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.
It 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
... Show MoreGestational Diabetes Mellitus (GDM) is the most common metabolic disorder that found during gestation and is define as hyperglycemia of variable severity with onset or first recognition during gestation that does not clearly characterize any form of the preexisting diabetes (American Diabetes Association [1]). It affects approximately 16.5% of pregnancies worldwide (Plows, et al.[2]). The placenta is an organ that connects the mother and her fetus during pregnancy (Gul, et al.[3]). In the placenta, glucose can be transformed into glycogen for storage by either glycogen synthase or using glycogenin as a prime. However, the function of glycogen deposition stays a matter of debate, it may be the source of fuel for placenta itself or the storag
... Show MoreCompetencies topic in general , and Administrative competencies in specific, are considered as important subject in the contemporary administrative literature in all countries as well as in public and privet Organizations. For this reason, we have need to study those competencies in many Iraqi Organizations.
Two Organizations wer chosen for this research one of them is the Institution of taxation, and the other is the General company of Electric the data and information related to the research have been collected by desined questioner which has been given to a sample of (50) persions divided eqully between the two maintioned organizations.
The results of the study had differences
... Show MoreLogic is one of the sciences that have receded and regressed in the field of Islamic sciences. This regression is the result of several factors, the most important of which are:
1- The Aristotelian logic, concerned with the seemingly essential shape and the underlying truth in the text, which has been translated into Arabic, is no longer able to keep pace with scientific revelations and epistemological spaces of our time.
2- The existence of logic in the curricula of Islamic studies was not subject to a study linking logic and Islamic sciences. Therefore, we find that the student studies logic as if it were a strange subject that has nothing to do with the subjects of Islamic studies and even Islamic philosophy.
3- Logic is
Tafsir, ‘interpretation’ is one of the most important sciences the Muslims need. Because Allah, Almighty, revealed the Qur’an to be a way of life for the Muslims in which the healing of what is in the chest, including their goodness and their peasant. Allah says:
“O people, an admonition has indeed come to you from your Lord and a healing for what is in the hearts; and a guidance and a mercy for the believers.”
In order to achieve the goal for which God revealed the Quran must be understood and managed verses:” This is a Book that We have revealed to you abounding in good, that they may ponder over its verses, and that those who have understanding may be mindful.”
The Prophet (PBUH) and his companions understood t
Background: Cross contamination of dental appliances in the dental clinics and laboratories may potentially be a health hazard to the dental team and the patient. This study aimed to evaluate bacterial contamination of acrylic complete denture as received from dental laboratory before delivery to the patient, and then to evaluate the effectiveness of disinfection with 2% chlorhexidine and Kin denture cleaner tablet. Materials and methods: 45 newly made upper complete dentures undergone biaacterial examination for contamination before delivered to the patient. Samples were examined in two stages, first after finishing and polishing; when collected from the laboratory and before inserting to the patient mouth, second; after the samples were
... Show MoreOut of the search for the truth, the reader of the Holy Qur’an should know the fate of the sorcerers whom Pharaoh threatened when they announced it as pure monotheism in front of seeing the stick as it turned into a clear serpent, when they said: We believe in the Lord of the worlds, the Lord of Moses and Aaron, and the clear promise came to cut and crucify the trunks of palm trees, and they said what they said if Being supplicants to God (May God cause us to die as Muslims), did Pharaoh actually carry out what he promised them?? So we studied that subject from this angle. Because what looms on the horizon of the Holy Qur’an is that there is no one who seeks refuge with God Almighty in times of adversity except that God Almighty has
... Show MoreAbstract:
The aim of the present research is to evaluate the child’s nutritional
method (2-5 years old) which is based on his resistance of the food highly rich
with nutritional elements and his acceptance of the food of a low nutritional
value in addition to his having forbidden food with other mates and making
use of all mates when having food, in establishing the sound social values and
affection since child hood. The required statistical equation have been used
by the researcher namely (Z test).
The sample of the present study consists of (26) children who were selected
intentionally and randomly from the kindergartens of Al-Bayaa region and the
college of Education for women. The questionnaires were d