All the groups developed significant improvement of Mini asthma quality of life questionnaire (MiniAQLQ) scores and percentage of symptom free days (SFD) at first follow up visit and continued further significant improvement at the second follow up visit (p<0.001). Generally, between groups comparison according to extent of change of study parameters revealed that third group produced the greatest improvement over the entire study period followed by the first group, whereas the second group was associated with the least extent of improvement. This study concluded that all groups caused significant improvement in study parameters compared to baseline values and also concluded that the third group of inhaled [tiotropium/budesonide] was associated with the highest extent of improvement followed by first group, while the second group was the least.
An enzyme linked immunosorbent assay (ELISA) for the detection and quantitation of human immunoglobulin G (IgG) antibodies against vero- cytotoxine (VT) producing Escherichia coli serogroup O157:H7 was produced. E. coli O157: H7 lipopolysaccharide was extracted from locally isolated strains by using hot phenol- water method, followed by partial purification using gel filtration chromatography by sepharose- 4B. The purity of the lipopolysaccharide was checked by measuring the protein and nucleic acid content and then used as antigen. Four isolates of vero- cytotoxin producing E. coli serogroup O157:H7 was obtained by culturing 350 stool samples from children suffering from bloody diarrhea. These isolates were identified on bacteriological, s
... Show MoreThe past decades have witnessed a development in the concept of corporate governance and the transformation of a concept that is limited to large companies listed in capital markets in major economies to an issue that concerns all business activities in the public and private sectors in both large and small countries. The aim of this research is to propose a guide to the mechanisms and rules of governance in the municipal institutions that contributes to the activation of the internal control system to reduce the fraud and manipulation of this activity. Institutions. The research was based on the hypothesis that the implementation of the principles and rules of governance in municipal institutions lead to the contribution of the activati
... Show MoreThe problem in the design of a cam is the analyzing of the mechanisms and dynamic forces that effect on the family of parametric polynomials for describing the motion curve. In present method, two ways have been taken for optimization of the cam size, first the high dynamic loading (such that impact and elastic stress waves propagation) from marine machine tool which translate by the roller follower to the cam surface and varies with time causes large contact loads and second it must include the factors of kinematics features including the acceleration, velocity, boundary condition and the unsymmetrical curvature of the cam profile for the motion curve.
In the theoretical solution
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The study aimed: To assess the level of trainers' knowledge about the application of strategies and to find out the relationship between Trainer's knowledge and their socio-demographic characteristics.
Methodology: Using the pre-experimental design of the current study, for one group of 47 trainers working at the private Autism Centers in Baghdad, data was collected from 8/January / 2022 to 13 /February /2022. Using non-probability samples (convenient samples), self-management technology in which trainers fill out the questionnaire form themselves was used in the data collection process; it was analyzed through descriptive and inference statistics.
Time is an essential element of contracts، as there is an independent in many parts of each contract، but the time dimension has a significant impact on the provisions of all contracts and is not limited to a particular range of contracts، and French and Arab jurists alike have called for this dimension to be given special attention، and as a result the French legislator has introduced the term duration of the contract، to try to limit the temporal elements، to clarify their provisions and to distinguish between them in decree131/2 016، but for our Arab country it did not receive the appropriate answer. The problem of duration in contracts relates to the lack of clarity of the idea، and then to confuse the various time terms in the
... Show MoreThe present research aims at identifying the effect of the cognitive discrepancy strategy on the fourth-stage students’ achievement in literature and texts. The researcher adopted the null hypothesis: there is no statistically significant difference at the level (0.05) between the average grades of the experimental group who study literature and texts following the discrepancies strategy, and those who follow the traditional method. A post-achievement test of (60) paragraphs was administered to (6) students as the study sample. The results showed that the experimental group who studied literature and texts with the strategy of cognitive achieved better than the control group who followed the traditional method in the post-achievement t
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The underlying objective of the international standard No. (6) to assist in accounting applications for the extractive industries, taking into consideration the goals and objectives contained in the sixteenth of the private International Accounting Standards criterion accounting for land, machinery and equipment, as well as Standard No. axes (38) relating to intangible assets, and in order to create a vision of a comprehensive development needs oil in order to exact evaluation of policies related to the particular needs and draw a comprehensive frameworks with respect to treatment of expenditures and revenues in the oil production industry, is also interested in Standard No. (6) within the primary objectiv
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