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.
The importance of this study stems from the importance of preserving the environment and creating a clean sustainable environment from waste and emissions and all the operations of industrial companies in general and cement companies in particular by activating sustainability accounting standards. The research aims to identify and diagnose deviations in violation of sustainability standards by employing the non-renewable resources standard (NR0401) For the construction industries to create a sustainable audit environment, the deductive approach was followed in the theoretical side and the inductive and descriptive approach to the practical side. The most important results of the research were the possibility of applying sustainab
... Show MoreExposure assays to magnetized water have so far revealed striking results. The present study was conducted to determine the effects of magnetized water treatment with in different intensities 500 , 1000 and 1500 Gauss on some biological aspects for species of freshwater Gastropod Lymnaea lagotis (Schrank, 1803) which important species in faun of aquatic habitats of Iraq. This species are considered a component of the food chain. The obtained results compared with these species which lived in the river(control). Result of these experiments showed increased significance the shell size (shell high, shell aperture length, shell aperture width and shell width) for L. lagotis with increased intensity magnetized water such as treated water with 1
... Show MoreThe increase globally fossil fuel consumption as it represents the main source of energy around the world, and the sources of heavy oil more than light, different techniques were used to reduce the viscosity and increase mobility of heavy crude oil. this study focusing on the experimental tests and modeling with Back Feed Forward Artificial Neural Network (BFF-ANN) of the dilution technique to reduce a heavy oil viscosity that was collected from the south- Iraq oil fields using organic solvents, organic diluents with different weight percentage (5, 10 and 20 wt.% ) of (n-heptane, toluene, and a mixture of different ratio
... Show MoreDocument source identification in printer forensics involves determining the origin of a printed document based on characteristics such as the printer model, serial number, defects, or unique printing artifacts. This process is crucial in forensic investigations, particularly in cases involving counterfeit documents or unauthorized printing. However, consistent pattern identification across various printer types remains challenging, especially when efforts are made to alter printer-generated artifacts. Machine learning models are often used in these tasks, but selecting discriminative features while minimizing noise is essential. Traditional KNN classifiers require a careful selection of distance metrics to capture relevant printing
... Show MoreThe co-occurrence of metabolic syndrome with type 2 diabetes mellitus (T2DM) will potentiate the morbidity and mortality that may be associated with each case. Fasting triglycerides-glucose index (TyG index) has been recommended as a useful marker to predict metabolic syndrome. Our study aimed to introduce gender-specific cut-off values of triglycerides- glucose index for diagnosing metabolic syndrome associated with type 2 diabetes mellitus. The data were collected from Baghdad hospitals between May - December 2019. The number of eligible participants was 424. National cholesterol education program, Adult Treatment Panel III criteria were used to define metabolic syndrome. Measurement of fasting blood glucose, lipid pro
... Show MoreThis work was conducted to study the ability of locally prepared Zeolite NaY for the reduction of sulfur compounds from Iraqi natural gas by a continuous mode adsorption unit. Zeolite Y was hydrothermally synthesized using abundant kaolin clay as aluminum precursor. Characterization was made using chemical analysis, XRD and BET surface area. Results of the adsorption experiments showed that zeolite Y is an active adsorbent for removal H2S from natural gas and other gas streams. The effect of temperature was found inversely related to the removal efficiency. Increasing bed height was found to increase the removal efficiency at constant flow rate of natural gas. The adsorption capacity was evaluated and its maximum uptake was 5.345 mg H2S/g z
... Show MoreThe current study investigated the stability and the extraction efficiency of emulsion liquid membrane (ELM) for Abamectin pesticide removal from aqueous solution. The stability was investigated in terms of droplet emulsion size distribution and emulsion breakage percent. The proposed ELM included a mixture of corn oil and kerosene (1:1) as a diluent, Span 80 (sorbitan monooleate) as a surfactant and hydrochloric acid (HCl) as a stripping agent without utilizing a carrier agent. Parameters such as homogenizer speed, surfactant concentration, emulsification time and internal to organic volume ratio (I/O) were evaluated. Results show that the lower droplet size of 0.9 µm and higher stable emulsion in terms of breakage percent of 1.12 % were
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