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 collected premiums and the compensations paid are among the main variables that have a prominent role in determining the level of financial solvency of insurance companies, as the higher the financial solvency of the insurance company, the more attractive it is to the target audience to acquire the company's insurance services.
Hence the importance of the issue of the solvency of insurance companies, as it is one of the critical matters on which the effectiveness of the insurance company and its continuation in the labor market depend.
In this research, we try to clarify the role of collected premiums and compensations paid in determining the level of operational solvency of t
... Show MoreAbstract Liver cancer with hepatocellular carcinoma a serious clinical illness that progresses quickly and has a bad prognosis because to increased malignancy. Fibrosis is the precursor of liver cancer, which progresses to cirrhosis and carcinoma Diethylnitrosamine (DEN) is a chemical molecule that has been used as a carcinogenic agent to promote cancer in test animals because of its strong carcinogenic potential. Herbal plants have long been used as inexpensive, effective alternatives to pharmaceuticals in various liver-associated complications, since they contain many bioactive compounds useful in liver disorders. Hibiscus tiliaceus L. (Malvaceae) contain various phytochemicals in the plant extracts such as Flavonoids, phe
... Show MoreChronic periodontitis (CP) is an inflammatory disease affecting tooth supporting structures in response to bacterial dental plaque causing irreversible tissue destruction. Cyclooxygenase-2 (COX-2) is an effective mediator in the pathogenesis of periodontitis. Polymorphisms in the COX-2 gene may contribute to its overexpression and increased disease susceptibility. To evaluate the association between -1195 A/G single nucleotide polymorphism (SNP) in the promotor area of the cyclooxygenase-2(COX-2) gene and severity of chronic periodontitis in a sample of Iraqi population. -1195A/ G COX-2 SNP was investigated in 70 chronic periodontitis (CP) cases and 30 healthy controls. CP cases composed of 2 subgroups (35 moderate CP cases and 35 severe CP
... Show MoreThe research aimed to determine the role of the agricultural extension in educating farmers about the legislation on the protection of the rural environment from pollution with chemical pesticides working in the Department of Agricultural Extension and Training and the Department of Agricultural Extension in the directorates of agriculture of Najaf and Qadisiyah, and to determine the role of the agricultural extension in the axis of farmers' use of the correct methods to protect the rural environment from pollution with chemical pesticides and the axis of the reasons that lead farmers to pollute the rural environment with chemical pesticides, and to achieve the objectives of this research prepared A questionnaire in the light of rev
... Show MoreSamuel Beckett’s Happy Days (1961) clearly portrays a lack of communication among the characters of the play which refers to the condition of modern man. This failure of communication led Samuel Beckett to use a lot of pauses and silences in all plays written instead of using words. To express the bewilderment of the modern man during the 20th century, Beckett adopts the use of no language strategy in the dramatic works. After World War II, people were without hope, religion, food, jobs, homes, or even countries. Beckett gave them a voice. He used a dramatic language out of everyday things, in which silence was part of the syntax as a poetic repetition. Language is no more important to the modern man; instead, he us
... Show MoreThe Boltzmann equation has been solved using (EEDF) package for a pure sulfur hexafluoride (SF6) gas and its mixtures with buffer Helium (He) gas to study the electron energy distribution function EEDF and then the corresponding transport coefficients for various ratios of SF6 and the mixtures. The calculations are graphically represented and discussed for the sake of comparison between the various mixtures. It is found that the various SF6 – He content mixtures have a considerable effect on EEDF and the transport coefficients of the mixtures
The study is about Maxwell , three dimensions of non – Newtonian fluid. Method of th Homotopy applied to analysis mass transfer and heat with thermophoresis effects. (Sc), Impact of therrmophoretic (𝜏), magnetic (M), Biot (γ), radiation (Rd),Schmidt Prandtle (Pr) parameters and ratio parameter(β) on concentration, temperature are offered in the paper.
Background: The use of Miswak, chewing sticks (salvadorapersica) can be traced back to Babylonians some 7000 years ago. It is commonly used throughout the world especially for the purpose of oral hygiene. Muslims are using as the religious view. Current study aimed to test the ability of aqueous siwak extract to increase the resistance of enamel surface against acid dissolution compared to sodium fluoride. Materials and Method: Twenty maxillary first premolars were treated with the selected solutions included two aqueous siwak extract concentration(5%,10%) and sodium fluoride(0.05%)as control positive for 2 minutes once daily for 20days interval, de ionized water was used as control negative. The concentration of the dissolved phosphorus i
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