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.
Routing is the process of delivering a packet from a source to a destination in the network using a routing algorithm that tries to create an efficient path. The path should be created with minimum overhead and bandwidth consumption. In literature, routing protocols in VANET were categorized in many ways, according to different aspects. In the present study, we prefer the classification based on the number of hops to reach the destination node. In literature, these are single-hop and multi-hops protocols. We first discuss the two types and then compare the MDDV (multi-hops protocol) with VADD (single-hop protocol). The comparison is theoretically and experimentally implemented by providing a network environment consisting of SUMO, VIENS and
... Show MoreThe purpose of this study is discuss the effect of Corporate Governance in the Tax Planning, has been made in a sample of Iraqi Industrial contribution Companies listed in Iraqi Stock Exchange Market (ISE) , for the period from 2008 to 2012.The study used the" Experimental Research Approach" . Also used the (Modified Jones Model, 1995) in order to measure the corporate governance, to measure the extent of the practice of corporate governance in the samples companies. While it use to measure tax planning, the model that used by studies and researches of tax that adopted in discussions of tax reform, by analyzing the financial statements of companies to reach a measurement for the two variables of the study. T
... Show MoreThe research deals with the concept of a New Urbanism as an urban development strategy in the suburbs of cities or in its centers that are affected by pedestrian-oriented design and the possibility of walking, as well as integrating economic classes through the diversity of housing and its costs, and this works to facilitate access to jobs and services while providing more diverse neighborhoods and reducing the use of cars , As designing separate houses in the suburbs and increasing car trips poses a threat to the environment and the quality of urban life, and thus the new urban provides a good strategy for developing
... Show More40 blood sample were taken from children infected with kala-azar at age less than ten years, who were admitted to El-Eskan child hospital, and central health laboratory in Baghdad. At the same time 15 sample collected from healthy child for comparing. During research estimated immunoglobulins level ( IgG, IgM, IgA) and (IFAT) IFAT test recorded a higher indicate antibodies level witch was synergistic with infected severity, the stander level of antibodies arrange between 1/16, 1/32 and 1/64 that means it graduate from the lowest one 1/16 into the highest one 1/64 within groups. During infectious the IgG ,IgM level recorded the higher level (2012.9 mg/dl) and (154.3 mg/dl) compared to the control group (874.3 mg/dl),
... Show MoreThe subject of fear is one of the most important tasks that one should seek to find out the reasons behind it, and push it up with all its sound mental concepts.
The main reason for the lack of security and fear and disturbance in the world is to commit the legitimate violations that God warned us in his Holy Book as well as in the Sunnah of His Prophet (peace be upon him).
The talk about the causes of fear in the Koran is not limited to the word (fear) Fakk but came in different and varied methods such as (horror) and (awe) and (shares) and (narrow).
Ground water hydrochemical study in Yusufiyah depends upon (25) wells where major cations and anions were obtained as well as trace elements. The hydrochemical properties include the study of (pH, EC, TDS, and TH). The groundwater of the study area is odorless and colorless except the wells (13 and 16) with a salty taste due to the elevated (TDS) concentration in it, where the wells depth ranges between 7-20 meters. Depth of water in these wells was about 25-35 meters above sea level. Groundwater generally flows from east to west and from north east to south west. The resource of groundwater depends upon surface water. Physical specifications are measured in the water samples included temperature, color, taste, odor, pH, electrical condu
... Show MoreEvaluating a reservoir to looking for hydrocarbon bearing zones, by determining the petrophysical properties in two wells of the Yamama Formation in Siba field using Schlumberger Techlog software. Three porosity logs were used to identify lithology using MN and MID cross plots. Shale volume were calculated using gamma ray log in well Sb-6ST1 and corrected gamma ray in well Sb-5B. Sonic log was used to calculate porosity in bad hole intervals while from density log at in-gauge intervals. Moreover, water saturation was computed from the modified Simandoux equation and compared to the Archie equation. Finally, Permeability was estimated using a flow zone indicator. The results show that the Yamama Formation is found to be mainly limest
... Show MoreHeritage is considered as the civilization and cultural wealth accumulated over the . centuries, whereas architectural heritage is the physical witness of that civilization. Despite the fact that architectural heritage is the most important effort for economic development of any communit,، it suffers from deterioration and neglection especially in the Arab communities. Recently awareness has increased about the importance of investing on architectural heritage generally and sustainable investment particularly. The goal of investment process in heritage areas is to revive economic activity in addition to attempt to revive the heritage and community values. Research aims to examine the relationship between sustainable investment and
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