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.
Abstract
The leases, are regarded as one of the most controversial accounting issues in recent years, since they represents one of the important sources of funding, which may be exploited by the tenant as off- Balance sheet Financing , which negatively affects the quality of financial reporting. The Financial Accounting Standards Board (FASB) and the International Accounting Standards Board (IASB) have "significant" interest in accounting for leases . FASB issued Statement of Financial Accounting Standards 13 on lease contracts in 1976 and IASB issued IAS 17 in 1980, which was amended in 1997 and IFRS 16, issued in January 2016, which will be effective on January 1, 2019 , to solve
... Show MoreThis study was conducted at the Poultry Research Station of the Agricultural Research Department/Ministry of Agriculture in Abu Ghraib for the period from 25/2/2019 to 7/4/2019 (42 days) with the aim of using several levels of Spirulina (SP)
In this paper, compared eight methods for generating the initial value and the impact of these methods to estimate the parameter of a autoregressive model, as was the use of three of the most popular methods to estimate the model and the most commonly used by researchers MLL method, Barg method and the least squares method and that using the method of simulation model first order autoregressive through the design of a number of simulation experiments and the different sizes of the samples.
The research gained its importance from the importance of technical reserves in the insurance activity and its impact on the result of the activity of insurance companies and their financial position and thus reflected on the insurance prices as the technical reserves are one of the most important and most valuable budget items usually, as well as that the insurance activity has a role in maintaining economic development where some countries develop laws and instructions for the formation of those reserves binding application to insurance companies and the fact that the financial statements in general are of interest to shareholders, banks, the General Tax Authority and other beneficiaries In the insurance activity as policyholders and t
... Show MoreThe research aimed mainly to discover the effectiveness of the (PEOE) model in teaching science to develop the skills of generating and evaluating information and the emotional side of the scientific sense of the intermediate first grade students. An experimental approach with a quasi-experimental design called pre-test and post-test control design was used. The research sample consisted of (60) students, who were selected in a random cluster method, (30) students in the experimental group studied the unit "The Nature of Material" using the (PEOE) model, and (30) students in the control group studied according to the prevailing method of teaching. The research materials and tools were represented in: a teacher's guide for teaching the un
... Show MoreThe research aims to achieve proof of convergence between optimal costs and standard costs in calculating costs for the economic unit, support efforts aimed at adopting optimal costs in cost accounts and accounting thought in general, and achieve benefit from the theory of convergence between optimal costs and standard costs in the field of achieving actual costs in The economic unit in order to reduce and converge, and this came to address the possibility of adopting the concept of optimal costs in the production costs calculations for the purposes of rationalizing administrative decisions, and rationalizing the preparation of financial statements within management accounting.
The research concluded that
... Show MoreThis experiment was conducted to study the effect of injecting hatching eggs into a flock of broiler aged mothers with different concentrations of the alcoholic extract of Moringa oleifera powder on productive performance of broilers during the period of rearing of 35 days. The study included two experiments for a period at 2/10/2021 to 28/11/2021, where eggs were injected into the Mustafa Poultry Hatchery/ Wasit Governorate- Aziziyah District. A 400 hatching eggs of 308 Ross mothers of modern broilers used at age of 48 week, eggs of average weight 66 ± 1 g/egg were collected in same day then stored for two days. A quarter of treatments were randomly distributed with 100 eggs for each treatment.
... Show MoreThis study was conducted to detect the relationship between organic content in the sediment of Rivers Tigris and Diyala, at two locations south of Baghdad, with some environmental factors and the benthic invertebrates and values of diversity indices. Monthly samples collected from the area for the period November 2007 to October 2008. Results showed differences in the physical and chemical characteristics of the two sites, Where the annual average in Tigris and Diyala were respectively for: water temperature (19, 20) C°, pH (8, 8), dissolved oxygen (4, 8) mg / l , Biochemical oxygen Demand BOD5 (3,44 ) mg/l, TDS (632,1585) mg / l, TSS (42, 44) mg / l, turbidity (28,74) NTU, and total hardness as CaCO3 (485,823) mg / l ,Sulfat
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