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 study aims at diagnosing the importance of environmental analysis (external, industrial and internal) in the organization's strategy for the development of public organizations. The theoretical problem derived from the existence of a knowledge gap for studies and research that dealt with the variables of the study. Three public organizations were selected as the study society (the Civil Defense Directorate, the Directorate of Nationality, Passports and Residency, the General Traffic Directorate). The sample of the study was a sample of (215) managers (managers, department managers, Analysis of the data and hypothesis testing using the appropriate statistical tools, Pearson, the simple and multiple regression coefficient to te
... Show MoreThe research aims to demonstrate the impact of tax techniques on the quality of services provided to income taxpayers by studying the correlational and influencing relationships between the exploited variable (tax techniques) and the dependent variable (the quality of services provided to income taxpayers), and in line with the research objectives, the main hypothesis of the research was formulated (there is a relationship Significance between tax techniques and the quality of services provided to income taxpayers) a number of sub-hypotheses emerged from this hypothesis that were stated in the research methodology, and a number of conclusions were reached, the most important of which were (through the use of the correlation coeff
... Show MoreAbstract
The objective of this research is to identify the analysis of the ethics of the administration in the development of the social responsibility of one government organizations, and to achieve the objectives of the research was the use of a questionnaire developed for the purpose of data collection and distribution to the research sample, was chosen as a total sample population (50) individuals were relying on statistical package to do a statistical analysis for this research, user, ANSI (SPSS) simple regression analysis, standard deviation, Pearson correlation coefficient.
Research findings show the role of social responsibility in achieving the university's strategy,
... Show MoreThe experiment was conducted inside a glasshouse at the Department of Biology/
Education college Ibn- Alhaitham/ Baghdad University during the growing season 2010-2011. The aim of the study was to assess the influence of increasing of NaCl concentration in
the nutrient solution and different concentrations of proline as spray on the vegetative growth
on the chlorophyll content, soluble carbohydrates percentage, flowers number and the proline
content of vegetative growth. The aim of this study was also to determine the satiable
concentration of proline while decrease the injerion. Effect of NaCl on the studied traits of
two hyborids of tomato plants namely Olga F1 and Hymar F1. Sodium chloride concentration
of 0
The administration on the basis of the activities designed to evaluate the performance of activities in terms of cost, time and quality by identifying activities that add value and those that are no add value and enables the administration of making up their own continuous improvement in production, through lower costs and reduce the time and improve the quality and reduce the incidence of spoilage and waste, y based search Ally premise that (the continuous improvement of the adoption of management style on the basis of the activities helps management in decision-making wise to reduce costs) to prove the hypothesis has sought research to achieve its goal of Alkadivh and Alkoppelan &nb
... Show MoreMixed convection heat transfer in a vertical concentric annulus packed with a metallic porous media and heated at a constant heat flux is experimentally investigated with water as the working fluid. A series of experiments have been carried out with a Rayleigh number range from Ra=122418.92 to 372579.31 and Reynolds number that based on the particles diameter of Red=14.62, 19.48 and 24.36. Under steady state condition, the measured data were collected and analyzed. Results show that the wall surface temperatures are affected by the imposed heat flux variation and Reynolds number variation. The variation of the local heat transfer coefficient and the mean Nusselt number are presented and analyzed. An empirical
... Show MoreBabesiosis is a tick-borne disease caused by Babesia microti. We present a case of false positive HIV in the setting of confirmed babesiosis infection. An understanding that patients with babesiosis can have a false positive HIV test result is important in management decisions.
A political perusal of Initiations in Declaring Middle East a District vacant of mass Destruction weapons
In this effort, we define a new class of fractional analytic functions containing functional parameters in the open unit disk. By employing this class, we introduce two types of fractional operators, differential and integral. The fractional differential operator is considered to be in the sense of Ruscheweyh differential operator, while the fractional integral operator is in the sense of Noor integral. The boundedness and compactness in a complex Banach space are discussed. Other studies are illustrated in the sequel.