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.
Organizational learning is one of the most important means of human resource development in organizations, but most of the organizations, especially public ones do not realize the importance of organizational learning enough, and estimated his role accurately in building intellectual capital, the resource competitive importantly for organizations of the third millennium and who suffers is other end of lack of understanding of its meaning and how to prove its presence and measured in public organizations, so there is the need for this research, which aims to investigate the effect of organizational learning its processes (knowledge acquisition, Information transfer, Interpreting the information, Organizational me
... Show MoreEveryone agrees on the importance of internal music, as it is the greatest pillar in poetry music. Because it differs in internal music, and we seek in this research to shed light on the internal music in the book The Young Branches of Ibn Saeed Al-Andalusi, in terms of the poets' choice of words and styles that make up the internal music
Often requires the investor to know the result of the company's activity contribute to the investor or by wanting to invest in them because profit or loss of the company affect positively or negatively in the price of shares of the company and with the end of the fiscal year delayed companies often to issue its financial statements after it is approved and audited by an observer External Auditor, From here came the idea of research that appears to stakeholders of financial statements proactive appear, including actual figures for earlier stages have been prepared lists about lists and planned by the administration reflect the results of its phase remainder of the year as if they are (half a year or season or month) to offer At the
... Show MoreThe research aims to identify the concept of financing structure and what are the determinants that affect it and the goals achieved by financing in commercial banks in addition to the sources upon which the financing structure depends consisting of internal financing sources and external financing sources and their connection to the profits of commercial banks. Baghdad, Khaleeji Commercial Bank) registered in the Iraq Stock Exchange during the period for the years (2011-2020) published in the Iraq Stock Exchange from and the research relied on financial analysis tools to analyze the independent variable the following financing structure (the ratio of equity to total assets, the ratio of deposits to Total liabilities, the ratio of loans
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The study aims to identify the common fears of preschool children and their relationship to the approaches to parental treatment in South Al Batinah Governorate from their mother’s point of view. Total of (466) mothers were selected as the study sample. The researcher used the scale of common fear and the scale of parental treatment approaches. The results of the study have shown that the most common fear among the study sample was (the fear of darkness) in the first level with a rate of 75.03%, and in the second level came the item (my child is afraid to sleep alone) by 72.74%, in the third level came to the item (fear of seeing insects) with a rate of 67.59%, and the last one was (the fear of rain) w
... Show MoreIben Katheer Al Dimashqi is considered among the eminent scholars in the eighth Hijri century / fourteenth Gregorian century. He acquired eminent academic and social standing. His book Albidaya Walnihaya is considered among the important historical sources. This book's study of the subject of commercial dealing methods clarifies that the commercial dealing methods dealt by the people throughout the successive historical eras were multiple, most prominent of which was money (whether Dirhams, Dinars, measures (mikyals), weights (like Sa') in addition to other means like usury. But here we notice that Iben Katheer stressed that usury must be prohibited because it is religiously forbidden and cited many Quranic verses and Prophetic sayings w
... Show MoreObjective: To assess the Impact of Socio-economic status on age at menarche among secondary school students at
AL-Dora city in Baghdad, Iraq.
Methodology: This is a cross sectional study with multi-stage sampling was carried out during the period from the
3
th of December2013 to 12th of March 2014. The Sample comprised of 1760 girls, 1510 girls from urban area and
250 from rural area was included in the study. In first stage, selection of schools was done, and one class was
selected randomly from each level of Education, The data collection through a special questionnaire which Contain
the age of girl by year, class level, birth order, number of household, number of rooms, residency (urban/rural),
education level
Objectives: The study aims to assess the nurses knowledge toward prevention of complications related to valvular replacement surgery and to find out the relationship between nurses knowledge and their demographic and occupational characteristic's Which as (Age, gender, level of education ,years of experience in Surgical Department , and training sessions)
Methodology: A descriptive design (a cross-sectional study ) was carried out from December 2017 to May 2018 in order to assess nurses' knowledge of preventing complications Valvular Replacement Surgery at Surgical Department in Nasiriyah Heart Center on a purposive (non-probability) sample
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