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.
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 MoreThis 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 MorePraise 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
The 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 MoreAbstract
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 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
... Show MoreThe research dealt with the design of the cost accounting system for the transport service and its Role in improving the efficiency of pricing decisions through the application of the cost system based on ABC activities. The main activities were defined and cost guides were to measure the cost of each service and to determine the cost of each service for the purpose of providing management with appropriate information and pricing decisions The problem of research in the lack of adoption by some public companies in the service sector on the cost accounting system to calculate the cost of service as well as the lack of identification of productive activities and service activities and therefore cannot make the appropriate decision t
... Show MoreThe present work focuses on examining the strategy of cognitive trips and the Arabic language teachers’ training needs of such a strategy when teaching Arabic language courses in the Saudi Arabia Kingdom. To achieve the objective of the study, and check whether this strategy is used in lesson planning, lesson teaching, or lesson assessment, a descriptive approach and a questionnaire have been adopted. The researchers used a number of statistical tools, and chose a purposive sample, which consists of (58) Arabic language teachers from Saudi Arabia Kingdom. Results have shown that the training needs of Arabic language teachers for implemining the strategy of cognitive journeys while teaching Arabic language courses came in the following
... Show MoreBackground: Saliva is one of the most important etiological host factors in relation to dental caries. It affects the carious process by its organic and inorganic constituents; in addition to its physiological functions as (flow rate, pH and buffer capacity). The aims of this study were to determine the concentrations of major elements (calcium and phosphorus) and trace elements (ferrous iron, nickel, chromium and aluminum) in saliva among a group of adolescent girls, and to explore the relation of these elements, flow rate and pH with dental caries. Material & Methods: The study group consisted of 25 girls with an age of 13-15 years old. Dental caries was diagnosed by both clinical and radiographical examinations following the criteria of
... Show MoreBackground: Langerhans' cell histiocytosis (LCH) is a group of conditions affecting the reticuloendothelial system. It includes Letterer-Siwe disease, Hand-Schuller-Christian disease and eosinophilic granuloma and most often presents in childhood. Materials and methods: Twenty-five cases of LCH were diagnosed histologically and confirmed by CD1a antibody and assessed immunohistochemically using anti-RANKL and anti-RANK antibodies to evaluate osteoclastogenic mechanism. Results: Regarding jaw cases, there was a significant correlation between CD1a and RANK (P=0.016). While in the skull, highly significant correlation existed between RANK and RANKL (p=0.001). Among the sites, there was no statistically significant difference found for each
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