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.
Despite the multiplicity of institutions contributing to the decision-making process in the United States of America, they interact to crystallize positions regarding international and strategic situations. The formulation of the national security policy depends on a number of institutions that complement each other in order to achieve an advanced security situation. Thus, the decision reflects the process of interaction of the existing regulatory institutions. This is because the essence of the national security and achieving its requirements also stems from the existence of a coherent system of shared beliefs and principles in the American society. Besides, these elements are the bases for achieving
... Show MoreThe aim of this research is to identify the level of mental mindfulness among female students of the College of Education at Umm Al-Qura University, as well as to identify the statistically significant differences in the level of mental mindfulness according to academic level, specialization, and academic achievement. A mental mindfulness scale was designed to cover five dimensions. The study employed the analytic descriptive approach applied to a random sample of (217) female students from various academic specializations. The findings indicated that the level of mental mindfulness was average among female students. Statistically significant differences were attributable to the academic level, academic specializations, and academic achi
... Show MoreA survey to show the reality of educational guidance in schools in Baghdad Rusafa 3\ from the point of view of educational guides. It used the analytical descriptive technique. The research community consists of () male and female advisors in schools of Baghdad. The sample was haphazard( 51\.) The questionnaire was made and it consists (50) items. The research statistics have been analyzed by (SPSS), The questionnaires have been used in the first term in (2017-2018) and the results showed the relationship between the advisor and other teachers, the advisor and students fathers and the local society. According to the results, the research made some recommendations and suggestions.
The research problem is dedicated to investigate reservoirs irrational economic behavior adopted by the ruling elites in developing countries about the investment methodology of human capital and operating policies is based on the terms of reference of economic theory and standards governing the market, which led to a chronic structural imbalance in the workforce structure and lack of consistency with different production structure, in turn, which had a reported effects in the emergence of the phenomenon of unemployment and that they involved a certain privacy, as has become the issues of unemployment and employment in the various countries of the world are issues more important due to the presence of large numbers of the workforce in th
... Show MoreThe research deals with the problem of visual pollution, as it is one of the most important urban problems that cities suffer from. The concept of visual pollution has recently emerged to describe the deformation and degradation of the urban environment. Visual pollution is defined as any component of the surrounding environment that is inconsistent and not homogeneous with its natural and human components. The volume of visual pollution has doubled due to the non-compliance with the laws, regulations and controls set by the Municipality of Baghdad by the citizens, and to the weak municipal role that the municipality plays in implementing these laws. Therefore, it has become necessary to know the manifestations of visual pollution and th
... Show MoreTwelve students rinsed their mouths once daily with ten ml. of 0.2 % aqueous solution of chlorhexidine gluconate for five days, and seven students served as a control group that used distilled water for rinsing. The result indicated that after one hour of treatment, an obvious sharp reduction in the viable counts of mutans streptococci, total aerobic bacteria, and to less extent the count of lactobacilli in saliva after one hr. of treatment. Anآ increase in the number of these bacterial groups was clearly noticed three hrs. after the application of chlorhexidine and continued to increase later on. In spite of that increase, the bacterial numbers in saliva remained below the initial numbering in this study.