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.
his project try to explain the using ability of spatial techniques for land cover change detection on regional level with the time parameter and did select for explain these abilities study case (Hewaizah marsh ) . this area apply to many big changes with the time. These changes made action on characters and behaviors of this area as well as all activities in it . This Project concerting to recognize the Using importance of remote sensing and GIS Methodology in data collecting for the changes of land use and the methodology for the analyses and getting the results for the next using as a base data for development and drawing the plans as well as in regional planning .This project focus on practical
... Show MoreObjective: The evaluation of serum osteocalcin (OSN) for Iraqi infertile patients to see the effect of osteocalcin insufficiency, which may lead to a decreased level of testosterone production in males that may cause infertility. Methods: Forty two newly diagnosed infertile males age range (24–47) years and thirty two apparently healthy males as controls age range (25–58) years. Serum levels of testosterone (TEST), stimulating follicle hormone (FSH) and luteinizing hormone (LH), prolactin (PROL), osteocalcin OSN, and fasting blood sugar (FBS) were performed in both patients and controls. Estimation of serum OSN by Immulite1000 auto-analyzer, TEST, FSH, LH, PROL, and FBS by Immulite2000 auto-analyzer. Results: Infertile patients
... Show MoreCholesteryl ester transfer protein gene contains some single nucleotide polymorphisms, which have been associated with serum high-density lipoprotein concentration and other lipoproteins. This study is done for determining of cholesteryl ester transfer protein polymorphism and evaluate its effect on serum lipid profile concentrations in some hyperlipidemic patients compared with healthy subjects in Salah Al-din governorate-Iraq. Blood samples were taken from (90) patients suffering from hyperlipidemia, and (70) samples that were apparently healthy controls. Serum lipid concentrations were measured by enzymatic assays. The polymorphism was genotyped using polymerase chain reaction restriction fragment length polymorphism analysis.&n
... Show MoreObjective)s): To evaluate the quality of life for adult clients with hypermobility syndrome at private clinics in Baghdad City. Methodology: A cross-sectional study used a purposive ‘’non-probability’’ sample of (75) adult clients with Hypermobility Syndrome (HMS) male and female who age (25-64) years. The data were collected through the utilization of standard developed questionnaire of the world health organization (WHO). Data collected by interview with each client who is involved in the study. Each interview takes approximately (20) minutes. Results: The study revealed that there is an effect of hypermobility syndrome on the quality of life, which recorded fair level in general. The study also reported that there is an effect
... Show MoreDuring the period 1970-2006 the Marshes-land region was exposed to several change into many sides of vanishing steeling and growth as follow :
1- Drying this region after 1991,and re-flooded again during 2003. Many other large Marsh-land, like al-Hawaisa was dried by cutting off inlet-water fed from Iran sources .As asqunance there are transferred to different kinds of swamps ,followed by major change in the structure of the region as the rural settlement concerned. Rural settlement in this area starts new push of migration. The research did not take that in consideration in this thesis because some others took it in details in some thesis and researches. The situation of Marsh-land is getting anew face after those major changes which
Praise be to God, and may blessings and peace be upon our master and Prophet Muhammad and those who follow him, and may God be pleased with him
Taha is my guardian and whoever follows their path until the Day of Judgment. And after... The book (The Treasure in the Ten Recitations), written by Abu Muhammad Abdullah bin Abd al-Wasiti, who died in the year 710 AH, is considered one of the important books in recitations: because it included the universal custom that it contained in the books Al-Taysir by Al-Dani and Al-Irshad by Al-Falanisi, as the first of them was specialized.
Satisfy the second with the ten readings
May God bless my time, through His grace and generosity, to achieve this treasure and to publish it
... Show MoreDuring the 1970s, communicative view of language teaching began to be incorporated into syllabus design. The central question for the proponents of this view was: what does the learner want/need to do with the target language? This lead to the emergence of a teaching method (or approach) called communicative language teaching (CLT) during the late 1970s and early 1980s focusing on the functions that must be incorporated into a classroom. According to Brown (2001:43) CLT is a unified but broadly based, theoretically well informed set of tenets about the nature of language and of language learning and teaching. Harmer (2001:84) states that the communicative approach is the name which was given to a set of beliefs which included not only a
... Show MoreThe work reported in this study focusing on the abrasive wear behavior for three types of pipes used in oil industries (Carbone steel, Alloy steel and Stainless steel) using a wear apparatus for dry and wet tests, manufactured according to ASTM G65. Silica sand with
hardness (1000-1100) HV was used as abrasive material. The abrasive wear of these pipes has been measured experimentally by measuring the wear rate for each case under different sliding speeds, applied loads, and sand conditions (dry or wet). All tests have been conducted using sand of particle size (200-425) µm, ambient temperature of 34.5 °C and humidity 22% (Lab conditions).
The results show that the material loss due to abrasive wear increased monotonically with