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.
Research summary
Muslim scholars have established fundamental rules for deriving rulings to be a methodology for every mujtahid who wants to extract rulings from his reliable sources, and one of the most prominent fundamental rules on which many rulings are built is the permissible and the many rulings related to it.
Leaving what is permissible on its own terms sometimes causes embarrassment and distress in some cases, so we need something that restricts it. In our Islamic law, many legal rulings are embodied in which the restriction of what is permissible is in the public interest, or to relieve embarrassment in public.
Because of the importance of this fundamentalist rule, and the difference in some
... Show MoreThe aim of this paper is to prove some results for equivalence of moduli of smoothnes in approximation theory , we used a"non uniform" modulus of smoothness and the weighted Ditzian –Totik moduli of smoothness in by spline functions ,several results are obtained .For example , it shown that ,for any the inequality , is satisfied ,finally, similar result for chebyshev partition and weighted Ditzian –Totik moduli of smoothness are also obtained.
Taxes are an essential axis in the economy as the most effective and effective economic tool in any country (economy). Expanding the scope of taxation without adequate study has produced a dangerous result with a negative impact that is almost apparent, namely (tax evasion), which stands as a barrier preventing the state from reaching Therefore, the research sought to study strategic tax planning and its importance in reducing tax evasion, and the research aims from that to prove the importance of adopting strategic planning in the field of taxes according to modern and effective scientific foundations to reduce tax evasion to enhance the achievement of tax evasion. The financing objective is in addition to the other objectives,
... Show MoreMany of the key stream generators which are used in practice are LFSR-based in the sense that they produce the key stream according to a rule y = C(L(x)), where L(x) denotes an internal linear bit stream, produced by small number of parallel linear feedback shift registers (LFSRs), and C denotes some nonlinear compression function. In this paper we combine between the output sequences from the linear feedback shift registers with the sequences out from non linear key generator to get the final very strong key sequence
In this paper, we introduce and study the notation of approximaitly quasi-primary submodules of a unitary left -module over a commutative ring with identity. This concept is a generalization of prime and primary submodules, where a proper submodule of an -module is called an approximaitly quasi-primary (for short App-qp) submodule of , if , for , , implies that either or , for some . Many basic properties, examples and characterizations of this concept are introduced.
This study aimed to extract, purify, and characterize the protease of local Okra Abelmoschus esculentus pods. The extraction process was conducted using ten extraction solutions with different pH and ionic strength values. Phosphate buffer solution with (pH 7, 0.05M, containing 2% sodium chloride) gave the highest activity which was (7.2 Unit/ml) as compared to other solutions, which ranged from 0.8-5.9 Unit/ml. The extracted enzyme purified by several stages. Being, precipitation by gradual addition of Ammonium sulphate from 20 to 85% saturation, then the precipitated enzyme was dialyzed and fractionated through DEAE-Cellulose (22X1.1cm), the enzymic fractions were pooled. The specific activity, purification fold and the enzyme yield value
... Show MoreThe contemporary ideas were characterized by the abundance and diversity of their knowledge, human and conceptual production, the strategy is both a general and a detailed framework covering all design disciplines both inside and outside the field of architecture. From here, many of these terraces emerged from fields outside the field of architecture, but soon moved to form an important nerve within the field of architecture. Hence the need to define a more comprehensive framework for studying one of the concepts that can frame the framework, namely the concept of "Alliteration", and its adoption as an architectural design strategy aimed at giving the resulting form a feature of rhetoric. So the research highlighted the
... Show MoreThe current research aims to identify the impact of the amputated story style in the collection of sixth graders in elementary in the written expression subject.
The researcher, intentionally, chose Al-Ameen primary hybrid school which belongs to the directorate of education in Baghdad / Karkh first. The number of people of the sixth grade three classes. The researcher chose the two classes randomly to represent one of the experimental group, the number (32) pupils (male and female) have studied the expression subject by the amputated story style. Other control group, the number (32) pupils studied according to the traditional method.
The researcher prepared the lesson plans and presented to the experts, the researc
... Show MoreThis study concerns a new type of heat exchangers, which is that of shell-and-double concentric tube heat exchangers. The case studies include both design calculations and performance calculations.
The new heat exchanger design was conducted according to Kern method. The volumetric flow rates were 3.6 m3/h and 7.63 m3/h for the hot oil and water respectively. The experimental parameters studied were: temperature, flow rate of hot oil, flow rate of cold water and pressure drop.
A comparison was made for the theoretical and experimental results and it was found that the percentage error for the hot oil outlet temperature was (- 1.6%). The percentage
... Show MoreThe concept of a 2-Absorbing submodule is considered as an essential feature in the field of module theory and has many generalizations. This articale discusses the concept of the Extend Nearly Pseudo Quasi-2-Absorbing submodules and their relationship to the 2-Absorbing submodule, Quasi-2-Absorbing submodule, Nearly-2-Absorbing submodule, Pseudo-2-Absorbing submodule, and the rest of the other concepts previously studied. The relationship between them has been studied, explaining that the opposite is not true and that under certain conditions the opposite becomes true. This article aims to study this concept and gives the most important propositions, characterizations, remarks, examples, lemmas, and observations related to it. In the en
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