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 research aims to analyse the problem of organizations in general and universities in particular, in dealing with �quality subjects� in a world where these organizations face the risks of becoming side lined and possibly vanished without looking for solutions that allow them to move in an open arena where change becomes the key to those solutions. Change here must be strategic and planning must adopts a way for organizations to develop mechanisms to manage change itself. Management leaders play a central role in achieving the principle required to chart new trends for universities in dealing with quality as a strategy that allows excellence and competition in light of the success of the processes of change. Change through reengineer
... Show MoreSimulation Study
Abstract :
Robust statistics Known as, Resistance to mistakes resulting of the deviation of Check hypotheses of statistical properties ( Adjacent Unbiased , The Efficiency of data taken from a wide range of probability distributions follow a normal distribution or a mixture of other distributions with different standard deviations.
power spectrum function lead to, President role in the analysis of Stationary random processes, organized according to time, may be discrete random variables or continuous. Measuring its total capacity as frequency function.
Estimation methods Share with
... Show MoreThe present study addresses the behavior of gases in cultivation media as an essential factor to develop the relationship between the microorganisms that are present in the same environment. This relationship was explained via mass transfer of those gases to be a reasonable driving force in changing biological trends. Stripping and dissolution of oxygen and carbon dioxide in water and dairy wastewater were investigated in this study. Bubble column bioreactor under thermal control system was constructed and used for these processes. The experimental results showed that the removal of gases from the culture media requires more time than the dissolution. For example, the volumetric mass transfer coefficient for the removal
... Show MoreThe main challenge is to protect the environment from future deterioration due to pollution and the lack of natural resources. Therefore, one of the most important things to pay attention to and get rid of its negative impact is solid waste. Solid waste is a double-edged sword according to the way it is dealt with, as neglecting it causes a serious environmental risk from water, air and soil pollution, while dealing with it in the right way makes it an important resource in preserving the environment. Accordingly, the proper management of solid waste and its reuse or recycling is the most important factor. Therefore, attention has been drawn to the use of solid waste in different ways, and the most common way is to use it as an alternative
... Show MoreThis search in the virtues of the daughter of the Prophet Muhammad, to read on their boards want to recount loving and faithful), as stated in the introduction to the author, Abdullah Bin Ibrahim Al-Mirghani (D. 1207 H.) to give reasons in writing the manuscript, which was of an introduction and three chapters and a conclusion was the first in the door thanks to the great lady and on her birthday and her marriage and her death and subsequent events and the third in her them prayers and then the finale which was in love with the Prophet and calling for God to pardon and forgiveness and a good end. I was interested in this manuscript by Mirghani, Hadith and all accounts in reference to the virtues of the great lady to examine a manuscript
... Show MoreResearch Summary
Praise be to God, and may blessings and peace be upon our master Muhammad al-Mustafa, his family, his companions, and those who follow his gift until the Day of Judgment.
As for the dimension: This is a historical description of my conquest (Al-Khandaq and Ba
... Show MoreObjective(s): To measure the level of job satisfaction and job performance of nurses and to find out
the association between participants' socio-demographic characteristic of nurse and their job
satisfaction and job performance.
Methodology: A descriptive analytic study design was carried out to measure the nurses' level of job
satisfaction and job performance in Al-Suwaira general hospital and to find out the association between
nurses and their socio-demographic characteristic. The study was started from March 5th, 2017 to
September 31th, 2017. The sample was Non - probability (purposive) sample of (100) nurses were
selected according to the study that are actual working in nursing department in Al-Suwaira General<
Abstract. Shatt Al-Arab River was the most important tide river in Iraq, it suffered from neglect and lack of maintenance in the past decades. The river embankment is constantly exposed to erosion processes due to several factors, one of the most important of these factors is the movement of water currents due to the tidal energy coming from the Arabian Gulf. In this study, one dimension unsteady-state model was implemented to study river flood capacity simulation by using HEC-RAS (5.0.7) software in Shatt Al Arab River and its tributaries. The data included flow rate, water level records were collected daily from 2018 to 2020 at different stations along the mentioned river and its feeders, additionally, the considered flood discharge data
... Show MoreAllah, in his Holy Quran introduced great prophet stories so as to learn from. The greatness of these stories lies in Allah himself being the author. He portrays his characters, lays the plot, defines the tests and Al- Ibtilla, provides ways of being patient, using Duaa to end all hard tests and generously describing the greatness of his rewards to all those who are patient. The purpose of this research is to study selected English prophet stories for children on three levels, the stories ability to convey lessons and Islamic teachings to children who do not speak Arabic, the stories portray the Islamic concept of patience, the teaching and learning styles andstrategies that Allah uses with each prophet. The concept of patience is defined a
... Show More