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.
Narcissism is a complicated phenomenon that can be reflected in the narcissist’s language. Investigating narcissism in terms of linguistics, and pragmatics in particular, does not seem to have been given its due attention, as this study reveals. Thus, this study is an endeavor to discover how narcissism is reflected in the American movie Big Eyes (2014). It is known for introducing narcissistic behaviors. This paper aims to identify the types, motivations, and pragmatic manifestations of narcissism in the selected movie. Three pragmatic theories are chosen to scrutinize narcissism in the data: Searle’s speech acts (1969), Grice’s maxims breaching (1975), and Culppeper’s impoliteness (1996). To cope with the nature of the
... Show MoreRacism changes its meaning, shape, purpose or function according to various factors such as time, place, motives, and backgrounds; among others. It seems, however, to have deep roots back in the history of mankind. Such a concept stems from a perceived difference with the other. It is fed by the feeling of being hierarchically superior in opposition to another party that is depicted as inferior. Since ancient times, racism is disguised in different forms and manifests itself on various levels. It is a truism that this ideology can be best presented via language.
Due to its negative implication, racism lends itself to a critical kind of research. As such, this paper is a critical pragmatic investigation for this phenomenon a
... Show MoreBackground: Suffering from recurrent boils (furunclosis) is a common problem in our locality as it is noticed by many dermatologists especially in association with increasingly hot weather. The most common causative organisms are staphylococci. Objective: The aim of the study was to shed the light upon this problem and compare two systemic therapeutic agents for the prevention of recurrence, doxycycline and rifampicin. Patient and method: One hundred thirty-five (135) Patients with recurrent boils from Al-Yarmouk teaching hospital dermatology outpatient department were included in this study; age ranged from 10 to 64 years old and out of total patients 32 were males and 103 were females. Patients were assessed by full history and cl
... Show MoreThe purpose of the current investigation is to distinguish between working memory ( ) in five patients with vascular dementia ( ), fifteen post-stroke patients with mild cognitive impairment ( ), and fifteen healthy control individuals ( ) based on background electroencephalography (EEG) activity. The elimination of EEG artifacts using wavelet (WT) pre-processing denoising is demonstrated in this study. In the current study, spectral entropy ( ), permutation entropy ( ), and approximation entropy ( ) were all explored. To improve the classification using the k-nearest neighbors ( NN) classifier scheme, a comparative study of using fuzzy neighbourhood preserving analysis with -decomposition ( ) as a dimensionality reduction technique an
... Show MoreGod saw his servants with truth and light, and made him easy for them, and he commanded those who help them, including a counselor, guide and preacher, so if a Muslim sees deficiencies or defects, he must help him to reform and refine it. That it was in the hands of the prophets, God Almighty created the human being together straight, then melted on those scholars and researchers in all religions on psychological counseling and religious sychotherapy, stressing the importance of religious values in the process of understanding man in the process of psychotherapy and in controlling human behavior. A lot of research and studies have been published. I dealt with the religious approach in the process of treating mental disorders and the aim of
... Show MoreFilm and literature exchanges it’s influences since the early beginning of the motion pictures appearance .it was a phenomenon in other genres such as theatre ,short stories and novels .the film used out of this interaction with literature the content , themes and subjects whish were more attached to the society. based on that , the film gains it’s successes and wide spread of influences on it’s audiences who became more familiar with the motion picture style.Astrok , the French film critic wrote about “Camera the pain “ and called it as the a way of writing in the future .he was talking about the future’s role of the film .It is the importance of the film in the creation and documenting the life and its various fields.Becaus
... Show MoreThe present study aims to investigate the various request constructions used in Classical Arabic and Modern Arabic language by identifying the differences in their usage in these two different genres. Also, the study attempts to trace the cases of felicitous and infelicitous requests in the Arabic language. Methodologically, the current study employs a web-based corpus tool (Sketch Engine) to analyze different corpora: the first one is Classical Arabic, represented by King Saud University Corpus of Classical Arabic, while the second is The Arabic Web Corpus “arTenTen” representing Modern Arabic. To do so, the study relies on felicity conditions to qualitatively interpret the quantitative data, i.e., following a mixed mode method
... Show MoreThe importance of the construction sector and its Great role in the provision of services and infrastructure, reduce poverty, improve living conditions and improve the economic situation in the country, impose attention to the way in which the projects implemented for its improvement and to get successful projects. The objective of this research was to determine the criteria for success as well as critical success and failure factors that have a significant impact on project success. A selected 75 engineer (department managers, project managers and engineers) are asked to fill the questionnaire form, Sixty-seven valid questionnaire forms were analyzed statistically to get search results, which were as follows : Twe
... Show MoreThe problem of the paper focused on the role of the learning organization in the crisis management strategy, and the extent of the actual interest in both the learning organization and the crisis management and aimed at diagnosing and analyzing that and surrounding questions. The Statistical Package for the Social Sciences (SPSS) program was used to calculate the results and the correlation coefficient between the two main variables. The methodology was descriptive and analytical. The case study was followed by a questionnaire that was distributed to a sample of 31 teachers. The paper adopted a seven-dimensional model of systemic thinking that encourages questioning, empowerment, provision of advanced technologies, and strategic lea
... Show MoreThis study seeks to address the impact of marketing knowledge dimensions (product, price, promotion, distribution) on the organizational performance in relation to a number of variables which are (efficiency, effectiveness, market share, customer satisfaction), and seeks to reveal the role of marketing knowledge in organizational performance.
In order to achieve the objective of the study the researcher has adopted a hypothetical model that reflects the logical relationships between the variables of the study. In order to reveal the nature of these relationships, several hypotheses have been presented as tentative solutions and this study seeks to verify the validity of these hypotheses.
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