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 service system has become a necessity of life in modern cities to be the most basic necessities of modern humans, they constitute a major base, which is based on the sustainability of life in the city and a standard measured through the degree of well-being and progress of civilized peoples and their interaction with the surrounding environment, making the services sector as a need not be an option, whenever the cities widened in population and space whenever provision of services and upgrading the quality and quantity more pressing, which made the subject of the services takes the biggest area of the trends and thinking of urban planners and those who in charge of drawing the cities policies. Consideri
... Show MoreThe aim of the current research is to verify the effect of the cognitive modeling strategy on the achievement of the chemistry course for the students of the first intermediate grade. To achieve the objective of the research, the null hypothesis was formulated via cognitive modeling strategy. The results showed that the experimental group's students performed better than the students in the control group. In the light of the results, the researchers concluded: The impact of the cognitive modeling strategy in the achievement of students of first intermediate grade in chemistry.
My study here is about the (possible for itself) features especially in the (Alashaira) opinion, also I touch to the other logicians opinions, I clarified these features concisely in the preface to be clear in front of the reader, I made it in two studies and five subjects.I talked about the meaning of the existence in the ((possible for itself) theme, and I clarified its types in the logicians and the philosophers' opinions, through which the existence and the nonexistence are equal in it, as it cannot be existed nor be nonsexist unless with a separated reason, and there is no necessity to oblige its existence, or its nonexistence is impossible.Then I talked about the outweighing of the (possible for itself) as one side of the exi
... Show MoreObiovisly that the holy thresholds are directly related to Islam and Muslims and related to the general culture of the Islamic peoples. In terms of architecture, it is considered a distinctive architectural scene that reviews the history of this origin and its architectural styles. Recently, with the increase in the number of pilgrims and visitors to the holy shrines, there is a need to develop and expand the buildings and provide them with services and introduce modern technology. The building of the holy thresholds consists of a number of functional design indicators: The general problem of research is that there is no clear theoretical framework for the design indicators for the development of the holy shrines according to the functio
... Show MoreThis study attempts to determine the necessary teaching competencies for teachers and the level of their importance in the development of their performance professionally and scientifically, and the progress towards a better future to achieve an effective level. Accordingly, the research community consists of the morning-preparatory schools for boys at the General Directorate of Education of Baghdad \ Rusafa2. The study sample included (68) teachers constituted 88.31% of the total community of teachers. As for the research tools, the researcher adopted the descriptive method by using the observation method in which the researcher prepared a list of teaching. For verifying the re
... Show MoreThe research problem lies in the fundamental questions that revolve around the role of each of the tools of promotion, namely advertising, personal sale, public relations, sales promotion, and direct marketing in achieving leadership for business organizations. Research to know the role of promoting the service in the researched company and whether the promotion of the service is qualified to lead the researched company to leadership, and for this purpose formulated research hypotheses of three hypotheses, the first hypothesis says that there is a significant impact relationship between promotion and entrepreneurship. The second hypothesis aimed to determine the role played by promotion in the researched company to achieve unique
... Show MoreThis study's objective is to assess how well UV spectrophotometry can be used in conjunction with multivariate calibration based on partial least squares (PLS) regression for concurrent quantitative analysis of antibacterial mixture (Levofloxacin (LIV), Metronidazole (MET), Rifampicin (RIF) and Sulfamethoxazole (SUL)) in their artificial mixtures and pharmaceutical formulations. The experimental calibration and validation matrixes were created using 42 and 39 samples, respectively. The concentration range taken into account was 0-17 μg/mL for all components. The calibration standards' absorbance measurements were made between 210 and 350 nm, with intervals of 0.2 nm. The associated parameters were examined in order to develop the optimal c
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