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.
Electrical distribution system loads are permanently not fixed and alter in value and nature with time. Therefore, accurate consumer load data and models are required for performing system planning, system operation, and analysis studies. Moreover, realistic consumer load data are vital for load management, services, and billing purposes. In this work, a realistic aggregate electric load model is developed and proposed for a sample operative substation in Baghdad distribution network. The model involves aggregation of hundreds of thousands of individual components devices such as motors, appliances, and lighting fixtures. Sana’a substation in Al-kadhimiya area supplies mainly residential grade loads. Measurement-based
... Show MoreThis study examines the relationship between the increase in the number of tourists coming to Tunisia and GDP during the period 1995-2017, using the methodology of joint integration, causal testing and error correction model. The research found the time series instability of the logarithm of the number of tourists coming to Tunisia and the output logarithm but after applying the first differences, these chains become stable, THUS these time series are integrated in the first differences. Using the Johansson method, we found the possibility of a simultaneous integration relationship between the logarithm of the number of tourists coming to Tunisia and the logarithm of GDP in Tunisia, and there is a causal relationship in one direc
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Abstract:
We can notice cluster data in social, health and behavioral sciences, so this type of data have a link between its observations and we can express these clusters through the relationship between measurements on units within the same group.
In this research, I estimate the reliability function of cluster function by using the seemingly unrelate
... Show MoreThe waste sorting and recycling plant in the district of al- Mahmudiya (Yusufiya) is the only laboratory in Baghdad governorate. It is the only one in Iraq that collects and recycles waste. After sorting, we have packages of raw materials (aluminum cans, glass bottles, plastic bottles, Nylon bags) as well as natural fertilizers (food residues and others) and a sanitary landfill with specifications that meet international standards; However, the absence of a structure for the management of the plant (manager, assistant manager, accountant, etc.) in addition to the non-supply of waste on a daily and continuous basis and the lack of cooperation of the Municipality of Baghdad with the management of the plant led to delay in the work
... Show MoreThe moon tree, the lover of the night, cholera, the sea changes its colors are poetic products left by the pioneer of free poetry, as many have called her. She used to write poetry and publish it in magazines and newspapers until she published it with collections that came into existence from an early age. Several factors helped her in that that contributed to the formation of her personality and the maturity of her talent, including factors Family, including environmental, and psychological, until she later became the focus of attention of many, so she became taught in the universities of London, and students stood by her method of writing free poetry, this poetic color that Badr Shaker Al-Sayyab participated in pioneering. Whoever exam
... Show MoreThe levels of shooting in basketball not very good appears un healthy phenomenon for age stages especially youth players on Iraq and therefore there is lower level in skills especially shooting that seems the players represent their players not good levels which cause difficult in choosing players for youth national team. The research sample were youth teams in Baghdad for season 2012-2013 their birth 1996 and the number teams (7) and after getting results and treat it statically the important ones were : there is a large number of failure attempts on success ones in basic shooting in basketball for youth teams in Baghdad teams (2012-2013) season and basic shooting have effective participation (positive relation) in youth teams ranking in B
... Show MoreThe research aims to presenting a number of scenarios for the investment of the marshes. The problem of research problem was that there is no in-depth analysis of the marshes environment. The traditional methods of the environmental analysis are insufficient. The research community is represented by the decision makers in Maysan Governorate. The research led to proposing of three scenarios with statement the requirements for the success of each one. The most important conclusions are that the three proposed scenarios for marshes investment depend on the availability of the required volunteers for each scenario. The higher the availability of the requirements, the more optimistic the scenario becomes. If t
... Show MoreThe objective of this study is to attempt to provide a quantitative analysis to the causes of unemployment in Iraq and its mechanisms of generation, as well as a review of the most important types of both visible and invisible unemployment, and an attempt to measure the disguised unemployment and analyze the causes. The problem of the research lies in the fact that the Iraqi Economy has been suffered for a long time although its characterized by abundant physical and natural resources, from the existence of the phenomenon of unemployment in the previous two types. Causing a lot of economic problems, represented by the great waste of resources and
... Show MoreFounding a System to secure deposits and protecting the depositors is considered one of the important and exchanged subjects out there in the banking system/field in Iraq at the current time, and the reason behind the exchange and spread of this subject is due to the financial crisis of which the banking sector is suffering from and the stumbling of many banks, those factors have had led to the insecurity of the depositors and their mistrust towards banks, thus, it is necessary to create a system to secure deposits in which depositors would be compensated for the losses caused by the banks' failures. in addition, it could be a countermeasure system which maintains the banking stability, protects the rights of depositors and gains
... Show MoreAims: Assess selected measures of oral health: Enamel defect, eruption of permanent teeth, dental caries, investigate the nutritional status of orphans by physical examination and relate the nutritional status with measures of oral health.
Materials and methods: 192 orphans aged of 6 and 12 who were living in all orphanages in Baghdad, Iraq, were studied. Enamel defect was derived from the WHO's modified developmental defects of enamel (DDE) index, investigation of caries using Decay -Missing – Filled index for permanent teeth (DMF), the decay-missing filled index for primary teeth (dmf) index and all of the perm