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.
Praise be to Allah, Lord of the Worlds and prayers to our master and our beloved Muhammad and to his God and companions.
The Sunnah of the prophet completed the prayer and delivery agreed to accept them as evidence of legislation, and the fundamentalists differed in accepting the news of Sundays in the pieces, and most likely if the hadeeth is proven, and completed the correct conditions there is no objection to accept it in branches and pieces. As for the work of the people of the city is one of the evidence adopted when the imam Malik, who is the Imam of the House of the Prophet's blessed immigration, and scientists differ greatly. If you offer a ruling and the ruling of the Hadith of the individual, and the rule of the work of the
This paper deals with the process of evaluating the performance of agricultural activity in Iraq and in particular the agricultural initiative launched by Prime Minister Nuri al-Maliki, during the period from 2008 - 2011. Where it is possible to use criteria or indicators that are fabricated by a statement on the calendar and the results of which may be by comparing planned performance with actual performance or the evaluation of the actual performance of successive periods selected. With an emphasis on the agricultural initiative is subject to the evaluation process by implementing and destinations specialized loan funds its own projects as one of the agricultural lending. With the need to co
... Show MoreThe research aims to identify Determination talent management dimensions of (attracting talent, developing talent, directing talent, performance management talent, retain talent) in the entrepreneurial performance of the organization dimensions of (advance planning, efficiency, effectiveness), so search occupies the extreme importance of being treated important and recent issue of the performance Entrepreneuria, management talent, aware of the importance of the subject and expected results of the company surveyed, was an analysis of data obtained through field visits in addition to the questionnaire and interviews, highlights were the results that have been reached to take the sample into account all the management requirements knack of att
... Show MoreThe Diyala River is considered the third most important river in Iraq. However, in the recent period, Diyala Governorate has been subject to several floods. This study aims to simulate an efficient labyrinth weir at the flood escape entrance branching from the Diyala River to reach the best entrance through which the flood waves can pass safely. The discharge coefficient was calculated laboratory for five types of trapezoidal side labyrinth weirs with different sidewall angles. Results showed that the coefficient discharge for the trapezoidal labyrinth side weir with an angle of the sidewall is 75ᵒ and has a discharge coefficient greater than the rest of the labyrinth side weirs. The second part of this study is valida
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The space occupied by the dialogic imperative in the language is a very wide range, as it is present in most of the speeches received by the recipient, and this is not limited to dialogues. That the literary discourse is a dialogical and fulfillment imperative, as the implication is related to the implicit connotations, as if the implication covers the indirect actions of the speech act theory.
The ideas and information obtained by the viewer in the cinema have always been the source of the visual image, but that doesn’t negate the fact that the mental image can produce a lot of the information and ideas in the cinematic art and the most important means to achieve this mental image in the film is the eloquent cinematic sound. This research is conducted to show this important and effective contribution of the sound in the production of the mental image. Hence the importance of this research is in that it addresses an important issue which is the eloquent performance of the sound and its role in the production of the mental image inside the space of the feature film. This research concerns those working the field of cinema and
... Show MoreThe developments and transformations taking place in the era and the growth of knowledge economies and communication technology led this development to compel higher education institutions in Iraq to reconsider their objectives to keep pace with development. And one of the most important tools of development was the application of e-learning standards and its long-term impact on the performance of the educational institution. Performance auditing plays an important role in verifying the extent to which these institutions have implemented their activities and programs that auditing performance by adopting e-learning standards helps the institutions’ management by providing appropriate information on the extent to which they achieve thei
... Show MoreAppending is a morphological term which means the addition of one or two letters to a structure to be similar to other structures of well-known abstractor additional nouns and verbs constructions. The goal of appending is to organize what have been expanded linguistically and collect similarities to reduce the syntactic rules. This is because the appended word exists for expanding purposes; however, it has no construction of its own. An appending was included with another construction with mentioning the additional letter. This by itself means that appending as a process is a term that helps organize rather than expand language. Scholars further noticed that the appending letter is not semantically significant, and so it differs from the
... Show MoreAbraham son of Izra, the poet, the philosopher, the grammarian, and the Turah exegesis, is considered one of the famous poets in the era of Islamic reign in Spain which is called the "Golden Era". He was taught all types of teaching which was rich in Jewish literary products. He learned Arabic and studied Arabic language and literature. He travelled a lot, and made tours within Spanish places, and even reached the North of Africa. He preferred living with Muslim rulers in the south of Spain, like the rest of the Jews who emigrated from the north of Spain to the South in search for freedom and to participate in higher positions of the Islamic Palace. He was influenced by Arabic culture, and even translated "Th
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