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.
Background: There is a strong desire of adolescent to have a peer group and to be appreciated and also to become a member of this group which can affect one each other. There for; encourage, adapting,and imitating of friends and group consider as the main reasons behind starting of smoking among youngsters. Smoking habits in the family were found tobe acause of smoking pressure among adolescentas peer pressure. Smoking habit may be started before 18 years of age in most adult smokers.
Objectives: To study the effect of peer pressure and family smoking habiton the prevalence of smoking among secondary school students.
Type of the study: A cross
... Show Morethe Current research aims to identify the psychological stressors coping strategies and their relationship to the cognitive motivation among Al-Anbar University students through the following hypotheses: 1) no statistically significant differences at a level (0.05) among the sample according to the instrumental support strategy depending on the variable type and specialization, 2) No statistically significant differences at a level (0.05) among the sample in regard of coping avoiding strategy depending on the variable type and specialization, 3) There is no statistically significant difference at a level (0.05) in cognitive motivation level among Al-Anbar University students, 4) No statistically significant differences at a level (0.05)
... Show MoreRemoving Congo red (CR) is critical in wastewater treatment. We introduce a combination of electrocoagulation (EC) and electro-oxidation (EO) to address the elimination of CR. We also discuss the deposition of triple oxides (Cu–Mn–Ni) simultaneously on both anodic and cathodic graphite electrodes at constant current density. These electrodes efficiently worked as anodes in the EC-EO system. The EC-CO combination eliminated around 98 % of the CR dye and about 95 % of the Chemical Oxygen demand (COD), and similar results were obtained with the absence of NaCl. Thus, EC-EO is a promising technique to remove CR in an environmentally friendly pathway.
This research attend about Alienation form for ornament’s clouds in Quran, which includes four parts, the first part talks about the research problem, the researcher identified by following question :( what’s the Alienation form for ornament’s clouds in Quran?). And then the research importance. The research goal talks about Alienation form for ornament’s clouds in Quran. And also research borders, likes means objectives borders, places borders, As well as Terms Definitions, in second part talks about Theoretical framework and previous studies, includes two parts, the first one study Alienation form, meaning and understandable, the second one talks about Alienation form in Islamic arts, As well as the researcher find only one stu
... Show MoreThe design of future will still be the most confusing and puzzling issue and misgivings that arouse worry and leading to the spirit of adventures to make progress and arrive at the ways of reviving, creativity and modernism. The idea of prevailing of a certain culture or certain product in design depends on the given and available techniques, due to the fact that the computer and their artistic techniques become very important and vital to reinforce the image in the design. Thus, it is very necessary to link between these techniques and suitable way to reform the mentality by which the design will be reformed, from what has been said, (there has no utilization for the whole modern and available graphic techniques in the design proce
... Show MoreMany critics suggest that Beckett’s early plays are comic because they focus their analyses on the use comic elements. Waiting for Godot is one of Beckett’s early plays, and it has been heavily analyzed and read as a comic text partly because its subtitle is “a tragicomedy in two acts” and also because of the comic techniques used in the play. The present paper, however, attempts to read the play as a piece in which comedy fails to produce any effects on the characters who remain apparently very desperate and frustrated throughout the play. The characters perform different comic acts, but they do not really feel amused or entertained. The paper suggests that the acts these characters put on stage are only means to pass t
... Show MoreMany economists believe that the development and promotion of small and medium-sized enterprises is one of the most important sources of economic and social development in countries in general and in developing countries in particular. This is considered to be an essential starting point for increasing production capacity and contributing to tackling poverty and unemployment. In view of the importance of these projects, most developing countries have concentrated their efforts on them. They have encouraged the establishment of small and medium industries, especially after they have proved their ability and efficiency in dealing with the major problems facing different economies.
The banking system plays an important role by finan
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