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 research aims to achieve a set of the most important objectives of the review of the role of creative administrative leadership in achieving aspects of economic reform in various government institutions and indicate the role of supervisory awareness of administrative leadership in the revitalization of the role of the internal control system to achieve the best use of available resources. This paper deals with three problems is the loss of financial resources of the state as a result of the growing phenomenon of administrative and financial corruption in the majority of government institutions, and the weakness of the role of the internal control system in the province on the resources available and to achieve the best use of these reso
... Show MoreThe function of internal auditing has become an important function that aims at achieving objectives that are compatible with these developments and changes that have occurred in many countries in the world, which required the emergence of professional associations and institutes in the profession of internal auditing. Improve the guideline of the internal audit units issued by the Federal Audit Bureau to enhance the efficiency of internal audit performance in Iraqi government units. The researchers adopted the statistical method of proving the hypothesis by constructing a questionnaire that included three main axes: supporting the senior management in adopting the current guide, and the second being the importance of improving t
... Show MoreThe main focus of research is on how to achieve the internal and external dimensions of corporate social responsibility through human resources management strategies, which is a major of research aimed. The main problem of this research was confirmed, which confirms that there is an unclear role for social responsibility, lack of human resources management strategies, and ambiguity of roles in the municipality under study. The diagnose of the problem and determining the gap between the internal and external dimensions of social responsibility and human resources management was identified, which attacked the researcher's attention to navigate in this subject, look for the reasons for the gaps and try to reduce them. The case study
... Show MoreThe second half of the last century witnessed a great scientific revolution that was able to bring about wide changes in various fields, including the field of physical education, which plays a fundamental role in the process of change for the better, and which knocked all the doors of modern science in various aspects and from this perspective we see that students have different capabilities And interests and motives, which require providing a differentiated education, and this depends on the necessity of knowing each student and on the school’s ability to know appropriate strategies for teaching each student so there is no single way to teach so the research problem comes in experimenting with an educational method that works on
... Show MoreThe job that confronts players with the effectiveness of shooting with an air rifle is high, so it requires necessary functional adaptations that differ in their degrees from other sports. Regular training in air rifle shooting leads to physiological changes in most of the body's internal systems, and changes and responses can be identified. The functional accompanying physical activity through the presence of body components that reflect these physiological changes in the form of changes in some components, and the importance of research lies in studying the physiological changes accompanying the maximum physical effort and the consequent development of the level of achievement in the effectiveness of shooting with air rifle and body
... Show MoreThis research aims to measure the productivity of nursing services and recognize the reality of providing such services in some public hospitals in the province of Diyala, as well as identify the most important factors affecting the productivity of nursing services, and developer measure adopted by the researcher (Kien, 2012), which includes seven factors (workforce , management team, stimulation, pressure of working hours (time), material / equipment, supervision, safety), Used the experimental method in the search, one of the private scientific research curriculum depends primarily on the scientific experiment and study of the subject, or a scientific phenomenon, which provides an opportunity to learn the facts
... Show MoreTranslation as a human endeavor has occupied the attention of nations since it bridges the gab between cultures and helps in bringing out national integration. The translation of Kurdish literature started with personal efforts in which newspapers and magazines had played a vital role in supporting translation and paved the way for promoting the publication of Kurdish products.
The bulk of the materials translated from Arabic exceeds that translated from other languages owing to the influence of religious and authoritarian factors.
The survey of the Kurdish journals was limited to the period 1898-1991 since it marked a radical and historic change represented by the birth of Kurdish journalis
... Show MoreStudied the effect of foliar fertilizers Alaongrin results showed that spraying fertilizer Alaongrin and Fertilizers and Ministry of Agriculture and rack licorice extract every three weeks after thirty days from planting seedlings
The beginning of COVID-19 in Wuhan, China in late December 2019 and its worldwide transmission has led the World Health Organization to formally address the pandemic. The pandemic has imposed influential impacts on different environmental, economic, social, health, and living aspects. Publishing in scholastic journals was not immune from these impacts.
The recent study aimed to identify the level of Self- Esteem and its relation to some variables (Gender, Experience years, and Educational stage) among psychologists in schools of the Sultanate of Oman. The study sample consisted of (154) psychologists of both male and female who are working in different stages of study in the schools affiliated to the Ministry of Education in the Sultanate of Oman. The sample of the study consisted of (43) male and (111) female psychologists from (11) governorates of the Sultanate. The descriptive analytical methodology was used. In order to collect data the Self-Esteem questionnaire prepared by the researcher were used. Statistical processing was done using the Statistical Package for Social Sciences (
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