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 research addresses the questioning of political loads in a cinematic model from the films of the author (David Abdel Sayed), who has been busy throughout his films in criticizing political power, where he presented protests visions her body the artistic composition of cinematic means of expression through artistic treatments that facilitate the representations of modernity in contemporary cinematic trends, and by this Several contemporary cinematic criticism is an example of a thinker cinematographer who presents his critical thesis on power politics through the composition of the film (material - form - expression). The research consisted of four chapters. The first was a methodological framework that included the research problem o
... Show MoreThe field of graphic design has witnessed a unique, unique form transformed in its construction and installation and superior to systems through its creation of foundational data for design ideas with functional aesthetics and utilitarianism and effective and moving formulation in light of modern trends and what globalization has brought about in terms of openness to the outside world and the processes of communication and communication with the international community through graphic design. Based on the above, this study marked (Aesthetics of the Design Idea and its Communication Role in the Graphic Outcome) comes to clarify the topic through three chapters, including the first chapter, which was devoted to the research methodology, th
... Show MoreThe constructivist learning model is one of the models of constructivist theory in learning, as it generally emphasizes the active role of the learner during learning, in addition to that the intellectual and actual participation in the various activities to help students gain the skills of analyzing artistic works. The current research aims to know the effectiveness of the constructivist learning model in the acquisition of the skills of the Institute of Fine Arts for the skills of (technical work analysis). To achieve the goal, the researcher formulated the following hypothesis: There are no statistically significant differences between the average scores of the experimental group students in the skill test for analyzing artworks befor
... Show MoreThis research discusses the rehabilitation of heritage markets in the historical centers of Islamic Arab cities and their use in the field of cultural tourism as one of the most important tourist attractions and the subsequent revival of the national economy in addition to preserving the urban heritage as these markets part of the historical centers of cities. The research also discusses the preservation of the continuity of heritage markets as a product of cultural heritage value within an integrated framework to preserve the urban heritage in the historic centers of cities. The study then reviews a number of experiences of Arab and Islamic countries in the field of preserving and rehabilitating heritage markets, which qualify them to b
... Show MoreThis research investigates the meanings and significance of the verse and the concluded educational purports. The expression “And in the heaven is your provision” signifies the deism of Allah. This research introduces the what have been said by Quran Explainers about meaning of Heaven & Provision. It introduces also the meaning of the sentence “which you are promised” and its concluded educational purports. This research discuses the role of educational institutions as well as the family and mosques in connecting Muslims and their children with the promise given by Allah.
Provision is guaranteed for all people if moral and material causes have been considered.
Key Words:
Purports – Educational – Co
... Show MoreWe aimed to examine the potential protective effects of Iraqi
Rats were assigned to four groups, six in each group. Group I: rats were administered a daily oral dose of 1 mL/kg/day of distilled water. Group II: rats were intraperitoneally injected with 70 mg/kg DEN once per week for 10 conse
The function of internal auditing has become an important function that aims at achieving objectives that are compatible with these developments and changes that have occurred in many countries in the world, which required the emergence of professional associations and institutes in the profession of internal auditing. Improve the guideline of the internal audit units issued by the Federal Audit Bureau to enhance the efficiency of internal audit performance in Iraqi government units. The researchers adopted the statistical method of proving the hypothesis by constructing a questionnaire that included three main axes: supporting the senior management in adopting the current guide, and the second being the importance of improving t
... Show MoreIn this paper investigate the influences of dissolved CO2/H2S gases, crude oil velocity and temperature on the rate of corrosion of crude oil transmission pipelines of Maysan oil fields southern Iraq. The Potentiostatic corrosion test technique was conducted into two types of carbon steel pipeline (materials API 5L X60 and API 5L X80). The computer software ECE electronic corrosion engineer was used to predict the influences of CO2 partial pressure, the composition of crude oil, flow velocity of crude oil and percentage of material elements of carbon steel on the rate of corrosion. As a result, the carbon steel API 5L X80 indicates good and appropriate resistance to corrosion compared to carbon steel API
... Show MoreThis research presents a numerical study to simulate the heat transfer by forced convection as a result of fluid flow inside channel’s with one-sided semicircular sections and fully filled with porous media. The study assumes that the fluid were Laminar , Steady , Incompressible and inlet Temperature was less than Isotherm temperature of a Semicircular sections .Finite difference techniques were used to present the governing equations (Momentum, Energy and Continuity). Elliptical Grid is Generated using Poisson’s equations . The Algebraic equations were solved numerically by using (LSOR (.This research studied the effect of changing the channel shapes on fluid flow and heat transfer in two cases ,the first: cha
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