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.
The extraction of pesticides is a critical and urgent issue in the preparation for and determination of pesticide residues. The lack of a quick, easy, and successful extraction process is the most critical and challenging problem, even if diagnostic tools have improved and pesticide residues have been better understood. This study contrasted the QuEChERS method, which uses gas chromatography with a flame ionization detector, with the LLE method, which uses liquid-liquid extraction, in order to extract pyridaben from cucumbers and spiromesifen from tomatoes. The GC-FID device was employed to ascertain the spiromesifen LOD and LOQ, which were 0.002 μg mL-1 and 0.00
Liposomal amphotericin B (Amph B) has been used effectively to treat leishmaniosis, in spite of its high toxicity appeared in some patients. In our study, Amph B was administered in Leishmania donovani that infected BALB/c male mice using different concentrations to evaluate its efficacy challenge against infection as well as its effect in modulating immunity of the host. We observed that low doses with short duration of Amph B as a therapy regime significantly enhanced the induction of Th1 cytokine (INF-γ), but suppressed Th2 cytokine (IL-10) production. Groups of mice infected with L. donovani and treated with Amph B showed clearly increasing in INF-γ level and reduction in IL-10 level in concentration (3, 4, 5 mg/ml/kg) with best resul
... Show MoreThe increasing level of residents’ requirements of the local community led to the necessity for sufficient local funding to satisfy the residents’ requirements and services of the local units affiliated with the decentralized administrative systems on the one hand, and to the role of local financing in the financial independence of local units on the other hand.With the presence of local financing, the financial independence of local units is achieved and is considered one of the conditions for financial independence, which is the provision of local financing to the units away from central support. The study focused in this research to clarify the concept of local financing for local units with a statement of its conditions and importan
... Show MoreThe experiment was carried out in the Department of Biology, College of Education for Pure Science –Ibn AL Haitham, University of Baghdad, Iraq, during the growing season 2017 – 2018. The objective was to find out the effect of foliar spraying of tryptophan and IQ COMBI nano fertilizer on cumin plants. The obtained results show that both tryptophan and IQ COMBI nano fertilizer increased plant height, root length, shoot dry weight, the content of nitrogen, phosphorus, potassium, protein percentage, no. compound umbel.plant-1, wt. seeds. plant-1. The optimum treatment combination was calculated as 30 mg.L-1 tryptophan, 1000mg.L-1 IQ COMBI nano fertilizer, which gave the highest values for most of the parameters studied
The present study aims to describe the histological structure of kidney of, (Herpestes javanicus ) that inhabits Iraqi lands. Transverse sections of kidney stained with hematoxylin and eosin showed two distinct regions, the outer thin darkly stained cortex and inner thick lightly stained medulla, which further subdivided into external and internal medullary zones linked with one conical renal papilla. The lateral margin of the outer medullary tissue forms a secondary renal pyramid with a specialized fornix. All the nephrons in the kidney start with the renal corpuscle [Malpighian], which is formed from two distinct parts, these are a centrally located glomerulus, which represented by a tuft of blood capillaries and an outer Bowman’s capsu
... Show MoreAcquires Find importance of the overall quality and e-marketing management have become important factors in evaluating the performance of banks, which are related to the life of the community intimately, so it is important that the banks applying comprehensive quality and e-marketing management requirements in order to maintain their performance and determine their level, as well as the manifest importance of research in part, practical linking the requirements of total quality management and banking performance on the one hand and between the e-marketing and performance banking on the other hand, through the provision of scientific bases that can be based on the banks in question, as it kicks off the research problem in that mos
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