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.
Abstract:
The current research is aimed at analyzing the impact of the dimensions of Job involvement of all of (the enthusiasm, the Devotion, Assimilation ) in the Crystallize organizational Identification across the dimensions of (organizational loyalty, membership, similarities) and was named the Middle East, the Iraqi Investment Bank room to look as the research community of staff adopted in the bank, to be applied to a Random sample of (100) employees working in the said bank, and developed for the purposes of data collection, a questionnaire form included three axes covered (32) paragraph of the measure, which is included adopted Liekrt Quintet for the
... Show MoreThe capital banking foundation stone upon which the bank in the practice of business activities, the more capital a good financial adequacy of the increased bank's ability to grant credit and expand the various activities and provide a safety element for depositors and other sources of funding to achieve profits and increase the trading volume of the shares, causing the rise the rate of return for the shares of banks and have the Central Bank as head of the banking system by issuing instructions capital increase banking, according to the requirements of economic development and increase gross domestic product by supporting investment projects that are financed through banks, the research aims to show the extent of the banks commitment to
... Show MoreThis study assessed the advantage of using earthworms in combination with punch waste and nutrients in remediating drill cuttings contaminated with hydrocarbons. Analyses were performed on day 0, 7, 14, 21, and 28 of the experiment. Two hydrocarbon concentrations were used (20000 mg/kg and 40000 mg/kg) for three groups of earthworms number which were five, ten and twenty earthworms. After 28 days, the total petroleum hydrocarbon (TPH) concentration (20000 mg/kg) was reduced to 13200 mg/kg, 9800 mg/kg, and 6300 mg/kg in treatments with five, ten and twenty earthworms respectively. Also, TPH concentration (40000 mg/kg) was reduced to 22000 mg/kg, 10100 mg/kg, and 4200 mg/kg in treatments with the above number of earthworms respectively. The p
... Show MoreBackground: Piezosurgery improved the split approach by making it safer, easier, and less prone to complications when treating extremely atrophic crests. Densah drills, with their unique design, expand the ridge by densifying bone in a reverse, non-cutting mode. Objective: To assess the effectiveness of sagittal piezosurgery, which involves cutting bone to the full implant depth and then expanding it using osseodensification drills. We use this technique to expand narrow alveolar bones and simultaneously place dental implants in the maxillary and mandibular arches. Methods: Fourteen patients received 31 dental implants. The maxillary arch received 19, and the mandible received 12 dental implants. This study will include patients who
... Show MoreThe study seeks to determine the levels of credit structure (independent variable) depending on its components (loans, credit disseminate, other facilities) To get the eight patterns of the structure of bank credit for the purpose of assessing the relationship between changes in levels of each style of structure credit (increase or decrease) and reflected in maximizing the value of the Bank(The adopted a measured variable depending on the approximate equation of simple Tobin's Q) to determine the style that achieves the highest value of the Bank, to take advantage of it in management, planning and control by knowing the strengths and weaknesses of the historical distribution of the facilities . the sample of the
... Show MorePatients with decompensated cirrhosis have typically prescribed a combination of therapeutic and prophylactic medications. Polypharmacy increases the probability of medication errors and drug related problems. Clinical pharmacists are highly effective at identifying, resolving, and preventing clinically important drug-related problems in their patients' care. The objectives of the study were the identification and classification of drug-related problems, as well as the discussion of these problems with health care providers (physicians, pharmacists, and nurses) and patients. Reduce their incidence as effectively as possible and educate all research participants on the significance of following their prescribed drug regimen
... Show MoreBackground: Indeterminate colitis (IC), a term
originated by pathologists to characterize confounding
histopathlogic appearance of resected mucosa, has
become catch phrase for cases in which diagnostic
criteria at all levels elude classification as Crohn's
disease (CD) or ulcerative colitis (UC).
OBJECTIVES: evaluate the prevalence of pANCA
expression in the sera and its isotypes.
Patients and methods: PATIENTS GROUP
consisted of 60 patients (40 males and 20 females)
with indeterminate colitis and their age range was (19-
84 years). CONTROL GROUP consisted of 30 (15
males and 15 females) healthy volunteers and their
age range was (20- 66 years).
Antineutrophil cytoplasmic ( pANCA and cANCA)
te
Rheumatoid arthritis (RA) is characterized by persistent joint inflammation, which is a defining feature of this chronic inflammatory condition. Considerable advancements have been made in the field of disease-modifying anti-rheumatic medicines (DMARDs), which effectively mitigate inflammation and forestall further joint deterioration. Anti-tumor necrosis factor-alpha (TNF-α) drugs, which are a class of biological DMARDs (bDMARDs), have been efficaciously employed in the treatment of RA in recent times Adalimumab, a TNF inhibitor, has demonstrated significant efficacy in reducing disease symptoms and halting disease progression in patients with RA. However, its use is associated with major side effects and high costs. In addition,
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