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.
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The research aims to identify how to audit potential liabilities and contingent liabilities in light of the pandemic and its reflection on the auditor's report. The research problem is represented by the complexity of the process of checking potential liabilities and contingent liabilities in insurance companies, which was negatively reflected in the auditor's neutral technical opinion. The researchers hypothesize that auditing potential liabilities and contingent liabilities in light of the Corona pandemic is positively reflected in the auditor's report. The research concludes that the process of checking potential liabilities and contingent liabilities is
... Show MoreAccounting disclosure is the main means and effective tool for communicating business results to users in support of their decisions, especially those with thought and specialization from academics and professionals in the field of accounting and auditing about the importance of accounting disclosure and transparency in financial reports.
Contingent liabilities represent commitments based on the occurrence of one or more events in the future to confirm the value due, the party entitled to it, the maturity date, or to confirm the existence of the obligation itself, and therefore they should not be recognized as a contingent liability i
... Show MoreThe study aims at knowing the actual uses of instructional technology in teaching history subject in the colleges of education for humanities from the college staff members' perspectives and their attitudes towards it. The sample of the study consisted of (24) instructors from the Colleges of Education for the Humanities, the College of Basic Education- Haditha and the College of Education for Women, the study used the descriptive method, and the questionnaire was consisted of (50) items, and the psychometric properties of the instrument of the study were extracted. The researchers used the appropriate statistical means to analyze the data, and the results of the study showed the following: the teaching staff attitudes towards the use of
... Show MoreSubjected Find winged bull Assyrian monetary analysis in order to identify the formative relations in terms of percentages, movement and public swab for being aesthetic values upon which the mechanisms of artistic composition, which did not give researchers artistic interest that affects the status of these sculptures and the like of the achievements of the Iraqi civilization in Assyria.
Resulting analysis to a number of the most important results, the percentages approved in the calculation of the parts to do with all when viewed status horizontal with a realistic formulas while in the case of considering frontally clear for Ras stylized proportions and head size larger in length, a ratio confirmed by previous studies, and
... Show MoreThe sol-gel preparation technique of transparent silica monoliths containing up to 0.5 M of samarium have been described. The sol-gel processing parameters are: acid catalyzed hydrolysis and controlled drying. The prepared monoliths are analyzed by X-ray diffraction, pycnometer measurements, Fourier transformation infrared spectroscopy and optical spectroscopy. The oscillator strengths of the Sm3+ ions in the silica monoliths are calculated. The results show a linear concentration dependence of some Sm3+ transitions in UV/Vis absorption spectra and formation of Sm3+ clusters inside the pores structure of silica monoliths at high Sm3+ concentration
The political parties are considered to be the basic infrastructure in the political process for their great role in achieving the political movement in the country and to work on implementing the goals and interests of its voters in the event of their coming to power. If the parties that totalitarianism led to monopoly and monopolization, We can not talk in these countries about the liberal concept of the party and can not talk about the existence of a law or laws and regulations governing and regulate the work of parties. But on the other hand, which is represented by the liberal state, we find a lot of talk and practice about the form and nature of the legitimate law in regulating the formation of parties and their work in a manner th
... Show MoreThe primary issue addressed in this research revolves around identifying the interactive elements provided by the Twitter platform and understanding their utilization by digital newspapers with official accounts. These newspapers broadcast content in line with their policies. This study is classified within descriptive research that employed a survey method and content analysis tool. The methodology relies on the "how was it said?" approach to categorize the analysis. The research yielded the following results:
Twitter utilized numerous interactive elements for disseminating tweets, which include "text, branching links, hashtags, digital images, digital videos, digital audio, and digital polls." However, thes
Irisin is a myokine that controls energy metabolism by making adipose tissue brown. The present goal in doing this research was to determine how irisin concentration relates to other biochemical markers of disease. Hemodialysis (HD) for chronic kidney failure. The study included 30 individuals with end-stage renal disease on HD and 30 healthy subjects as the control group. The ages of all patients and the control group ranged from (25 to 60) years. The excluded criteria included patients with viral hepatitis and diabetes. Serum irisin concentration and the level of fasting serum glucose (FSG), urea, creatinine (Cr), total protein (TP), albumin (Alb), albumin to creatinine ratio (ACR), total cholesterol (TC), alanine aminotransferase (ALT),
... Show MoreExperimental and numerical investigations of the centrifugal pump performance at non-cavitating and cavitating flow conditions were carried out in the present study. Experiments were performed by applying a vacuum to a closed-loop system to investigate the effects of the net positive suction head available (NPSHa), flow rate, water temperature and pump speed on the centrifugal pump performance. Accordingly, many of the important parameters concerning cavitation phenomenon were calculated. Also, the noise which is accompanied by cavitation was measured. Numerical analysis was implemented for two phase flow (the water and its vapor) using a 2-D simulation by ANSYS FLUENT software to investigate the internal flow of centrifugal pump under c
... Show MoreIt is clear that correct application of antibiotic prophylaxis can reduce the incidence of infection resulting from the bacterial inoculation in a variety of clinical situations; it cannot prevent all infections any more than it can eliminate all established infections. Optimum antibiotic prophylaxis depends on: rational selection of the drug(s), adequate concentrations of the drug in the tissues that are at risk, and attention to timing of administration. Moreover, the risk of
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