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 multi-drug resistant efflux pump is a glycoprotein pump whose function is to push foreign substances. The efflux pump is found in humans, animals. It also has wide-ranging properties in bacteria and fungi. They are found in all species of bacteria, and efflux pump genes can be found in bacterial chromosomes or mobile genetic elements, such as plasmids. The most sensitive function that leads to a global problem is its resistance to antibiotics in bacterial cells, which increases the ability to bacteria from becoming strong virulence factors that most or all antibiotics cannot kill. It also has othe
... Show More
The research aims to identify the most important areas of voluntary work available to women in society, stand on the most important controls that push women to work in voluntary areas in society. The research also seeks to stand on the most prominent obstacles to the voluntary work of women in society. The research contained four main chapters: Chapter I: Definition of research, Chapter 2: Objectives, areas, controls and effects of volunteer work, Chapter 3: Voluntary Work of Women in the Celestial Religions, and lastly, Chapter 4: Theories, Constraints, and Recommendations for Voluntary Work for Women.The researcher suggested several recommendations: 1-establishing a unit responsible for planning,
... Show MoreIncreasingly, public organizations in the federal state are required to work together, as well as to work with others to achieve their objectives. In Iraq there are two levels of organizations, including federal and local, and these organizations have been forced to work for many years in an environment in which the responsibility for service delivery is shared between policy makers and service providers, and between local governments and the federal government. It is sometimes difficult to manage the relationship between these organizations (federal and local) and do not always provide the best possible outcome of this relationship. This paper reviews how to manage the relationship between local administrations and
... Show MoreThe Battle of Kadesh is replete with many military arrangements that reflect the tremendous development of war preparations in the thirteenth century BC; where the expressive pictures the Egyptians left on some of the walls of their temples show the tremendous ability to organize and divide the forces and the great development that affected the war machine. Furthermore, the text accompanied these pictures reveal some news about that battle, which is considered one of the most important wars in the ancient world. Thus, the importance of the study lies in the fact that it examines one of the most important battles of the ancient Near East, the results of which had great repercussions on the region. This is because it is the most abundant B
... Show MoreThe research topic (The dramatic structure transformations in the Iraqi Feature Film) studies the dramatic structure and its transformations in the Iraqi feature film. The research determined the research problem and the need for it in addition to the aims and the limits of the study as well as its importance. The theoretical framework consists of the following themes: the dramatic transformations mechanism and dramatic data in the Iraq film 1957-2003 then the dramatic values transformations and the performance contradictions in the Iraqi film.
The research, after concluding the theoretical framework, came up with a number of indicators of the theoretical framework that have been used as a tool to analyze the sample. The research proc
Language Teaching & Leaning Problems at the Iraqi university level: Image & Reality
Despite recent attempts to improve safety in the construction sector, this sector is considered dangerous and unsafe. Iraq is one of the emerging nations that suffers from a lack of construction safety management. In 2018, the construction sector in Iraq was responsible for 38% of all industrial accidents. Creating a safety program minimizes this problem by making safety an intrinsic part of construction projects. As a result, this article aims to identify the crucial safety factors that affect the safety performance in Iraqi construction projects. After conducting a critical literature review of the related literature, a list of 35 sub-factors classified into nine categories of main factors was chosen to rank each facto
... Show More