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 was conducted to delineate diversity and species composition of non-diatoms planktonic algae in Hoor- Al- Azime marshes, Iran. The samples were collected from four sites at monthly basis from April 2011 to March 2012. A total 88 taxa were identified, out of which (40 taxa, 45.45%) belonging to Cyanophyta followed by Chlorophyta (29 taxa, 32.96%), Euglenophyta (18 taxa, 20.45%) and (1 taxa, 1.14%) of Dinophyta recorded. Comparing species richness (65 taxa, 34.76%) at Shat- Ali (St4) was the highest and the lowest (34 taxa, 18.18%) was observed at Rafi (St2). Species occurrence was associated with temperature where in summer (66 taxa) and (25 taxa) encountered winter. The phy
Abstract To ensure that the distribution system has safe drinking water. It is necessary to know the residual chlorine concentrations at various points in the network. A chlorine photometer device was used to measure twenty points taken every day for a week at a selected time in the distribution system. Both pressures and flows in the network were measured using bourdon gauge and Tuf-2000H Handheld Digital ultrasonic flow meters. WaterGEMS CONNECT Edition update one software was used to simulate the flow in the network. The Baghdad water department provided the data about the network, such as the lengths of pipes, the layout of the network, and pipes diameters. The network calibrated consists of 781 pipes of different lengths and 542 juncti
... Show MoreThe subject of indication is one of many subjects that the Arabic language interest in and we decide that this research which we called (Indication of the abstract and Augmented Tri verbs) in one of Al-Quran Suras which is Al-moulk to dive in the secrets and knowledge of its meanings and knowledge of its structure in terms of abstraction and increase, And the investigation of our ancient scholars of linguistics and interpreters in its meanings. The verbss were classified according to the structure in which they were presented. The research includes two sections followed by the conclusion of the research, sources and its references. The first section (the indication of the abstract Tri verbs) in the sura is divided into four branches in w
... Show Morenouns , because deriving these names will lead to eternity which is impossible, and restrict the derivation only in agent nouns from their verbs, and the adjective names from their adjectives with the condition of truth in derivation.
The derivation of “Allah” names was denied due to a creed thoughts, because saying that “Allah” names is derived will not describe the eternal essence of “Allah”, and if it were derived this will make “Allah” is a Compound from his essence and Attributes.
The Al-Zaher people had recant the derivation of the agent nouns by preventing the derivation of “Allah” names because it will make “Allah” is a Compound from his essence and Attributes.
The Al-Zaher people had recant from
Heritage reflects peoples' memory and essence of nations. Thus, this divan was really the material and tool for writers in general and poets in specific both in their artificial innovations . Accordingly, modern writers have endeavored to bring heritage back in all its details and occurrences. Abdullwahab Al-Bayati's experience had reflected his innovative and strong link with the humanitarian heritage, in that heritage in view of Al-Bayati means both the humanitarian expertise and gains that are able to extend from past to future passing through the present.From this, the poet had not disconnected his strong link with the Arab poetic heritage .Thus, the poet had utilized the Arab poetic heritage in expressing on the Arab contrary realit
... Show MoreFor the past few years, the sediment began to accumulate in Al-Gharraf River which reduces the flow capacity of the River. In the present research, a numerical model was developed using Hec-Ras software, version 5.0.4. to simulate the flow and sediment transport in the upper reach of the river. The hydrological and cross-section data measured by the Ministry of Water Resources, for the reach located between Kut and Hai cities and having a length of 58200 m, was used to perform calibration and verification of the model. Moreover, field sampling of suspended and bed loads was gathered for five months starting from 7/2/2019, and laboratory tests of samples were conducted to be used as in
The environmental references represented by the intellectual, social, economic, political and religious pressures are considered fundamental factors for the artistic achievement whose importance comes from their multiplicity and branching into natural and psychological pressures that affect the multiplicity, diversity and variability of the artistic and performative methods. Thus they determine the artist's orientations and the creative artistic visions are summoned through symbols and semantic signs of the visual surface, because the societal thought in art in general and the fine art in specific occupies an influential position
... Show MoreBackground: A basic knowledge and understanding
of first aid can be invaluable for individuals to be
able to provide emergency care in the event of an
accident, possibly saving lives and minimizing
injury. Since injury is the fifth leading cause of death
and children at the age of primary school are liable
for accidents and lack of knowledge and good
judgment of their teachers may lead to dangerous
consequences when emergencies occur. Training
teachers how to deal with accidents is of obvious
importance.
Objectives: To estimate the adequacy of primary
school teachers’ knowledge of first aid concerning
external bleeding and fractures and Whether there's a
difference in knowledge in regard to yea
يتناول البحث شخصية شعرية وأدبية فذة هو محمد صالح بحر العلوم الشاعر العراقي المعروف والمولود في بيت ثوري من بيوتات النجف المعادية للاستعمار البريطاني في مطلع القرن العشرين، وينحدر من أسرة عريقة مشهورة بالعلم والأدب، عاش بحر العلوم شاعراً ينقل بصوره الجمالية كل ما يقع في حواسه، وتجربته تثري من اتصاله ببيئته فنجد الشاعر اشبه بالمصور يستمد صوره من واقع بيئته المتنوع. ونحن في بحثنا هذا نحاول أن نرصد أهم المصادر
... Show MoreBackground : The kidneys may be injured in abdominal trauma, both blunt & penetrating. Renal trauma may manifest in a dramatic fashion for both the patient and the clinician. Objectives: To evaluate the incidence, management, morbidity &mortality of renal injury in blunt & penetrating abdominal trauma.
Results:The majority o f patients were males (35= 77.8%), the rest were females (10= 22.2%). The average age was 37 years (range= 18-56 years). The most common grades were grade1, grade2 and grade3 (40=88.9%), while 5 patients (11.1%) were grades 4 and 5.The most common associated injuries were liver, spleen, small & large bowels and diaphragm. The mortality was 20% (9 patients). The most common cause of death was multip