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 goal of current research to describe and diagnose the level of attention of doctors to design and regulatory dimensions, (strategic vision, organizational structure, organizational processes, business systems, personnel), and the performance of hospitals and dimensions, in six hospitals in medicine and selected a sample for research, as well as identify organizational design effect in the performance of hospitals and dimensions (efficiency, the development of human resources, patient satisfaction, achieve financial results, quality of health care).
Research has focused in part theoretical on key variables to look organizational des
... Show MoreThe media, especially the satellite channels in our time, are one of the most important pillars of daily life, public and private, for society and people, and are considered by sociologists and sociologists as one of the most important factors of social upbringing and the most important, as a result of the technological and technological development of the media as well as increasing their numbers and vertical and horizontal expansion locally, As well as entering into the lives of individuals and people and leading them to important sites within their interests and preferences, not to mention the long time spent exposure to those media and benefit from the programs offered or broadcast. , The problem of this research is that there is a l
... Show MoreHepatitis B virus (HBV) infection is a significant global health problem. Populations of different ethnicities show great heterogeneity in HBV genotype frequency distributions. A cross-sectional study was conducted during June–October 2018 to determine frequency of HBV genotypes among chronic HBV patients from Baghdad, Iraq. The method of detection was nested polymerase chain reaction system. Further, the study assessed the impact of HBV genotypes on serum level of liver-function tests: total serum bilirubin, alkaline phosphatase, alanine aminotransferase and aspartate aminotransferase. Eighty chronic HBV patients were enrolled in the study. Six HBV genotypes were identified (A, B, C, D, E and F). The most frequently encountered genotypes
... Show MoreBackground: The skull offers a high resistance of adverse environmental conditions over time, resulting in the greater stability of the dimorphic features as compared to other skeletal bony pieces. Sex determination of human skeletal considered an initial step in its identification. The present study is undertaken to evaluate the validity of 3D reconstructed computed tomographic images in sex differentiation by using craniometrical measurements at various parts of the skull. Materials and Method: 3D reconstructed computed tomographic scanning of 100 Iraqi subject, (50 males and 50 females) were analyzed with their age range from20-70 years old. Craniometrical linear measurements were located and marked on both side of the 3D skull images.
... Show MoreRecently, microalgae have become a promising source in the production of biofuel. However, the cost of production is still the main obstacle to develop of this type of source. Although there are many extensive studies on the requirements provided for the cultivation of the microalgae, the study of the process, via the variables that affect the cultivation of microalgae, being still one of the important tasks to improve the production of biofuel. The present article is a serious attempt to investigate of use commercial fertilizer NPK (20:20:20+TE N: P: K) as considered a cheap nutrient medium in growth Chlorella vulgaris by comparison with traditional nutrient (Chu.10 medium). In addition, the current study addresses effect of di
... Show MoreRecently, microalgae have become a promising source in the production of biofuel. However, the cost of production is still the main obstacle to develop of this type of source. Although there are many extensive studies on the requirements provided for the cultivation of the microalgae, the study of the process, via the variables that affect the cultivation of microalgae, being still one of the important tasks to improve the production of biofuel. The present article is a serious attempt to investigate of use commercial fertilizer NPK (20:20:20+TE N: P: K) as considered a cheap nutrient medium in growth Chlorella vulgaris by comparison with traditional nutrient (Chu.10 medium). In addition, the current study addresses effect of different spar
... Show MoreThis Study Sought to Determine The Relationship and Impact Between The Tax Core Capabilities and Tax Settlement The Study Took Place in The Tax Administration, and Based The Problem Was to Two Hypotheses As Solutions Initial Mocked Content to Explain The Relationship Between The Phenomena, and to Test The Validity of Assumptions And Due To The Fact That The General Authority for Taxes is The Body for The Advancement of The Collection Tax In Iraq Random Sample Was Selected to Represent The Population of The Study, Since The Sample Included 22 Individuals Representing 70% of The Total Community to Study, Represented by The Director General, Agents and Directors of Departments and Branch Managers Managers Working in The General Authority fo
... Show MoreLocal communities are in need of self-resources so that they can perform their multiple functions which serve the objectives of the local development, and tax revenues are considered as important sources of their funding. However, despite the efforts of the state to reform the fiscal system and to improve the management in the local administration, tax collection can increase when the state adopts a more effective policy to combat tax evasion and tax fraud. Accordingly, this research aims to shed light on the role of local tax revenues in the local development. A set of conclusions are drawn; the most important one is that Algeria, in order to achieve local development, has taken a set of reforms, which are still valid until now. The mos
... Show MoreThe Purpose of this study is mainly to improve the competitive position of products economic units using technique target cost and method reverse engineering and through the application of technique and style on one of the public sector companies (general company for vegetable oils) which are important in the detection of prices accepted in the market for items similar products and processing the problem of high cost which attract managerial and technical leadership to the weakness that need to be improved through the introduction of new innovative solutions which make appropriate change to satisfy the needs of consumers in a cheaper way to affect the decisions of private customer to buy , especially of purchase private economic units to
... Show MoreThis research aims at studying and analyzing the creative research thinking of the educational staffs in private universities and colleges, and also the role of incentives, in its materialistic and moral sides in the development of such thinking and the pack of restraints which cause decline in interest level of the scientificresearch, and its weak role in the development of universities in Iraq, despite the interest of the Ministry of Higher Education and Scientific Research in Iraq in scientific research as part ofits academic and humanitarian targets.Based on study and analysis, and the using if some of statistical methods such as the Alpha Chronobaghcoefficient and the (T. Test)(F. Test),the research reached a number of conclusions.
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