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.
The current study tackles how slavery and racial segregation, which have obviously made an enormous impact in the United States of America for many years, can be defeated through optimism. The study opens with an introduction that clarifies some background about Langston Hughes as a poet who writes against slavery and oppression done to the American Blacks during an era which was known for racial segregation in the United States of America. The poet sheds light , in his poetry, upon the role of African Americans in activating hope and optimism to get freedom which has been reached at the end. The first section of the study analyzes the meaning of slavery and segregation as reflected in some selected poems, showing the oppressive face of
... Show MoreThe research aims to find ways to minimize the use of quantities of chemical fertilizers in agriculture in order to get to an environment that is free of contaminants. Magnetized water technology used in the experience of planting seeds of tomatoes Thomson type to obtain a higher efficiency to absorb fertilizer NRK in the protected environment of the period from February to June. Magnetized water system used locally made levels Gaues (4800,2500,1500) concentrations of 50 to 100% for each level and the rate of (4) replicates, and results indicated that the severity of the magnet (4800 Gaues) and a concentration of 50% gave the highest percentage of tomato fruit size and intensity ( 1500 Gaues) and a concentration of 100% did not give any inc
... Show MoreBuilding a geological model is an essential and primary step for studying the reservoir’s hydrocarbon content and future performance. A three-dimensional geological model of the Asmari reservoir in Abu- Ghirab oil field including structure, stratigraphy, and reservoir petrophysical properties, has been constructed in the present work. As to underlying Formations, striking slip faults developed at the flank and interlayer normal. Abu Ghirab oilfields are located on the eastern anticlinal band, which has steadily plunged southward. 3D seismic interpretation results are utilized to build the fault model for 43 faults of the Asmari Formation in Abu Ghirab Oilfield. A geographic facies model with six different rock facies types
... Show MoreThe Zubair reservoir in the Abu-Amood field is considered a shaly sand reservoir in the south of Iraq. The geological model is created for identifying the facies, distributing the petrophysical properties and estimating the volume of hydrocarbon in place. When the data processing by Interactive Petrophysics (IP) software is completed and estimated the permeability reservoir by using the hydraulic unit method then, three main steps are applied to build the geological model, begins with creating a structural, facies and property models. five zones the reservoirs were divided (three reservoir units and two cap rocks) depending on the variation of petrophysical properties (porosity and permeability) that results from IP software interpr
... Show MoreThe current research discusses "The Relationship critical factors for knowledge transfer in strategic success opportunities", the attention have been increased on knowledge transfer and strategic success subjects because on being one of the important and contemporary issues, which have a significant impact on the existence of organizations and its future. The research aims to identify the critical factors for knowledge transfer in private high education environment which enables (the college community surveyed) to achieve strategic success, also the research sought to answer questions related to research problem by testing a number of major and minor hypothes in correlation, in order to test the hypotheses I us
... Show MoreIn this paper, an approach for object tracking that is inspired from human oculomotor system is proposed and verified experimentally. The developed approach divided into two phases, fast tracking or saccadic phase and smooth pursuit phase. In the first phase, the field of the view is segmented into four regions that are analogue to retinal periphery in the oculomotor system. When the object of interest is entering these regions, the developed vision system responds by changing the values of the pan and tilt angles to allow the object lies in the fovea area and then the second phase will activate. A fuzzy logic method is implemented in the saccadic phase as an intelligent decision maker to select the values of the pan and tilt angle based
... Show MoreThis research aims to address the most recent international standard in the field of insurance contracts, the International Financial Reporting Standard (IFRS17) and the theoretical framework of the standard in addition to the most important characteristics of the standard (IFRS17), as well as to identify the paragraphs of the modern standard, with the challenges its application in general and the use of the approach (inputs - operations - outputs) to present the challenges of its application in the Iraqi environment and specifically in the environment of Iraqi insurance sector companies (government), the research is based on the main premise that the identification of the requirements for the application of the International Fin
... Show MoreInformation systems and data exchange between government institutions are growing rapidly around the world, and with it, the threats to information within government departments are growing. In recent years, research into the development and construction of secure information systems in government institutions seems to be very effective. Based on information system principles, this study proposes a model for providing and evaluating security for all of the departments of government institutions. The requirements of any information system begin with the organization's surroundings and objectives. Most prior techniques did not take into account the organizational component on which the information system runs, despite the relevance of
... Show MoreThe diabetic foot is considered one of the long term diabetes complications caused by a defect in blood vessel and nerve system. This requires dealing with diabetic foot with professional medical care, so as to prevent its development in advanced stages which could end to gangrene and amputation of the foot. This study has been initiated through follow-up of twelve patients with diabetes and the presence various occlusions in lower limb artery. One patient from them was chosen for investigation, this patient has stenosis in popliteal artery and presence multiple stenosis in superficial femoral artery. This study based on analysis present case of patient and prediction for progress stenosis in superficial femoral artery till arrive semi t
... Show MoreCloud computing provides huge amount of area for storage of the data, but with an increase of number of users and size of their data, cloud storage environment faces earnest problem such as saving storage space, managing this large data, security and privacy of data. To save space in cloud storage one of the important methods is data deduplication, it is one of the compression technique that allows only one copy of the data to be saved and eliminate the extra copies. To offer security and privacy of the sensitive data while supporting the deduplication, In this work attacks that exploit the hybrid cloud deduplication have been identified, allowing an attacker to gain access to the files of other users based on very small hash signatures of
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