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 current study highlighted the violations and the steady depletion of , and agricultural and green areas in and around cities , which is an accurate scientific research problem that affects the future perspectives of these areas, their production and their consequences for the life of cities and their vital surroundings. This research took Baghdad city as a model of this critical phenomenon in order to study the reality of these regions, the size of violations, and to set a future concept and strategy, in addition to the proper treatment that preserves the assets of this great wealth , It was one of the most important conclusions Urban planning disruption of Baghdad city formations ,One of the most important recommendations , Scaling Bag
... Show MoreExperienced organizations in recent years, significant challenges , especially with the spread of economic globalization, making it required to provide new and better through experience , creativity and innovation to achieve the quality and high-quality products of all kinds , in order to achieve the objectives of the study and to answer its questions tested the study in the woolen Industries sector in Baghdad . The study was applied to a sample of 30 people in the senior management and the middle and lower in the company (managers of sections , and managers of people , and managers of the units , and office managers ) and for the processing of data and information used several statistical methods and extracted result
... Show MoreBackground. The motor response is a fundamental ability that is evident during any physical or motor activity. However, the need for this ability varies from one sport to another and depends on the specific skills required in each sport. Objectives. This study aims to compare the average motor reaction times of the arm and leg among handball, basketball, and volleyball players aged 14 to 16 years. Methods. The sample included 30 players aged 14-16 years from the sports talent care center, evenly distributed on handball, basketball, and volleyball. Standardized tests were used to measure the speed of motor response, including the Batak Micro test for hands, which records the number of responses to light stimuli in 30 seconds, and the Saqer t
... Show MoreThe evaluation of banks plays an important role in maintaining the interests of customers with the bank as well as providing continuous supervision and control by the Central Bank. The Central Bank of Iraq conducted an assessment of the Iraqi banks through the implementation of the CAMEL model during a certain period. This evaluation did not continue. The research provides continuity to the Central Bank's assessment and as a step to continue the evaluation process for all banks through the use of the CAMEL model. ROA and ROE by using the regression model for four Iraqi banks registered in the Iraqi market for securities during the period 2010-2016. The results showed that the capital and profitability indicators have a significan
... Show MoreBACKGROUND: Many genetic factors are known to be related to osteoporosis, and currently the role of the glucagon-like peptide-1 receptor (GLP-1R) gene in bone health has been studied intensively. Some variation of this gene, such as rs1042044 and rs6458093, are known to be linked to metabolic diseases and lower bone mineral density, however their specific contribution to osteoporosis remains largely unexplored. Therefore, this study was conducted to investigate the combined genotypic effect of rs1042044 and rs6458093 as a genetic risk factor for osteoporosis in postmenopausal Iraqi women.METHODS: Blood samples from 75 osteoporosis patients and 75 healthy controls, aged 45-85, were collected. DNA was extracted, and a region of GLP-1R
... Show MoreThe traditional city suffers from the decline of the urban image due to urban development and homogeneity with the urban context of the city, and because of the lack of determinants governing the urban image, it is that the center of the city of traditional Kadhimiya suffers from a break in the urban image, Therefore, the research included how to build a distinctive urban image of the center of the traditional city of Kadhimiya and achieve the visual pleasure and comfort of the recipient and the urban image here means is an image not picture which are related to several aspects, including physical, social and psychological as well as the collective memory of individuals and their rela
DBNRAHA Hameed, IJRSSH PUBLICATION, 2018
Dell Hymesin 1964coined The Ethnography of Communication in an attempt to explain the ways in which people use the language to interact. It hypothesizes that ethnography is less applicable among participants who have the same sociocultural background. It was proven that all the basic speech components occur whenever there is an interactional situation. The elements of (SPEAKING) schema are closely connected. However, the findings establish the fact that these elements take place effectively among participants who have the same sociocultural background.One of the most outstanding conclusions is the capability of the (SPEAKING) model to analyze not only an interaction between two or more participants, but also any event which consists of a mo
... Show MoreNeed organizations today to move towards strategic thinking which means analyzing situations faced by particular challenges of change in the external environment, which makes it imperative for The Organization That to reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures, to try to achieve improvement root in the installation of the organization and methodscompletion of its work towards achieving high levels of performance and that is reflected to achieve its objectives, and this is what aims to Current search to deal with implications characteristics of strategic thinking in the stages of application re-engineering business of the company General Industries
... Show MoreIn this research, a selection of some mineral water was selected on the basis of being the most marketed by the owners of shops in Najaf province, with six types, where daily samples of this water were taken by 50 ml for two months from (1/11/2018 -1/1/2019). The following ions concentrations were measured (Br-, Cl-, F-, NO3-, SO42-, Na+, K+, Ca2+, Mg2+), pH and the electrical conductivity were measured and the results were compared with the allowable rates according to the international organizations. It was noted that they conform to international and Iraqi standards.