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.
Many water supplies are now contaminated by anthropogenic sources such as domestic and agricultural waste, as well as manufacturing activities, the public's concern about the environmental effects of wastewater contamination has grown. Several traditional wastewater treatment methods, such as chemical coagulation, adsorption, and activated sludge, have been used to eliminate pollution; however, there are several drawbacks, most notably high operating costs, because of its low operating and repair costs, the usage of aerobic waste water treatment as a reductive medium is gaining popularity. Furthermore, it is simple to produce and has a high efficacy and potential to degrade pollu
... Show MoreLearning is the process of gaining knowledge and implementing this knowledge on behavior. The concept of learning is not strict to just human being, it expanded to include machine also. Now the machines can behave based on the gained knowledge learned from the environment. The learning process is evolving in both human and machine, to keep up with the technology in the world, the human learning evolved into micro-learning and the machine learning evolved to deep learning. In this paper, the evolution of learning is discussed as a formal survey accomplished with the foundation of machine learning and its evolved version of learning which is deep learning and micro-learning as a new learning technology can be imple
... Show MoreInsulin like growth factor-1 has metabolic and growth-related roles all over the body and is strongly associated and regulated by growth hormone. It is produced by almost any type of tissue, especially the liver. The study aimed to measure insulin like growth factor in growth hormone deficient patients and find its relation with other studied parameters. The Subjects in the study were 180 studied in the National Diabetic Center for Treatment and Research/Al-Mustansiriya University in Baghdad/Iraq for the period from November 2021 to April 2022. Blood was drawn and investigated for the levels of IGF-1, IGFBP-3, LH, and FSH. Also testosterone and statistical analysis was carried out to find the potential correlations. The results relived t
... Show MoreThe natural ventilation in buildings is one of effective strategies for achieving energy efficiency in buildings by employing methods and ways of passive design, as well as its efficiency in providing high ranges of thermal comfort for occupants in buildings and raises their productivity. Because the concept of natural ventilation for many people confined to achieve through the windows and openings only, become necessary to provide this research to demonstrate the various passive design strategies for natural ventilation. Then, research problem: Insufficient knowledge about the importance and mechanism of the application of passive design strategies for natural ventilation in buildings. The research objective is: Analysis of passive desi
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تتعامل الجهات الضريبية في مختلف دول العالم بأساليب عديدة لجباية الضرائب من المكلفين بغض النظر عن فئات وأصناف هؤلاء المكلفين،وفي العراق تم اعتماد العديد من الأساليب لجباية الضرائب على امتداد المدد الزمنية المتعاقبة،وكان لأسلوب التقدير الذاتي وهو أحد تلك الأساليب مجالاً للتطبيق خلال مدة زمنية معينة،حيث جرى تطبيق هذا الأسلوب على وحدات اقتصادية معينة، وبالرغم من المساوئ التي قد ترافق تطبيق
... Show MoreThe role of the climate in the development of the performance of the administrative bodies of sports clubs
Gabriel Garcia Marquez, the Nobel laureate of literature in 1982, is one of the most famous Latin American writers who have been distinguished by the magic of realism. We can say the months in the world and he is almost the most controversial for many reasons and for these reasons he did not accept that his novels turn into movies Marquez agreed to turn one of his most important and most beautiful novels, "Love in the Time of Cholera," which he wrote in 1985 and agreed to convert to a film in 2006 after the novel was bought by the author for $ 3 million. Mike Noel to bring out
In this paper, compared eight methods for generating the initial value and the impact of these methods to estimate the parameter of a autoregressive model, as was the use of three of the most popular methods to estimate the model and the most commonly used by researchers MLL method, Barg method and the least squares method and that using the method of simulation model first order autoregressive through the design of a number of simulation experiments and the different sizes of the samples.
The research dealt with the effect of the tax examiner's efficiency in detecting tax evasion, as the research problem dealt with tax evasion, especially in Iraq, for many reasons and factors, including those related to tax administration represented in administrative corruption and the complexity of procedures in the tax accounting process and failure to achieve justice in the tax treatment, including the taxpayer himself, as he tries to evade for reasons Related to the level of tax awareness, loss of confidence in the tax administration, and reasons related to the state's inability to manage the services file well and its ability to achieve the set goals, This reflected negatively on the emergence of some of the consequences of
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