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 importance of this research comes from the possibility of achieving positive interaction between accounting and tax through the interest in setting accounting standards and adapting them to local tax legislation, as the adoption of the application of the international standard (IAS 12) for income taxes helps to measure and determine the base for income tax and may lead to an increase in the tax outcome. Through the reliance of enterprises on many accounting bases, and that the tax administration in Iraq depends on the element of personal judgment in determining the tax base, which leads to lack of objectivity in determining the tax outcome, as the impact of the accounting standard (IAS 12) on the tax base and tax outcome is one of th
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В данном исследовании рассматривается символичность (( Джикора )) в лирике иракского поэта ас-Саййаба и перевода лирики o деревне и городе с арабского на русский. Русский читатель пока не имеет возможности познакомиться с стихотворениями Бадра Шакера.
Abstract
The paper aims at making the Russian reader acquainted with the Iraqi Poet Badr Shakir as-Sayyab, and showing the effect of the village an
... Show MoreJumping ability is a fundamental variable in many sports, as its execution requires an integration of muscular strength Q1 and certain biomechanical variables. This is particularly evident in gymnastics jumping events and jump shots in ball games, both of which rely on a high level of vertical resistance. Vertical resistance serves as an indicator of an athlete’s ability to overcome their body weight while counteracting gravitational force to achieve optimal performance. As such, it is considered one of the key factors in movements that demand explosive power and speed. The researchers believe that despite the significant relationship between vertical resistance, speed-strength of the arms and legs, and certain biomechanical varia
... Show MoreFrançois Mauriac’s novel The Desert of Love (1949) puts the reader before an experienced sociologist who is skillfully able to analyze the most mysterious human emotions and feelings. The writer's starting point is that people are similar in feelings but different in behavior. He severely criticized the aristocratic class and uncovered its defects and faults.
The novelist presents Courege's family as an example of the aristocratic class. It is a family torn by hatred, selfishness and disagreements due to absence of intimacy and love. This poisoned environment pushes the father and his son, Raymond, to search away for emotional ventures and banned relations
... Show MoreCharacterization of the heterogonous reservoir is complex representation and evaluation of petrophysical properties and application of the relationships between porosity-permeability within the framework of hydraulic flow units is used to estimate permeability in un-cored wells. Techniques of flow unit or hydraulic flow unit (HFU) divided the reservoir into zones laterally and vertically which can be managed and control fluid flow within flow unit and considerably is entirely different with other flow units through reservoir. Each flow unit can be distinguished by applying the relationships of flow zone indicator (FZI) method. Supporting the relationship between porosity and permeability by using flow zone indictor is ca
... Show MorePurpose: To use the balanced measurement approach as a strategic link for increasing the effectiveness of strategic planning in the direction of achieving satisfaction rates at Bisha University in Saudi Arabia
Design / methodology / approach –The questionnaire survey was used to collect the data of the study from the faculty members at University of Bisha.
Findings –Prove the assumption that the use of the balanced measurement approach - as a strategic planning tool - leads to maximize the satisfaction rates among faculty members at the University of Bisha.
Research limitations/implications- adopt effective strategic planning in order to achieve
... Show MoreCurrent research targeted: Recognizing the impact of the differentiated education strategy on the achievement of the students of the Institute of Fine Arts / Diyala, for the academic year (2018-2019).
The researcher used the experimental approach designed by two groups (control - experimental) and with a post-test to achieve the goal of the research, and the research sample was chosen from students of the fourth stage for the academic year (2018-2019).
The sample was distributed randomly into two groups, the first experimental consisting of (30) students who studied using the differentiated education strategy, and the second control group consisting of (30) students who studied using the traditional method.
The researcher pre
The current research aims to assess the Brief Book of the Modern and Contemporary History of Asia from the perspective of the students in the Department of History, University of Baghdad. The study is carried out in Iraq and the research group has included students of the Department of History in the College of Education--Ibn Rushd and the College of Education for Women- University of Baghdad. The chosen sample of the assigned research consisted of (72) students from third stage in the Department of History, which equals (0.38%) of the total group members amounted (188) female and male students representing (40) students from the College of Education--Ibn Rushd, and 32 students from
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