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.
Foreign trade is very important in global economies because of its impact on the sustainability of economic growth by stimulating economic activity, creating jobs and expanding production . On the other side , this policy is a major obstacle to many developing countries and the reason is due to the nature of the economies of those countries because they rely mostly on one or a few economic resources, which makes them rely mostly on exports to that resource while they import most of the needs of their local market Which makes them in a spiral of underdevelopment , dependence and economic exposure, which requires them to break that cycle and the launch of economic development Perhaps one of the most important means to a
... Show MoreTrichomonas vaginalis is a causative agent of trichomoniasis , one of the most common non-viral sexually transmitted disease (STD) over all the world, especially in immunocompromised women such as pregnant. Wet smear and Giemsa stain are the current methods used in hospital to diagnosis trichomoniasis. DNA based diagnosis is still to be validated to diagnose the local isolates, the objective of the present study was to compare the conventional methods of disease diagnosis with the DNA-based method to diagnose Trichomonas incidence in local isolates. In the present study, 105 samples were collected from outpatient women (18-45 years) of Maternity hospital in Mosul who showed a classical presentation of Trichomonas
... Show MoreThe purpose of this study is to examine the moderating role of business environment on the relationship between Entrepreneurial Skills (ES) and business performance of Small Business (SB) in Iraq, Baghdad. This study aims to resolve the inconsistencies found in the contemporary literature regarding the relationship between ES and business performance. Questionnaire using a 5-point Likert scale was adopted from previous work to ascertain the responses of the respondents. Survey research design was adopted, and self-administered questionnaires were used to collect the data from small business owners in 9 districts in Baghdad the capital of Iraq. The analysis was conducted using SPSS version 23.0. The direct relationship and hierarchical regre
... Show MoreThis research is aiming to analyze the impacts of the current budget in Iraq by using the Government Finance Statistics Manual (GFSM) , the research is based on hypothesis: (There is an impact on the using of the Government Finance Statistics Manual (GFSM) In public budget in Iraq) .This hypothesis was demonstrated by using the questionnaire, a number of conclusions were reached, the most important being the lack of terminology adopted in the government accounting system and the Iraqi financial and accounting manual as a result of their adoption of the monetary basis for the lack of accounting terminology that meets t
... Show MoreAgricultural loans play an important role in the growth and stimulation of agricultural investment opportunities in Iraq, as well as the sustainability and development of existing agricultural projects. The agricultural sector is characterized by the specific conditions of seasonal production and fluctuations in production conditions, which makes the situation of uncertainty more acute in this sector, the need for any agricultural project for financing is urgent and continuous if it wants to continue production and development at all stages. The study proved the impact of agricultural loans in increasing investment and agricultural production at specific times, However, the fluctuation of funding
... Show MoreThe interest in the issue of capital movement as an economic phenomenon has increased because of its effects and effects and its ability to influence the economic balance and the effectiveness of monetary policy. All countries seek to attract capital and benefit from it because of its effects and results such as supporting economic development process and optimal allocation of economic resources. The problem of the financing gap that most countries suffer from, and others, but sometimes the movement of capital creates challenges for monetary policy makers in achieving their goals.
After 2003, the Iraqi economy witnessed an openness and economic liberalization unlike previous years, which
... Show MoreCutaneous leishmaniasis is one of endemic diseases in Iraq. It is considered as widely health problem and is an uncontrolled disease. The aim of the study is to identify of Leishmania species that cause skin lesions among patients in Thi-Qar Province, South of Iraq, also to detect some virulence factors of L. tropica. This study includes three local locations, Al-Hussein Teaching, Suq Al-Shyokh General and Al-Shatrah General Hospitals in Province for the period from the beginning of December 2018 to the end of September 2019. The samples were collected from 80 patients suffering from cutaneous leishmaniasis, both genders, different ages, various residence places and single and multiple lesions. Nested-PCR technique was
... Show MoreIslamic law has relied on a number of sources in order to denote the rulings issued by them, including what is original and what is sub, and it is known to all scholars, that the Prophet's Sunnah is the second major source after the Koran, which separated the overall and devoted its year and restricted absolute. God Almighty obeyed the owner and his followers, and that his obedience of obedience to God Almighty said: (Who obeys the messenger has obeyed God) (women: 80), and then between the peasant who believes in him and his victory and follow him, he said: (and he said: And the one who was revealed with them were the successful ones (al-A'raf: 157).
It is known that the Sunnah commanded to follow is the
This study concluded detection of Toxoplasma gondii in milk, immunologically by using Elisa and nested PCR)nPCR (based on B1 gene, also to investigate the effect of toxoplasmosis, parity, breed and flock on some milk composition in the Iraqi local and Shami goats in the middle of Iraq. A total of 80 milk samples of the lactating goats were collected. Results of this study showed the prevalence of Toxoplasmosis was 21.25% and 28.75% by Elisa and nPCR respectively without significant differences. The sensitivity of Elisa was a low (30.43%) whereas the specificity was a high (82.45%). The degree of agreement estimated by Kappa coefficient revealed a slight agreement (0.14) between two methods. The results indicated that goats infected
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