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 concept of narration stems from the connotation of continuous communication through which narration is manifested as a message that is exchanged between the sender and the recipient, and that narration is an educational conceptual necessity, representing the philosophy of intellectual inclusion achieved in a direct speech to the mind, but it is encapsulated in a colorful frame that attracts the soul and attracts attention, and the graphic narration is a speech A visual based on the basis of interference and sequence of the event in weaving the elements in a consensual way through a continuous communication process that begins with the embodiment of an event - an important event - to the recipient, in which an intellectual employment
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The sciences related to the Book of God are many, and the benefits of every science in it are abundant, and among those sciences is the science of readings, which is for the sake of science and the most honorable, due to its strong attachment to the Book of God Almighty. From this care, and aims to show the attention of scholars to the science of readings in general and the scholars of the fifth century in particular, as the literature on it abounded until it became the principal for those who came after them.
The research consists of an introduction that includes the objectives of the research, the reasons for choosing it, previous studies, research questions, and research terms, then a preface dealing with the im
... Show MoreThis research aims to study the effect of different pH values on the growth of CdTe nanoparticles during specific times. The reflux method has been used as a method for preparing CdTe quantum dots. A difference in absorbance and intensities of peaks at pH 10.5 and 11.5 was observed during the reaction period. The growth rate of the NPs (nucleation) was irregular at low pH values. Optical examinations showed that the best growth rate of NPs was at pH value 12.
The current research deals with the specificity of the interior design of the classes of art education in the schools of excellence for the province of Muthanna and its center of the city of Samawah. In the first chapter، the problem of research was determined by the lack of internal spaces of the classes of art education to designs that meet the requirements and needs of students in these educational stages. The importance of the research in being an addition to knowledge in the field of interior design and engineering department of the general directorates of the Ministry of Education. The objectives of the research were determined through.
- Identifying the reality of the halls of art education for sch
The relationship between the elements of the climate and the productivity of citrus (kg
/ tree) in the province of Karbala has been determined through the use of simple correlation
coefficient of Pearson (rp) and (t) test. The result for each of oranges, limes and tangerine had
all shown moral and relevant statistical indications; except for relative humidity, which were
not linked to a moral relationship with productivity of tangerine, oranges and limes.As for the
relationship between climatic factors and yield of bitter orange were all not significant
statistically and very weak.
In order to determine the strength of the correlation between fluctuations in the
climatic elements and fluctuations in the productivi
The relationships between the related parties constitute a normal feature of trading and business processes. Entities may perform parts of their activities through subsidiary entities, joint ventures and associate entities. In these cases, the entity has the ability to influence the financial and operating policies of the investee through control, joint control or significant influence, So could affect established knowledge of transactions and balances outstanding, including commitments, and relationships with related to the evaluation of its operations by users of financial statements, including the risks and opportunities facing the entity assess the parties. So research has gained importance of the importance of the availability
... Show MoreThe spectacular film is a type of feature films which has specific elements that contribute in increasing the aesthetics of the shape in its structure. The researcher started studying this type of films by researching the spectacular film concept, the history of its development, who are its most important stars and then tackling the Indian cinema represented by Bollywood, which is considered a school for this type of film. The researcher addressed the most important influential elements that entre in its production as well as studying these elements that contribute to building the shape including the configuration, movements of cameras, lenses, the lighting, colors, costumes etc. and what influence they have in forming a special aestheti
... Show MoreThis study is concerned with the concept of offering a point of view as a narrative construction element, especially the element and point of view of the novel to the letter Alcinmatugrave both business taken from masterpieces and literary works in the foundation or set of cinema. On the whole, the narrator participate in mock narrative process and support the narrator visual image, especially stories that need to exist scenes prove added to the image that uses signs of reality to take those marks a new dimension not only across the image, but also the intervention of the narrator in the re-formation of this realism marks surrounding Palms perceived and visible and put markers regularly between what the narrative of privacy and image, fo
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