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.
Regular sampling for six months from January to July 2012 were taken in small, shallow, perennial, standing ponds near the Greater Zab River, Gwer district, Erbil. A variety of physicochemical parameters were determined. Air and water temperature were falling between 15.2 - 34.7 ? C and 15.5 and 26.5 ?C. The waters are neutral (pH 7.38-8.27), hard, alkaline, salty, high in TDS and EC (892-966?S/cm, and rich in nutrients (NO3: 2.1-4.1mg/l, PO4: 0.33-0.62 mg / l , SO4: 24.7-80.2 mg / l ). The attention fixed on a filamentous blue- green algae Glaucospira Lagerheim, 1982) which is new to Iraqi flora. It is a filament (trichome), solitary, pale or yellowish blue – green, without sheath, Screw like coiled, motile, some of them are activ
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Abstract
Despite the fact of the importance and effectiveness of supporting the pricing policy for agriculture sector in Iraq, but this policy has stopped in supporting those agriculture production needs, and it was confined to support the final product only, and supporting the strategic corps exclusively after the U.S. Invasion in 2003, but after 2008 the state has returned to support some of this policy activities through providing financial loans through the agricultural initiative campaign, with trillions of iraqi dinars without any use, also providing support to some of the agricultural production needs such as fertilizers , tractors and agricultural combines, in addition supporting the pricing policy for the
... Show MoreThe guava plant, Psidium guajava L., serves as proof of the abundant donations of nature, providing a delicious guava fruit; this plant is rich in groups of medicinal and nutritional benefits. Guava belonging to the Myrtaceae family, many previous studies reported many phytochemical constituents in its leaves that have many pharmacological activities and medicinal properties; this study focuses on the isolation, structural elucidation and calculation concentration of flavonoids, assessment of the cytotoxic activityof hyperin from Psidium guajava leaves newly cultivated in Iraq. The isolation process involved the use of thin-layer chromatography (TLC) and preparative high-performance liquid chromatography (PHPLC) and structural eluci
... Show MoreIn this study; the genus of Sinoxylon Duftschmid, 1825 (Coleoptera, Bostrichidae) was revised. There were 3 species registered in our investigations: S. anale Lesne, 1897; S. ceratoniae (Linnaeus, 1758) and S. muricatum (Olivier, 1790), the last species was redescribed as being found for the first time for the Iraqi faunal insects. Key to the species were constructed and supported by figures of the main diagnostic characters and some morphological features.
In this study an illustrated key for the identification of the Iraqi species of the genus Chalcophorella Kerr. is given with information about general distribution for each species. Information is also given about period of collection, plants on which the specimens were collected. The real host plant if they are available and known are also given referring to the previous works.
The trade balance is considered as a way to join the national economy with the world, So it is the mirror that reflect the economic center of the country and it is point to competitive ability of it, The tariff and the exchange rate perform a great role to motivate the domestic production and improve the trade balance if we direct them to achieve the same purpose. The Iraqi economic has trade balance which achieve overabundant during the years of studying because of the oil exports, while the other exports represent a small percentage it is hardly remember, and expansion in imports from other side causes exhaustion in oil revenues, and this make the trade balance in permanent
... Show MoreThe research problem lies in identifying the challenges facing spreading the culture of peace in Iraq, and the most important factors of its instability from the point of view of leaders and intellectual elites.The research derives its importance from the fact that the peace imposed by justice leads to a stable Iraq and a prosperous future.
The study aims to identify the most prominent challenges and obstacles created by wars and faced the process of spreading the culture of peace and instability in Iraq, and to shed light on the reasons leading to the employment of the capabilities of community leaders in spreading the culture of peace.The objective of the current research is to identify the challenges of spreading the culture o
... Show MoreBirds of prey (Raptors) are top predator avian species that many migrate annually through Mesopotamian marshes in southern Iraq toward their wintering grounds in Arabia and Africa, while others are breeding residents; however, information on their current status is scarce. From January 2016 to April 2019, a total of 20 field expeditions were conducted in the geographical zone of the Mesopotamian marshes, wetlands of international importance. The survey covered the Central Marshes, Al-Hammar and Hawizeh Marsh. One of the objectives of the field surveys is to list the raptors species that wintering and/or migrating through the Mesopotamian marshes and to understand their current spatial and temporal distribution. In the present study, a to
... Show MoreIn this paper all possible regressions procedure as well as stepwise regression procedure were applied to select the best regression equation that explain the effect of human capital represented by different levels of human cadres on the productivity of the processing industries sector in Iraq by employing the data of a time series consisting of 21 years period. The statistical program SPSS was used to perform the required calculations.