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.
KS Ismaeil, BR Jawad, Journal of Physical Education, 2023
We found that 4,5- diphenyl- 3(2- propynyl) thio- 1??-triazole [1? forms a complex with Pd (11) ion of ratio 1:1 which absorbs light in CH2CI2 at 400 nm, and 4,5- diphenyl- 3(2- propenyl) thio- 1,2,4- triazole [II] forms complexes with Pd (II) ion of ratio 1:1 which absorbs light at 390 nm, and of ratio 2:1 which absorbs light at 435 nm. On the other hand, we found that the new derivative 4- phenyl- 5( p- amino phenyl) -3- mercapto- 1,2,4- triazole ?111? forms complexes with Cu (II) ion of the ratio 1:1 which absorbs light at 380 nm, with Ni (II) ion of the ratio 3:1 which absorbs light at 358 nm; and with Co (11) ion of the ratio 3.2:1 which absorbs light at 588 nm. The ratio of the complexes were determined by measuring the electronic spe
... Show MoreThe research aims to show the impact that the information of the supporting bodies can have and its dimensions represented by (information credibility, efficiency and effectiveness of information, cooperation with the tax administration, obligating the taxpayer, accuracy and completeness of information and the appropriate time) in tax inventory, as well as clarifying the moral differences in The response of the surveyed sample according to the personal variables represented by (gender, educational attainment, scientific specialization, job title, years of service), and the descriptive analytical approach was adopted and in light of it, the questionnaire was designed as a main tool in collecting data from the sample of (80)
... Show MoreThe wild populations of the vinegar fly Drosophila melanogaster Meigen from two regions in Baghdad , Saidiya and Tuwaitha were selected for this study to investigating the frequency of the dominant lethality , this parameter was investigated through fecundity and egg hatchability rate which considered as main indicator for the presence of mutation . The results showed that fecundity rate in Saidiya increased with time , so the lowest rate was 65.5 eggs per female in November and the highest was 87.4 eggs in May , the same results was observed for Tuwaitha except a significantly decrease in fecundity rate that was observed in May which was 42.7 eggs , as well as another significant differences between the two regions was observed in March
... Show MoreThe present study was carried to evaluate antibacterial activity of Acetone, Alcholic (cold and hot) and Aqueaus(water) extracts of Citrus aurantifoliaseeds,against growth of some bacteria isolated from burns infections(Pseudomonas aeruginosa,Escherichia coli, Klebsiellapneumonia,Staphylococcusaureus)fromKindy HospitalIn Baghdad from March to June 2012.Antibiotic Sensitivity was done for all isolated bacteria used in this study.Results showed variation in antibacterial activity of different extracts against all tested bacteria by well diffusion technique in agar and measuring the diameter of inhibition zone, at concentration 250Mg-ml. Acetone extract had the greatest inhibitory effect followed by hot alcoholci extract, and then cold alcohol
... Show MoreBackground: The bond strength of the root canal sealers to dentin is very important property for maintaining the integrity and the seal of root canal filling. The aim of this study was to evaluate and compare the push-out bond strength of root filled with total fill Bioceramic, AH Plus and Gutta-flow®2 sealers using GuttaFusion®obturation system versus single cone obturation technique. Materials and method: sixty of mandibular premolars teeth with straight roots were used in this study, these roots were instrumented using Reciproc system, instrumentation were done with copious irrigation of 3 mL 5.25% sodium hypochlorite solution (NaOCl) during all the steps of preparation, and smear layer will be removed with 1 ml of 17% EDTA kept in
... Show MoreThe aim of the research is to diagnose and analyze the gap between the actual reality and the application of the eighth requirement (operation) in the National Insurance Company in accordance with the international standard specification for the quality management system (ISO 9001:2015), which is related to the planning, implementation and control of operations, which would raise the level of performance of employees and be reflected in the provision of An appropriate service for the faithful, as the reality of the condition of the requirement was studied by identifying the strengths and weaknesses of the system to diagnose the gap and find ways to address it. A workshop was held with company officials, through which questions were raise
... Show MoreIn this research, we tackled the idea of absence and what companies it of interpretations and human, textual, philosophical and explanatory concerns. We also tackled the features and drawing them and identifying and lighting them by Ali Abdunnabi Az-Zaidi and how he read them as an Iraqi who writes in order to express a social, intellectual, political and religious reality in some of its aspects. The idea of absence and what accompanies it of pain or heartbreak or human change was a rich subject for all the writers and authors in the Iraqi theatre, and Ali Abdunnabi Az-Zaidi was one of them and the closest and most affected by it, who deserves discussion, explanation and briefing. The research problem was looking for the nature of absenc
... Show More