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.
In his masterpiece ’The Prophet’, Kahlil Gibran presents his unwavering faith and passionate belief in the healing power of universal love that brings humans to sublime ideas and elevates their souls and behavior. The current study aims to find out the stylistic devices utilized to represent the concept of love based on the hypothesis that Gibran tends to use certain stylistic effects to convey his meaning. The study adopts Leech and Short’s (2007) framework of stylistic analysis to analyze the lexical items and figures of speech in selected extracts from the book. The findings reveal that Gibran prefers concrete nouns, dynamic verbs, and physical adjectives over abstract nouns, stative verbs, and psychological adjectives to s
... Show MoreBackground: It was stated in scientific literatures that the entire craniofacial complex is influenced by the growth of the cranial base structures. Nevertheless, many times this is not the case, and this point is subject to great controversy so the aim of this study is to evaluate the possible differences in cranial base shape and flexure between different skeletal classes for both genders and to investigate any possible correlation between cranial base variables and other skeletal base variables. Materials and Methods: The sample include 75 lateral cephalometric radiographs of Iraqi adults aged between 18-25 years (39 males, 36 females), collected from patients and undergraduate students in the orthodontic department of College of Dentist
... Show MoreThe study aims to build a model that revolves around the main question of the role of strategic agility (SA) in enhancing organizational excellence (OE). For the purpose of achieving OE and to determine the extent of interest and knowledge of managers at the Midwest Refineries Company (MRC) on the theoretical and practical implications, and on the performance foundations of these two vital variables with the aim of continuous improvement. A questionnaire was used and distributed to a random sample of 54 managers in this important energy production company. The study followed the descriptive analytical approach to answer the questions raised. The study model and dimensions were built according to reference models, most notably the mo
... Show MoreDeontic modality expresses what is necessary or possible according to the norms of morality and laws of community. It is a cover term for those cases where modal auxiliaries used to express notions like ''obligation'', ''prohibition'' and, ''permission''. Deontic modals are basically performatives, having the ''so-be-it'' component of directives in that the speaker directs the behavior of the addressee to get things done. The present study identifies the use of deontic models in international contracts to prove that there are major pragmatic strategies employed in writing them. To achieve the aim of the study, a modified model of Danet’s (1980) and Trosborg’s (1995) in accordance to Searle (1969) is used to analyze 16 texts selected fro
... Show MoreObjectives: To assess the qualifications and performance of newly graduated pharmacists and explore factors that affect their performance in public hospitals. Methods: This qualitative study included face-to-face, semi-structured interviews with hospital practitioner pharmacists. It was conducted between March and May 2023 in Kerbala province, Iraq. The participating pharmacists were selected purposefully because they had three or more years of work experience at governmental hospitals. The audio-recording interviews were transcribed. Thematic analyses were used to generate themes and subthemes from the interviews. Results: Twenty-seven hospital pharmacists participated in this study. The study found that there are several factors t
... Show MoreA study of irrigation water was conducted Baghdad city to find out extent of its pollution by some heavy metals (Pb, Cd, Ni, Co, CU, Cr, Zn and Fe). Water samples were collected randomly from different sources (river, well and stream). Results showed that the concentration of studied heavy metals were as follows: Lead between 0.43-11.75 mg L-1, Cadmium between 0.01-0.95 mg L-1, Nickel between 0.008-0.46 mg L-1, Cobalt between Nil - 0.185 mg L-1, Copper is between 0.326 - 1.58 mg L-1, Chromium is between Nil-0.068 mg L-1, Zinc 0.398-1.182 mg L-1, as for Iro
The research dealt with the issue of strategic information systems and its impact on the global marketing channel. As the research aims to know the strategic information systems used in the cement company. Which support the senior management in supporting decisions taken in the process of global orientation and moving to foreign markets by choosing the marketing channel that will suit the company. Product and competition with it. With other companies' products. The problem of the study focused on how to move to global markets, and any marketing channel that can be followed to move the cement product globally, what are the strategic information systems used in the company and how will it contribute to supporting senior management dec
... Show MoreThis study aims to determine the prevalence of Entamoeba histolytica, Entamoeba dispar and
Entamoeba moshkovskii by three methods of diagnosis (microscopic examination, cultivation and PCR) that
were compared to obtain an accurate diagnosis of Entamoeba spp. during amoebiasis. Total (n=150) stool
samples related to patients were (n = 100) and healthy controls (n= 50). Clinically diagnosed stool samples
(n=100) were collected from patients attending the consultant clinics of different hospitals in Basrah during
the period from January 2018 to January 2019. The results showed that 60% of collected samples were
positive in a direct microscopic examination. All samples were cultivated on different media; the Bra
Subjects took physical fitness for health imposed on the area of research that have become an important and clear answer to the many problems resulting from the nature of dealing with modern life current actions that were needed to be hours of manual work has become accomplished by modern technology circumstance minutes, and mediated equipment And machinery. The lack of traffic rights and further burdens the intellectual and psychological pressures and the typical method of work has led to the identification of kinetic activity, thereby threatening public health in many ways stands at the forefront of these threats the problem of smoking, which causes many types of cancers, notably lung cancer. The most important reasons that led to This dr
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