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.
Research Summary
This research is an attempt to explain the Qur’anic verses of the vision in the practical divine vision on the Day of Resurrection, and the legal texts narrated from the Companions regarding the vision of the Prophet, may God’s prayers and peace be upon him, regarding the vision of the Prophet, may God bless him and grant him peace, regarding the vision of the Prophet, may God’s prayers and peace be upon him, regarding the vision of the Prophet, may God bless him and grant him peace He was greeted with regard to vision, and he explained the two sayings of Ibn Abbas and Aisha on the same subject, including an area of conflict between them.
With the development of communication technologies, the use of wireless systems in biomedical implanted devices has become very useful. Bio-implantable devices are electronic devices which are used for treatment and monitoring brain implants, pacemakers, cochlear implants, retinal implants and so on. The inductive coupling link is used to transmit power and data between the primary and secondary sides of the biomedical implanted system, in which efficient power amplifier is very much needed to ensure the best data transmission rates and low power losses. However, the efficiency of the implanted devices depends on the circuit design, controller, load variation, changes of radio frequency coil’s mutual displacement and coupling coef
... Show MoreErbil city is located in the northern Iraq with a population of over one million people. Due to water crises farmers usually use wastewater and well water for the agricultural production. In this study six stations were designed to sample waste water and three from well water to define waste water and ground water characteristics. In this study, Residual Na+ Carbonate, Mg++ hazard, salinity hazard, Kelley index, %sodium, total hardness, permeability index, potential salinity, sodium adsorption ratio, and Irrigation Water Quality Index (IWQI) were determined. The order of average cation concentrations in water was Mg2+> Ca2+ > Na+ > K+. While the proportion of main
... Show MoreThe corona virus epidemic outbreak has urged an extreme worldwide effort for re‐purposing obtainable approved medications for its treatment. In this review, we're focusing on the chemicals properties andpharmacologicaleffectiveness of medicationsofsmallmolecule that are presently being evaluated in clinical trials for the management of corona virus (COVID‐19). The current review sheds light on a number of drugs that have been diagnosed to treat COVID‐19 and their biological effects.
Water has a great self-generating capacity that can neutralize the polluting interventions carried out by humans. However, if human activities continue this uncontrolled and unsustainable exploitation of this resource, this regenerating capacity shall fail and it will be jeopardized definitively. Shatt Al-Arab River in South of Iraq. It has an active role in providing water for irrigation, industry, domestic use and a commercial gateway to Iraq. in the last five years Shatt Al-Arab suffered from a rise in pollutants due to the severe decline in sewage networks, irregular networks and pesticide products, as well as the outputs of factories and companies that find their way to water sou
The study aims to identify the effectiveness of employing microteaching in acquiring teaching skills of students teaching basic stage in Al-Aqsa University. The two researchers used the experimental method and a quota sample consisted of a group of (80) students who were distributed on the university two branches in Gaza and Khan younis and on males and females equally, and on four teaching courses counted (20) students for each. The study tool represented in an observation card ,and the results showed statistically significant differences between the level of all the skills of teaching and between the standard rate (75%) in favor of teaching skills, also showed statistically significant differences attributed to the variable of the univ
... Show MoreWater has a great self-generating capacity that can neutralize the polluting interventions carried out by humans. However, if human activities continue this uncontrolled and unsustainable exploitation of this resource, this regenerating capacity shall fail and it will be jeopardized definitively. Shatt Al-Arab River in South of Iraq. It has an active role in providing water for irrigation, industry, domestic use and a commercial gateway to Iraq. in the last five years Shatt Al-Arab suffered from a rise in pollutants due to the severe decline in sewage networks, irregular networks and pesticide products, as well as the outputs of factories and companies that find their way to water sources and lead to a widespread collapse of water quality.
... Show MoreAmongst the literary writers who used their art to direct the attention towards the issue of woman and her rights in a proper life is the English poet and novelist Thomas Hardy (1840-1928), who has been praised for his “openness to the feminine principle” 1 as Irving Howe put it. Hardy’s wide readings have changed his way of dealing with and thinking about so many critical issues which started to float on the surface of the English society during the mid and late of the 19th century. His readings for a number of writers, who seem of huge impact on his writings as he later admits that – “[his] pages show harmony of view with
... Show MoreCommunity pharmacists faced more complex challenges in meeting patients’ medication needs during the pandemic than previously reported in the literature. Objectives To explore the perception and abilities of community pharmacists in managing patients’ needs in terms of medication dispensing during the pandemic, and to examine its effect on improving the patients’ situations. Materials and Methods A cross-sectional study design, validated by 30 experts, was conducted using an electronic survey (Google Form) to assess the effect of the dispensing practice of Iraqi community pharmacists on the patient’s clinical outcomes during the pandemic. The survey was distributed on professional pharmacist’s social media platforms from December
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