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 research acquires its importance by motivating the behavioural side of the employees to apply modern technology in the work, because of its great importance in increasing the efficiency of employees’ performance and excellence. The research was based on two main hypotheses to show the relationship and impact between the variables through the adoption of a questionnaire to collect data and information related to the research, which consisted of (50) people from administrators working at different levels, based on personal interviews and field visits to collect research data. The data collection process was subjected to statistical analysis using the statistical program (SPSS) (Statistical package for social science) to reach
... Show MoreThe aim of the research is to find out the nature of the relationship between the interrelationships and the interrelationships between risk management strategies (avoiding danger, risk exposure, risk exhibition, preventive programs and activities to reduce risks) and the dangers of container transportation, as an independent variable in the dangers of container transportation as a dependent variable, the study started from the problem that the company suffers from The practical aspect of the study was applied at the National Insurance Corporation, and the researcher designed a diagram according to the study's schematic diagram. The study, and for the purpose of data and information related to that, it relied on the descriptive a
... Show MoreFiled experiment was conducted to test the effect of saline water and potassium fertilizers rate on proline and water potential of Pisum sativum L. (Var.Senador Cambados ) leaves . Treatments of the experiment included two levels of water salinity( 2, 7 dSm-1) as a main plot and fertilizer rates as a sub plot. Results indicated that irrigation of plant with saline water 7 dSm-1 and fertilization 150 kg/donum increased proline accumulation and water potential 0.31 mmol/g,-17.00 bar at 9 AM morning and 0.62 mmol/g , -21.00 bar at 3 PM afternoon ,Irrigating plant with a 2 dSm-1 and fertilization 300 kg/donum decreased proline accumulation and water potential of leaves 0.22 mmol/g, -16.00 bar at 9 A
... Show MoreBehavioral and emotional disorders represent one of the commonest problems facing children in particular and disturbing their parents and educators in general. This is because Iraqi people have long been living in difficult conditions and faced various terrorists’ operations, such as killing, destruction, robbery, and looting. Such operations are said to be one of the reasons that leads to the development of such disorders, and may negatively affect the psyche of the child and be reflected on his behavior as represented by playing with the IPad for hours, and suffering from nightmares. Accordingly, the current research aims to examine specifically the commonest negative behavioral disorders among kindergarten children during the post-t
... Show MoreIn this study, concentrations of radon and uranium were measured for twenty six samples of soil. The radon concentrations in soil samples measured by registrant alpha-emitting radon (222Rn) by using CR-39 track detector. The uranium concentrations in soil samples measured by using registrar fission fragments tracks in CR-39 track detector that caused by the bombardment of U with thermal neutrons from 241 Am-Be neutron source that has flux of 5 ×103n cm-2 s-1.
The concentrations values were calculated by a comparison with standard samples The results show that the radon concentrations are between (91.931-30.645Bq/m3).
The results show that also the uranium concentrat
Anchusa strigosa - prickly alkanet from Boraginaceae grows in roadsides, and fields of a broad range of habitats from mediterranean woodlands, to steppe vegetation, to true desert. It is commonly known as" him him" or "lisan al thawr". Anchusa can withstand hard weather conditions and hence is widely cultivated. The color of its flowers can range from pure white to deep cobalt blue. Various parts of A. strigosa are used in traditional medicine for treating several diseases or symptoms, such as abdominal pain, bronchitis, cough, and diarrhea. The goal of this study was to examine the cytotoxic effect of the crude extract of A. strigosa roots and leaves and their fractions against various tumor cell lines: adenoc
... Show MoreThis study tackles the contribution of the environmental audit in achieving the sustainability of the environmental balance in the Sudanese business environment. The study aimed at clarifying the role of environmental auditing in supporting sustainable development, and to recognize the role of environmental audit in urging businesses to abide by environmental protection. It also shows how effective the environmental audit reports are, in providing the reliable data for the concerned authorities, in order to use it in making the decisions that would help in the sustainability of the environmental balance. To achieve the goals of the study, a questionnaire was developed and distributed to the registered chartered accountants in Sud
... Show MoreBackground: Breast cancer (BC) is the most widespread cancer among women worldwide. Its incidence and mortality rates have risen in the previous three decades as a result of changes in risk factor profiles, improved cancer registry, and cancer detection. Objective: The study's goals were to establish if Ki-67 could be used as a potential marker in serum of cancer disease patients as well as their interaction with vascular endothelial growth factor (VEGF) and ES in various stages of breast cancer to assess their function in the progression of BC. Materials and Methods: The levels of Ki-67, VEGF and endostatin (ES) in serum were assessed by commercial enzyme linked immunosorbent assay (ELISA) kits in 60 women diagnosed with breast cancer
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