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.
One of the most significant elements influencing weather, climate, and the environment is vegetation cover. Normalized Difference Vegetation Index (NDVI) and Normalized Difference Built-up Index (NDBI) over the years 2019–2022 were estimated based on four Landsat 8 TIRS’s images covering Duhok City. Using the radiative transfer model, the city's land surface temperature (LST) during the next four years was calculated. The aim of this study is to compute the temperature at the land's surface (LST) from the years 2019-2022 and understand the link, between LST, NDVI, and NDBI and the capability for mapping by LANDSAT-8 TIRS's. The findings revealed that the NDBI and the NDVI had the strongest correlation with the
... Show MoreThis research aims at to identify the extent to which creative thinking skills Impact the change &development of Administrative Leadership styles In Administrative Leadership of the Medical City Department. Identify the nature of the relationship between them, determine the prevailing leadership style, &measure the level of creative thinking skills they have. In order to achieve the objectives of the research, the descriptive analytical method was adopted.
The research tool consisted of a questionnaire consisting of (61) paragraphs, in addition to the interview & observation. The research sample consisted of (170) administrative leaders in the upper &middle organizational levels. The
... Show MoreAromatic hydrocarbons present in Iraqi national surface water were believed to be raised principally from combustion of various petroleum products, industrial processes and transport output and their precipitation on surface water.
Polycyclic aromatic hydrocarbons (PAHs) were included in the priority pollutant list due to their toxic and carcinogenic nature. The concern about water contamination and the consequent human exposure have encouraged the development of new methods for
PAHs detection and removal.
PAHs, the real contaminants of petroleum matter, were detected in selected sites along Tigris River within Baghdad City in summer and winter time, using Shimadzu high performance liquid chromatography (HPLC) system.
Analysi
The digital communication of a product of communication and information revolution. It is characterized by accurate and comprehensive in its services and its effects, which brought changes in the structure of many communities and their organizational structures. They have significant impacts on the social systems and social relations, especially in the Arab societies, which are the focus of the globalized Western media, for many reasons: economical, political , cultural and social.
According to this perception, the Arab identity has become in an encounter with big challenges by the globalized media of trade and the media, which aims to achieve greater profits because of identity and its importance to the communities. This occurs par
Abstract
This study aims to identify the degree to which the first cycle teachers use different feedback patterns in the E-learning system, to identify the differences in the degree of use according to specialization, teaching experience, and in-service training in the field of classroom assessment as well as the interaction between them. The study sample consisted of (350) female teachers of the first cycle in the governmental schools in Muscat Governorate for the academic year 2020/2021. The study used a questionnaire containing four different feedback patterns: reinforcement, informative, corrective, and interpretive feedback. The psychometric properties of the questionnaire were verified in terms of validity
... Show MoreAbstract
This research deals with the technical of opening text during the critical
study about the poem of Al- ssiyab which is named ( city with out rain)
We chose this poem also to make connection with the western critical
theories.
Our study aims to explain the act of opening texts and critics and its
methods and directions in modern Arabic poetry.
It also aims to show the differences in the point of view between critics
and poetries.
The research depends on dimension vision of selective, and descriptive.
This research Sheds highlights the procedural protections that must be enjoyed by the consumer in the face of the product, which is the protection of no less dangerous than the substantive protection of our obligations and duties delivered by the legislature upon the product of consumer interest, what is the benefit of the right if the access road to him complicated, so know The consumer has a right to the face of the product, but leaves the claim, either to ignorance For access to this right either to the difficulty of connecting to him.
That this research modest attempt we tried through which to focus on the way to the consumer behavior of arrived right, as we tried to highlight the weaknesses and the complexity of the procedure to
Public relations are amongst the social sciences that rely on scientific methods in achieving new knowledge or resolving existing problems by means of its scientific researches that are often applied and require a classification in terms of their results’ analysis. It also requires subtle statistical processes whether in constructing their material or in analyzing and interpreting their results.
This research seeks to identify the relation between public relations and statistics, and the significance a researcher or practitioner in the domain of public relations should assign to statistics being one of the important criteria in identifying the accuracy and object
... Show MoreIn this study, multi-objective optimization of nanofluid aluminum oxide in a mixture of water and ethylene glycol (40:60) is studied. In order to reduce viscosity and increase thermal conductivity of nanofluids, NSGA-II algorithm is used to alter the temperature and volume fraction of nanoparticles. Neural network modeling of experimental data is used to obtain the values of viscosity and thermal conductivity on temperature and volume fraction of nanoparticles. In order to evaluate the optimization objective functions, neural network optimization is connected to NSGA-II algorithm and at any time assessment of the fitness function, the neural network model is called. Finally, Pareto Front and the corresponding optimum points are provided and
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