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 objective of this research is to measure the training programs and identify the nature and then measure how it reflected on the quality of municipal services provided by the municipal departments investigated by measuring the quality of services based on quality standards, the researcher chose four municipal departments in the Rusafa / Baghdad (164 people) representing the directors and their assistants, officials of the municipal departments, the people and the engineering staff in charge of the task forces as well, including the survey of the views of the concerned persons in the management of the Vocational Training Institute in the Secretariat of the Republic, The quality of the municipal services
... Show MoreThe Search stressed on the importance of the role of property tax as a tributaries of the state budget that depend on it to cover the side of public expenditures, along with the rest of the other types of taxes through a review of the tax framework and tax proceeds and stand on the research problem and its effects, according to the following logic questions : -
- What is the contribution of property tax in the overall tax revenue?
- Are there any certain problems in collection of property tax?
3. What are the factors that lead to a negative impact on the outcome of the property tax?
4. How do we strengthen the role of the property tax in the overall tax revenue?
This r
... Show MoreThe research tagged (Perceived Organizational Support in High Performance) deals with identifying the extent of the impact of perceived organizational support as an explanatory variable on high performance as a response variable for the purpose of reaching appropriate mechanisms that enable colleges of the University of Baghdad to exploit the perceived organizational support in achieving the required high performance and pursuit of its goals. The researcher relied on the descriptive and analytical approach in carrying out the research. An intentional sample was selected and reached (70) persons from the higher leadership of the colleges represented by (deans, assistants deans, heads of departments) that r
... Show MoreAbstract Background: The emptied sheep’s ovarian follicles recently used as a container for spermatozoa during cryopreservation, it was found a proper carrier to cryopreserving spermatozoa in vapor-dependent cryopreservation. The aim of this study was to evaluate the effect of two periods of exposure to liquid nitrogen (LN2)vapor on the parameter of spermatozoa during cryopreservation in this technique. Method: The study was conducted on 30 semen samples from patients with oligozoospermia diagnosed by semen analysis according to the standard criteria of World Health Orgnization (WHO) 2010. Sheep’s ovarian follicles obtained from local slaughterhouse and prepared by slicing the ovaries and evacuating the follicular fluid and oocyt
... Show MoreExperimental model was done for pile model of L / D = 25 installed into a laminar shear box contains different saturation soil densities (loose and dense sand) to evaluate the variation of pore water pressure before and after apply seismic loading. Two pore water pressure transducers placed at position near the middle and bottom of pile model to evaluate the pore water pressure during pullout tests. Seismic loading applied by uniaxial shaking table device, while the pullout tests were conducted through pullout device. The results of changing pore water pressure showed that the variation of pore water pressure near the bottom of pile is more than variation near the middle of pile in all tests. The variation of pore water
... Show MoreThe research aims to study the marketing costs in its various items, which are important costs as it specializes in tunnels on the marketing side through which the company's services are introduced to ensure that these services reach as many segments of society as possible, which serves the company's objectives and expand its business and increase its market share. As well as the definition of profitability and its relation to marketing costs in the portfolios of the national insurance company. The research hypothesis was formulated to study and analyze the relationship and impact between the marketing costs and profitability of the research sample company. The research sample was determined by the National General Insurance Comp
... Show MoreUniversity libraries seek to evaluate their performance in order to correct their path and adjust it in the right direction. Therefore, they use (performance indicators), which are a tool used by institutions to evaluate the weaknesses and strengths in their work and the reasons for failure to achieve some goals sometimes. They convert (goals, procedures and actions) into a formula that can be measured mathematically, which contributes to the library determining the gap between its current performance and what those libraries are supposed to be on, clarifying the path that the library is following, controlling the risks that may befall it, and thus enhancing the process of continuous improvement to avoid areas of failure and weakness becaus
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The developed financial infrastructure is one of the most important elements for achieving stable financial system in a country. The importance of developed financial infrastructure comes from its role in create economic and financial context attractive for foreign investments. Thus, this paper aims first to measure an index of financial infrastructure, and secondly, to gauge the nexus between the developed financial infrastructure and foreign investments inflow in Malaysia and Indonesia. We estimate the index of financial infrastructure by using different indicators such as (the institutional environment, access to finance, legal environment, and others).
By using the G
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