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 sustainable competitive advantage for organizations is one of the requirements for value creation, which centered on the possession of scarce resources that achieve maximum flows to invest in intellectual capital, if what has been interest in them, measured and employed the way properly and style, so I figured the need for new technologies to enable organizations to measure the intellectual and physical assets and to assess its performance accordingly, so it sheds search light on the measurement of the added value of existing knowledge using the standard value-added factor is the intellectual (value added intellectual coefficient) (VAIC) and to develop a set of assumptions about the extent of the difference between the sample
... Show MoreIn the midst of rapid changes and difficultiesand the tough competition faced by the Iraqi banks, it has become necessary to focus on a significant aspect of administrative work; that is strategic planning and the key role of implementation within this process in improving the banking service quality. It has emerged as a critical and main competitive weapon for distinguishing the services provided by banks from each other in an effort to participate in increasing market share of the bank in question in question; in its growth, continuation and profit increase.
The research has addressed the relation between the independent variable (implementation within strategic planning), and the dependent variable (banking service quality and
... Show MoreTransport is a problem and one of the most important mathematical methods that help in making the right decision for the transfer of goods from sources of supply to demand centers and the lowest possible costs, In this research, the mathematical model of the three-dimensional transport problem in which the transport of goods is not homogeneous was constructed. The simplex programming method was used to solve the problem of transporting the three food products (rice, oil, paste) from warehouses to the student areas in Baghdad, This model proved its efficiency in reducing the total transport costs of the three products. After the model was solved in (Winqsb) program, the results showed that the total cost of transportation is (269,
... Show MoreCNC machines are widely used in production fields since they produce similar parts in a minimum time, at higher speed and with possibly minimum error. A control system is designed, implemented and tested to control the operation of a laboratory CNC milling machine having three axes that are moved by using a stepper motor attached to each axis. The control system includes two parts, hardware part and software part, the hardware part used a PC (works as controller) connected to the CNC machine through its parallel port by using designed interface circuit. The software part includes the algorithms needed to control the CNC. The sample needs to be machined is drawn by using one of the drawing software like AUTOCAD or 3D MAX and is saved in a we
... Show MoreThree cohesionless free flowing materials of different density were mixed in an air fluidized bed to study the mixing process by calculating performance of mixing index according to Rose equation (1959) and to study the effect of four variables (air velocity, mixing time, particle size of trace component and concentration of trace component) on the mixing index and as well as on mixing performance. It was found that mixing index increases with increasing the air velocity, mixing time and concentration of trace component until the optimum value. Mixing index depends on the magnitude of difference in particle size The first set of experiments (salt then sand then cast iron) give higher mixing index and better performance of mixing than the
... Show MoreThe problem of research was the lack of research that dealt with issue of the job design approach that is more suitable for knowledge work, therefore, the research aims to determine the impact of job enrichment, and knowledge capitalon strategic success, starting from the hypothesis that there significant impact of job enrichment and knowledge capital on strategic success, to achieve this goal the researchers from the theoretical literature and related studies conclude to the construction of the scheme shows the hypothetical relationship between the variables, which was adopted job enrichment as independent variable while knowledge capital plays two roles, the first as an independent variable and the second as an intermediate
... Show MoreBackground: As a multifactorial disorder, temporomandibular joint (TMD) is difficult to diagnose, and multiple factors affect the joint and cause the temporomandibular disorder. Standardization of clinical diagnosis of TMD should be used to reach a definite clinical diagnosis; the condylar bone may degenerate in accordance with these disorders. Aims: Evaluate the correlation between the clinical diagnosis and degenerative condylar change (flattening, sclerosis, erosion, and osteophyte). Materials and Methods: A prospective study with a study group of 97 TMD patients (total of 194 joints) aged 20 to 50. Patients were sent to cone beam computed tomography (CBCT) to assess the degenerative condylar change. Results: No association was found bet
... Show MoreThis present study demonstrated that liver was involved in 14 %of typhoid patients manifesting with hepatomegaly. Elevation of serum enzymes in typhoid fever was presumably of a muscular origin, while elevation of liver enzyme was relatively less common. This study was performed on 30 female patients diagnosed by ultrasound (US) of abdomen, with paratyphoid A, ranged between (20-40) years compared with 30 healthy control .Patients volunteers were treated with appropriate antibiotics for 14 days and investigations were repeated 2-3 week after completion of treatment. Patients had clinical and biochemical evidence of hepatic dysfunction. The spectrum of hepatic involvement included hepatomegaly , jaundice, derangement of various hepatic func
... Show MoreAbstract [email protected] Background: Acute Traumatic Stress Disorder (ATSD) might be complicated by Post Traumatic Stress Disorder (PTSD). Psychological First Aid (PFA) said to be helpful to reduce the possibility of reduction of ASD and PTSD symptoms. PFA is simple procedure to deliver help & support to victims, may be by some one close to him, quietly and professionally. Iraq has and is still experiencing, continuous traumatic stresses. ATSD is especially seen in war such as during the Gulf War, Embargo and nowadays under the current American occupation. With the extreme shortage of recourses and the given late priority to psychological problems and intervention have disastrous consequences on the psycho-social wellbeing of peop
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