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.
Synthesis of PEG 200-Di- Acetate ant Its Influence on the Viscosity of PEG 4000 in Different Organic Solvents
Bacteriocins were partially purified by ammonium sulphate 50% concentraction, bacteriocin activity of Pediococcus acidilactici-FMAC278 was 25600 U/ml with 5.8 folds and 7.6% yeild, the activity decrease to 12800 U/ml after dialysis with 6.3 folds and 3% yield, On the other hand the bacteriocin activity of Weissella paramesenteroides-DFR6 was 12800 U/ml with 2.7 folds and 8.8% yeild, after dialysis the activity became 6400 U/ml with 5.1 fold and 3.4% yield, Chicken Sausage were made by adding 0.25, 0.5 and 1% particaly purified bacteriocin to study its effect on microorganisms and increasing shelf life of Sausage. It is found that bacterial numbers were decreased after 3 days of storage at refrigerator at 0.5% conc. While the molds decrea
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This study aims at investigating the effectiveness of the cooperative inquiry strategy in developing the achievement and development of mathematical communication skills of elementary school students. To achieve this aim, the experimental method was utilized. The study sample consisted of an experimental group (n = 34) and a control group (n = 31), which were randomly selected from primary schools. A Teacher's Guide for teaching a unit entitled "Statistics and Graphic Representations" for the sixth elementary graders in the first semester were devised. A (30) multiple-choice item achievement test distributed at the levels of (recall, comprehension, and application), as well as an (18) item mathematical c
... Show MoreThe present research aims at identifying the effect of the cognitive discrepancy strategy on the fourth-stage students’ achievement in literature and texts. The researcher adopted the null hypothesis: there is no statistically significant difference at the level (0.05) between the average grades of the experimental group who study literature and texts following the discrepancies strategy, and those who follow the traditional method. A post-achievement test of (60) paragraphs was administered to (6) students as the study sample. The results showed that the experimental group who studied literature and texts with the strategy of cognitive achieved better than the control group who followed the traditional method in the post-achievement t
... Show MoreBackground: MicroRNAs (miRNAs) are small noncoding RNAs that postâ€transcriptionally regulate gene expression by targeting specific mRNAs. The main objective of this study was measure the level of salivary (hsa-miR-200a, hsa-miR-125a and hsa- miR-93) in both oral squamous cell carcinoma and healthy controls to asses the association of them with age, gender and tumor grade materials and methods The level of three salivary microRNAs namely hsa-miR-200a, hsa-miR-125a and hsa- miR-93 were measured in saliva of patients with oral squamous cell carcinoma and healthy controls by using reveres transcription, preamplification and quantitative PCR also the general information from each patient including the age, sex and tumor grade were record
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The aim of the research is to identify the effect of using the self-questioning strategy on the achievement of fourth-grade students in science and the development of their reflective thinking in physics in the city of Baghdad. The research sample was divided into two groups: an experimental group of (20) students and a control group of (20) students. The researchers developed two tools: a test of (40) multiple-choice questions. The second tool is a test to measure the reflective thinking skills of fourth-grade students. It consists of (25) multiple-choice questions distributed on skills as follow: reflection and observation, detection of inaccuracies, reaching conclusions, giving clear explanations, an
... Show MoreNew simple and sensitive spectrophotometric methods for the determination of paracetamol in aqueous medium were developed. The first method is based on coupling of paracetamol with p-amino-2-hydroxy sodium benzoate (AHB) in the presence of sodium periodate, as oxidizing agent, to form a brownish-orange compound which shows a λmax at 470 nm. The molar absorptivity (εmax) of the colored product was found to be (3371) l. mole1. cm-1 and Sandel’s index 0.0449 μg. cm-2. The method follows Beer’s law in the concentration range of 12.5-500.0 μg of paracetamol in a final volume of 25 ml (0.5-20.0) μg. ml-1 with relative standard deviation percent (RSD%) ranged between 0.26-4.71% and accuracy, expressed by recovery percent, 95-106% for five
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