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.
François 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 MoreIn the tenth century, Turks began to convert into Islam and adopted for official and literary use the Arabic language to study the teachings of the new religion they believed in. The use of many of the loanwords have become absolute in the Ottoman period, but even in Modern Turkish a large number of loanwords from Arabic can be often recognized because they are not subject to the strict rules of Turkish. Yet, some of these words lost its original meaning and acquired new different Turkish meaning. Moreover, some of the Arabic nouns of singular form in Turkish, modified the plural Turkish form. The present study entitled “the adaptation and the different modifications of borrowed Arabic Plurals in Modern Turkish” sheds light on
... Show MoreThe study aimed to identify the relationship between the speed and direction of the ball's rotation in the accuracy of the front and rear side longitudinal blow in wheelchair tennis players. The descriptive approach wasused in the manner of correlations to suit the nature of the problem to be studied. The research community identified the 32 players aged18 and over, and the search sample was selected from players with a local classification registered with the 2020 Wheelchair Ground Tennis Federation (2020) in the intentional manner of 8 players, using Smart Tennis Sensor technology to measure the speed and direction of the ball and test the accuracy of the front and rear side longitudinalstraightstrike. She conducted the reconnaissance exp
... Show MoreThis research aims to identify the impact of Daniel's model on the development of critical thinking. In order to achieve this objective, the following hypotheses are formulated: 1. There is no statistically significant difference at the significance level (0.05) between the average differences in the posttest scores of the experimental group taught according to Daniel's model and the control group taught according to the traditional method in the measure of critical thinking. 2. There is no statistically significant difference at the significance level (0.05) between the average differences in the preand post-tests scores of the experimental group taught according to Daniel's model in the measure of critical thinking. The current research i
... Show MoreThe importance of this research has been to rationalize the cost of producing maize seeds through the followers of modern techniques and methods in agricultural activities such as genetic engineering for the purpose of increasing production efficiency of maize seeds as well as the importance of calculating seed cost rationalization through the ABC system and thus rationalizing government spending. The research is based on a single hypothesis that the use of genetic engineering on corn seeds works to:increase production efficiency of seeds and savings in agricultural inputs, calculation of rationalization through the cost system on the basis of activity ABC The research reached a number of conclus
... Show MoreThe importance of this research has been to rationalize the cost of producing maize seeds through the followers of modern techniques and methods in agricultural activities such as genetic engineering for increasing production efficiency of maize seeds as well as the importance of calculating seed cost rationalization through the ABC system and thus rationalizing government spending. The research is based on one hypothesis in two ways that the use of genetic engineering on maize seeds works to: one - increase production efficiency of seeds and savings in agricultural inputs. 2. Rationalize the costs of examining and planting maize seeds. In order to calculate the costs will be based on the cost system based on activities ABC. The research
... 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 Moreבמחקר 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 MoreThe issue of nuclear proliferation is one of the most vital issues as it reflects a form of dealing in the field of international relations. Therefore, the Middle East region has taken great interest in reducing the levels of nuclear armament and acquiring nuclear power within the strategic framework of the international and regional powers. The establishment of a nuclear-weapon-free zone in the Middle East region is currently one of the most important international and regional arrangements for controlling the levels of nuclear proliferation and attempting to build a state of stability and balance. In the Middle East and the world. The importance of the research comes from the fact that it deals with an important and vital issue
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