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 research aims to identify the factors effecting the investigation of insurance fraud from the perspective of the National Insurance Company employees, by analyzing the study variables and make recommendations on how to enhance the company and employees performance, and to achieve the objectives of the study and test hypotheses a questionnaire was designed after referring to the international standards and the 1969 Iraqi punishment law, and it was answered by 20 employees that were approved for the purposes of this research and analysis.
The study found that lack of employee training was a strong factor, while the supervisory staff and operational procedures was a weak one.
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... Show MoreThis research is about the resources and the way of al-Waqidi in his
researching of al-sira of the Prophet. And what happened in the first of Islam.
This research is about the documents which al-Waqidi had it. Some of it,
which he had visited, was the places, especially the periods which the events had took
place in. He was asking those whom were contemporary to the happenings, from the
sons of al-Sahaba and al-Tabi’een.
Also this research is lightening on the new studies that gave this historian a
good respect during his work, in which he could gave the reality about his authorship.
The research is trying to draw real way of al-Waqidi and what were reported by him,
especially the documents, and what he had s
Labor movement is considered important in Britain because it is an international phenomenon of the feudal system and one of the flowerings of the era of the capitalist machine. At the beginning of the 18th century, the world witnessed a change and progress in many aspects of the industrial fields such as the different means of production .this era is called the industrial revolution which especially appeared in Britain and extended to other areas of the world .it leads to many changes in Europe and participated in different economic, political and cultural and social fields. and it has a very important role in progress and development but its disadvantage is that it is exploited by the capitalists to achieve their special rights .in othe
... Show MoreThis study had succeeded in producing a new graphical representation of James abacus called nested chain abacus. Nested chain abacus provides a unique mathematical expression to encode each tile (image) using a partition theory where each form or shape of tile will be associated with exactly one partition.Furthermore, an algorithm of nested chain abacus movement will be constructed, which can be applied in tiling theory.
This research which is entitled (Devine Beauty), aims at studying the philosophical and literary extensive visions of Andalusian poets in search of pleasure in the beauty of divine self and its impact on the formation of a philosophical frame of mind. It also attempts to investigate the aesthetic aspects that highlight the prestige and greatness and majesty of that absolute beauty.
The most important conclusion of the reach is the Bany Ahmar poets use the beauty of women and the pleasure of wine as cods to reach divine beauty and get the happiness desired with the reflection of absolute beauty in a clear philosophy and thinking of the kingdom of God Almighty.
This research is a theoretical study that deals with the presentation of the literature of statistical analysis from the perspective of gender or what is called Engendering Statistics. The researcher relied on a number of UN reports as well as some foreign sources to conduct the current study. Gender statistics are defined as statistics that reflect the differences and inequality of the status of women and men overall domains of life, and their importance stems from the fact that it is an important tool in promoting equality as a necessity for the process of sustainable development and the formulation of national and effective development policies and programs. The empowerment of women and the achievement of equality between men and wome
... Show MoreMost Internet-tomography problems such as shared congestion detection depend on network measurements. Usually, such measurements are carried out in multiple locations inside the network and relied on local clocks. These clocks usually skewed with time making these measurements unsynchronized and thereby degrading the performance of most techniques. Recently, shared congestion detection has become an important issue in many computer networked applications such as multimedia streaming and
peer-to-peer file sharing. One of the most powerful techniques that employed in literature is based on Discrete Wavelet Transform (DWT) with cross-correlation operation to determine the state of the congestion. Wavelet transform is used as a de-noisin
Endoscopy is a rapidly growing field of Neurosurgery, it is defined as the applying of endoscope to treat different conditions of brain pathology within cerebral ventricular system and beyond it, endoscopic procedures performed by using different equipment and recording system to make a better visualization enhancing the surgeon's view by increasing illumination and magnification to look around corner and to capture image on video or digital format for later studies.
A 20 year-old male was admitted with a history of recurrent palpitations from 5 years. Baseline ECG revealed premature ventricular contractions (PVCs) with delta waves. Stress ECG showed short non-sustained Ventricular tachycardia (VT). Echocardiography showed moderate dilation of the left ventricle with mild reduced systolic function and Ejection fraction was estimated to be 42%. Right ventricle was mildly dilated and hypokinetic. Both atria were mildly dilated. The patient referred to CVC for EP study with possible ablation. The ablation of the focus led to complete suppression of the ectopy. Post-procedure ECG and echocardiography showed normalized rhythm and systolic function.
