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.
This competition between competing forces, organized into axes with conflicting objectives, is reflected in all regional affairs and the goals and interests of countries within them, including Iraq. Among the most important aspects impacted by the repercussions of international and regional competition in the region is Iraqi national security, based on its vital importance in preserving the sovereignty and entity of the Iraqi state, protecting the interests and cohesion of the state and people, ensuring and defending their present and future, and interacting with various regional and international activities. The Kurdistan Region, as an important part of Iraq with its own unique characteristics, may be one of the most important regi
... Show Moreמטרת המחקר הזה היא לבדוק את שלושה סיפורים קצרים מהקובץ הראשון של אהרון אפלפלד , שנחשב ההצהרה הרשמית על היותו סופר השואה הראשון בישראל , המשותף לשלושת הסיפורים הוא הנימה של הגיבורים היוצאים למסע פיזי ונפשי לגלות את אשר אירע להם , מגמתו של המחקר היא לבדוק את הצורה המיוחדת שבה אפיין אפלפלד את גיבוריו שמעידים על כך , כי השואה היא החוויה המרה והקשה בקרב היהודים והשלכותיה נשארה טמונה בקרבם גם אחרי המלחמה ואחרי שנים
... Show MoreIn accounting studies, more than one method is used to measure income and balance sheets elements. One of these methods is called the fair value, which use to determine the assets and liabilities ad it includes the benefits or self-satisfaction ability. This paper aims to focus on the importance of fair value as a basis of accounting measurement and its effects to achieve the relevant characteristics by using the equation is used by (Kythreotis) in his research, And Also , Editing this equation depending on the financial data and information of Iraqi Banks as a case.
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The research problem lies in the lack of accurate scientific perceptions concerning the reality of the communicator and the factors influencing his job. The research is aimed at introducing the communicator in the university press, clarifying the obstacles facing him, and uncovering the level of his job satisfaction and his visions of developing his work. The researcher adopted the survey method in the collection, analysis, and interpretation of the data using a questionnaire. A set of results and conclusions has been reached, most importantly are:
*The communicator performs multiple missions including writing, editing, and collecting info |
Nominal ellipsis is a linguistic phenomenon found in English and Arabic .It is
based on leaving out a part of a nominal construction or more for the sake of good
style , compactness and connectedness .This phenomenon is found in the language of
the Glorious Qur’an .The study in hand is concerned with how translators handle
translating Qur’anic verses which contain ellipted nouns , i ,e. , to what extent the
translated Qur’anic verses are close to the original ones , and to what extent their
translations serve understanding the meanings of the glorious verses while at the
same time maintaining their beauty in style. The study aims at shedding light on
nominal ellipsis in English and Arabic .The study undertak
The research aims to identify the impact of managing performance's employees in building intellectual capital, Because employing the practice of managing the performance of employees may acquire familiar skills to improve their performance and reflect on the construction of intellectual capital in the surveyed area, Especially that the independent dimension represented by the management of the performance of employees is one of the important topics that has received attention in the world of management in general and human resource management in particular. While the adopted dimension was represented by Intellectual capital in the important practice of human resource management in the increasing of their knowledge, to
... Show MoreObjective: Loranthus europaeus is a parasitic plant that lives on the branches of trees. The present study aimed to evaluate the anti-inflammatory effects of two different extracts on chronic inflammation induced by cotton pellets in rats. Methods: Loranthus seed was extracted by maceration with absolute methanol, in which dry Loranthus seeds were triturated in a mortar and macerated with 500 mL of methanol. After 24 h, the mixture was filtered, and the residue was re-extracted. The filtrates were combined and dried under vacuum. The mixture was mixed with 100 mL of distilled water and fractionated by petroleum ether and ethyl acetate using 70 mL × 3 times each. The organic fractions were dried, filtered, and evaporated to dryness.
... Show MoreIn the present research we the study the deposition of radioactive elements naturally and particularly radioactive radon gas in parts of the body of organisms which are of direct relevance to human life in the city of Baghdad as the samples which were collected from the bones and skin of some kinds of birds and chicken based on the principle that radioactive elements are concentrated always on the bones. We use of this as the exercise detector impact nuclear (CR-39), using the technology Cylindrical diffusion , the results indicated that the largest concentration of radon found in the bone bird Seagull tapered as it was (625 ± 37) Bq.cm-3, and less concentration of radon gas in the chicken bones of Al-kafeel as it was (105 ± 10) Bq.c
... Show MoreBACKGROUND: Hepatocyte growth factor (HGF) is a proangiogenic factor that exerts different effects over stem cell survival growth, apoptosis, and adhesion. Its impact on leukemogenesis has been established by many studies. AIM: This study aimed to determine the effect of plasma HGF activity on acute myeloid leukemia (AML) patients at presentation and after remission. PATIENTS AND METHODS: This was a cross-sectional prospective study of 30 newly-diagnosed, adult, and AML patients. All patients received the 7+3 treatment protocol. Patients’ clinical data were taken at presentation, and patients were followed up for 6 months to evaluate the clinical status. Plasma HGF levels were estimated by ELISA based methods in the pa
... Show MoreBackground: Anemia of chronic disease (ACD) occurs in the presence of chronic infection, inflammatory conditions or neoplastic conditions despite of adequate iron and vitamins storage. Gingivitis is the inflammation of the gingiva, periodontitis is the inflammation in the periodontium that extend deeper with loss of connective tissue attachment and supporting bone. The main pathogenesis of periodontal diseases and ACD is immune activation. Aims of study: Determine and compare the clinical periodontal parameters (plaque index (PLI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment level (CAL)). Evaluate the hematocrit (Hct) level, red blood cells (RBCs) count and white blood cells (WBCs) c
... Show More