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 most important recommendations of this research are:-
1.The benefit of the other countries experiences about the transparency of the government performance, without depending on the transparency that imitating the other experiences; that may not fit with the Iraqi government units.
2.The Ministry of Finance has to prepare the citizen guidebook about the government performance which is considered an essential document, it should be simple and available for all the parties of relation; and for not specialized citizen for the purpose of simplifying the understanding of government performance details.
3.The benefit of the government units websites of inte
... Show MoreAmong a collection of ground beetles from Iraq the new species Acinopus euphraticus was designated and described here. The erection of this new species was mainly built on external features and the description of male genitalia.
Sixteen species of Armored Scale insects were recorded from Baghdad city during 2001-2005. Three of these are reported here for the first time Abgrallaspis cyanophylli (Signoret, 1869), Aonidiella citrina (Craw,1870) and Chrysomphalus aonidium (Linnaeus,1758). The other thirteen species were recorded earlier Aonidiella aurantii (Maskell), Aonidiella orientalis (Newstead), Chrysomphalus dictyospermi (Morgan), Diaspidiotus ostreaeformis (Curtis), Diaspidiotu perniciosus (Comctock), Hemiberlesia lataniae (Signoret), Lepidosaphes beckii (Newman), Lepidosaphes conchiformis (Gmelin), Lepidosaphes ulmi (Linnaeus), Mercetaspis halli
... Show More134 samples of plants and animals wastes were taken from three different regions outside Baghdad and three different regions in Baghdad. 24 cellulolytic isolates fungi AO, C1, TH1, AN1, R1, TV, PG, AF, B1, L1, AP, TH, AP1, AN3, AO2, A, A1, C, F, AO1, C2, F1, CL and AP2 independent were chosen out of 48 selected fungi. The best optimal conditions for growth were 30ºC and pH 7. The isolates were identified and screened according to the colony diameter, biomass and density of spores in addition of capability to produce the hydrolytic enzymes for cellulose.
Research is a central component of neurosurgical training and practice and is increasingly viewed as a quintessential indicator of academic productivity. In this study, we focus on identifying the current status and challenges of neurosurgical research in Iraq.
An online PubMed Medline database search was conducted to identify all articles published by Iraq-based neurosurgeons between 2003 and 2020. Information was extracted in relation to the following parameters: authors, year of publication, author’s affiliation, author’s specialty, article type, article citation, journal name, journal
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 MoreAbstract:
Due to the importance of technology and the accompanying changes of the environment affecting companies that use the technology mainly in their work, especially as most companies live in an unstable dynamic environment, which motivated the researchers to choose the International Company for smart card (Keycard) as a field of research and find ways to them to face Those changes.
The problem of the study was "limited attention to the components of technological change", which included research and development, innovation and information technology, which had an impact on the design decisions of the process (process selection, cust
... Show MoreThis research deals with a part of our heritage and Arab culture, which is the poetry of contemporary Islamic poets, especially the poetry that was said in the mother in contemporary Islamic poetry, when extrapolating the offices of some contemporary Islamic poets found a clear presence of the mother, and during the search for the subject or its I found that the subject did not receive research and study, although the bureaus of contemporary Islamic poets included in it a huge amount of verses in which they stood at the mother Pharthua, and expressed their feelings and emotions towards them, and accordingly this research tagged (mother in contemporary Islamic poetry _ Dr Artistic models in models of contemporary Islamic poetry) to stand
... Show MoreThe main aim of this research study is to point out the vital importance of high-quality exterior audits to limit discretionary accounting, as it could distort a company’s commercial results. The research introduces a well-founded hypothesis on the preventive powers of high-quality audits, as it can act as a strong exterior control. The research focuses on testing the complex relationship between earnings management and investors’ behavior within the public-listed companies from the food industry. The research gathers credible annual comprehensive data from thirty-five publicly-listed firms from the United States. It encompasses the twenty years prior to 2024, as it includes the twenty years prior to 2024. Additionally, the gathered dat
... Show MoreThe main aim of this research is to introduce financing cost optimization and different financing alternatives. There are many studies about financing cost optimization. All previous studies considering the cost of financing have many shortcomings, some considered only one source of financing as a credit line without taking into account different financing alternatives. Having only one funding alternative powers, restricts contractors and leads to a very specific financing model. Although it is beneficial for the contractor to use a long-term loan to minimize interest charges and prevent a substantial withdrawal from his credit line, none of the existing financial-based planning models have considered long-term loans in
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