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.
Back ground: Chronic total occlusion (CTO) of coronary arteries remains one of the most challenging lesion subsets in interventional cardiology even with the development of medical devices and operator expertise. Successful revascularization results in improved in angina status ,increased exercise capacity and reduces the need for lat CABG surgery .
Objectives: This study sought to determine the overall procedural success rate of percutaneous coronary intervention (PCI) for CTOs and to examine the relation between variables such as; patients’ characteristics, risk factors, lesion characteristics and procedural success rate.
Methods: In this study ,clinical and coronary angiography data of (80) patients with CTO who underwent PCI
Almost human societies are not void of poverty, as the latter accompanied the emergence of humanity, and it, thus, represents an eternal problem. To advance an individual's reality and raise the level of the poor social classes, social security networks have been established. Such networks operate in society following social systems and laws to provide food, and material support. Besides, such networks help to rehabilitate the individual academically and vocationally. They empower vulnerable groups through the establishment of courses and workshop, provide (conditional) subsidies related to the health and educational aspects in order to achieve the sustainable development goals of (2030), and apply developmental roles of social safety ne
... Show MoreThe study focuses on the causes of minaret tilting as well as possible solutions. The major aims of this study are to improve knowledge of historical tall structure stability and rehabilitation operations using the finite element approach to model the soil and minaret (PLAXIS 3D 2020), a platform for computational soil investigation and modeling. The numerical analysis aims to identify stresses, settlement, and deformation of the soil and minaret in various scenarios like Earthquakes, explosions, and winds. The simulation of the problem by the PLAXIS 3D revealed that the greatest lateral displacement computed at the Top Minaret is 5.5 cm, and the greatest vertical movement is calculated to be 3 cm. Seismic settlement is the effect of ear
... Show MoreThe research represents an applied study to the urban scene of Baghdad city center within the area of (Al Bab Al Sharqi – Al Tahrir Square) through studying and identifying the levels of the reciprocal correlation of advertising signs impact on urban scene , then finding out the indicators and potential values which have made advertising signs as positive value by achieving the mechanisms of visual quality or a negative value by achieving mechanisms of visual pollution. And then examining the resulted visual perception defect reforming mechanism from it and identify the basic elements represented of the laws and legislation known worldwide. When presenting the problem, The research depends on: (Lack of clear perception
... Show MoreThis study aims to assess the removal efficiency andestablish the BOD5 and COD statisticalcorrelation of the sewage flowing in Al-Diwaniyah wastewater treatment plant in Iraq during the study period (2005-2016). The strength of the influent wastewater entering the plant varied from medium to high in strength. High concentrations of BOD5 and COD in the effluent were obtained due to the poor performance of the plant. This was observed from the BOD5 /COD ratios that did not confirm with the typical ratios for the treated sewage. To improve the performance of this plant, regression equations for BOD5 and COD removal percentages were suggested which can be used to facilitate evaluation of liquid waste and optimal control process. The equations
... Show MoreThe Al-Shishtary is considered one of the well-known Andalus poets. His poetry represents a flood of kind emotions, springs from the sincere sources of Divine Love, and this is what we felt in his life and his literary prestige. He was a poet who was familiar withthe art of his timeknowsthe oldand popularintellectual assets ofIslamicSciencesof Sharee'a. This wide culture, which he had, is available to him through his many travels between the coasts of Syria, Egypt and others ... to become Imam of the religion way known as(Al-Shishtariyah)resonatedin the hearts ofthe general publicespecially the poor people. This showshis smoothand influential styleand his humanitarian andsimple words which resonate in the hearts of his followers, therefo
... Show MoreThis study falls within the core of the deliberative theory, as this research seeks to highlight the concept of dialogical imputation that is present in all the discourses received by the recipient, and that this is not limited to dialogues, and that is why it is called (deliberative imperative). This is in agreement with the deliberative and functional approach that sees literary discourse as a dialogical and fulfilling necessity, due to its attachment to artistic connotations and submerged meanings in the saying. The allotted obligation and its impact on determining the purposes: The specific implication represented an important axis of pragmatic research, and a major concern in the work of discourse analysis. Because of its great importa
... Show MoreMarketing is one of the most important pillars on which most industrial and commercial sectors depend on evaluating their performance, improving their financial position, development and economic growth. The presence of effective marketing activities in any industrial or commercial organization (which works to meet the requirements of customers in order to ensure the integration of trading and handling rings with consumers and to ensure the growth of the marketing process regularly and not to retreat) effectively contributes to maintaining the company's position between its competitors and its customers. It is necessary to have these marketing activities in order to meet the requirements of the organization on the one hand and to
... Show MoreThrombosis is a common clinical feature associated with morbidity and mortality in coronavirus disease-2019 (COVID-19) patients. Cytokine storm in COVID-19 increases patients' systemic inflammation, which can cause multiple health consequences. In this work, we aimed to indicate the effect of Pfizer-BioNTech vaccination on the modulation of monocyte chemoattractant protein-3 (MCP-3), matrix metalloproteinase 1 (MMP-1), and tumor necrosis factor-alpha (TNF-α) levels, and other systemic inflammatory biomarkers that associates with COVID-19 severity in patients who suffers from thrombosis consequences. For this purpose, ninety people were collected from Ibn Al-Nafees Hospital and divided into three groups each of which contained 30 people, 15
... Show MoreWith its rapid spread, the coronavirus infection shocked the world and had a huge effect on billions of peoples' lives. The problem is to find a safe method to diagnose the infections with fewer casualties. It has been shown that X-Ray images are an important method for the identification, quantification, and monitoring of diseases. Deep learning algorithms can be utilized to help analyze potentially huge numbers of X-Ray examinations. This research conducted a retrospective multi-test analysis system to detect suspicious COVID-19 performance, and use of chest X-Ray features to assess the progress of the illness in each patient, resulting in a "corona score." where the results were satisfactory compared to the benchmarked techniques. T
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