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 researchers Sought to determine the impact of the customer contact (Within a client contact there are two times, first is the total time required to create a service and within it there is contact time while the second time is the time of client contact ؛ where means a time that records the physical presence of the customer during the process of service) on operations performance by concentrate attention on the cost (labor productivity) and quality (patient ratio to the doctor) and speed (cycle time) and flexibility (the flexibility range) , as well as ruling out variable of innovation because of impossibility to measure this variable in the Specialty Center for Dental in al-alwia due to the center is lacking of mechanisms t
... Show MoreThis research reveals the treatment mechanisms followed in the media for covering the topic of displacement and captivity of Yazidi in the Iraqi press, through studying all the publishing in one of the Iraqi newspapers concerning the research subject. The research problem is in the following questions:
- What are the journalistic arts that are tackled by the newspaper concerning the subject of the Yazidi women?
- What are the editing forms for the model of the press subjects that have been employed about the event and what are its sources?
- What are the highlighting means used in presenting the subjects within the journalistic arts?
- What are the i
Background: Ulcerative colitis (UC) is an inflammatory bowel disease restricted to the large intestine, characterized by superficial ulceration. It is a progressive and chronic disease requiring long-term treatment. Although its etiology remains unknown, it is suggested that environmental factors influence genetically susceptible individuals, leading to the onset of the disease. (C-X-C) ligand 9 is a chemokine that belongs to the CXC chemokine family, it plays a role in the differentiation of immune cells such as cytotoxic lymphocytes, natural killer T cells, and macrophages. Its interaction with its corresponding receptor CXCR3 which is expressed by a variety of cells such as effector T cells, CD8+ cytotoxic T cells, and macrophage
... Show MoreThis study attempts to address the importance of communicative digitization in the field of various arts for the sake of continuity of shopping and aesthetic, artistic and intellectual appreciation of artistic achievements by the recipient on various places of their residence in light of the COVID 19 crisis, and to highlight the importance of the plastic arts of the Iraqi painter exclusively and how it expresses in a contemporary way the environment or life reality in Iraq in light of this crisis. With all its implications affecting the life reality from various aspects and methods of its negative and positive employment. As for the research procedures, the researcher reviewed the research methodology represented by the descriptive ana
... Show MoreSome major pollutants of polycyclic aromatic hydrocarbons (PAH) those discharged as water produced (WP) from the AlAhdab oil field (AOF) in the ponds close to it may leak to the water resources around and eventually reaches the marshes which will affect its ecosystem. Thus, this work aims to track the availability of PAH in the water resources and the Main Outfall Drain (MOD) nearby. The determination of PAH was evaluated using “High-Performance Liquid Chromatography (HPLC)”. The mean concentration of sixteen PAH in the produced water within the field was relatively high (0.01 to 10.89 g/ml) with standard deviations of (0.10.9). While, PAH outside the field were gradually diminishes down to (0.01-0.039) x10-2 g/ml which exceeds th
... Show Moreresearch objectives to:
1. identify the social, economic and cultural factors affecting consumption.
2. detect the consumption culture among the population in the city of Erbil.
3. Identify the GATT consumer protection and rights.
The most important results:
1. that there is variation in the answers of respondents about keep up with modernity in the basic consumption (necessary), it swallowed the proportion of yes answers about keep up with modernity in food consumption (72%), and is an indication of growing consumer awareness of the individual in the side of nutrition. The clothing on the side of the proportion of yes answers amounted to (85%), in the health field note that the percentage of yes answers (83%), who are abr
Objective: To assess the impact of a social support for pregnant women upon their pregnancy outcome Methodology: A descriptive purposive study was used to assess the impact of a social support on their pregnancy outcomes. The study was conducted from (22 \ September \ 2020 to 15 \ February \ 2021). A non-probability sample (purposive sample) was selected from 100 women. Data were collected through an interview with the mother in the counseling clinic, during the third trimester of pregnancy, as well as after childbirth in the labor wards to assess the outcome of pregnancy. Data were analyzed through descriptive statistics (frequency and percentages). Results: The most important thing observed in this study was the positive pregnancy outcome
... Show MoreThis paper aims to identify how the United Nations works through its website in prioritizing audiences towards international issues، by identifying the digital PR mechanisms used in digital PR contents in prioritizing audiences towards the international issues they deal with. To achieve the objectives of this paper, the researcher used the survey method and content analysis tool with a view to identifying the ranking of international issues on the website of health، peace and security، humanitarian assistance، human rights، women، migrants، refugees and displaced persons، economic development، United Nations affairs، culture and education، environment and climate، sustainable development, and law and crime prevention. One of
... Show MoreUnder aerobic and anaerobic conditions, two laboratory-scale reactors were operated. Each reactor
was packed with 8.5 kg of shredded synthetic solid waste (less than 5 cm) that was prepared according to an
average composition of domestic solid waste in the city of Kirkuk. Using an air compressor, aerobic
conditions were created in the aerobic reactor. This study shows that the aerobic reactor was more efficient in
COD and BOD5 removal which were 97.88% and 91.25% while in case of anaerobic reactor, they were
66.53%and 19.11%, respectively.
Land use change, particularly the expansion of urban areas and associated human activities at the expense of natural and semi-natural areas, is a major ecological issue in urban areas around the world. Climate change being a very strong additional driver for changing the temperature and habitat in the cities. This also applies to Baghdad, Iraq, where urbanisation and climate change exerts a major pressure on the natural habitats of the city, and thus may affect the ability of city planners to adapt to future climate change scenarios. Here we present evidence of substantial growth in urban areas, increases in temperature, and degradation of natural vegetation within Baghdad city by using Remote Sensing techniques and an assessment for the
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