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.
Since the end of World War II, the United States of America began to look at the Gulf States and Iraq due to the possession of huge quantities of oil, after taking the American oil depletion in order to tighten control over the oil of these countries, has pursued various means, political and military, in the framework of its strategy So that it could achieve this control, which focused on control of production and prices, for the conviction that those who control oil impose control over the political decision of the countries of the world.
Because of the diverse circumstances in Andalusia, the Jews lost much of the atmosphere of freedom and coexistence, which they enjoyed under Islamic rule there, to leave more Jews in the sixth century AH, under Spanish rule abolishing the existence of the other. And to impose his negativity with unjust domination. What motivated the people of Judaism; to turn their faces on the Islamic East; according to the coexistence climates that glorified various religions. It has emerged in this regard Benjamin Title (d. 685 e), who made a long journey to the east, recorded in the texts of the traveler, what will be shown research, God willing.
Background:In this study,TiO2 layer was thermally grown as a diffusion barrier on CP Ti substrate prior to electrophoretic deposition of HA coatings, to improve the coating’s compatibility also macro and micro pores in nano Hydroxyapatite dual coatings were created and their effect on the bond strength between the bone and implant was evaluated. Materials and methods: Electrophoretic Deposition technique (EPD) was used to obtain coatings for each one of four types of Hydroxyapatite(HA)on CP Ti screws (micro HA, nano HA, dual nano HA with micro pores, dual nano HA with macro pores) where carbon particles used as fugitive material to be removed by thermal treatment to create porosity.For examination of the changes occurred on the subs
... Show MoreAn experimental and theoretical works were carried out to model the wire condenser in the domestic refrigerator by calculating the heat transfer coefficient and pressure drop and finding the optimum performance. The two methods were used for calculation, zone method, and an integral method. The work was conducted by using two wire condensers with equal length but different in tube diameters, two refrigerants, R-134a and R-600a, and two different compressors matching the refrigerant type. In the experimental work, the optimum charge was found for the refrigerator according to ASHRAE recommendation. Then, the tests were done at 32˚C ambient temperature in a closed room with dimension (2m*2m*3m). The results showed that th
... Show MoreVarious activities taking place within the city of Baghdad have significantly contributed to organic pollution in Rivers Tigris and Diyala. The present study aimed to assess some physical, chemical and biological aspects of six sites on Rivers Tigris and Diyala as they flow through the city of Baghdad. Monthly samples were collected for the period January to December, 2005. Marked differences in the physical and chemical characteristics of water were noted between the two rivers’ sites. Average values during the study period of dissolved oxygen, biochemical oxygen demand, particulate organic matter, nitrate, phosphate and total dissolved solids for Tigris and Diyala were 7.8,4.7; 2.4,10.4; 350.1,921.4;7.8,13.9;1.2,4.8;814,2176 mg / l re
... Show MoreThe most significant function in oil exploration is determining the reservoir facies, which are based mostly on the primary features of rocks. Porosity, water saturation, and shale volume as well as sonic log and Bulk density are the types of input data utilized in Interactive Petrophysics software to compute rock facies. These data are used to create 15 clusters and four groups of rock facies. Furthermore, the accurate matching between core and well-log data is established by the neural network technique. In the current study, to evaluate the applicability of the cluster analysis approach, the result of rock facies from 29 wells derived from cluster analysis were utilized to redistribute the petrophysical properties for six units of Mishri
... Show MoreObjective(s): The present study aims at identifying the Iraqi Colleges of Nursing Deans' leadership
behaviors effectiveness and faculty members' motivation towards work in these colleges.
Methodology: Descriptive design has been used for the sample survey manner, which is the
appropriate approach to the study of social phenomena in the field where provides data on the reality of
these phenomena and relations between the causes and consequences and an analysis of it and perhaps
the factors affecting it and how it appears. The study relies on a questionnaire to collect data from the
participants which is composed of (86) items distributed on three axes: First, the demographic
characteristics which are composed of (8) i
The article states that the Russian verbs of destruction belong to the lexical-semantic group of physical impact. They include verbs with the meaning of “damage” and “destroy”. It is emphasized that each of these groups is relatively independent; the cut line between them is fuzzy and arbitrary. It is postulated that when the object is completely destroyed, then the verb has the meaning of “destruction”, and when the object is partially destroyed, then the verb has the meaning of “damage”. It is this feature that individualizes the meaning of verbs. The study distinguishes between the groups and the nature of the object as- animate / inanimate. The object of the action of the “destruction” can only be inan
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The research aims to determine the role of Entrepreneur decision-making in its dimensions in improving the activities of Ambidexterity performance in its dimensions in the researched company. The importance of the research is also evidenced by assisting the oil products distribution company/session in directing the interest of the researched company because it has a prominent role in the Iraqi industrial community for the Entrepreneur decision-making variable that Contributes to building sustainable competitive advantage. This will happen when the company has an Entrepreneur orientation and a good strategic plan is built by the smart leaders in the researched company The researcher adopted the method of the analyti
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Binary logistic regression model used in data classification and it is the strongest most flexible tool in study cases variable response binary when compared to linear regression. In this research, some classic methods were used to estimate parameters binary logistic regression model, included the maximum likelihood method, minimum chi-square method, weighted least squares, with bayes estimation , to choose the best method of estimation by default values to estimate parameters according two different models of general linear regression models ,and different s
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