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 amicus curiae is one of the judicial procedures adopted in many judicial and legal systems around the world, under which a person who is not a party to the case, and without having a personal and direct interest in it, intervenes to draw the court’s attention to many factual and legal aspects
Although cinema is moving towards art, it has dealt with the character since the beginning of the discovery of cinematic art in films such as (Doctor Caligari's cabin) and most German expressive films in the third decade of the twentieth century, but the interest of cinema is growing in the estranged human personality, meaning that this character It lives by its alienation from the environment and society that surrounds it, because our present days have witnessed on the material and moral level more social breakdowns such as wars and disasters, and the sharp contradiction in the social and economic level of people themselves or between different societies, or between the individual and his community, and new social relations have increas
... Show MoreThis study aims to determine the extent to which Palestinian elites use digital diplomacy to confront the Israeli narrative by exploring the motives for usage, patterns, essential digital diplomatic tools, and achieved satisfactions. The study adopted a survey methodology and employed a questionnaire distributed to a sample of 110 Palestinian political and media elites.
The study arrived at several key findings, including: Palestinian elites allocate a substantial (%67) of their efforts towards employing digital diplomacy as a response to the Israeli narrative. The foremost platforms employed for this purpose are Facebook and Twitter. The primary motivation for utilizing these digital platforms is to present
This study sought to determine the impact of spreading the culture of quality in improving the quality of tourism service in some hotels in Erbil governorate. The theme of excellence in providing service and attention to it has become the concern of most organizations in general and tourism service organizations in particular. Tourists try to establish the mental status of customers about their tourism organizations had to pay attention to the quality of service provided to the customer and work to develop them to the advanced stages of satisfaction and happiness of customers and this will certainly positively affect the improvement of service in the tourism sector, Of the research variables were examined statistically by distrib
... Show MoreThis research aimed to examine the correlation and influence of leader-member exchange in the organizational citizenship behavior in the existence of organizational trust as mediator variable among workers in ministry of migration and displaced, has been collecting data and information relating to research by designing questionnaire was distributed to the stratified random sample included (56) member of the workers in the ministry mentioned, and through the use of several statistical method were the main findings of research was the existence of a correlation relationship and influence between leader- member exchange and organizational trust, while the results confirmed no correlation and influen
... Show MoreMultimedia is one of the most important elements of modern educational media and must be used in educational websites in order to disseminate knowledge on a large scale and should be used to provide scientific information to all, as the current research tried to explore the possibilities of employing them in the design of educational websites and highlight their role in promoting the scientific aspects of the user. This study included four axes, the first of which was devoted to the introduction which includes the problem of research, its importance, objectives and its objective, temporal and spatial limitations, which were limited to the study of the main pages of Arabic educational websites published in 2019. The second axis cont
... Show MoreValues and ideals are two basic pillars in human life, and high societies have been keen throughout their ages to adhere to and establish them so that man can distinguish good and evil, right and wrong, as they are a balance of actions that give man a higher value. Many of the followers of Abbasid literature, poetry and prose – it is noted that many imams and writers have been keen to highlight these values and make them material for their poetry and literature, courage, generosity, chastity and....All meanings of human values and there is no doubt that one of the texts abounding in this field is what was reported from the people of the house of infallibility pure (peace be upon them), including we touch it in the visit of Imam Jaafar al-
... Show MoreThe multimetric Phytoplankton Index of Biological Integrity (P-IBI) was applied throughout Rostov on Don city (Russia) on 8 Locations in Don River from April – October 2019. The P-IBI is composed from seven metrics: Species Richness Index (SRI), Density of Phytoplankton and total biomass of phytoplankton and Relative Abundance (RA) for blue-green Algae, Green Algae, Bacillariophyceae and Euglenaphyceae Algae. The average P-IBI values fell within the range of (45.09-52.4). Therefore, water throughout the entire study area was characterized by the equally "poor" quality. Negative points of anthropogenic impact detected at the stations are: Above the city of Rostov-on-Don (1 km, higher duct Aksai) was 38.57 i
... Show MoreThe research seeks to design a program of guidance in the form of emotional perception rational to reduce the fear of failure, to identify the effect of method of emotional perception rational in reducing the fear of failure. To achieve these objectives, the researcher adopted the null-hypotheses, which assume there are no statistically significant differences in the degree of fear of failure (for the control group) in the pre-posttest. There are no statistically significant differences in the fear of failure (for the experimental group) in the pre-posttest. There were no statistically significant differences in the fear of failure of the groups (experimental and control) after the application of the program in the post-test. In order to
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