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.
Nature and natural beauty have always been the source of inspiration for poets and mystics. For them, nature is one of the most recurrent and celebrated themes. It is a significant symbol of the beauty, righteousness and freshness they are looking for. For religious and mystical poets, it is a reference to God, his beauty, and splendour. Comparing it with the scripture, Thomas Ryan, a Catholic priest and a mystical writer, says ''The Bible is the 'small book', the world of nature is the 'big book'. Both reveal the Creator.''1
For Muslim mystics, God does exist everywhere as the Qur'an states: ''Wherever (Whithersoever) you turn, there is God's face” (Chapter (Surah): 2
... Show MoreThis study aims at investigating the partial Islamic rules of preparing and distributing cartoons in order to issue an overall Islamic rul. To reach an end, descriptive and analytical approaches are adopted to clarify the nature of cartoons and other related concepts. The researcher, as well, with reference to verses of the Holy Quran, tradition (Hadith) and Islamic jurists, adopts a deductive approach to issue Islamic rules related to the industry of cartoons and it's distribution
The study consists of three sections. The first Section addresses the following issues: Definition animation; and related wordy. The second Section: Origin of Cartoon's history and it's negative and positive effects. The third Section: Islamic rules related
Optimization of well placement plays a considerable role in the production and maximizing the net present value of the investment of oil field developments. However, the application of the optimization techniques in well placement developments is so complicated because many decision variables, objective functions, and constraints are involved in the well placement optimization case. Furthermore, many computational techniques; conventional and non-conventional, have been utilized to optimize well placement operations. This study displays the advancement of the optimization methods applied in the well placement. Subsequently, the study assorted the applied optimization methods, and it demonstrates the restriction and the range of implementati
... Show MoreOptimization of gas lift plays a substantial role in production and maximizing the net present value of the investment of oil field projects. However, the application of the optimization techniques in gas lift project is so complex because many decision variables, objective functions and constraints are involved in the gas lift optimization problem. In addition, many computational ways; traditional and modern, have been employed to optimize gas lift processes. This research aims to present the developing of the optimization techniques applied in the gas lift. Accordingly, the research classifies the applied optimization techniques, and it presents the limitations and the range of applications of each one to get an acceptable level of accura
... Show More Taurodontism is a rare developmental dental anomaly marked by apical displacement of the pulpal floor, enlarged pulp chambers, and root bifurcation or trifurcation near the apex. Its etiology involves genetic mutations, syndromic associations, or developmental disturbances of Hertwig’s epithelial root sheath. Diagnosis relies mainly on radiographic assessment, with CBCT offering superior accuracy, and indices such as Shaw’s and Shifman’s aiding classification. Clinically, taurodontism complicates endodontic, surgical, orthodontic, and restorative procedures and may indicate underlying systemic disorders. Early recognition and interdisciplinary planning are crucial to optimizing patient outcomes. DOI: ht
... Show MoreAbstract The League of Arab States took many procedures against the Syrian political system, like suspended Syria's membership in the League of Arab States and sent a team of Arab observers headed by Dabi to discuss the situation there and issued some decisions and statements that called the Syrian regime to stop the use of violence and repression against the Syrian opposition.Through these steps, the Arab League has tried to help the Syrian parties to resolve the crisis. However, the role of the league in the Syrian crisis was characterized by weakness in general, and lack of seriousness, which contributed in the aggravation of the situation in Syria, and the intervention of major powers in the internal affairs of Syria.
Water drainage pattern in the rivers and changed the nature of the renewed feeding areas
in the basin in terms of topographic and geological conditions and climate in addition to the
human role in organizing the process flow within these basins. This study addressed the
development of the Tigris River Hydrological in the city of Baghdad and found that the
annual rate of water drainage in the Tigris River was driven down very significantly,
especially in the past twenty years, and since 1996 up to 2014 record flow rates of less than
the overall rate of discharge of water, a (950 m3 / s ), in addition to the quarterly decrease the
discharge rates, especially since the beginning of the year 2000 and took converge all fo
The city of Ghana is one of the important commercial cities in the country of Sudan, as it was a major source of commercial exchanges, and a commercial mediator across the countries of the Maghreb and the metropolises of the countries of Sudan. Many, and most of them take the desert road, Which traders had to endure the hardships of these roads from the insecurity, high winds and dust that sometimes destroyed the trade convoys, in order to obtain gold, which is one of the most important minerals that Ghana traded with various countries, in addition to the different goods that the merchants carried In particular, salt and its trade with Ghana, and also taxes, which were an important financial resource imposed by some gov
... Show MoreThe Concept of the Constitution and the most Important of Human Rights