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.
Paul Auster's City of Glass is here singled out as representative of the writer's The New
York Trilogy. All throughout his novelistic career, Auster has been working on a pseudothesis
that adheres to a certain aesthetic of disappearance. The study engages this Austerian
aesthetic apropos of certain theoretical stretches such as the Emersonian "Not Me", the
Thoreauvian "interval" or "nowhere", the Deleuzian "nomadic trajectory", the Derridian
"grammè" or "specter", and the Baudrillardian "disappearance". The city of the novel's titling
is here seen as the trope of all that which has already disappeared, and hence it is seen as the
space (mise en scène) where the perfect crime of the murder of the real is to be thoro
The article discusses political discourse as a communicative space of modern politics in the context of the anthropocentric paradigm. The following components of the political discourse have been outlined: the character of the subject and that of the addressee, genres of oral and written speech, the opposition of monologue and dialogue, the functions, the amount of information among the genres, the aim of speech.
The current study aimed to identify the role of the theatrical technical supervisor in developing and enhancing the skills of middle school students in Baghdad. The sample consisted of 73% of the original community of theatrical technical supervisors, randomly selected from those working in the first, second, and third educational directorates in the Rassafa and Karkh areas. The sample size was 32 theatrical technical supervisors. The study used a questionnaire to collect data on three axes: the cognitive skills developed by the theatrical technical supervisor, the voice and speech skills developed by the supervisor, and the body movement skills developed by the supervisor. The results showed that the theatrical technical supervisor play
... Show MoreThe research aims to know the extent of the impact of the risks of foreign exchange centers represented in the risks of commitment, exchange rate changes and liquidity risks in audit procedures, and accordingly the research will provide an applied framework of knowledge that shows the relationship between the variables addressed, and the importance of the research lies in the light of its presentation of intellectual, cognitive and applied contributions On the risks of foreign exchange centers and audit procedures, the research community is represented in the banking sector. The sample included nine private commercial banks listed in the Iraqi Stock Exchange. The research relied on a time series consisting of four years that extended fro
... Show MoreThe present research deals with studying the formal variations for the Quranic calligraphy at the beginning of Islam , as being regarded from the original Arabic calligraphies which were developed later till they became as they are now, where the calligraphers in pushing for simulating these original calligraphies and knowing the methods of their writing by the calligraphers at that time.That helped in enriching and developing the aesthetic and designing valuesFor these calligraphies, as being calligraphic achievements represent transmission resulted from the objective, aesthetic and indicative vision in producing the verses according to a certain form. This has a clear impact in tendency to the technical, aesthetic and expressing develo
... Show MoreConcentrated research topic in the study of variables key to the work of offices of inspectors Amyin ، a (re- design function، and performance Organisational ) and took this message to know the nature of the relationship and the impact of the dimensions of the re- design function as a variable interpretative through its dimensions، is ( the diversity of skill، selecting the task ، the importance of task، autonomy، feedback )، and performance Organisational variable responsive through two dimensions are ( effectiveness ، efficiency )، and in order to test the research hypotheses were absorbed variables in the form of a questionnaire and were questionnaire primary means of gatheri
... Show MoreThe duty of care is the essence of the error of negligence under the English legal system, and without it, responsibility for negligence cannot be judged, regardless of the extent of the damage incurred. contained in English law. In view of the importance of proving the existence of the duty of care on the defendant so that it is possible to judge his responsibility for negligence, the need arises to find a general principle to which the defendant is subject in order to decide whether he owes the plaintiff with the duty of care and therefore responsible for the negligence, and this is what we will explain in the research topic the study.
The artistic process operates whether in general in all arts or specifically in one type of arts or one of the genres of arts types on the preoccupations of the pressing artistic references as the founder of the artistic work in the material formulations on the one hand and on the other hand as a translator to understand the artistic achievement in general and plastic art in particular and for the importance The researcher chose the title of her research tagged (the preoccupations of the pressing reference and its impact on the formations of postmodern arts).
The first chapter of the methodological framework deals with the problem of research, importance, objective, limits, and then terminology and its definition, and then the secon
Homosexuality is one of the important topics that have emerged in recent times in the Islamic and Arab world, as the topic was in the past one of the taboos and majorities and one of the topics that arouse disgust and is talked about secretly and practiced secretly as well.But today, with international and organizational support for this anomaly and its misrepresentation under the name of gender once again and gender again. It began to spread in all countries of the world, including Islamic and Arab countries, and with the presence of associations and influential people in the legislative and judicial authorities of countries that protect and defend homosexuals. Writing on this subject has become a necessity and a duty; to warn against the
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