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.
Water supply projects (WSP) requires high plan information, specialized capabilities, capable human resources, and high administrative capacity. However, in the developing countries, particularly in Iraq, these projects experience a lack of a large number of these necessities, which shows the need to identify the critical success factors (CSFs). Accordingly, the objectives of this research are to investigate the CSFs for WSP and their significance among the construction (public and private) and education sectors. To achieve this, first we have carried out a comprehensive literature review of the CSFs for WSP. Second, we administrated a questionnaire survey to 260 construction experts
This study aims to suggest an alternative to the use of quality agricultural soil in the brick industry (Iraq). The Late Miocene claystone bed in the Injana Formation in central Iraq was targeted through the study of 18 exposed sections that were sampled by using the trench sampling method. The claystones are characterized by quartz (36.4%) followed by calcite (32.8%), quartz (36.4%) feldspar (2.6%), gypsum (1.3%) and dolomite (0.7%), kaolinite (10.5%), illite (7.7%), chlorite (6.7%), palygorskite (6.0%) and montmorillonite (0.7%). New thermal mineral phases were formed at 950°C, including diopside (62.9%), quartz (18.4%), wollastonite (8.28%), akermanite (7.6%), Anorthite (6.25%), Nosean (4.9%), gehlenite (3.75%) and Lazurite (3.1
... Show MoreIn this paper, we will study non parametric model when the response variable have missing data (non response) in observations it under missing mechanisms MCAR, then we suggest Kernel-Based Non-Parametric Single-Imputation instead of missing value and compare it with Nearest Neighbor Imputation by using the simulation about some difference models and with difference cases as the sample size, variance and rate of missing data.
Diversity has become one of the required phenomena to be available within public organizations, in light of the changes taking place in the global and international environment and in various fields. Therefore, it was imperative to study the impact of this phenomenon in various institutions, especially public ones, in most developing countries, including Iraq. The current research aims to analyze the relationship between The demographic diversity and institutional effectiveness of a sample of workers in public institutions included (500) respondents. The questionnaires were distributed to them randomly. Diversity is considered an independent variable and institutional effectiveness a dependent variable. The researcher used interview tools a
... Show MoreThe aim of the research is to identify the extent of the ability to ensure the integrated reports by the auditor in verifying the credibility of these reports, and their implications for the benefit of all parties dealing with the economic unit, as well as measuring the impact of the assurance procedures followed by the auditors and their role in confirming these reports.
The research methodology was designed after studying the previous literature related to the research variables, and then the relationship between these variables was tested, through the use of a questionnaire list. A questionnaire targeting the community of auditors in the local environment, and the results of the study wer
... Show MoreThe dangers of (Israel's) integration with Arab countries in the middle east region will threaten the Arab security structure dimension, which the latter makes the Arab regional system vulnerable for distortion due to its nominal and symbolic value which is far from the Arab self and questioning with its effectiveness in comparing with the real capabilities to Arab countries in achieving the common targets. So, how to assess the different problems that began to hit the structure of the Arab regional system? and how to pledge an allegiance after putting forward what is known as the American Deal of the Century for the administration of former US President Donald Trump for making another step toward normalization with (Israel)?. The reveal
... Show MoreThe research focuses on determining the role of customer relationship management in improving financial performance by surveying the opinions of a number of employees of a number of Iraqi private banks. The customer has become the focus of attention and the most important factors of success and profitability and competition. Therefore, decisions related to the customer are important decisions that support the process of making, And follow-up of administrative decisions, including financial decisions aimed at improving the financial performance of banks and distinguish them from competitors. Thus, the techniques used in customer relations management programs to collect, analyze and use data and information have beco
... Show MoreA modified water injection technique has organized by this study to improve oil recovery of the Mishrif reservoirs using polymerized alkaline surfactant water (PAS-Water) injection. It is planned to modify the existing water injection technology, first to control and balance the hazardous troublemaker reservoir facies of fifty-micron pore sizes with over 500 millidarcies permeability, along with the non-troublemaker types of less than twenty micron pore sizes with 45 to 100 millidarcies permeability. Second to control Mishrif reservoirs rock-wettability. Special core analysis under reservoir conditions of 2250 psi and 90 °C has carried out on tens of standard core plugs with heterogeneous buildup, using the proposed renewal water f
... Show More