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.
Many writers and scientists hardly differentiate between the two instruments of use
(If) and (if) to convergence in the meaning, as they perform the meaning of the penalty and condition, as the answer relates to his condition, but when linguistic meditation we find a great difference in use in terms of meaning, so this research came to reveal these meanings and was extrapolated applied in Surat al-Maidah By counting the verses in which (if) and (if) the cops were given and looking at their contexts, the connotation of the cops in most places was within the context of probability, which is the origin of its use, given in twenty places of Surat al-Ma'idah, and it had multiple connotations according to the contexts of the verses received
The study focuses on identifying the reality of administrative creativity of secondary schools' managers in Al-zarqaa province. The descriptive approach was adopted to conduct this study. To achieve the study objective, the author designed a questionnaire composed of (24) items included (4) domains applied on (80) male and female school managers were selected randomly. The results showed that the administrative creativity level of secondary school's managers over all domains were too high which ranked as school management domain followed by public community domain then teacher domain and finally, school environment domain. Additionally, each of male, private sector, and experience over 10 years revealed significant differences.
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.
Aim of the present study is Identification of specific gene for GPCR using specific primers .and identification of difference in PCR analysis in patients with heart thrombosis and compared with healthy, Sequencing of PCR product regarding GPCR compared for all three subject, Identification the similarity of human GPCR with local strain of yeast fifty healthy control and fifty patients with thrombosis which diagnosed medically with cardiac specific troponin t, troponin 1 levels and electro myocardiogram ECG. The aged for all subjects ranged (39-75) years patients were lying in cardiac care unit at Ibn- al- Nafees teaching hospital and Sheikh Zayed teaching hospital. Genomic DNA of whole blood was extracted from buffy coat and cell cu
... Show MoreAdolescence important and sensitive stage in social terms, being a stage where learns teenager bear social responsibilities and composition of their ideas about family life, as well as it is the stage where the teenager looking to himself for an important place in the community to become independent socially people, so it highlights the role of Social Work to do better effort and I believe him in order to prepare for the adolescent stage of adolescence and help him overcome the problems so that makes it adapts to the society in which he lives
In this paper, the relationship between urban growth, land use, site availability, and impacts on the general appearance of the city generated by functional characteristics of port cities were analyzed. Various data were used to identify patterns of land use change and city growth and expansion. The research aims to analyze the impact of the port on the growth of the city, study the urban growth of the city of Umm Qasr and predicting the growth trends, and to identify the most influential factors in this growth. The study dealt with the concepts of urban growth and the factors that characterize the growth of port cities and the current situation of the city. The practical part included the mechanisms used by the researcher to analyze the
... Show MoreBesides the role of state institutions that come in the forefront of their priorities and obligations to provide security and development of the economy and reduce the unemployment rate and the reduction of inflation and improving education, health and others, the Community Partnership At frames what has become known as the institutions of society civil-with the state does not eliminate the role, but rather complements its role ; it is the role of civil society partner and an extension of the role of the state in the face of challenges and crises, but it may be sometimes a race role in addressing social, political and economic issues of the role played by the state, not complementary.
The highlighting the specificity of the relationsh