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.
Background: Postoperative morbidity after extraction of the impacted mandibular third molar (IMTM) is inevitable. One of the most common postoperative complication is alveolar osteitis (AO) which is a painful non healed socket. Many researches were attempted to prevent the occurrence of AO by introducing and applying a new materials inside the extraction socket. Platelet rich fibrin (PRF) is a biological complex fibrin matrix where autologous platelets and leucocytes are present, used to enhance tissue healing process and reduce the early adverse effects of the inflammation. Aims: To evaluate the effect of PRF on the incidence of AO. Also to assess PRF effect on pain, swelling, and trismus following the surgical removal of IMTM and compa
... Show MoreIt was rumored in the grammatical circles that the (short) refrigerant is only a copy of (book) Sibweh, except some of the views that violated it, or some of the evidence that increased it; On the (brief) or not, the researcher has chosen the subject (what is going away and not leave) a field of study of the budget, has come on three demands, the first devoted to the study of the term, and the second to explain the methodology of scientists in the presentation of the topic, and the third was limited to the study of the evidence they invoked .
God grants success
This research calculated the effect of partial replacement of Trillium with tin by weight ratios x=0, 5, 10, 15, and 20 of the weight of manufactured samples on the thermal conductivity coefficient of Se60Te40-xSnx chalcogenide glasses. The thermal conductivity coefficient of the samples was calculated using a disk- Lee. The results showed that increasing the concentration of tin improves the thermal insulation ability by decreasing the thermal conductivity value and then determining the optimal weight ratios at which a large thermal insulation is obtained.
The electrical resistivity as a function of temperature was studied. The electrical resistivity (rd.c) was calculated as a function of temperature for all
... Show MoreThe primary goal of in-situ load testing is to evaluate the safety and performance of a structural system under particular loading conditions. Advancements in building techniques, analytical tools, and monitoring instruments are prompting the evaluation of the appropriate loading value, loading process, and examination criteria. The procedure for testing reinforced concrete (RC) structures on-site, as outlined in the ACI Building Code, involves conducting a 24-h load test and applying specific evaluation criteria. This article detailed a retrofitting project for an RC slab-beams system by utilizing carbon fiber-reinforced polymer (CFRP) sheets to strengthen the structure following a fire incident. The RC structure showed indicators of deter
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It is clear to everyone how important it is to implement transactions electronically, as it facilitates the provision of services to beneficiaries, whether individuals or institutions, to achieve many benefits that are not exclusive to the beneficiary or the applicant, but extends to the governmental and international bodies. And the number of users has reached millions since its emergence in 1995, because the concepts of electronic transactions have great advantages for the economy in general and the banking sector in particular, so cooperation in various fields with the aim of becoming an information society has become paramount, It allows customers to pay money to any company they want t
... Show MoreThe research aimed to use HIIT exercises, and to know the effect of HIIT exercises on some physiological and physical indicators of the young badminton players, and to identify the degree of competition anxiety and the performance of some offense skills among the young badminton players. The research community (the young badminton players), the research sample and its selection method (the research sample was chosen by the intentional method (8) badminton player from the Athwari Club), the scientific method (the experimental method with pre and post tests), measurement tools: physiological tests (high and low blood pressure) , pulse, and physical exams (explosive force of arms and legs) and the offense skills and the scale of competit
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The research aims to achieve the basis of tax justice by making a comparison between the tax accounting process according to the application of the International Financial Reporting Standard IFRS15 and the tax accounting procedures currently used in the General Authority for Taxes to determine the annual and total tax differences, to give credibility and enhance transparency in the reports and financial statements of companies Long-term contracts when prepared in accordance with the requirements of applying the international standard IFRS15 “Revenue from Contracts with Customers”, which increases the possibility of relying on them when calculating taxes. Thus, the resea
... Show MoreAbstract Physical requirements are an important priority for the development of football gymnastics coaches because the nature of performance is interconnected and interconnected in terms of the player's duties in the match. In the gameplay situations, the player must perform the skill with strength and speed coupled with accuracy and the reactions of the colleague and competitor alike, which represents the normal reality of the football gymnasium Skilled exercises are one of the most suitable technical side exercises as they are built according to the components of the skill requirements of the game and the nature of its performance, which appear on the gro
... Show MoreSome auditors may think that the audit process ends with discovering misstatements and informing management about them, while the discovery of misstatements may be classified by some as the first step in the phase of separating these distortions, as the auditor should collect these misstatements, evaluate them and detail them into misstatements involving errors or misstatements involving fraud Then evaluating it to material or immaterial according to what was stated in the international auditing standards and directing management to amend the essential ones. The importance of this research lies in identifying the concept of distortions and their types, identifying the method of evaluating distortions into substantial and non-essent
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