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 irony pushes us to inquire about what is in the text of contradiction, irony, suspense, and other acts of paradox, as well as a departure from what is logical, or familiar, that attracts the attention of the addressee, and this is what drives us to introspect the text and interrogate it in order to get to know the intended product of the text or its real or metaphorical intent. On the other hand, the irony is more in the literary text than in the scientific texts. Therefore, critics add the word literature to it in their definition.
As it is represented by the paradox, we will seek to study the paradox of the title and the problematic that it may pose as the beginning of the text, and i
... Show MorePurpose: The research aims to build an integrated knowledge framework for the basic research topic. The spirituality of the workplace is through access to the most important scientific proposals on these topics. In management thought framing, the knowledge within them in a serious attempt is to provide the appropriate answers about the intellectual dilemma of research by diagnosing the nature of the relationship with the influential elements and its historical development . Methodology: The study is relied on the analytical survey method. The research sample targeted (88) managers in the center of the Iraqi Ministry of Health exclusively from the researched senior leaders (general manager, assistant general manager, and head of department),
... Show MoreThe general objective of the research is to better understand changes in land cover and their impact on climatic factors by measuring changes in land cover for the Baghdad city for the period 1999-2021 and evaluating changes in land cover and measuring changes in climatic factors (relative humidity and evaporation). This study from 1999 to 2021 and in two different seasons: the April of the growing season and August the dry season. When using the supervised classification method to determine the differences, the results showed remarkable changes, the study showed the spatial variations in LC from 1999 to 2021 as follows: increase in the vegetation and water bodies during April and decrease this in August while the soil and built up decreas
... Show MoreIn a report by Transparency Organization in 2010, Iraq has 200 newspapers, magazines, sixty-seven radio stations and 45 satellite TV channels. The increase in these figures is measured in days or weeks and not months and years. This fact confirms the importance of studying content providers, especially youth sports content, for two reasons: the first is that young people constitute the highest percentage in Iraqi society, with all the potential involved in shaping the future aspects; the second reason is that for years sport has become an important pillar in people's lives not only in the entertainment aspect as it was seen in the past; Rather, sport has an influential presence in politi
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The pressures of life have become a tangible phenomenon in all societies in varying degrees. This disparity determines several factors, including the nature of societies, the level of their urbanization, the intensity of interaction, the intensity of conflict, and the increasing rate of change in those societies. many people name The modern era in which we live the “era of pressures", where one of the most important of these changes is the “new Coronavirus 19-COVID”, which has spread widely throughout the world, as the pandemic, has affected all aspects of daily life, including the educational and academic process, academic activities have been suspended in universities, which caused sudden change
... Show MoreIn his masterpiece ’The Prophet’, Kahlil Gibran presents his unwavering faith and passionate belief in the healing power of universal love that brings humans to sublime ideas and elevates their souls and behavior. The current study aims to find out the stylistic devices utilized to represent the concept of love based on the hypothesis that Gibran tends to use certain stylistic effects to convey his meaning. The study adopts Leech and Short’s (2007) framework of stylistic analysis to analyze the lexical items and figures of speech in selected extracts from the book. The findings reveal that Gibran prefers concrete nouns, dynamic verbs, and physical adjectives over abstract nouns, stative verbs, and psychological adjectives to s
... Show MoreThe paper presents an annotated checklist of the Salticidae of Armenia. This study was carried out in 2019-2020 in order to provide an inventory of the Salticidae fauna. Thirteen species are reported for the Armenian fauna for the first time: Afraflacilla epiblemoides (Chyzer, 1891); Aelurillus v-insignitus (Clerck, 1757); Asianellus festivus (C. L. Koch, 1834); Heliophanus dubius C. L. Koch, 1835; Heliophanus kochii Simon, 1868; Heliophanus tribulosus Simon, 1868; Heliophanus curvidens (O. Pickard-Cambridge, 1872); Macaroeris nidicolens (Walckenaer, 1802); Pellenes diagonalis (Simon, 1868); Pellenes geniculatus (Simon, 1868); Pellenes seriatus (Thorell, 1875); Pellenes tripunctatus (Walckenaer, 1802) and Phlegra fasciata (Hahn, 1826).
... Show MoreObjective: preparing exercises for the third intensity zone for strength and speed for the legs, and identifying their effect on some physiological and biochemical indicators for (the level of lactic acid concentration, the concentration of sodium bicarbonate, the concentration level of (potassium K+) and (sodium Na+) in the blood, and the number of breathing times (RF) Research methodology: the experimental research method was adopted by designing the experimental and control groups on a sample of Army Sports Club players amounting to (16) players, deliberately selected (100%) from their community using a comprehensive enumeration method, and then divided into two groups of equal number, After determining the tests for physiologica
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