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.
Onomatopoeia has always been a functional poetic device which enjoys a high sound significance in the poetry of many languages. In modern English and Arabic poetry alike, it proves to be vital and useful at different levels: musical, thematic and at the level of meaning. Still, the cultural difference looms large over the ways it is employed by the poets of each. The present paper investigates the employment of onomatopoeia in the poetry of D. H. Lawrence (1885-1930) and Badr Shakir al-Sayyab (1926-1964) who are chosen due to the importance they enjoy in modern English and Arabic poetry and the richness of their poems in onomatopoeias. The conclusions reached at are in a sense related to cultural differences which govern the use of onomato
... Show MoreBringing about urban, economic, and social changes in rural areas similar to those occurring in urban areas aims to reduce urban-rural disparities by providing services in those areas, decentralizing the management of these services, expanding citizen participation in local governance (decentralized administration), and achieving comprehensive development, developing and empowering localities, and keeping pace with new transformations and their impacts on the functions of the center and localities. In fact, the lack of clarity of the role of local government in planning and managing services has hindered development plans, and declined the level of services in rural areas, and has negative
... Show MoreExploration activities of the oil and gas industry generate loads of formation water called produced water (PW) up to thousands of tons each day. Depending on the geographic area, formation depth, oil production techniques, and age of oil supply wells, PW from different oil fields contain different chemical compositions. Currently, PW is also known as industrial waste water containing heavy metals that are toxic to humans and the environment, requiring special processing so that they can be disposed of in the environment. To determine the heavy metals content in PW from the Al-Ahdab oil field (AOF), the Ministry of Science and Technology/Agricultural Research Department determined som
Background: Ear infections can manifest in many forms depending on site of infection whether external, middle or internal ear and the culprit pathogen whether viral, bacterial or fungal. Acute middle ear infections are usually accompanied by aural discharge. Objective: 1. To get an overview on the bacterial pathogens involved in ear infections. 2. To assess the antibiotic resistance of bacterial pathogens. Methods: A cross sectional study conducted in Al-Kindy Teaching Hospital / Baghdad /Iraq. Swabs taken from 225 patients suffering from aural discharge were tested for culture and sensitivity for the duration of two years 2018-2019. Aural discharge is cultured by inoculating it into blood, MacConkey agar, chocolate agars and Sabou
... Show MoreIn this study, a total of 209 individuals of leeches were collected from Al-Hindyia River / Babil Province. 116 individuals were identified as Erpobdella octaculata (Linnaeus, 1758), 50 individuals as Erpobdella punctata (Leidy,1870) and 43 individuals as Hemiclepsis marginata (Müller, 1774). Four samples were collected monthly during a period from February to June 2018. Some physical and chemical water properties were also examined, including air and water temperature, potential of hydrogen pH, Electrical Conductivity EC, Total Dissolved Solid TDS, Dissolved Oxygen DO, and the Biological Oxygen Demand BOD₅. Air and water temperature were r
... Show MoreBased on the diazotization-coupling reaction, a new, simple, and sensitive spectrophotometric method for determining of a trace amount of (BPF) is presented in this paper. Diazotized metoclopramide reagent react with bisphenol F produces an orange azo-compound with a maximum absorbance at 461 nm in alkaline solution. The experimental parameters were optimized such as type of alkaline medium, concentration of NaOH, diazotized metoclopramide amount, order additions, reaction time, temperature, and effect of organic solvents to achieve the optimal performance for the proposed method. The absorbance increased linearly with increasing bisphenol F concentration in the range of 0.5-10 μg mL-1 under ideal conditions, with a correlati
... Show MoreA survey conducted at Dalmaj marsh, Al-Diwaniya Province during 2013 revealed that the marsh encounters a considerable part of the Iraqi vertebrate fauna including 147 species belonging to five classes; Pisces, Amphibia, Reptilia, Aves and Mammalia. Some species are of globally conservation importance. The present results are discussed with the pertinent literature.
This research is dedicated to study Al-Ra’ee Al-Numayri, a distinctive poetic character, to find out the most important (artistic) pre-Islamic features that contributed to its formation. It is further dedicated to know the influence of these features on his literature in the literary arena. After surveying his poetic texts and reading them according to the analytical and investigative methods, the art of the researcher was limited to the field of traditionalists. He was following the footsteps of the ancients by adhering to the traditional Arabic poetry style and the traditional poetic image. Despite that, he had his own imprints and unique style of interrogating times and places with its people, animals and plants. H
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