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 current study is based on previous findings, where corporate governance (CG) significantly increased corporate social responsibility (CSR) to enhance transparency while reducing the tendency of corporate management to engage in earnings management (EM). A sample of 11 Iraqi banks listed on the Iraq Stock Exchange from 2010 to 2020 was selected. The CG was included in the board size and board independence apart from the variables of Chief Executive Officer (CEOs) gender, majority shareholder ownership, foreign ownership, and institutional ownership. The CSR included the wage growth rate, bank contribution growth rate for social security, training programmes, subsidies, environmental protection, and bank compliance with the law. Specifica
... Show MoreThe research aims to know the impact of science, technology, engineering, and mathematics education on both creative thinking and mathematical achievement. To achieve it, the two researchers followed the quasi-experimental approach with an experimental design for two groups, one experimental and the other a control. The research sample consisted of (32) female students from the fourth scientific grade in Al-Intisar Preparatory School for Girls/ AlRasafa, First Directorate. The sample was chosen intentionally and was divided into two groups: a control group studying by the traditional method, their number (16), and an experimental group that applied the STEM approach, their number also (16). There was parity between the two research groups i
... Show MoreObjective: This experiment was conducted to study the effects of ionized water on certain egg quality traits and the levels of proteins and enzymes in the blood of the Japanese quail Coturnix japonica . Materials and Methods: One hundred 42-day-old quail were randomly distributed among five treatment groups with four replicates for each group. The following treatments were used: T1 (control): The birds were provided normal water, T2: The birds were provided alkaline water (pH = 8), T3: The birds were provided alkaline water (pH = 9), T4: The birds were provided acidic water (pH = 6) and T5: The birds were provided acidic water (pH = 5). A Complete Randomized Design (CRD) was used to investigate the effects of the studied treatments on diffe
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Flavonoids were extracted from Zizyphus spina-christi leaves by Ethyl acetate after acid digested and used as antioxidant. The dried extract was added separately to each sample of fat extracted from hallow cow and sheep bones as follows: T1 cow fat, T2 control for cow fat, T3 sheep fat and T4 control for sheep fat (the control T2 and T4 reffered to samples without added antioxidant).
Samples were stored at -18, 5, 25 and 55 °C for 28 days. The storage trials were conducted at -18, 5 and 25 °C for 28 days for T1, T2, T3 and T4. The chemical indices examined initially and at the end of storage period. PVs was 1.46, 1.46, 1.8 and 1.8 meq/ Kg oil respectively, FFA values were 0.245, 0.245, 0.244 and 0.244% respectively and TBA va
במחקר זה אבקש לעסוק בתימת העקדה בשירתה של חוה פנחס כוהן. סיפור העקדה נבחר לעמוד בבסיסה של המחקר ממספר סיבות. ראשית, כיון שהסיפור הוא סיפור משמעותי, מאורע חשוב במסורת היהודית. שנית, כיוון שעניינו אותי מערכות היחסים השונות בסיפור. מערכת היחסים בין יהוה לאברהם, מערכת היחסים בתוך המשפחה ומערכת היחסים בין יצחק לאברהם. במערכות היחסים הללו משכו את תשומת לבי גם אותם דברים שאינם כתובים בתנ״ך (לדוגמה: מה הייתה תגובת שרה
... Show MoreTranslation is a dynamic and living process that cannot be considered equal to the original text and requires the appropriate structure, language, thought and culture of the target language, and the translator's intellectual, linguistic and cultural influences inadvertently penetrate into the translated text. It causes heterogeneity of the destination text with the source text.
Admiral's theory is trying to help by providing components and suggested approaches to resolve these inconsistencies. In the meantime, in addition to the mission of putting words together, the translator must sometimes sit in the position of the reader and judge and evaluate the translated text in order to understand its shortcomings and try to correct it a
... 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 MoreThe 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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