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.
This 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
... Show MoreNiTi (also called Nitinol) transforms from cubic (austenite) to monoclinic (martensite), and vice versa, owing to the shape memory effect and superelasticity. Nitinol has a large number of biomedical applications because of its low elastic modulus close to that of natural bone material and good resistance to corrosion and fatigue, in addition to the transformation temperatures of nitinol that are close to body temperature. It has many other important applications, such as in the aircraft industry. In all these important applications, especially medical applications, Nitinol stability is an important factor for safety. Our goal is to study the stability of NiTi by calculating the phonon dispersion relation to obtain an accurate u
... Show Moreالمستخلص يهدف هذا البحث الى تجاوز مشكلة البعدية من خلال طرائق الانحدار اللامعلمي والتي تعمل على تقليل جذر متوسط الخطأ التربيعي (RMSE) , أذ تم استعمال طريقة انحدار الاسقاطات المتلاحقة (PPR) ,والتي تعتبر احدى طرائق اختزال الابعاد التي تعمل على تجاوز مشكلة البعدية (curse of dimensionality) , وان طريقة (PPR) من التقنيات الاحصائية التي تهتم بأيجاد الاسقاطات الاكثر أهمية في البيانات المتعددة الابعاد , ومع ايجاد كل اسقاط
... Show MoreThe actual observations for Jupiter radio storm were taken for Hawaii station within multi years from 2001 to 2012. The Central Meridian Longitude (CMLІІІ) and Io's phase (γIo) were calculated for each year from Radio Jove program, the results of CMLІІІ for year 2006 was A=(180-300)º,B=(15-239)º, C=(60-280)º, phase was A=(182-260)º,B=(40-109)º, C=(200-260)º, which were close to the theoretical values, longitude was A=(180-300)º, B=(15-240)º, C=(60-280)º and phase was A=(180-260)º,B=(40-110)º and C=(200-260)º.
Since her early beginning in 1974 in her novel "Les armoires vides", Annie Ernaux writing about life in all its various aspects remained her main goal. This novel gave the earliest signals of what would happen later on in her literary career. Indeed, her works showed abilities of echoing reality, her sufferance and experiences via the use of simple and clear language. Add to this, her writings are to be viewed as an expression of deep felt journey, and a continuous search due to the consequent changes coming out of her identity.
We try here to give an answer to the question about writing as to whether being, to Ernaux herself, a need for the search about her social and feminist identity, or a pure literary work
... Show MoreThe flexibility of interaction between the movement of macroeconomic variables that affect and are affected by the balance of payments, especially the movement of the current account, implies a perception of the maturity of economic development and what the theory assumes from the launch of a wide range of economic movement that varies in the degree of its influence according to the level of economic development and the vitality of the internal/external overlap relations through the assumed response to the movement of the macroeconomic variables. On this basis, it is possible to estimate the soundness and rationality of the economic decision taken that takes into account the required reciprocal repercussions between the current a
... Show MoreThis paper introduces cutpoints and separations in -connected topological spaces, which are constructed by using the union of vertices set and edges set for a connected graph, and studies the relationships between them. Furthermore, it generalizes some new concepts.
Tax governance is a set of legal means that directs the tax administration to deal in good faith with taxpayers based on transparency, integrity and accountability while ensuring the achievement of tax justice and works to introduce advanced means by which it deals with all stakeholders.
In this study, we try to explain its rooting and legal nature by shedding light on the position of some international organizations and their internal legislation in the context of public finance.
The aim of the current study is to identify the level of goal conflict with twelfth-grade students in South Sharqiah/ Sultanate of Oman according to gender and specialization. The study used the descriptive method. A scale of (28) items was developed and divided into six dimensions: time pressure, goal achievement, limit of power, limit of budget, incompatible strategies, and unclear task. To validate the scale, it was piloted (40) students. The scale was administered to a sample of (402) students (209) males in the Governorate of South Sharqiah. The results showed that the conflict level was high in “unclear task”, and an average conflict level in “limit of power”. Other dimensions (goal achievement, time pressure, limit of powe
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