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.
Fine aggregate (Sand) is a necessary material used in concrete construction purposes, it’s naturally available and it’s widely used around the world for different parts of construction in any building mainly for filling the voids between gravel. Sand gradation is important for different composite materials, and it gives good cohesion when compared with coarse sand that provides strength for the building. Therefore, sand is necessary to be tested before it is used and mixed with other building materials in construction and the specimen must be selected carefully to represent the real material in the field. The specimen weight must be larger than the required weight for test. When t
Praise be to God, Lord of the worlds, and prayers and peace be upon our master Muhammad and upon his family and companions as a whole.
The topic of attention was drawn to the attention of the speakers, as it made me ponder it carefully, and my goal in that is to know the reason for the interest of the speakers and their care for it, and to clarify from their books the purpose of making this topic one of the advanced investigations with them.
The idea of writing a paper on the subject of consideration was not absent from my thinking, because I saw the attention of speakers on this issue, as they made it one of the first issues that they deal with studying in their work
... Show MoreThe proposal of nonlinear models is one of the most important methods in time series analysis, which has a wide potential for predicting various phenomena, including physical, engineering and economic, by studying the characteristics of random disturbances in order to arrive at accurate predictions.
In this, the autoregressive model with exogenous variable was built using a threshold as the first method, using two proposed approaches that were used to determine the best cutting point of [the predictability forward (forecasting) and the predictability in the time series (prediction), through the threshold point indicator]. B-J seasonal models are used as a second method based on the principle of the two proposed approaches in dete
... Show MoreIn the light of what is witnessing in the advertising arena of new ways and methods in delivering advertising message to consumers by finding new outlets to communicate with them especially through social networking sites, which became the first choice of advertising companies in order to spread its goods and services. These companies now are relying gradually on celebrities to appear with their products and goods to drive the audience's attention towards them. The thesis aims to find out the attitudes of young people towards the the advertisements that show famous celebrities on social networking sites. The researcher used survey method which aims to record, analyze and interpret the phenomenon after collecting the necessa
... Show MoreThere are obstacles to high levels of hypertension awareness that are embedded in gender, income and lifestyle habits which need to be addressed leading to high levels of undiagnosed and uncontrolled hypertension. This study aimed to explore the various factors which affect hypertension awareness among a hypertensive population in a tertiary care hospital.
A quantitative study was conducted among hypertensive patients at a tertiary care hospital in Selangor, Malaysia. A validated and translated questionnaire was utilised as a data collection tool. Descriptive and inferential statistical analysis was done using SPSS version 25.
A thousand participants (female n=621, male n= 379) were recruited, and their
... Show MoreThe present work focuses on examining the strategy of cognitive trips and the Arabic language teachers’ training needs of such a strategy when teaching Arabic language courses in the Saudi Arabia Kingdom. To achieve the objective of the study, and check whether this strategy is used in lesson planning, lesson teaching, or lesson assessment, a descriptive approach and a questionnaire have been adopted. The researchers used a number of statistical tools, and chose a purposive sample, which consists of (58) Arabic language teachers from Saudi Arabia Kingdom. Results have shown that the training needs of Arabic language teachers for implemining the strategy of cognitive journeys while teaching Arabic language courses came in the following
... Show MoreThe research dealt with the design of the cost accounting system for the transport service and its Role in improving the efficiency of pricing decisions through the application of the cost system based on ABC activities. The main activities were defined and cost guides were to measure the cost of each service and to determine the cost of each service for the purpose of providing management with appropriate information and pricing decisions The problem of research in the lack of adoption by some public companies in the service sector on the cost accounting system to calculate the cost of service as well as the lack of identification of productive activities and service activities and therefore cannot make the appropriate decision t
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The research the impact of the application of some of the production system tools in the specified time, which can be adapted in the service sectors (banking sector) over the improvement and increase the quality of banking services, and highlights the research problem in the low quality of banking services provided to customers because of the reliance on traditional banking systems in the provision of services Because of the lack keep pace with global developments in the banking industry, and the goal of research is to clarify the applicability of the production system in the time specified in the service sector and th
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