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.
New microphotometer was constructed in our Laboratory Which deals with the determination of Molybdenum (VI) through its Catalysis effect on Hydrogen peroxide and potasum iodide Reaction in acid medium H2SO4 0.01 mM. Linearity of 97.3% for the range 5- 100 ppm. The repeatability of result was better than 0.8 % 0.5 ppm was obtanined as L.U. (The method applied for the determination of Molybdenum (VI) in medicinal Sample (centrum). The determination was compared well with the developed method the conventional method.
The current research aims to know the effect of teaching using multiple intelligences theory on academic achievement for students of primary school. The sample search of pupils . The research sample was divided into two groups where the first group represented the experimental group which studied the use of multiple intelligences and the second group represented the control group which studied the use of the traditional way . The search tool consisted of achievement test. Showed search results, there are statistically significant differences(0.05) between the average scores of students who have studied according to multiple intelligences between the average scores of students who have studied in accordance with the tradition way in the p
... Show MoreSummary
I wanted to address this topic because of creedal purposes importance,and its r le in regulating lives of individuals and society, and to talk about purposes of Almighty's saying:{It is easy for me},to simplify its meanings for general educated person to obtain the believe of the Creator’s power and his oneness.
Therefore,this research came,whichincludes:an introduction and topics, first :concept of creedal objectives and their divisions,second: creedal purposes in Almighty’s saying:{It is easy for me},and conclusion:in where most important results were included:
... Show MoreOne of the main techniques to achieve phase behavior calculations of reservoir fluids is the equation of state. Soave - Redlich - Kwong equation of state can then be used to predict the phase behavior of the petroleum fluids by treating it as a multi-components system of pure and pseudo-components. The use of Soave – Redlich – Kwon equation of state is popular in the calculations of petroleum engineering therefore many researchers used it to perform phase behavior analysis for reservoir fluids (Wang and Orr (2000), Ertekin and Obut (2003), Hasan (2004) and Haghtalab (2011))
This paper presents a new flash model for reservoir fluids in gas – oil se
The aim of this research is to find out the satisfaction functional for faculty members
To Girls College of education at the University of Baghdad, and to find out the differences in this variable according to gender and qualification of education.
The sample was chosen from 60 teachers (males – females), they applied a questionnaire consisting of (30) paragraphs after the verifying of sincerity and persistence for paragraphs.
The main findings of the studies,
The results are indicated that the samples (faculty members) have a good level of satisfaction functional. In addition, results are shown; there are no significant differences of statistically between males and females for the faculty members. However, results are sho
The research aims to measure the sustainability of the Iraqi economy for the period 1990-2018 as well as to show the impact of fluctuations in the level of GDP on financial sustainability, where financial sustainability is the necessary and sufficient condition for achieving economic and financial balance in the country, as financial sustainability reflects the movement of the state budget and its relationship to GDP through the indicators of deficit, fiscal surplus and public debt internal and external, as well as reflecting the art of managing public debt, and the more managed public debt is achieved, the more the management of public debt is achieved financial sustainability. for the state in the sense that there is a reciprocal
... Show More<p>Vehicular ad-hoc networks (VANET) suffer from dynamic network environment and topological instability that caused by high mobility feature and varying vehicles density. Emerging 5G mobile technologies offer new opportunities to design improved VANET architecture for future intelligent transportation system. However, current software defined networking (SDN) based handover schemes face poor handover performance in VANET environment with notable issues in connection establishment and ongoing communication sessions. These poor connectivity and inflexibility challenges appear at high vehicles speed and high data rate services. Therefore, this paper proposes a flexible handover solution for VANET networks by integrating SDN and
... Show MoreA reduced-order extended state observer (RESO) based a continuous sliding mode control (SMC) is proposed in this paper for the tracking problem of high order Brunovsky systems with the existence of external perturbations and system uncertainties. For this purpose, a composite control is constituted by two consecutive steps. First, the reduced-order ESO (RESO) technique is designed to estimate unknown system states and total disturbance without estimating an available state. Second, the continuous SMC law is designed based on the estimations supplied by the RESO estimator in order to govern the nominal system part. More importantly, the robustness performance is well achieved by compensating not only the lumped disturbance, but also its esti
... Show More