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.
Biosorption of lead, chromium, and cadmium ions from aqueous solution by dead anaerobic biomass (DAB) was studied in single, binary, and ternary systems with initial concentration of 50 mg/l. The metal-DAB affinity was the same for all systems. The main biosorption mechanisms were complexation and physical adsorption of metallic cations onto natural active functional groups on the cell wall matrix of the DAB. It was found that biosorption of the metallic cations onto DAB cell wall component was a surface process. The main functional groups involved in the metallic cation biosorption were apparently carboxyl, amino, hydroxyle, sulfhydryl, and sulfonate. These groups were part of the DAB cell wall structural polymers. Hydroxyle groups (–O
... Show MoreThe accession of countries to the World Trade Agreement and the openness of markets to each other without restrictions led to the emergence of the philosophy of "a world without borders and business units without countries", which required adapting the modern business environment to that philosophy, which is considered as objectives for the activities of the units that must be implemented in order to achieve competition. The objective of the units has changed from making profit to meeting the desires of customers, which is what imposed a new role for management accounting as a field of knowledge renewed in it visions of competitiveness between units. Because of the increasing needs for information in light of environmental change
... Show MoreThe performance measures and traditional methods used in management accounting is no longer able to provide convenient to evaluate the performance of economic units in the modern manufacturing environment information، and so this information is more important and feasibility must be Mistohat of all the company's activities and functions، and it is a problem Find the inadequacy of information management accounting that contribute to meet the needs of the upper levels of management to cope with the problems resulting from the increased size and complexity of the business، and lack of management accounting information and methods used in the performance evaluation، which reflected negatively on the value chain activities and then on the
... Show MoreIn this paper we study the selection of cognitive elements and criteria of the inflectional structure of the Russian and Arabic languages in the process of speech communication. Phonetic-physiological principle is the main parameter by which the elements and criteria of cognitive activity in the presented study are distinguished. On the basis of the above mentioned parameter, we select the investigated criteria and elements. The first criterion is semantic, reflects the accordance of the elements of thinking to sound combinations in the studied languages, and allows us to distinguish the second criterion – morphonological. The second criterion depends on the phonetic changes of these combinations occurring in the process of speech activit
... Show MoreThis study was included preparing acold aqueous extract of clove buds The study also comprised the isolation and studying the proteinous compound,which was seperated using gel filtration technique and determined approximately molecular weight of this isolated compound(6799) dalton . The aim of the study demonstrate effects of the crude aqueous, non proteinous extract, proteinous precipitate and proteinous compound on serum glucose, total cholesterol, triglyceride and high density lipoprotein-cholesterol levels, also glutathione and malondialdehyde levels in liver and kidney tissues in diabetic mice-induced alloxan.Extracts were administerated interaperitioneally. The results were indicated that the crude aqueous, non proteinous extr
... Show MoreIn this research the specific activity of natural radionuclides 226Ra, 232Th and 40K were determined by sodium iodide enhanced by thallium NaI(TI) detector and assessed the annual effective dose in Dielac 1 and 2 and Nactalia 1 and 2 for children of less than 1 year which are available in Baghdad markets. The specific activity of 40K has the greater value in all the types which is in the range of allowed levels globally that suggested by UNSCEAR. The mean value of annual effective doses were 2.92, 4.005 and 1.6325 mSv/y for 226Ra, 232Th and 40K respectively.
Escherichia coli (E. coli) is a frequent gram-negative bacterium that causes nosocomial infections, affecting more than 100 million patients annually worldwide. Bacterial lipopolysaccharide (LPS) from E. coli binds to toll-like receptor 4 (TLR4) and its co-receptor’s cluster of differentiation protein 14 (CD14) and myeloid differentiation factor 2 (MD2), collectively known as the LPS receptor complex. LPCAT2 participates in lipid-raft assembly by phospholipid remodelling. Previous research has proven that LPCAT2 co-localises in lipid rafts with TLR4 and regulates macrophage inflammatory response. However, no published evidence exists of the influence of LPCAT2 on the gene expression of the LPS receptor complex induced by smooth or rough b
... Show MoreThe world and the business environment are constantly witnessing many economic changes that have led to the expansion of the business' volume due to mergers and the increase in an investments volume and the complexity of business and the transformation of some systems, which was reflected on the size of the risk and uncertainty which led to necessity of a presence of transparent and objective accounting information In the way that reflects the financial performance of the economic units to be available to all users of that information, therefore, The need for the existence of indicators for transparency in the disclosure of accounting information that these units adhere to. Standards & Poor's indicators, which included items
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