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.
Theatrical techniques took upon themselves the responsibility of building and organizing the theatrical form for the various forms of performances, and it was the important tool that the show makers could rely on in carrying out the various works at the audio-visual level, and lighting is one of the most important elements of the visual formation of the image in the show, as it is related to the visual process and what it can achieve in operations The contrast that constitutes the aesthetic and intellectual values of the theatrical show, especially since the process of adjusting the element of time and the timings for receiving or delivering, moving, and the movement of the actor is what can determine the rhythm of the scene, which in it
... Show MoreInterval lies at rest in the speech; so as to improve to speak out, which is how Evaln Koran by other speech, called separators; for the secession of Alkalaman then, as the last verse separation between it and its aftermath in the Al-Jinn had a comma significant impact on the statement of the case of gin, as portrayed interval Gin and like the distraught after hearing of the Koran
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Linguistic sounds of Koranic breaks played a significant role in a statement carried by the linguistic meaning of these interludes
Advertising is an important and influential tool in various commercial operations, as it represents a means of communication that depends on influencing individuals or society as a whole, working on a link between the producer and the consumer, so the importance of advertising appears in two dimensions, the first is economic represented in its role in achieving economic growth for the facility, while the social dimension lies in its role By influencing the behaviors and ideas of individuals, and from here it appears to us the importance of formulating, organizing and designing the advertising message that advertising agencies resort to in their advertising campaigns. Orientation, definition, and raising the level of the advertising messa
... Show MoreThe Trump administration asserts that the actions of the United States are neither constrained by international organizations nor international controls, as they strive to seek a leadership position in a competitive manner, advance the reform of the United Nations in order to gain strength and support for US interests, and promote conservative social values. This negative policy is the result of the influence and mutual influence of long-term isolationism, the "American exception" and popular trends in the United States, as well as the result of the Trump administration's attempt to employ powerful means to revitalize the United States' strong position in the United Nations. However, the Trump administration’s policy toward the United
... Show MoreAim of the research is the study of improving the performance of the thermal station south Baghdad and the main reasons for reduced its efficiency. South Baghdad power planet comprises (6) steam turbine units and (18) gas turbine units .The gas turbine units are composed of two groups: the first group is made up of gas units (1,2), each of capacity (123) MW. The design efficiency of gas turbine units is 32%. The actual efficiency data of steam units is 18.3% instead of 45% which is the design efficiency. The main reason for efficiency reduction of gas units is the rejected thermal energy with the exhaust gases to atmosphere, that are (450-510) ℃.The bad type of fuel used (heavy) fuel. Another reason for the low efficiency and has a neg
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