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 aim of this research is to find out the impact of cognitive incompatibility schemes on the development of creative thinking skills among first grade students.
To prove the objective of the research, the researcher put the following hypothesis:
There is no statistically significant difference at the level of (0.05) between the average score of the experimental group who study the history of ancient civilizations according to the patterns of cognitive conflict and the average grades of the control group students who study the same subject in the usual way in the test of post-creative thinking skill
The research aims to identify the rates of hair loss during pregnancy and lactation and its relation to the rates get some elements motivator urged through the results of the continued failure to meet the need of daily assessments of these elements, which led to the continuation of Hair Loss
Organizations nowadays, whether public or private organizations, productive or service (such as banks), face major challenges as a result of rapid and continuous changes, and in front of these challenges traditional management operations and tools become unable to make the organization able to work, which makes it imperative for these organizations to follow the methods and management practices, including the proposed knowledge risk management and strategic direction so that it can elevate its actions at the level of developments in reality, in the sense that these organizations and in the light of environmental developments to characterize their strategic direction as an intellectual approach characterized by mo
... Show MoreWe use of multi-choice Goal Programming (MCGP), which is a developed model of Goal Programming where it is used in circumstances of the multiplicity and difference of goals when choosing between decision alternatives in cases of allocating resources, as it is a model that seeks to find the closest and best solutions to the specific values of the goals within the aspiration levels, as the first goal in the multi-choice goal programming model that is used to reduce the total cost of storage and shortage, while the other goal was to reduce the difference between the real demand that the hospitals need from the blood transfusion center and the units that already achieved. The case Iraqi Center
... Show MoreThe aim of the study was extraction of arial part of Euphorbia cyathophora constituents with methanol and evaluate its effect on mitotic index and total chromosomal aberration bone marrow cell and spleen cell in mice 200 gm of E. cyathophora fine powder was defatted then extracted by cold maceration 80% ethanol for seven days. The extract was filtered and dried in a rotary evaporator then the dried extract was suspended with water and consecutively extracted using chloroform, ethyl acetate for each. The aqueous layer was then mixed with 100ml methanol. These fractions are dried under reduced pressure to obtain the dry extract. Twenty-four Albino mice were used for the experiment. The animals were divided into four groups: Gr
... Show MoreThe fluctuation properties of energy spectrum, electromagnetic transition intensities and electromagnetic moments in nucleus are investigated with realistic shell model calculations. We find that the spectral fluctuations of are consistent with the Gaussian orthogonal ensemble of random matrices. Besides, we observe a transition from an order to chaos when the excitation energy is increased and a clear quantum signature of the breaking of chaoticity when the single-particle energies are increased. The distributions of the transition intensities and of the electromagnetic moments are well described by a Porter-Thomas distribution. The statistics of electromagnetic transition intensities clearly deviate from a Porter-Thomas distribution (i
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Objectives: This study aimed to evaluate the effectiveness of an educational program on nurses' practices concerning therapeutic communication.
Methodology: A quasi experimental design was carried out at Karbala Center for Cardiac Diseases and Surgery, Imam Hussein Medical City and Al-Handia General Hospital for period 10th June 2017 to the 15th of August 2018.
The program and instruments were constructed and developed by the researcher to measure the purpose of the study. Purposive sample comprised of (57) nurses were divided into two groups, study and control groups. The questionnaire consisted from two parts, first part is related to nurses' demographic characteristics and second part which include practices checkl
Silver diamine fluoride (SDF) has shown effectiveness in hardening tooth structure and killing bacteria. Therefore, it can be used to prevent and arrest dental caries. Riva Star (SDF) treatment alone will stop cavities but will not reverse the cavitation. The Silver Modified Atraumatic Procedure, often known as Smart, is the optimum technique for regaining the tooth's structure and function. Glass ionomer was introduced in (1972) as a new material that has become one of the most widely used materials in restorative dentistry. By releasing fluoride ions, this material has a therapeutic impact on the surrounding tooth structure. Microleakage is the ingress of bacteria, its byproducts, toxins, chemicals, oral fluids, and ions between t
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El Ultraísmo es un movimiento literario que comenzó en España a finales de 1918 y continuó hasta el año 1922. Este movimiento, que representó la contribución de España al Vanguardismo literario, que en la primera parte del siglo XX surgió en toda Europa, se desarrolló no tanto a través de los libros, cuanta a través de las revistas literarias de la época.
La creacionista es, sin duda, la escuela que dio a Ultra mayores aportes. Por esta razón, en las literaturas de Vanguardia se funden, y a veces también se confunden, con frecuencia, Ultraísmo y Creacionismo. Los dos movimientos eran como una revo
... Show MoreHerein, a cost-effective bio approach using extract derived from desert truffles (Tirmania nivea) is utilized to synthesize gold nanoparticles (AuNPs). AuNPs were thoroughly investigated using UV–vis, XRD, SEM, and TEM analyses. It was shown that nanoparticles had an fcc structure with a smooth spherical surface, an average diameter of 9.44 ± 0.26 nm, and an SPR band observed at 548 nm. Investigations were conducted on AuNPs' antibacterial and anti-cancer properties of prostate cancer cells. The findings suggest that AuNPs showed better antibacterial effects against S. aureus compared to E. coli, P. aeruginosa, and K. pneumoniae. AuNPs’ combination with antibiotics demonstrated a synergistic effect with significant antibacterial activi
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