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 construction project is a very complicated work by its nature and requires specialized knowledge to lead it to success. The construction project is complicated socially, technically and economically in its planning, management and implementation aspects due to the fact that it has many variables and multiple stakeholders in addition to being affected by the surrounding environment. Successful projects depend on three fundamental points which are cost-time, performance and specifications. The project stakeholder's objective to achieve best specifications and the cost-time frame stipulated in the contract.
The question is, was the optimum implementation accomplished? The provision for the success of the project
... Show MoreThe reason for my choice of the topic (what Imam Al-Tirmidhi mentioned in his book Al-Sunan regarding the provisions of sales) is that he mentioned many topics that affect people's lives, which are represented by commercial transactions and the exchange of benefits between them, so it became clear to them what is forbidden and what is not, aiming not to fall into the prohibited, and to achieve their interests, and relieve them of embarrassment. What we will see in the research.
The phenomenon of celebration of army leaders in the Abbasid era formed a distinct phenomenon at which the poets stood, and among those leaders was the Arab leader Hamid al-Taie, and the poets who stood on him and his sons Abu Tammam and al-Bohtari recorded in their poems the exploits of that leader, and the exploits of his sons through images that represented sadness, courage In this research, the generosity, and the rhetorical and artistic aspects of those images, have been spotted, balancing the poets.
The aim of the research is to know the level of time management application and its impact on the performance of the job, a survey search in the general company for communication and information technology and provide recommendations that help employees to optimize the use of time and improve performance, which is an important element in controlling the various functions of the company. In order to achieve the objectives of the research, the questionnaire was based on two main variables and distributed to a random sample of (44) employees in the company out of (308) employees, thus the proportion of the sample (14%). After collecting the samples from the sample, there are (6) incomplete forms that have been retri
... Show MoreThis work deals with the effect of adding aluminum nanoparticles on the mechanical properties, micro-hardness and porosity of memory-shape alloys (Cu-Al-Ni). These alloys have wide applications in various industrial fields such as (high damping compounds and self-lubricating applications). The samples are manufactured using the powder metallurgy method, which involved pressing in only one direction and sintered in a furnace surrounded by an inert gas. Four percentages (0%, 5%, 10%, and 15%) of aluminum nanoparticles were fabricated, which depended on the weight of aluminum powder (13%) in the sample under study. To find out which phase is responsible for the reliability of the formation of this type of alloy and its porosity, X-ray diffr
... Show MoreThe research is a contemporary stylistic study of the text that expresses the psychological
meanings in Nahj Al-Balaghah.
The research is divided to three chapters.
The first chapter : characteristics of psychological text.
It is about the power to influence the addressee ,that is to say ,the text influence power
connects with vulnerability and emotions inside the addressee spirit and his response to
violent effects shaking his feelings and that is represented in outbreaking of words vitality and
homogeneously. The Imam's wrath , grief , love to rightness , hatred of falsehood and
deviation from Islam arouses the words and emotions through :
1. Reduction in words and expansion in meaning by means of inspiration
this research adopts the study of experimentational fiction in the characters for the writer Fadhil Al-Azzawi ,which appear in the miraculous characters that the writer creates in his enumerative paragraphs , and these characters are featured by there reveling on traditions which is prevalent in the formation of these characters, The research also included theoretical beginning foe experimental fiction and miraculous characters, followed by analysis and examination of these characters in the writer`s texts, finishing by an epilogue for the results of the research , giving the references and resources we depended on writing this research .