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.
The problem of the research is focused on importance limited of Iraq industrial companies in application of scientific measurements of supply chains performance, The research sought to achieve a group of goals, the most important are , identifying the strengths and weaknesses in the reality of supply chain in General Company for Cotton Industries, The data and information required are gathered from the dependence company, records through the field observations and personal interviews, the research used some quantitative indicators to measure of supply chain performance, The research reached to many conclusions , the most outstanding among them is the existence of a strong inverse correlatio
... Show MoreEngineering equipment is essential part in the construction project and usually manufactured with long lead times, large costs and special engineering requirements. Construction manager targets that equipment to be delivered in the site need date with the right quantity, appropriate cost and required quality, and this entails an efficient supplier can satisfy these targets. Selection of engineering equipment supplier is a crucial managerial process .it requires evaluation of multiple suppliers according to multiple criteria. This process is usually performed manually and based on just limited evaluation criteria, so better alternatives may be neglected. Three stages of survey comprised number of public a
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The aim of the research to define the concept of moral intelligence and its dimensions and its relationship to some personal characteristics with the internal auditors and identify the importance of the employment of moral intelligence dimensions of (empathy, conscience, self- control, respect, kindness, tolerance, fairness) in the internal audit and the extent of support for the performance of the internal audit process in light of these dimensions. And that by answering the following question : Is there a role for moral intelligence of internal auditors in support the performance of internal audit process ? How are employ these dimensions i
... Show More- Identifying the visual culture skills of students of the College of Education for Pure Sciences / Ibn Al-Haytham.
- Identifying the statistically significant differences in the visual culture skills of students of the College of Education for Pure Sciences / Ibn Al-Haytham according to the gender variable.
And the descriptive approach was used, due to its relevance to the nature of the research objective.
To verify this, the visual culture skills test consisted of (22) items of the multiple choice type, where the (Koder Richardson 20) equation was applied to calculate the stability of the visual culture skills test. For the skill of writing
This study is concerned with the effect of adding two kinds of ceramic materials on the mechanical properties of (Al-7%Si- 0.3%Mg) alloy, which are zirconia with particle size (20μm > P.S ≥ 0.1μm) and alumina with particle size (20μm > P.S ≥ 0.1μm) and adding them to the alloy with weight ratios (0.2, 0.4, 0.6, 0.8 and 1%). Stirring casting method has been used to make composite material by using vortex technique which is used to pull the particles to inside the melted metals and distributed them homogenously.
After that solution treatment was done to the samples at (520ºC) and artificial ageing at (170ºC) in different times, it has been noticed that the values of hardness is increased with the aging time of the o
... Show More Heat exchanger is an important device in the industry for cooling or heating process. To increase the efficiency of heat exchanger, nanofluids are used to enhance the convective heat . transfer relative to the base fluid. - Al2O3/water nanofluid is used as cold stream in the shell and double concentric tube heat exchanger counter current to the hot stream basis oil. These nanoparticles were of particle size of 40 nm and it was mixed with a base fluid (water) at volume
concentrations of 0.002% and 0.004%. The results showed that each of Nusselt number and overall heat transfer coefficient increased as nanofluid concentrations increased. The pressure drop of nanofluid increased slightly than the base fluid because
Determination of the level of adipokines (obestatin, vaspin, tumor necrosis factor-? and interleukin-6)in hypo-and hyperthyroid patients from Educational Baghdad Hospital in Baghdad City was investigated. Fifty patients with hypothyroidism and Fifty patients with hyperthyroidism were selected. A control group of thirty euthyroid persons was included. Blood was collected by vein puncture and serum was separated and stored at –20C. Adipokines (obestatin, vaspin, tumor necrosis factor-? and interleukin-6) were estimated using ELISA method. The findings show a significant (p<0.05) increase in obestatin level in hypothyroid patients, while there is no significant difference in hyperthyroid patientsas compared with the euthyroid subjects.
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The problem of the study is the main question (Can tourism planning address the phenomenon of unemployment in Iraq ?) , And the importance of the study in the fact that the tourism sector can become an effective development alternative in many countries, especially Iraq, as tourism contributes to diversify sources of income and stimulate other economic sectors , We know how important Iraq's qualifications are in the field of tourism and what it can generate on the public treasury, To confirm the current study on the need to pay attention to tourism planning for its role in providing employment opportunities that reduce the unemployment rate in the future.
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