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.
Artificial pancreas is simulated to handle Type I diabetic patients under intensive care by automatically controlling the insulin infusion rate. A Backstepping technique is used to apply the effect of PID controller to blood glucose level since there is no direct relation between insulin infusion (the manipulated variable) and glucose level in Bergman’s system model subjected to an oral glucose tolerance test by applying a meal translated into a disturbance. Backstepping technique is usually recommended to stabilize and control the states of Bergman's class of nonlinear systems. The results showed a very satisfactory behavior of glucose deviation to a sudden rise represented by the meal that increase the blood glucose
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Shmuel Yosef Agnon, a well-known Jewish writer, wrote many literary works, including poetry, story, etc. In the field of story, this writer used two areas: the first: a simple exterior, and the second: an inner full of secrets and mysteries. This area is common when Agnon is affected by his symbolic method of purpose. In his productions, we find the political and historical significance embodied in his characters, where there is almost no story without it.
Agnon and all his productions gave the character a large area, Agnon’s characters often play the center and cornerstone in those productions, where the author dealt deeply and stated the fines details of the external and internal of that ch
... Show MoreThe importance of research and study of classical Persian literature is not overlooked. So far, there have been many studies in this area. But there are still some things that need more research. Persian grammar is one of the most important branches of Persian literature. This section has always been converted at different times. One of the issues that has been neglected in the studies of classical literature is the study of the technical tales of past and past poetry. These texts can be studied from different perspectives. Because Persian is a mixed language, it is possible to combine language terms with each other or to add prefixes and suffixes to express new concepts. They can be used by exam
... Show MoreKnowing the Messengers, peace and blessings be upon them, and explaining their obligatory, impossible, and permissible qualities is a legal necessity. It is a rooting of the faith, a means of understanding the Sharia, and a preventer from falling into the scourge of denial and bad manners against them. Therefore, sound belief in their presence is a major reason for the validity of the faith in the aspect of divinity and unseen hearing. Studying the status of prophethood is an urgent necessity in a time in which knowledge is scarce and attachment to the Messenger, may God Almighty’s prayers and peace be upon him, his family, and his companions, is weak, and suspicions and ideas hostile to the faith abound until we begin to hear - unfort
... Show MoreThe study of topography most important studies and depth of any literary or artistic text and occupy the thinking of many who work in art at generally. There is hardly any film scenario from description in general of the indispensable elements of the composition and place one. So the place starts form since the scriptwriter begins to view the result of the description begins to feature the emergence of there are simple operations in the scenario soon to receive growth as a final achievement in the film. The description of the place begins to take on an allegorical character as a language version in the script, soon translated into another language, the language of the picture. Which in turn complement the creative ring of cinematic art a
... Show MoreEnvironment suffered in recent years a large corrupting by human; and because of his ignorance of the dimensions of Caliphate in the ground and ignore what it means gearing. The gearing is that the son of Adam, which will benefit the board of Allah Almighty to him in the land of the causes of life, without exaggeration or negligence and without prejudice to the cosmic Balnoames enacted by the Almighty Creator, has urged verses of the Quran Muslim to preserve and protect the environment which is a religious duty, as it showed a great verses he is the author and the splendor and beauty of workmanship and manufacturer greatness of the Almighty, who created all things beautiful.
Koran played a major role in the consolidation of environmen
The research aims to study the extent of the influence of the dimensions of sensory marketing on the perceptual mental image of customers, knowing the type of relationships that link the dimensions of sensory marketing with each other, no one from the researcher mentioned (as far as the researcher knows) the link between sensory marketing and mental image, from this point of view the main goal is determined, the effect of sensory marketing on the mental image taken from customers, as the research was conducted on a number of first-class restaurants represented (Chef City, Chili House, Mado, Fried Chicken Saj Alreef) and the research community was represented by the customers of the aforementioned restaurants, a
... Show MoreMatrix acidizing is a good stimulation process in which acid is introduced into the reservoir near the wellbore area via the wellbore or coil tubing. In the oil industry, formation damage is a prevalent problem. Bypassing wellbore damage by producing wormholes in carbonate reservoirs is the main purpose of acidizing the matrix of the formation. When doing lab tests, scientists are looking for a wormhole-inducing injection rate that can be used in the field. Meantime the ongoing works on the Ahdeb oil field's Mishrif reservoir, several reports have documented the difficulties encountered during stimulation operations, including high injection pressures that make it difficult to inject acid into the reservoir formation; and only a few
... Show MoreIn this research, damping properties for composite materials were evaluated using logarithmic decrement method to study the effect of reinforcements on the damping ratio of the epoxy matrix. Three stages of composites were prepared in this research. The first stage included preparing binary blends of epoxy (EP) and different weight percentages of polysulfide rubber (PSR) (0%, 2.5%, 5%, 7.5% and 10%). It was found that the weight percentage 5% of polysulfide was the best percentage, which gives the best mechanical properties for the blend matrix. The advantage of this blend matrix is that; it mediates between the brittle properties of epoxy and the flexible properties of a blend matrix with the highest percentage of PSR. The second stage
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