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.
Abstract
The leases, are regarded as one of the most controversial accounting issues in recent years, since they represents one of the important sources of funding, which may be exploited by the tenant as off- Balance sheet Financing , which negatively affects the quality of financial reporting. The Financial Accounting Standards Board (FASB) and the International Accounting Standards Board (IASB) have "significant" interest in accounting for leases . FASB issued Statement of Financial Accounting Standards 13 on lease contracts in 1976 and IASB issued IAS 17 in 1980, which was amended in 1997 and IFRS 16, issued in January 2016, which will be effective on January 1, 2019 , to solve
... Show MoreThe research gained its importance from the importance of technical reserves in the insurance activity and its impact on the result of the activity of insurance companies and their financial position and thus reflected on the insurance prices as the technical reserves are one of the most important and most valuable budget items usually, as well as that the insurance activity has a role in maintaining economic development where some countries develop laws and instructions for the formation of those reserves binding application to insurance companies and the fact that the financial statements in general are of interest to shareholders, banks, the General Tax Authority and other beneficiaries In the insurance activity as policyholders and t
... Show MoreAchieving goals effectively reflects the success of the institution. However, unless this indicator is coupled with efficiency when achieving goals, the institution will be equal in its achievements, and distinction will remain unachieved. Perhaps the role of the teaching staff in pushing the institution or college towards brilliance focuses on their ability to motivate people on the one hand and their interest in achieving brilliance for the institution. On the other hand, the importance of the research lies in the institution’s reaching a prominent position through the brilliance and creativity of teaching and achieving competition between institutions that make it more brilliance. The study seeks to achieve the goal of the real
... Show MoreThe research aims to identify the availability of some basic competencies that are required to be available to workers in digital agricultural Extension from the point of view of senior management, middle management, and, employees with Post-graduate education degrees, represented by the following: Transition to digital agricultural Extension for sustainable and smart family farms, benefiting from international expertise and experiences in applying for Digital agricultural Extension, preparing and implementing Extension messages through platforms, factors affecting the effectiveness of digital agricultural Extension and its platforms, following up and evaluating the activities and programs of the digital Extension platform. The research pop
... Show MoreThe herein research was carried out in order to identified the presence of bacteria in cervix and uterine lumen in Iraqi cattle during the different estrus phase with focusing on Protus and E coli. Estrus phases were determined by the structures which found on ovary (follicular growth for pro-estrus, mature growing follicle for estrus, hemorrhagic corpus luteam for meta-estrus and active corpus luteam for di-eatrus). Forty cervical swabs (ten for each estrus phase) and forty uterine swabs (ten for each estrus phase) were taken from macroscopically healthy reproductive animals after slaughtering and cultivated on nutrient agar and blood agar, the bacterial isolation were identified with biochemical teats. The present study found that
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The logistic regression model is one of the nonlinear models that aims at obtaining highly efficient capabilities, It also the researcher an idea of the effect of the explanatory variable on the binary response variable. &nb
... Show MoreA novel ligand, (E)-5-((2-hydroxy-4,6-dimethylphenyl)diazenyl)-2,3-dihydrophthalazine-1,4- dione, was synthesized through the reaction of 3,5-dimethylphenol with the diazonium salt of 5-amino-2,3-dihydrophthalazine-1,4-dione. The ligand underwent characterization through the utilization of diverse spectroscopic methods, including UV-Vis, FT-IR, 13C, and 1H-NMR, alongside Mass spectroscopy and micro elemental analysis (Carbon, Hydrogen, Nitrogen, and Oxygen). Metal chelates of transition metals were prepared and analyzed using elemental analysis, mass spectra, atomic absorption, UV-Vis, FT-IR spectral analysis, as well as conductivity and magnetic measurements. The investigation into the compounds’ nature was conducted by utilizing mole r
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