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.
Seven fish species were collected from the drainage network at Al-Madaen region, south of
Baghdad with the aid of a cast net during the period from March to August 1993. These fishes
were infected with 22 parasite species (seven sporozoans, three ciliated protozoans, seven
monogeneans, two nematodes, one acanthocephalan and two crustaceans) and one fungus
species. Among such parasites, Chloromyxum wardi and Cystidicola sp. are reported here for
the first time in Iraq. In addition, 11 new host records are added to the list of parasites of
fishes of Iraq.
This research was carried out to reveal the the technique of the recitation in this story including a preface, introduction, two chapters and the conclusion. the introduction consisted of the problem, significance , purpose and limitations of research. The preface included two paragraphs. The first included a meta-recitation of terminology and semantic. The second paragraph devoted to show the cultural identity of Hussein Rahim. The first chapter aimed to reveal the reality and the imaginary in the story of Na'lat Al Hakawaty (storyteller's curse). The second chapter aimed to study the strange arguments in the story. The research concluded the conclusion by presenting the results for attaching them with the margins, and the references
... Show MoreOBJECTIVE: To evaluate the patient satisfaction to hospital services and identify factors that influences this satisfaction.
Man was closely associated with nature in its various forms, as it represented the incubator for him in all areas of his life, so writers often made it a material for their literature and a fertile ground for their productions, so it appeared in its various forms and man’s need for it, its good and its bad in literature throughout history, and the Arabs are like Other nations, since the pre-Islamic era, nature was an important outlet and a refuge for poets in the production and creativity of literature and to this day, and when we talk about a poet from the Fatimid state, we find that nature - especially spring and its flowers - in that period took its take from literature and represented a phenomenon for many Among the
... Show MoreThis study included the Zakhikhah area in the Al- Anbar desert, which it bounded on the north, east, and west by the Euphrates River and on the south by the Ramadi-Qaim road. Several exploratory field trips were taken to the study area. During this time, a semi-detailed area survey was carried out based on satellite imagery captured by American Land sat-7, topographic maps, and natural vegetation variance. All necessary field tools, including a digital camera and GPS device, were brought to determine the soil type and collect plant samples. All of these visits are planned to cover the entire state of Zakhikhah. All vegetation cover observations, identifying sampling sites and attempting to inventory and collect medicinal plants in t
... Show MoreBackground: laparoscopic cholecystectomy (LC) is getting popularity for the treating of symptomatic gall bladder disease; conversion from laparoscopic to open cholecystectomy (OC) is also common.
Objective : To find out the prevalence of causes, risk factors of conversion from LC to OC among patient suffering from gall bladder disease, and to explore the most common causes of conversion from laparoscopic to open cholecystectomy.
Methods: This prospective study was conducted in the department of general surgery at Alkindy teaching hospital from first of January 2016 to the end of December 2017 .Nine hundred twenty patient were included. Patient age, gender, his
... Show MoreThe form imposes its importance in the structure of the artwork through its indication of the type of relationship between the artist and his external world in all its aspects, as well as its manifestation of artistic and aesthetic values, and the multiplicity of experimental means of expression that include the artist's feelings and imagination. The form is also a recording of the events in their temporal and spatial circumstances, and in that it is of value in directing his artistic discourse with the aim of influencing the recipient with its connotations and emotional states. Horses in the drawings of Amer Al-Obaidi, and the research came within two frameworks: The first framework is the methodological framework that represents us t
... Show MoreThe research studies the melody and rhythmic characteristics in the songs of the Baghdadi quartet, as it is a type of popular singing in Iraq, reviewing its origins, social purposes, special and public events in which it is performed. The methodological framework included the problem of the research, the need for it, its importance, its purpose, and the limits of the research which included the objective limit: the songs of the Baghdadi quartet, the spatial limit: the city of Baghdad and the temporal limit (1960-1980) and identifying the terms included in the research.
The theoretical framework consisted of three items: the first is the popular singing, the second is the Iraqi popular singing and the third is the Baghdadi quartet. It