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.
Student performance may influence by several factors in all his study levels such as primary school, intermediate school and even in his college; some of these factors are psychological factors, social factors, and the factors which correlate with student environment.
In this paper we study some of these factors to discover their influence by using canonical correlation analysis to analyze the data. Many conclusions are discovered to help who focuses student performance or to make it pest in future.
Sports skills in some individual games require physical and motor qualities to facilitate the process of skill performance and also require the instructor or trainer to use more than one strategy, method and way to bring the performance to the level of mastery and avoid injury. The aim of the research is to know the effect of using special exercises using tools and their effect on teaching the skill of a front shoulder circle. The research hypothesis is that using special exercises with tools has a positive effect on teaching the skill of a front shoulder circle on the rings apparatus. Research method: - The researchers used the experimental method by designing two equal groups, the control and the experimental, to suit the research
... Show MoreExperience the Islamic financial industry faces many challenges, most notably the lack of proper risk management tools that meet the requirements of legality and economic efficiency advantage from another side, so it requires the search for innovative ways to manage the risk of Islamic banking, Islamic finance industry is manufacture up-to-date, if compared with the financial industry (traditional), which increases the problematic of risk management in the Islamic financial industry nature of treatment which should be compatible with Islamic law, as well as economic efficiency, thereby Progress came the importance of research to highlight the entrance to Islamic financial engineering and the goals sought to be achieved through the use of
... Show MoreA simple, rapid and environmentally friendly dispersive liquid–liquid microextraction method-based spectrophotometric method for the trace determination of folic acid has been developed. The proposed method is based on the formation of a deep yellow product via reaction of folic acid and 1,2-naphthoquine-4-sulfonate at pH = 9. The formed complex was extracted using a mixture of chloroform and ethanol. Then, the tiny organic droplets were measured at λ = 520 nm. At the optimum conditions, linearity was ranged from 0.05 to 1.5 μg/mL for the standard and samples, with a linear correlation coefficient of 0.9996. The detection limits were 0.02, 0.027, 0.03, 0.02 and 0.04 μg/mL for standard, tablet (5 mg), tablet (1 mg), syrup and fl
... Show MoreThe research aims to determine the role of the practices of green human resources management in achieving requirements of environmental citizenship in the workplace, the General Company for Vegetable Oils was chosen for the application of field-side of research which represent one of the important industrial companies in Iraq, which suffers from poor Green human resources management applications, which reflected negatively on the development Environmental citizenship among Employees. The questionnaire use as a tool to collect data and information as well as field presence of the researcher, The research sample included (30) managers of departments and Division ,and through using statistical program (SPSS) the data has been analys
... Show MoreA simple, economic, rapid, reliable, and stability-indicating high-performance liquid chromatography (HPLC) method has been developed and validated for the simultaneous determination of paracetamol (PCM) and caffeine (CF) in solid dosage form. The chromatographic separations were achieved with a Waters Symmetry® C18 column (5 μm, 4.6 × 150 mm), using a mixture of methanol and water (40:60, v/v) as a mobile phase, under isocratic elution mode with a flow rate of 0.8 mL/min, and ultraviolet (UV) detection was set at 264 nm. The oven temperature for the column was set and maintained at 35 °C. The method was validated according to International Conference on Harmonization (ICH) guidelines, and it demonstrated excellent linearity, wi
... Show MoreAs the banking sector is a strong influence on the country's economic growth,The solid financial well-being of anybank does not mean only a guarantee for its investors, It is also important for both owners and workers and for theeconomy in all its joints.The elements of capital adequacy and quality of assets are important to the functioning of thebanking business.In this study, the research sample included four private banks. Quarterly data were used for the period(2011 - 2018).Moreover, data is also collected from articles, papers, the World Wide Web (the Internet) and specializedinternational journals.In this research, an effort was made to try to find out the effect of (the ratio of the capital owned todeposits on the value of the bank),
... Show MoreMorphologies of ceramic hollow fiber membranes prepared by a combined phase-inversion and sintering method were studied. The organic binder spinning solution containing suspended Al₂O₃ powders was spun to a hollow fiber precursor, which was then sintered at elevated temperatures( 300 ˚C, 1400 ˚C, 25 ˚C) in order to obtain the Al₂O₃ hollow fiber membranes. The spinning solution consisted of polyether sulfone (PES), N-methyl-2-pyrrolidone (NMP), which were used as polymer binder, solvent, respectively. The prepared Al₂O₃ hollow fiber membranes were characterized by a scanning electron microscope (SEM). It is believed that finger-like void formation in asymmetric ceramic membranes is initiated by hydrodynamically unstable vis
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