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.
Many managers in geometrical and technical organizations prefer to deal with quantitative values to choose between the available options and choose the best alternative to avoid randomization and bias in decision making. One of them Baghdad Water Department, which seeks to develop the quality of its product (drinking water) and achieve its objectives under increasing growing population and the demand for water, Some of TQM tools, especially the statistical, have this ability because there is chance to use historical data and experiment of employees in Application . Two statistical tools were applied: the nominal group technique, matrix data analysis technique as well as the brainstorming tool to search for the best o
... Show MoreThe research aims to show the impact that the information of the supporting bodies can have and its dimensions represented by (information credibility, efficiency and effectiveness of information, cooperation with the tax administration, obligating the taxpayer, accuracy and completeness of information and the appropriate time) in tax inventory, as well as clarifying the moral differences in The response of the surveyed sample according to the personal variables represented by (gender, educational attainment, scientific specialization, job title, years of service), and the descriptive analytical approach was adopted and in light of it, the questionnaire was designed as a main tool in collecting data from the sample of (80)
... Show MoreThis study was aimed to evaluate the effect of conventional ingredients replacement with alternative ingredients on growth performance, carcass quality, nutrient digestibility and intestinal microbial of broilers. One hundred twenty Cobb500 broiler chicks were randomly assigned to four diets. Corn, soybean meal and fish meal were replaced with rice waste, meat and bone waste and black soldier fly larvae (BSFL) at 0, 10, 30 and 50% to form four treatments. Body weight gain, feed conversion ratio and digestibility of crude protein and fat were improved in broilers fed the replacement diets. Feed intake was not affected by the treatments suggesting that the replacement diets were well accepted by the chicken. Escherichia coli was decre
... Show MoreHemorrhagic insult is a major source of morbidity and mortality in both adults and newborn babies in the developed countries. The mechanisms underlying the non-traumatic rupture of cerebral vessels are not fully clear, but there is strong evidence that stress, which is associated with an increase in arterial blood pressure, plays a crucial role in the development of acute intracranial hemorrhage (ICH), and alterations in cerebral blood flow (CBF) may contribute to the pathogenesis of ICH. The problem is that there are no effective diagnostic methods that allow for a prognosis of risk to be made for the development of ICH. Therefore, quantitative assessment of CBF may significantly advance the underst
The goal of the study is to discover the best model for forecasting the exchange rate of the US dollar against the Iraqi dinar by analyzing time series using the Box Jenkis approach, which is one of the most significant subjects in the statistical sciences employed in the analysis. The exchange rate of the dollar is considered one of the most important determinants of the relative level of the health of the country's economy. It is considered the most watched, analyzed and manipulated measure by the government. There are factors affecting in determining the exchange rate, the most important of which are the amount of money, interest rate and local inflation global balance of payments. The data for the research that represents the exchange r
... Show MoreThe aim of the current research is to reveal the effect of using brain-based learning theory strategies on the achievement of Art Education students in the subject of Teaching Methods. The experimental design with two equal experimental and control groups was used. The experimental design with two independent and equal groups was used, and the total of the research sample was (60) male and female students, (30) male and female students represented the experimental group, and (30) male and female students represented the control group. The researcher prepared the research tool represented by the cognitive achievement test consisting of (20) questions, and it was characterized by honesty and reliability, and the experiment lasted (6) weeks
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The study aims to know the degree of secondary school managers' practice of servant leadership in Gaza from their teachers’ perspective. It further aims to examine whether there are any statistically significant differences at (α 0.05≥) between the means of the study sample’s members attributed to variables such as (gender, educational qualification, and years of experience). To achieve the objectives of the study, the study adopted the descriptive survey method, using a questionnaire consisting of (30) items distributed to four domains: (workers service, ethical dealing, motivation & influence, and building an organized, integrated society). Then, the questionnaire was distributed to t
... Show MoreA field experiment was conducted during the spring season 2020 in Karbala proving/ Al-Sharia Distrit, located at latitude N 32° 42' 13.8" and longitude E 43° 54' 36.6" and at an altitude of 27 m above sea level. The experiment included a study of two factors: the first, Irrigation Interval, three treatments were used: irrigation treatment every 2 days, Irrigation treatment every 4 days, and Irrigation treatment every 6 days. The second factor is the addition of soil conditioners, in which four treatments were used: the control treatment without any addition, the treatment of adding bio-organic fertilizers, the treatment of adding water-conserving technology (polymer), and the treatment of adding water-conserving technology + fertilizers O
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