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.
This study is concerned with the concept of offering a point of view as a narrative construction element, especially the element and point of view of the novel to the letter Alcinmatugrave both business taken from masterpieces and literary works in the foundation or set of cinema. On the whole, the narrator participate in mock narrative process and support the narrator visual image, especially stories that need to exist scenes prove added to the image that uses signs of reality to take those marks a new dimension not only across the image, but also the intervention of the narrator in the re-formation of this realism marks surrounding Palms perceived and visible and put markers regularly between what the narrative of privacy and image, fo
... Show MoreThe spectacular film is a type of feature films which has specific elements that contribute in increasing the aesthetics of the shape in its structure. The researcher started studying this type of films by researching the spectacular film concept, the history of its development, who are its most important stars and then tackling the Indian cinema represented by Bollywood, which is considered a school for this type of film. The researcher addressed the most important influential elements that entre in its production as well as studying these elements that contribute to building the shape including the configuration, movements of cameras, lenses, the lighting, colors, costumes etc. and what influence they have in forming a special aestheti
... Show MoreThis research is based on the descriptive and analytical methodology. The importance of studying labor laws and labor unions in Japan between 1889 and 1946 constitutions is because Japan was out of a feudal phase, and had no idea about the factory system and industrialization in their modern sense before the Meiji era. Generally, its labor system used to be mostly familial, and the economic system was based on agriculture. This called for the enactment of legislations and laws appropriate for the coming phase in Meiji era. Thus, this paper examines the role of Meiji government in enacting labor legislations and laws when he came to power in 1896, and his new constitution in 1889 and the civil code of 1896. It further examines the way Mei
... Show MoreThis research seeks to try to address one of the important issues in society that prevents the state from achieving its social, economic, political and financial goals, represented by the low tax proceeds, through which it can achieve those goals. What is reflected on the tax proceeds, knowing that the General Tax Authority does not take into account the issue of analyzing the opportunity cost of corporate capital as one of the profit indicators when setting the annual controls, which leads to a decrease in the tax proceeds, and therefore the research objective will be to shed light on the importance of adopting the concept of analysis The opportunity cost by the General Tax Authority to achieve a tax proceeds commensurate with t
... Show MoreThe relationships between the related parties constitute a normal feature of trading and business processes. Entities may perform parts of their activities through subsidiary entities, joint ventures and associate entities. In these cases, the entity has the ability to influence the financial and operating policies of the investee through control, joint control or significant influence, So could affect established knowledge of transactions and balances outstanding, including commitments, and relationships with related to the evaluation of its operations by users of financial statements, including the risks and opportunities facing the entity assess the parties. So research has gained importance of the importance of the availability
... Show MoreSince the Internet has been more widely used and more people have access to multimedia content, copyright hacking, and piracy have risen. By the use of watermarking techniques, security, asset protection, and authentication have all been made possible. In this paper, a comparison between fragile and robust watermarking techniques has been presented to benefit them in recent studies to increase the level of security of critical media. A new technique has been suggested when adding an embedded value (129) to each pixel of the cover image and representing it as a key to thwart the attacker, increase security, rise imperceptibility, and make the system faster in detecting the tamper from unauthorized users. Using the two watermarking ty
... Show MoreThis study was conducted at the College of Education for Pure Sciences (Ibn Al-Haitham), University of Baghdad. The aim of this study was to isolate and diagnose fungi from fish feedstuff samples, and also detection of aflatoxin B1 and ochratoxin A in fish muscles and feedstuffs. Randomly, the samples were collected from some fish farms from Baghdad, Babil, Wasit, Anbar, and Salah al-Din provinces. This study included the collection of 35 feedstuff samples and 70 fish muscle samples, and each of the two fish samples fed on one sample of the feedstuff. The results showed the presence of several genera of different fungi including Aspergillus spp, Mucor spp., Penicillium spp., Yeast spp., Fusarium spp., Rhizopus spp., Scopiolariopsis spp., Ep
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