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.
In light of this, attention should be paid to tax reform as part of a comprehensive economic reform program. Therefore, the research started from the problem of the weak efficiency of the tax reform process in the General Authority for Taxation, as well as the need to know the addition of new taxes or increase taxes.The research aims study the relative importance of each disabled person, whether organizational, human, financial, legislative or technical. The research led to a number of conclusions, the most important of which were that the financial obstacles occupy the highest importance of the other obstacles and for the success of the tax reform, the material resources must be provided in order to provide the n
... Show MoreIraqi EFL teachers face problems in teaching “English for Iraq Series” for primary public school pupils. In this paper, the researchers are going to identify the main problems faced by our teachers and try to find solutions to these problems. To achieve the aim of the study, list of questions asked and from teachers’ responses, the researchers have got an idea about the main problems which are related to textbook material, parents, learners, environment and technology. Therefore, the researchers adapted a questionnaire to achieve the purpose of the study with some changes and modifications. This questionnaire with five point scale (strongly agree, agree, undecided, disagree, strongly disagree). To achieve face validity, the
... Show MoreThe Cenomanian – Turronian sedimentary succession in the south Iraq oil fields, including Ahmadi, Rumaila, Mishrif and Khasib formations have undergone into high-resolution reservoir-scale genetic sequence stratigraphic analysis. Some oil-wells from Majnoon and West-Qurna oil fields were selected as a representative case for the regional sequence stratigraphic analysis. The south Iraqi Albian – Cenomanian – Turronian succession of 2nd-order depositional super-sequence has been analyzed based on the Arabian Plate chronosequence stratigraphic context, properly distinguished by three main chrono-markers (The maximum flooding surface, MFS-K100 of the upper shale member of Nahr Umr Formation, MFS-K140 of the upper Mishrif carbonate
... Show MoreAbstract: Israel formulated its security theory, which it established on the "pretext of war", meaning converting any Arab action that Israel deems a threat to its security, into a pretext to ignite the fuse of war, considering this a violation of an existing situation, and then it initiates preventive and pre-emptive attacks, then immediately turns into transfer the war to the enemy's land, to achieve a quick solution by (destroying the enemy), occupying its lands, and benefiting of the advantage of working on (internal lines against an enemy) working on external lines, and ending the war quickly, before the major powers intervene to impose a ceasefire
In this study water quality index (WQI) was calculated to classify the flowing water in the Tigris River in Baghdad city. GIS was used to develop colored water quality maps indicating the classification of the river for drinking water purposes. Water quality parameters including: Turbidity, pH, Alkalinity, Total hardness, Calcium, Magnesium, Iron, Chloride, Sulfate, Nitrite, Nitrate, Ammonia, Orthophosphate and Total dissolved solids were used for WQI determination. These parameters were recorded at the intakes of the WTPs in Baghdad for the period 2004 to 2011. The results from the annual average WQI analysis classified the Tigris River very poor to polluted at the north of Baghdad (Alkarkh WTP) while it was very poor to very polluted in t
... Show MoreThe main aim of the current research is to focus the light on some bacterial contamination on cracked eggshell and egg content plus studying the sensitivity of these bacterial isolates to antibiotics. For this purpose, a total of 50 eggs were collected from the markets in Baghdad city (Iraq) and examined for bacterial isolation from cracked eggshells and from the egg contents. The bacterial isolates were cultured and purified then transferred to a specific media to study its sensitivity against antibiotics. The results revealed that bacteria isolated from both cracked eggshells (46%) and egg contents (44%). The bacteria isolated include E. coli, Staphylococcus, Enterococcus faecalis, Enterobacter and Pseudomonas. The results of antibiotic s
... Show MoreThe research involved attempt to inhibit the corrosion of Al-Si-Cu alloy in 2.5x10-3 mol.dm-3 NaOH solution (pH=11.4) by addition of six different inhibitors with three concentrations (1x10-3, 1x10-2, and 0.1 mol.dm-3). These inhibitors include three organic materials (sodium acetate, sodium benzoate, and sodium oxalate) and three inorganic materials (sodium chromate, disodium phosphate, and sodium sulphate). The data that concerning polarization behaviour are calculates which include the corrosion potential (Ecorr) and current density (icorr), cathodic and anodic Tafel slopes (bc & ba), and polarization resistance (Rp). Protection efficiency (P%) and activation energy (Ea) values were calculated for inhibition by the six inhibitors. The
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