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.
Foreign trade is very important in global economies because of its impact on the sustainability of economic growth by stimulating economic activity, creating jobs and expanding production . On the other side , this policy is a major obstacle to many developing countries and the reason is due to the nature of the economies of those countries because they rely mostly on one or a few economic resources, which makes them rely mostly on exports to that resource while they import most of the needs of their local market Which makes them in a spiral of underdevelopment , dependence and economic exposure, which requires them to break that cycle and the launch of economic development Perhaps one of the most important means to a
... Show MoreTrichomonas vaginalis is a causative agent of trichomoniasis , one of the most common non-viral sexually transmitted disease (STD) over all the world, especially in immunocompromised women such as pregnant. Wet smear and Giemsa stain are the current methods used in hospital to diagnosis trichomoniasis. DNA based diagnosis is still to be validated to diagnose the local isolates, the objective of the present study was to compare the conventional methods of disease diagnosis with the DNA-based method to diagnose Trichomonas incidence in local isolates. In the present study, 105 samples were collected from outpatient women (18-45 years) of Maternity hospital in Mosul who showed a classical presentation of Trichomonas
... Show MoreAbstract
Sovereign wealth funds are an important tool for achieving economic stability and avoiding the local economy from external shocks, including the shocks of international oil prices. The spread of these funds is the result of large current account surpluses in many Asian and oil-exporting economies. These surpluses are due to higher commodity prices Has led to a rapid accumulation of foreign assets in central banks. Many countries with rent economies face the problem of their dependence on non-renewable natural resources, especially the oil countries, including Iraq. Oil revenues are more than 97% of oil exports, so they suffer from structural imbal
... Show MoreThe study of the distribution of major oxides and heavy metals in some plants collecting and analyzing eighteen plant samples of vegetables including carrot, onion, eggplant, cucumber, and okra obtained from Abu Ghraib land located about 20 km west of Baghdad, Iraq. Eighteen plant samples of vegetables,.Heavy metals can have a severe impact if released into the environment, even in trace quantities. These can enter the food chain from aquatic and agricultural ecosystems and indirectly threaten human health.. Trace elements and oxides of As, Cd, Co, Cr, Cu, Mn, Mo, Ni, Pb, Se, Th, U, V, and Zn were measured in plant samples using an X-Ray Fluorescence Instrument (XRF). TEs analyses of vegetables were performed in the Iraqi German Lab
... Show MorePoverty phenomenon is very substantial topic that determines the future of societies and governments and the way that they deals with education, health and economy. Sometimes poverty takes multidimensional trends through education and health. The research aims at studying multidimensional poverty in Iraq by using panelized regression methods, to analyze Big Data sets from demographical surveys collected by the Central Statistical Organization in Iraq. We choose classical penalized regression method represented by The Ridge Regression, Moreover; we choose another penalized method which is the Smooth Integration of Counting and Absolute Deviation (SICA) to analyze Big Data sets related to the different poverty forms in Iraq. Euclidian Distanc
... Show MoreThe easternmost extent of the Pharaoh Eagle Owl Bubo ascalaphus (Savigny, 1809)
distribution has remained enigmatic due to id entification problems and lack of owl research.
In Iraq, B. ascalaphus has been reported from only few localities in western Iraqi deserts;
while its occurrence in Iran has not been reported before this study. In 2017 2020, several
new records of B. ascala phus in western through southeastern Iraq were made and a new
distribution range in western Iran was confirmed. Furthermore, field identification,
interspecific relationships and conservation status of B. ascalaphus in Iraq and Iran were
comprehensively di scussed.
The process of coordination and joint cooperation between SAIs and internal auditors in the public sector is considered one of the very important matters in performing efficient audits and are of high quality, especially if this coordination and cooperation is implemented in accordance with international standards, as it leads to avoiding duplication in auditing work. And the distribution of work in a distribution that achieves the objectives of auditing in general and is of general benefit to the economic unit.
The research problem lies in the weakness of the relationship between internal auditing and external auditing as a result of not applying INTOSAI Standard (9150) coordination and joint cooperation
... Show MoreThe closeness of residential neighborhoods to oil refineries and petrochemical plants in these areas has heightened the community’s exposure to dangerous air pollutants. This study aimed to investigate the impact of health literacy upon lung cancer screening beliefs among residents of neighborhood adjacent to a refinery oil.
A cross-sectional study design using nonprobability convenience sampling was applied, employin
In this paper, the dynamics of scavenger species predation of both susceptible and infected prey at different rates with prey refuge is mathematically proposed and studied. It is supposed that the disease was spread by direct contact between susceptible prey with infected prey described by Holling type-II infection function. The existence, uniqueness, and boundedness of the solution are investigated. The stability constraints of all equilibrium points are determined. In addition to establishing some sufficient conditions for global stability of them by using suitable Lyapunov functions. Finally, these theoretical results are shown and verified with numerical simulations.