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.
Background: MicroRNAs (miRNAs) are small noncoding RNAs that postâ€transcriptionally regulate gene expression by targeting specific mRNAs. The main objective of this study was measure the level of salivary (hsa-miR-200a, hsa-miR-125a and hsa- miR-93) in both oral squamous cell carcinoma and healthy controls to asses the association of them with age, gender and tumor grade materials and methods The level of three salivary microRNAs namely hsa-miR-200a, hsa-miR-125a and hsa- miR-93 were measured in saliva of patients with oral squamous cell carcinoma and healthy controls by using reveres transcription, preamplification and quantitative PCR also the general information from each patient including the age, sex and tumor grade were record
... Show MoreApical periodontitis (AP) is the most prevalent chronic inflammatory disease of the teeth. Bone resorption dynamics in symptomatic and asymptomatic AP are still unrecognized. This study examined different inflammatory markers within gingival crevicular fluid, including matrix metalloproteinases 8 (MMP8), tissue inhibitors of metalloproteinases 1 (TIMP1), receptor activator of nuclear factor κB (RANK), its ligand (RANKL), and osteoprotegerin (OPG), to be used in comparing symptomatic apical periodontitis (SAP) and asymptomatic apical periodontitis (AAP) versus healthy teeth. Subjects with SAP, AAP, and a control group were recruited and GCF samples were collected by Periopaper strips. Clinical and radiographical measures were used f
... Show MoreThis study evaluated the effect of spore suspension and fungal filtrate against different developmental stages of Tribolium castaneum third and fifth larval instars and adults. Two isolates of entomopathogenic fungus Metarhizium anisopliae were used (commercially (Met 52 EC), and domesticly). For the two isolates, the effectiveness of various conidial concentrations were (1 × 104 ; 1 × 106 ; 1 × 108 conidia/ ml) and various concentrations of fungal filtrate (100,75,50%) were evaluated. It is observed that the fungal filtrate at a concentration of 75% and the conidial concentration of 1 x 108 conidia /ml for both isolates were the most effective in causing the highest mortality rates to the third and fifth instar larva and adult
... Show MoreThis research aims to identify how organizational compatibility, which represents the independent variable, affects higher performance, which is considered a dependent variable, given the importance of these variables in industrial organizations and their clear impact on their stability, survival, and growth in the light of changing environmental challenges. Where the practical research problem was represented by the weakness of awareness of the importance toward organizational compatibility and its dimensions (organizational loyalty, organizational similarity, affiliation or membership, compatibility with goals, and compatibility with values), which is meant by the individual's compatibility with the organization in which he/she w
... Show Morethe bank sect for any country is very important because its represent a major nerve to feed a verity economic and finance activities .development any state measure by development banking sets and its represent important factor to investors attract . and because important of this subject ,teen accounting rule is a specialized for it .its related by Disclosures in the Financial Statements Of Banks and The Similar Institutions, its accredit by auditing and accounting standard consul in republic of Iraq.in date 10/28/1998. &
... Show MoreAcademic boredom is one of the most emotional problems that arouse an individual's fatigueness and lowers his interest. This is because of the environment's low efficiency and of spending long monotonous time. This state is characterized by having lack of interest, difficulties in concentration, and the desire to leave the class. It is considered one of the most prominent forms of boredom widespread among students and the most severe and dangerous one that has negative effects and severe psychological and social problems. The current research aims to investigate a randomly selected sample of 335 students from the first and third grades at the directorates of education (Karkh and Rusafa) who suffers from academic boredom. Similarily
... Show MoreThe highest incidence of injury is seen in adolescent playing pivoting sports such as soccer, basketball, and handball. Objective: To examine the effectiveness of a neuromuscular prevention program in reducing knee and ankle injuries in adolescent male soccer players.
Shmuel Yosef Agnon, a well-known Jewish writer, wrote many literary works, including poetry, story, etc. In the field of story, this writer used two areas: the first: a simple exterior, and the second: an inner full of secrets and mysteries. This area is common when Agnon is affected by his symbolic method of purpose. In his productions, we find the political and historical significance embodied in his characters, where there is almost no story without it.
Agnon and all his productions gave the character a large area, Agnon’s characters often play the center and cornerstone in those productions, where the author dealt deeply and stated the fines details of the external and internal of that ch
... Show MoreAbstract :In this study, amygdaline in Iraqi plant seeds was extracted and isolated from their seeds matrix using reflux procedure and subsequently identified and determined by high performance liquid chromatography (HPLC) on reversed phase column of LC-18 (150mm x 4.6mm, 5?m )with actonitrile :water ( 50 : 50 ) as mobile phase at flow rate of ( 0.5 mL/min ) and detection at wavelength of 215 nm.The experimental results indicated that the linearity of calibration is in the range of 1.0-30.0 mg L-1amygdaline with the correlation coefficient of 0.9949. The limit of detection (LOD) and limit of quantitation (LOQ) for amygdaline were of 0.88 and 2.93 mg L-1 in standard pure sample. The mean recovery percent is 97.34±0.58 at 95% confidence inte
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