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 research aims to shed light on the role of E-Audit in raising Independence and professional competence of the external auditor, the study has been applied on a sample of the branches of the Rafidain Bank n have been addressed research topic beside the theoretical, as put forward by the literature of accounting, audit and that the contents of the section first, either the practical side was required to test the hypotheses use form questionnaire, which was distributed to a sample of the external auditors and bankers research sample. He has applied for his part in the search for a standard of independence and professionalism of the external auditor and the factors influencing these standards, and the most import
... Show MoreCorruption has become the subject of great interest, and the subject of research and scrutiny in recent years, because of its penetration in all fields of life, whether these fields are political, economic, social, and administrative. It is one of the biggest challenges and problems that are facing communities. Therefore, this study is focused on the evaluation of measures implementing the national strategy to combat corruption in Iraq.
This study was launched, first because of its intellectual dimensions to ensure a conceptual presentation of the strategy and operational management in general with a special focus on the processes of implementation and control str
... Show MoreIn the present work, the image and representation of Adela, the youngest daughter of the family of the Casa de Bernarda Alba, one of the most popular works of the Spanish author Federico García Lorca (1898-1936), will be analyzed. In this work, there are different themes, but what concerns us is to show the repression, oppression and rebellion of this character in a context of customs of the 1920s in Spain. They are revealing elements in that period in which women were relegated to the background, despite the fact that a feminist movement had already begun in Spain. By studying Adela, we seek to see how a single woman confronts her family and the society that surrounds her to fight for freedom, although its end is finally linked to
... Show MoreThe research aims at introducing the principles of six sigma and if it had any effect of the dimensions of six sigma to improve the performance of the dentists and the availability of an appropriate environment in the center Specialist respondent to the application of six sigma principles and how to adopt Specialized Center under the dimensions of the six sigma and if there informed enough with the management methodology six sigma, and if you can adopt six sigma as one of the entrances to reduce medical errors. So Search creating six sigma five dimensions and are (the commitment and support of senior management, the focus on the patient, continuous improvement, training and civil, and infrastructure) as a variable int
... Show MoreObjectives: To determine the impact of the household hazardous waste’s aspects upon the environment
pollution .and to identify the relationship between the households’ demographic characteristics and the aspects
of household hazardous waste.
Methodology: A descriptive study is conducted between December 14th 2004 to October 20th 2005that uses of
an assessment tool. A probability (simple random sampling) of (336) principal’s households which is selected
from the zones around the (14) primary health care centers as focal points, (8) in the urban and (6) in the rural
areas of Baghdad Governorate. After reliability and validity were determined Data are collected through the use
of an assessment tool that is consist
The increasing efficiency of the telecommunications network in the city contributes to the increase in spatial interaction between activities (to influence and mutual influence) This study is based on the idea that the upgrading of telephone services provided to citizens are done exclusively through the growth and development of all levels of the service using advanced technologies to know the problems and appropriate solutions in short time and less cost. Thus, crystallized the objectives of the study which was built for the importance of GIS in the planning of services in general, and infrastructure services, in particular, including telephone services, which is represent a point of contact between individuals on the one hand a
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This research aims to apply the Performance Focused Activity Based Costing System in the offices of scientific and advisory services at the University of Technology for the purpose of measuring the cost of services provided by these offices in order to reduce costs. To test the hypothesis of the research, the research was applied in the consulting offices of the University of Technology through the financial statements for the year ending 12/31/2017 of the Scientific and Consulting Services Office of the University of Technology, because the data of these years were issued and audited by the Federal Office of Financial Supervision.
A number of
... Show MoreThis study tackles the contribution of the environmental audit in achieving the sustainability of the environmental balance in the Sudanese business environment. The study aimed at clarifying the role of environmental auditing in supporting sustainable development, and to recognize the role of environmental audit in urging businesses to abide by environmental protection. It also shows how effective the environmental audit reports are, in providing the reliable data for the concerned authorities, in order to use it in making the decisions that would help in the sustainability of the environmental balance. To achieve the goals of the study, a questionnaire was developed and distributed to the registered chartered accountants in Sud
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