Abstract Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions. Objective: compare the clinical outcome and the costs of two anticoagulants (heparin and (enoxaparin)) used to treat hospitalized patients with COVID-19 infection. Patients and method: The study was a retrospective review of medical records of adult, non-pregnant, COVID-19 infected hospitalized patients who had baseline and last outcome measurements at Alamal Epidemiology Center, Al-Najaf city from (Augast 2020 to June 2021). The outcome measures included D-dimer, length of stay (LOS), and mortality rate. Only the cost of the medical treatment was considered in the analysis. The pharmacoeconomics analysis was done in three different cost-effectiveness analysis methods. Microsoft Excel spreadsheet and Statistical Package for the Social Sciences software (SPSS), was used to conduct statistical analysis. Kaplan Meier test was used to compare the mortality rate. T-TEST was used to compare the outcomes of the two groups. Results and discussion: two groups were compared, the first group consists of 72 patients who received heparin, and the second group consists of 72 patients who received enoxaparin. COVID-19 infected patients had a higher abnormal average D-dimer (2534.675 ng/dl). No significant differences between both genders with regards to the basal average D-dimer (males= 2649.95 ng/dl, females= 2374.1mg/dl, P-value>0.05). There was a significant difference between patient's ages 60 years and patients <60. (3177.33 ng/dl, 1763.06 ng/dl, P-value <0.05). It seems that, higher D-dimer levels were associated with a higher mortality rate (died=3166.263 ng/dl, survived= 1729.94 ng/dl, P-value <0.05). Heparin was more effective in decreasing D-dimer levels than enoxaparin which inversely increased the D-dimer levels (-24.4 ng/dl/day, +154.701 ng/dl/day, P-value <0.05). Additionally, heparin was more effective in increasing the survival rate compared to enoxaparin (55% vs, 35%, P-value<0.05). Heparin was associated with a longer duration of stay in hospital than enoxaparin but with no significant difference (13.7 days, 12.3 days, P-value >0.05). Concerning the cost, treatment with heparin cost less than enoxaparin (2.08 U.S $, 9.44 U.S $)/per patient/per day. Conclusion: Originator heparin was a more cost-effective anticoagulant therapy compared to originator enoxaparin, it was associated with a lower cost and better effect, treatment with Heparin resulted in positive INB= 11.3, where a positive result means that heparin is more cost-effective than Enoxaparin. All three methods of pharmacoeconomic analysis decide that heparin was more cost-effective than enoxaparin in treating COVID-19 infected patients.
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Accelerates operating managements in the facilities contemporary business environment toward redefining processes and strategies that you need to perform tasks of guaranteeing them continue in an environment performance dominated by economic globalization and the circumstances of uncertainty attempt the creation of a new structure through multiple pages seek to improve profitability and sustainable growth in performance in a climatefocuses on the development of institutional processes, reduce costs and achieve customer satisfaction to meet their demands and expectations are constantly changing. The research was presented structural matrix performance combines methodology Alsigma in order to improve customer satisfaction significantly bet
... Show MoreObjective: To evaluate the effectiveness of educational program on female students’ knowledge toward premenstrual syndrome.
Methodology: A quasi-experimental design study conducing on (140) student purposely in four secondary schools at Al-sadder city (70) student for study group and (70) for control group. The prevalence of PMS selected through American College of Obstetricians and Gynecologists (ACOG) (2015) criterias to select PMS students before program. The education program were set in four steps, the first step (pre-test) is to assess the knowledge , before the implementation of the program, the second step is implementing the program, following two steps post-test I and II between each test two weeks. Validity is determined
The role of filamentous bacteria represented by Streptomycessp was studied as biological treatment for activated sludge AL- Restomia treatment unit in Baghdad city. The result shows reducing in phosphate concentration where apprise in started entrance the treatment unit 12.083 mg/L fast the unit stages reached to 8.426 mg /L where nitrate concentration apprises 3.59 mg/l and ending in 2.43 mg/L The concentration of ammonia apprises 1358 mg/L and reached to 140 mg/L. also the TDS concentration reduced from 1426 to 1203 mg/L where nutrient which represented (SO4, Mg, Ca, Na, K) reduced by range 30.883- 23.337 , 194- 121 , 440- 321 , 109.03- 101.53 and 16.85- 15.4mg/L respectively COD reduce from427.263- 82mg/L with absorbance0.018- 0.027
... Show MoreClean water supply is one of the major factors contributing significantly to society’s socio-economic transformation by improving living standards, health, and increasing productivity. It is imperative to plan and construct appropriate water supply systems in modern society, which supply various segments of society with safe drinking water according to their requirements to ensure adequate and quality water supply. In the current study, here was an attempt to develop a model for geographic information systems to manage the assets of the water distribution networks in the Karrada region and to evaluate the network geometrically, and from the results of the engineering analysis of the
Success in selecting the best among the sources of supply is one of the most important factors in the efficiency of the procurement activity in the company, because the proper selection of the source of the supply significantly affect the achievement of what is desired by the factors of quality, quantity, price and service, and the ability of the competent supplier to meet everything associated with this Factors of commitments, hereby supporting the procurement function's efforts to fully discharge its responsibilities, and in view of adopting of Al-Furat company quality management system by applying the standards of ISO (9001: 2015) and purpose of getting the on-demand benefits from the application of international standards reg
... Show MoreBackground: (ABO) Blood type have an effect on general health including oral health as salivary physicochemical characteristics differ among different type of blood and as consequence these affect the severity of dental caries. The aim of the present study is an assessment of the prevalence of caries experience among different blood type in relation to salivary physicochemical characteristic. Materials and Methods: Two hundred and fifty females' college students in Al-Qadisyia University aged 18 years old were selected on random basis; they were divided to four groups according to their blood type, Dental experience was diagnosed and recorded according to DMFs (Mülemman, 1976) Index, this allows recording decayed lesion by severity. A su
... Show MoreIn this study water quality was indicated in terms of Water Quality Index that was determined through summarizing multiple parameters of water test results. This index offers a useful representation of the overall quality of water for public or any intended use as well as indicating pollution, water quality management and decision making. The application of Water Quality Index (WQI) with sixteen physicochemical water quality parameters was performed to evaluate the quality of Tigris River water for drinking usage. This was done by subjecting the water samples collected from eight stations in Baghdad city during the period 2004-2010 to comprehensive physicochemical analysis. The sixteen physicochemical parameters included: Turbidity,
... Show MoreIn this study water quality was indicated in terms of Water Quality Index that was determined through summarizing multiple parameters of water test results. This index offers a useful representation of the overall quality of water for public or any intended use as well as indicating pollution, water quality management and decision making. The application of Water Quality Index
(WQI) with sixteen physicochemical water quality parameters was performed to evaluate the quality of Tigris River water for drinking usage. This was done by subjecting the water samples collected from eight stations in Baghdad city during the period 2004-2010 to comprehensive physicochemical analysis. The sixteen physicochemical parameters included: Turbidity, A