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.
Variation in the numbers of pectoral fin spines and rays, pelvic fin rays, gill rakers on the first gill arch, anal fin rays, and the number of vertebrae of Silurus triostegus Heckel were examined in specimens from 16 localities that span its entire distribution range in the Tigris, Euphrates, and Shatt al-Arab rivers in Iraq. The mean number of the six meristic traits increases toward high latitudes with maximum and minimum values in the north and south of Iraq. Based on cluster analysis and PCA, the Mesopotamian river samples were clearly separated into three distinct groups. The upper Tigris populations were isolated from those of the middle and southern populations of this river and from those of
Al-Rustamiya sewage treatment plant (WWTP) serves the east side of Baghdad city (Rusafa) and is considered one of the largest projects.It consists of three parts (old project F0, first extension F1, and second extension F2) that treat wastewater and the
effluent is discharged into Diyala river and thus into the Tigris River. These plants are designed and constructed with an aim to manage wastewater to reachIraqi effluent standard for BOD5, COD, TSS and chloride concentrations of 40, 100, 60 and 600
mg/L respectively. The data recordedfrom March till December 2011 provided from Al-RustamiyaWWTP, were considered in this study to evaluate the performance of the plant. The results indicated that the strength of the wastewater enterin
We have found through research , that administrative institutions on the outskirts of Kufa and their management is not as important as administrative institution in place that were associated with it and subject to its control ,as it often was express power , or poor ( if true ) expression , directors of the center for the suburbs , as it became clear to our diversity of those administrative institutions and prominent role in the interest of the affairs of the people and society in all aspects of life , and are the functions and different staff from the highest authority the suburbs represented by house of representatives ( the workers ) ,then workers abscess and Al-dhaqan and not to mention for other jobs came the actions of Bhaltsier a
... Show MoreThe current research consists of four chapters, the first chapter of which is devoted to presenting the research problem, its importance, purpose and limitations as well as a definition of its terms, as the research was limited to knowing the effect of plant decoration in the Kufic script, while the second chapter included the theoretical framework of the research, which consisted of two topics, one of which is the plant decoration, The second relates to the Kufic script and the stages of its formation, development, and intonation. The third chapter includes the research methodology and mechanisms for analyzing the linear panels. The fourth chapter, during which the most important findings of the researcher were presented, are as follows
... Show MoreThis conducted research, (The Scientific Efforts of Ahmed Mustafa Al-Maraghi) deals with Al-Maraghi's life, birth, upbringing, characteristics, title, family and religion secter, as well as his general biography. And his relationship with scholars, his learning and teaching, and the introduction of the Muhammed Abdo School and the College of Dar Al Uloom, and finally the discussion of his scientific, social and political poin of view, as an interpreter of twentieths century, was appointed as the president of Al-Azhar and Ifta during the days of the royal era, and he studied at the College of Dar Al-Uloom
Low incoming discharge upstream of Samarra-Al Tharthar System leads to sediment accumulation and forming islands, especially an island upstream of Al Tharthar Regulator. This island and the sedimentation threaten the stability of the structure and reduce the efficiency of the system. This study aims to hydraulically identify the sedimentation problem mentioned above, to find solutions of how to control the sediment problems, and to develop the capacity of
the system for 500 years return period flood of 15060 m3/s. Surface Water Modeling System (SMS10.1) with two dimensional depth average models (RMA-2) software were used to simulate and analyze the system. The results of analysis showed that the maximum permissible discharge through t
Eminent figures in Quranic studies in the fourth century of the Hegira, in his
copacity as the founder of the essentials of the indicative approach in interpretation
which is based on the consideration of research principles in interpretation science.
Al-Qushayri participated in clarifying the promotions of this approach in his
works which represent this approach. The mast distinguished of these works is
Tafseer Lataef Al-Isharat. The researcher examined the characteristics of this
approach and its effect on the interpretative movement in Al-Qushayri age an come to
employ them as a practical example for the indicative approach in studying the
interpretation mebods in Islamic sciences.
The practical picture was clear in the statement of the foundations of moderation and its impact on the future of the nation, and in it a statement of the foundations on which moderation is based as the foundations for building moderation, the goals that moderation seeks and the desired results as a result of the applications of moderation. It was about the positive impact of moderation on the future of the nation in maintaining social balances such as economic, cultural and political balance and preserving freedoms.
Background :Evening preparation for colonoscopy is often unsatisfactory and inconvenient. This study was performed to compare the efficacy of bowel preparation at two different timings: night before and morning of endoscopy and to compare the cecal intubation rate and disturbance of sleep hours between these two groups.
Methods: In this prospective randomized endoscopist- blinded trial, 150 patients were enrolled between March 2010 and August 2011. Patients aged between 18 to 80 years needing colonoscopy were included. Patients with prior bowel surgery, suspected bowel obstruction or those who didn't completely fulfill the preparation instructions were excluded. Patients received polyethyelen glycol electrolyte preparation in a mornin