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.
Stereolithography (SLA) has become an essential photocuring 3D printing process for producing parts of complex shapes from photosensitive resin exposed to UV light. The selection of the best printing parameters for good accuracy and surface quality can be further complicated by the geometric complexity of the models. This work introduces multiobjective optimization of SLA printing of 3D dental bridges based on simple CAD objects. The effect of the best combination of a low-cost resin 3D printer’s machine parameter settings, namely normal exposure time, bottom exposure time and bottom layers for less dimensional deviation and surface roughness, was studied. A multiobjective optimization method was utilized, combining the Taguchi me
... Show MoreSensibly highlighting the hidden structures of many real-world networks has attracted growing interest and triggered a vast array of techniques on what is called nowadays community detection (CD) problem. Non-deterministic metaheuristics are proved to competitively transcending the limits of the counterpart deterministic heuristics in solving community detection problem. Despite the increasing interest, most of the existing metaheuristic based community detection (MCD) algorithms reflect one traditional language. Generally, they tend to explicitly project some features of real communities into different definitions of single or multi-objective optimization functions. The design of other operators, however, remains canonical lacking any inte
... Show MoreThe purpose of this resesrh know (the effectiveness of cooperative lerarning implementation of floral material for calligraphy and ornamentation) To achieve the aim of the research scholar put the two zeros hypotheses: in light of the findings of the present research the researcher concluded a number of conclusions, including: -
1 - Sum strategy helps the learner to be positive in all the information and regulations, monitoring and evaluation during the learning process.
2 - This strategy helps the learner to use information and knowledge and their use in various educational positions, and to achieve better education to increase its ability to develop thinking skills and positive trends towards the article.
In light of this, the
Background: The clinical examination is one of the best suitable methods for diagnosis of low backache. Backache is one disease that the signs, clinical examination finding, and the results on imaging modalities not always related. The straight leg raising (SLR) and slump tests, can be used for diagnosis of lumber disc herniation.
Objectives: To compare the result of the slump test and SLR test in the diagnosis of lumber disc herniation.
Subjects and Methods: A prospective comparative study conducts on 280 patients in Al-Kindy teaching and private clinics complaints of backache, aging between 18-70 years old with acute or recurrent backache, sciatica pai
... Show MoreThere is no doubt that Jane Austen is one of the most studied authors of the late 18th and early 19th centuries. Her female characters have been extensively studied and they seem to have aroused much interest as manifestations of the conduct of their time. Her heroines have realized that there were many mistakes in the rules of conduct that controlled and restricted their behaviors. Thus, they have found no fault in correcting these mistakes, by behaving naturally without acting. Elizabeth Bennet the heroine of Pride and Prejudice and Marianne Dashwood of Sense and Sensibility are the chosen examples of that kind of women.
The study aims to analyze computer textbooks content for preparatory stage according to the logical thinking. The researcher followed the descriptive analytical research approach (content analysis), and adopted an explicit idea during the analysis process. One of the content analysis tools which was designed based on mental processes employed during logical thinking has utilized to figure out the study results. The findings revealed that logical thinking skills formed (52%) in fourth preparatory textbook and (47%) in fifth preparatory textbook.
The important factor in the success of construction projects is its ability to objective estimate of the cost of the project and adapt to the changes of the external environment, which is affected by a lot of elements and the requirements of the competitive environment. The faces of those projects are several problems in order to achieve particular goals. To overcome these difficulties has been the development of research in the last two decades and turn the focus on the role of the cost of project management, by providing information and assist management in planning and control of the budget among the main elements of the project, namely, (time-cost-quality),The research aims at the possibility of developing and implementing mechanisms
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