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Evaluating the Clinical Outcomes of Three Medication Regimens for Treating a Sample of Iraqi Persistent Asthmatic patients
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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.   

 

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The Effect of Time and Place Dimensions on Changing the Quality Dimensions of Sizes of Cities: A Case Study (Baghdad city)
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The city has normal natural state, and the man has a usual movement, change and search for the new .Also, the city has a usual change and transform in its time, place and quality (sizes)structures. The city has a solid memory diving into the past and the future and reflects The real present, and this memory has a timing layers change into real materialistic place making the city has accumulated overlapping circles which is hard to break u , and it broadcasts the lockup timing density ,in which there is no visual record precisely, it is just like((the social record)) that evaluates the un visual relationships between the components and parts of the city (community and form) in a visual quiet exhibition and transform change inside.

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Wed Dec 27 2023
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ANALYSIS OF THE HYDRAULIC CHARACTERISTICS OF AL MAHAWIL STREAM USING HECRAS: A FIELD STUDY
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Sat Jun 01 2019
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Thu Dec 31 2020
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Malaysia and the countries of the Middle East are a vision towards understanding the factors affecting the pattern of the relationship
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A careful study of the effect of the infectious diseases and refuge on the dynamical behavior of prey-scavenger modeling
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