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.
Aggression is a negative form of an anti-social behavior. It is produced because of a particular reason, desire, want, need, or due to the psychological state of the aggressor. It injures others physically or psychologically. Aggressive behaviors in human interactions cause discomfort and disharmony among interlocutors. The paper aims to identify how aggressive language manifests itself in the data under scrutiny in terms of the pragmatic paradigm. Two British literary works are the data; namely, Look Back in Anger by John Osborne (1956), and The Birthday Party by Harold Pinter (1957). This paper endeavors to answer the question of how aggressive language is represented in literature pragmatically? It is hoped to be significant to
... Show MoreWA Shukur, journal of the college of basic education, 2011 The aim of this research is designing and implementing proposed steganographic method. The proposed steganographic method don’t use a specific type of digital media as a cover but it can use all types of digital media such as audio, all types of images, video and all types of files as a cover with the same of security, accuracy and quality of original data, considering that the size of embedded data must be smaller than the size of a cover. The proposed steganographic method hides embedded data at digital media without any changing and affecting the quality of the cover data. This means, the difference rate between cover before hiding operation and stego is zero. The proposed steg
... Show MoreNanotechnology extends the limits of molecular diagnostics to the nanoscale. This study describes some of the details of how the body interacts with nanoparticles. Biological tests measuring the presence or activity of selected substances become quicker, more sensitive, and more flexible when certain nanoscale particles are put to work as tags. Particular emphasis is placed on the effects of surface changes on body-borne particles, their transport within the body, and the dose-response effect. Other considerations include the definition of "persistent" in the context of therapy, FDA scientific committees, and the need for nanoparticle tracking. In short, there have been dramatic changes in molecular and genetic research findings, as well as
... Show MoreBackground: Neonatal seizures are the most common neurological emergency in newborns, often associated with significant mortality and long-term neurodevelopmental disabilities. The aim is to determine the incidence, etiological causes, and risk factors associated with neonatal seizures.Patients and Methods: This prospective case-control study was conducted over eight months, from January 1 to August 31, 2022, the study was conducted at the neonatal care unit of Children Welfare Teaching Hospital. Neonates who developed clinically recognizable seizures before 28 days of life in term infants, or up to 44 weeks corrected gestational age in preterm infants, were included. Data collection involved demographic information, prenatal, perin
... Show MoreBackground: Significant advancements have been observed in the additive manufacturing (AM) technology industry in recent decades. Due to the inherent variations among each AM manufacturing technique, new areas of investigation continually arise and require consideration. Additionally, the novel applications of additive manufacturing present new difficulties and possibilities for targeted focus. The aim of this manuscript is to conduct a comprehensive literature review that describes the various processing methods, precision levels, types of materials utilized, and potential applications of 3D printing technology in the field of dentistry. Data: An online search was conducted on databases including Research Gate, Google Scholar, and
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Debate is a teaching strategy in nursing education that enhances students' critical thinking. Although debate can be an effective teaching strategy, it is not without limitations. This article discusses the advantages and disadvantages of debate as a teaching strategy in nursing. Also, evaluating debates and choosing topics are highlighted.
This research is aiming to analyze the impacts of the current budget in Iraq by using the Government Finance Statistics Manual (GFSM) , the research is based on hypothesis: (There is an impact on the using of the Government Finance Statistics Manual (GFSM) In public budget in Iraq) .This hypothesis was demonstrated by using the questionnaire, a number of conclusions were reached, the most important being the lack of terminology adopted in the government accounting system and the Iraqi financial and accounting manual as a result of their adoption of the monetary basis for the lack of accounting terminology that meets t
... Show MoreIn order to specify the features of higher education process and its quantitative and qualitative development in Iraq ; one should look back at its historical process and the need of interesting with it .
Accordingly , there will be a chance for verifying the demand of the Iraqi society according to the political , social , and cultural changes especially during the national governance (1932 – 1958 ) .
For depicting the most important quantitative and qualitative development of this kind of education the period of 1932 -1958 , and since there is no previous study that tackled this topic , here comes the need of writing this paper .
After historical
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