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 research aims to identify ways of upgrading the quality level of university education at the Middle Technical University in light of its application for the National Ranking project for the quality of Iraqi universities in order to obtain advanced grades among the Iraqi universities , Which is qualified to enter the Ranking of universities worldwide, through displaying the mechanism of the Application of National Ranking project for the quality of Iraqi universities in the Middle Technical University and its formations consisting of (5) technical colleges and (11) technical institute.
The results of the application showed several observations: The most
... Show MoreThe study aims to identify the impact of the implementation of the integrated education strategy in the curriculum of the Arabic language for the seventh grade on the academic achievement in the schools of the capital Amman. The researcher adopted the experimental method, where two divisions of the seventh grade students were chosen from the secondary school for girls. The sample of the study was 60 students divided into two equal groups: 30 students represented the experimental group (A) and (30) students represented the control group. To collect the needed data, a test of (40) Multiple Choices was used. The results showed statistically significant differences between the mean scores of the experimental group who were taught acc
... Show MoreThis study aims to investigate the degree of practicing the motivated classroom evaluation environment for learning and its relationship to different feedback patterns. To achieve the objectives of the study, the correlational descriptive research design was employed. A questionnaire was constructed consisting of two parts: the classroom evaluation environment (13) items, and feedback patterns (24) items on a five-point scale. The psychometric properties of the questionnaire were verified in terms of validity and reliability. The questionnaire was applied to a sample of (265) male and female teachers who work in the second cycle schools for grades (5-10) of basic education in all academic majors in the Governorate of Muscat in the Sultan
... Show MoreThe research aims to find out the effect of Cognitive Acceleration strategy and random excitement strategy in achievement of geography material and developing the reflective thinking for students of literary fifth class .
the researcher depended a partial control experimental design with the three groups(the competence groups of the pre & post tests), The sample is deliberately selected from first AL-Rusafah Directorate General of Education in Baghdad. AL.fardoos Interme
... Show MoreThe current research aims to evaluate the activities and evaluation questions implied in the content of the computer textbook for the fifth preparatory grade according to the creative thinking and developing suggestions through answering the following question: what is the percentage of creative thinking skills in the content of the computer textbook for the fifth Preparatory grade students issued by the Iraqi Ministry of Education/ Directorate General of the curriculum in the academic year (2019-2020)? The researchers followed the descriptive-analytical approach. The research community was determined by the content of the computer textbook for the fifth preparatory grade. As for the research sample, it was limited to all activitie
... Show MoreAn experiment was carried out in the vegetables field of Horticulture Department / College of Agriculture / Baghdad University , for the three seasons : spring and Autumn of 2005 , and spring of 2007 , to study the type of gene action in some traits of yield and its components in summer squash crosses (4 x 3 = cross 1 , 3 x 7 = cross 2 , 3 x 4 = cross 3 , 3 x 5 = cross 4 , 5 x 1 = cross 5 , 5 x 2 = cross 6). The study followed generation mean analysis method which included to each cross (P1 , P2 , F1 , F2 , Bc1P1 , Bc1P2) , and those populations obtained by hybridization during the first and second seasons. Experimental comparison was performed in the second (Two crosses only) and third seasons , (four crosses) by using RCBD with three repl
... Show MoreThere is a set of economic factors that affect the rationalization of decisions on unexploited resources within the economic unit and here determines the problem of the search for the question of what economic factors cause the emergence of asymmetric costs, and aims to identify these factors in the costs of adjustment to resources, change in The size of the activity of the economic unit, the general trend of sales change in the previous period, and the economic level of the country. Rh measure the impact of these factors on economic unity, and taking into consideration the impact when formulating decisions.
The Financial authority is considered as one of the most of benefited parts from financial statements which depends on it in process of accounting in taxes as basis to determine The Tax Base , but no confidence from financial authority part in objectivity of income financial information in them for many of limited companies led to no dependence on them to specify taxation contain & dependence on yearly regulations that issued them. To enhance the confidence of financial authority to these lists must meet its requirements, because the menus Fulfill the requirements of the financial authority increases the confidence in these statements and therefore reliable in determining the tax base. So this research aims to speci
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