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.
Management Representations Letter plays a significant role as an evidence to get conclusions the Auditor is looking for. These conclusions could show the professional opinion of auditor over the fairness and integrity of financial statements for many issues and numbers that management claims, Hereby, the research aims at highlighting the importance of Management Representations Letter and the way of using as an evidence with expressing its meaning and means of application in addition to identify the Responsibility of Auditor on that Letter, This research discusses also the effect of Management Representations Letter on the credibility of financial statement and enhancing the credibility of the submitted reports, From other side, in the t
... Show MoreThe banking sector is currently facing great challenges resulting from intense competition in the financial environment, and this is what makes the supreme audit bodies and the Central Bank audit as the highest supervisory authority on banks in order to achieve profit and not be exposed to loss, and this requires identifying the banking strengths and risks that constitute points Weakness that affects the future performance and the life of the bank, which requires special supervisory care, and from this point of view, the research aims to use the CAMELS model as a control tool in banks, through the use of its six indicators: capital adequacy, asset quality, management quality, profits, liquidity And sensitivity to market risks, th
... Show MoreThe aim of the research is to know the effect of financial leverage on the market value of the stock by applying it to a sample of private Iraqi commercial banks listed in the Iraqi Stock Exchange for the period (2010-2019) and to show the extent of that effect, based on the bank’s annual reports for the mentioned period through the use of financial leverage ratios represented b (Equity multiplier, cash balance ratio), its discussion, analysis, description, inferential description, and testing of research hypotheses,
A set of conclusions has been reached, the most important of which are: The research sample banks depend in their financial structures on borrowed funds in a greater proportion than their r
... Show MoreAim: This study aims to determine both the level of knowledge, attitude, and practice in clinical breast examination in women and the relationship between knowledge and practice.Data collection was performed within a three-month period starting from February 2019 on. Subjects and Method: A cross-sectional analytical study included 657 non-randomly selected women visiting primary health care centers in Baghdad city with an average of age between (20-59) years old. Results: Only 51.8% ever heard of clinical breast examination. The mean knowledge score for clinical breast examination was (51.2±44). Only 5.5% of women performed regular clinical breast examinations. Participants who adequately practice clinical breast examinatio
... Show MoreAccording to the circumstances experienced by our country which led to Occurrence of many crises that are the most important crisis is gaining fuel therefore , the theory of queue ( waiting line ) had been used to solve this crisis and as the relevance of this issue indirect and essential role in daily life .
This research aims to conduct a study of the distribution of gasoline station in (both sides AL – kharkh and AL Rusafa, for the purpose of reducing wasting time and services time through the criteria of the theory of queues and work to improve the efficiency of these stations by the other hand. we are working to reduce the cost of station and increase profits by reducing the active serv
... Show MoreBackground: White spot lesion considered as irreversible tooth demineralization presenting challenge to orthodontists during treatment schedules, fluoride was the most successfully used measure to overcome this challenge. Materials and method: A total of forty sound human permanent premolars were used in the present study and categorized into four groups, in one group the teeth were bonded with stainless steel brackets using Resin-modified glass ionomer cement (RMGIC) and the other three groups the teeth were bonded with light cured composite Resilience® (Ortho technology Co., USA). Group A; Acidulated phosphate fluoride (APF) topical gel (Mfg by DEEPAK PRODUCTS, INC, USA), fluoride ion 1.23% applied on examine area for four minute. Gro
... Show MoreThe current study performs an explicit nonlinear finite element simulation to predict temperature distribution and consequent stresses during the friction stir welding (FSW) of AA 7075-T651 alloy. The ABAQUS® finite element software was used to model and analyze the process steps that involve plunging, dwelling, and traverse stages. Techniques such as Arbitrary Lagrangian–Eulerian (ALE) formulation, adaptive meshing, and computational feature of mass scaling were utilized to simulate sequence events during the friction stir welding process. The contact between the welding tool and workpiece was modelled through applying Coulomb’s friction model with a nonlinear friction coefficient value. Also, the model considered the effect of nonlin
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