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.
This study estimated seven heavy metals (Fe, Cu, Zn, Pb, Ni, Cd, Cr) in water (dissolved and particulate phase), sediments and some aquatic organisms including two species from aquatic plants (Ceratophyllum demersum&Phragmites australis); one species of clam (Psedontopeses euphratics) and two species from fish (Oreochromis aureus& Leuciscus vorax)in four sites within Mashroo AL- Musayyib channel project/ branch of Euphrates river, Babylon , medial of Iraq . This aims to show the concentration of these elements, their fate and the mechanisms of their transmission through the food chain in this lotic aquatic system ; also in addition to examining some physicochemical properties of ri
... Show MoreSoil invertebrates community an important role as part of essential food chain and responsible for the decomposition in the soil, helps soil aeration , nutrients recycling and increase agricultural production by providing the essential elements necessary for photosynthesis and energy flow in ecosystems.The aim of the present study was to investigate the soil invertebrates community in one of the date palms plantation in Aljaderia district South of Baghdad, , and their relationships with some physical and chemical properties of the soil , as Five randomly distributed replicates of soil samples were collected monthly. Invertebrates samples were sorted from the soil with two methods, direct method to isolate large invertebrates and indirec
... Show MoreThe Green Productivity topic is considered as one of the more conceptual novelty in the field of Production and Operations Management, and one of the least topics addressed in the literature competent, Green Productivity (GP) is a strategy for enhancing a business's Productivity and environmental performance at the same time, for overall socio - economic development, It is the application of appropriate techniques , technologies , and management systems to produce environmentally compatible goods and services. the research aimed to find the contribution of this concept for success the industrial Organizations.
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The internal control is the tool through which it is possible to verify and ensure the implementation of tasks in accordance with the established plans and programs and to evaluate the level of performance that is implemented within the different companies.
A guarantee from the supplier with the absence of a specialized technical committee that follows up the stages of implementing the contract and disbursing all amounts of financial dues to the supplier before completing the implementation of the contract and overlooking the non-implementation of some clauses of the contract by the committee in charge of
... Show MoreCosmetic products contain variable amounts of nutrients that support microbial growth. Most contaminants in cosmetic products include bacteria such as Staphylococcus, Pseudomonas, Klebsiella, Achromobacter and Alcaligenes. Contaminated water is a likely source of organisms found in cosmetic products. Products such as shampoo, hand and body lotion, facial cleanser, and liquid soaps were analyzed. In this study, out of 60 cosmetic products analyzed, 26.4% were found to be contaminated. Most of the contamination was from bacteria and no fungal contamination was detected. The highest level o
... Show MoreConcentrations of heavy metals (Copper Cu, Iron Fe, Manganese Mn, Cadmium Cd, and Lead Pb) have been studied in river crab Sesarma boulengeri (Outer part of the shield and interior tissues) which caught from two stations in Shatt Al – Arab river (Salhia and Aldeir areas). Elements concentrations were measured by Flame Atomic Absorption Spectrophotometer, concentration of heavy metals in the internal tissues was higher than in the outer shield in both of the stations with the highest value of the elements was to iron 95.21 mg\ kg during the spring as well as copper was 55 mg\kg and manganese was 39.09 mg\kg. The study showed the presence of seasonal changes in the studied heavy metals concentrations values in the tissues of river crab;
... Show MoreWater samples were collected from output of water for Al-Wahda plant where located in al-karrada area in Baghdad city to study water contamination with bacteria, fungi and Algae. The study lasted one year started on August, 2016 to July,2017.Results were acquired according to two tests performed, the first is biological test included total coliform,E.coli, pseudomonas aeruginosa, total fungi, Diatom and non Diatom Algae and the second is physiochemical test included temperature, turbidity and residual chlorine. The results of bacteria were within the permitted specification in the Iraqi standards no. 14/2270 for the year 2015 except August was exceeded the permitted standard for total coliform, it was 1.1< cell/100 ml.Total Fungi, Dia
... Show MoreTopic management is the awareness of how speakers deal with initiating, developing, changing, and ending a topic and how they fix the relationship when a misunderstanding occurs. It is such an important unit of conversation as it includes the transition from one strategy to the other to be accomplished in a systematic and orderly manner. These strategies are impaired in dementia patients thus lead to communication breakdown. This study aims at detecting the dementia patients' topic management strategies in selected speeches and answering the questions of which of these strategies are fully or partially detected in these speeches. The researchers use a qualitative method to examine the speeches of those patients and they adopt an eclectic
... Show MoreEfforts of evaluating manuscripts have developed into sciences that take interest into the development of authorship movement. Expanding the rules and fundamentals of this scientific process along with the growing use of modern methods and techniques contributed further to its development.
Such a disciplinedemands comprehensive knowledge in various fields to reach the most valid results that help reveal significant aspects of the cultural heritage since such a process is an ethical responsibility .Therefore, the editor has to be patient and honest in correcting mistakes, choosing the most acceptable narration and pinpointing the additions and differences as well as other requirements of serious editing.
The study was divided into a