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 century is witnessing changes in various fields,which have become a challenge to the enterprises in the contemporary business environment, the most important of which is the importance of measurement and disclosure of the role of knowledge capital in the transition to the knowledge economy, which is no longer the land and labor and physical capital resources the basic. Knowledge-based capital has emerged that provides the enterprise with an area of excellence and enhances its position to achieve competitive advantage. The research tackled the concept, objectives, components and importance of knowledge capital, which is fundamental in knowledge management, creating value added and enhancing competitiveness, as well as an
... Show MoreThis study is an investigation of the drugs effect on some pathogenic Acanthamoeba isolated from Iraqi waters, where the problem of environmental adaptation that characterizes this organism in addition to being a reservoir for many pathogenic microorganisms that take shelter in it to escape disinfectants and medicines is sometimes difficult to treat it with traditional treatments. Twenty water samples were collected from different water regions in Iraq, namely the Dokan Lake, Tigris River, Euphrates River and Najaf Sea, 5 samples from each source. Acanthamoeba was isolated from water samples on NNA and PYG media, using an inverted microscope with an electron microscope to determine their phenotypic features. PCR and
... Show MoreThe research aims to verify that there is an influence between innovative marketing and the organization's reputation by brand mediation.
The research problem is that the Oil Marketing Company (SOMO) needs innovative, unconventional methods in marketing its products and improving its reputation by adopting a solid brand that adds value to the product.
The importance of the research: The importance of the research is highlighted as it deals with essential variables in business organizations that help increase customer loyalty by adopting a distinctive brand.
The research started from four main hypotheses to explore correlations and influence between researc
... Show MoreThe biosorption of lead (II) and chromium (III) onto dead anaerobic biomass (DAB) in single and binary systems has been studied using fixed bed adsorber. A general rate multi- component model (GRM) has been utilized to predict the fixed bed breakthrough curves for single and dual- component system. This model considers both external and internal mass transfer resistances as well as axial dispersion with non-liner multi-component isotherm (Langmuir model). The effects of important parameters, such as flow rate, initial concentration and bed height on the behavior of breakthrough curves have been studied. The equilibrium isotherm model parameters such as maximum uptake capacities for lead (II) and chromium (III) were found to be 35.12 and
... Show MoreThe experiment was conducted at the plant tissue culture laboratory of the Department of Horticulture and Garden Engineering College of Agricultural Engineering Sciences, University of Baghdad, in order to study the effect of some growth regulators on propagation an stimulation production of volatile oil compounds of rosemary plant Rosmarinus officinlis using two vegetative parts (apical and lateral buds). Factorial experiment was implemented in completely randomized design with twenty replications. The results indicated that culturing the apical meristem on the medium Murashige and Skoog (MS) media with 0.5 mg.l-1 (BA) with 0.1 mg.l-1 of NAA gave the highest response rate of 100%. As for the doubling stage, the levels of BAA and IAA (Indol
... Show MoreType 2 diabetes mellitus (T2DM) became the most prevalent health problem. Almost half of the world's people are ignorant that have diabetes. Menopause occurs as an important alteration in women through which take place the change in sex hormones, distribution in fat،s body, and metabolism, altogether which participate in the metabolism disease such as type 2 diabetes mellitus. Several studies have appeared the association between the TCF7L2 gene and different diseases like type 2 diabetes mellitus (T2DM). This study aimed to detect the relation of the genetic variation polymorphism for the TCF7L2 gene (rs12255372 G/T) in Iraqi women menopausal with T2DM. The outcomes indicated the increased levels of biochemical characteristics including H
... Show MoreWhat is important about this study is whether there is a relationship between the ability to balance and beating overwhelming for the Iraqi national team volleyball? The study aims to identify the percentage of the equilibrium contribution and its variables with the accuracy of the skill of beating the high spike Diagonal center (4) in the players. In the national volleyball team season (2016-2017), the researchers used the descriptive approach in the style of associative relationships to suit the problem of research. The research community included all the players specialized in the high beating of the Iraqi national team applicants in the ball The researchers concluded that the equilibrium variables contributed accurately and quickly to t
... Show MoreThe skill high-jump scoring is based on mechanical and physical abilities. The most important of all is the strength used by the player from the moment of preparation to the moment of scoring, which led the researchers to study the characteristics of the series of power chain functions of this skill according to (Biosyn System) The players of the national team's back line have a handball to find out the relationship between the properties of the power chain curve and the accuracy of the high jump to the upper and lower target angles. The aim of the research was to identify the values of the Force Series variables for the skill of the high-jump curve of the handball as well as the relationship between the properties of the power chain functi
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