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 deals with the concept of a New Urbanism as an urban development strategy in the suburbs of cities or in its centers that are affected by pedestrian-oriented design and the possibility of walking, as well as integrating economic classes through the diversity of housing and its costs, and this works to facilitate access to jobs and services while providing more diverse neighborhoods and reducing the use of cars , As designing separate houses in the suburbs and increasing car trips poses a threat to the environment and the quality of urban life, and thus the new urban provides a good strategy for developing
... Show MoreAims current research to identify the mistakes coding contained in the reading first grade. Encoding knew that he had failed in Retrieval or identifying information, the researcher diagnosis of mistakes and presented to a group of teachers first grade and they have an appropriate adjustment and using the percentage shows that the agreement on the mistakes ratio and adjusted researcher recommended a set of proposals and recommendations can work out the future for the advancement of scientific level
Limited importance of research in a stand on the most important difficulties faced by both faculty and parents to communicate with each process to follow up on their children, and the analysis and inventory of the obstacles that hinder the educational process, and work to develop a vision of how to address these constraints and the important role of technology in the treatment of problems of the society so as to develop frameworks future to minimize the errors and the problems they face, and the development outlook for future generations in order to promote the educational level, especially that Iraq is going through a change in conditions in all sectors. Through the questionnaire, which includes questions set that was made on a sample o
... Show MoreDiyala Governorate has many unique and diverse geomorphological features that the region enjoys, which are among the attractions for natural tourism, as the natural environment is considered a maker of tourism. The importance of geomorphological aspects as components of natural tourism is due to their association with tourism and entertainment, as a result of the enjoyment of many geomorphological aspects of the beauty of its natural landscape on the one hand, and on the other hand, the association of these manifestations with different types of tourism activity. Any tourist area as it is the main factor for tourist attractions, such as the presence of the Hamrin hills, and sand dunes. Planning for the development of tourism activity in the
... Show MoreThe study aims to identify the effect of training with weight added to different parts of the body in improving the biomechanical variables of the last step and upgrading the high jump for young people, the research was applied to one of the elite high jumpers for young people, and video imaging and kinetic analysis were conducted to extract the variables under study, and then the jumper underwent For the proposed exercises by 3 training units per week for a period of (8) weeks, in which emphasis was placed on improving the rotational forces (moments) of these parts, and then the post-tests were conducted, and the researcher concluded that the exercises applied and the added weights for all parts of the body (leg, thigh, trunk, and arms) le
... Show MoreA factorial experiment was conducted at the laboratories of the College of Agriculture – Kerbala University during 2016. The aim was inhibitory efficiency for some aqueous and alcoholic extracts of Cumin, Fenugreek, Sweet Fennel and Black cumin in growth of Escherichia coli and Staphylococcus aureus bacteria. Results of Lab the extracts alcoholic, Concentrations 10, and 20 μg/ml giving to the highest percentage of inhibition from water extracts for both types of bacteria. Alcoholic extract of cumin highest percentage inhibition and concentration reached 23 and 26 mm, respectively, for the bacterium Staphylococcus aureus, while the bacteria Escherichia coli giving the alcoholic extract of the concentration of 20 μg/ml
... Show Moreهدف البحث التعرف الى اسباب سلوك التنمر لدى طلاب الصف الاول المتوسط من وجهة نظر المدرسين والمدرسات واساليب تعديله، واستعمل الباحثان المنهج الوصفي واختيار عينة عشوائية من المدرسين والمدرسات في متوسطة أرض الرافدين ومتوسطة الرحمن للبنين وكان عددهم (46) مدرساً ومدرسة بواقع (32) مدرساً و(14) مدرسة، واعتمد الباحثان الاستبانة أداة للتعرف الى اسباب سلوك التنمر واساليب تعديله، واشارت نتائج البحث الى تنوع اسباب التن
... Show MoreBackground. The use of modern aids and technology has contributed greatly to football development, the goalkeeper is the most important position in the team, and the use of devices gave objective readings about the goalkeeper's ability in terms of skill and physical aspects. Objectives. The research aimed to prepare exercises using an electronic device to measure the knee bending angle because of its great importance in developing the skill of catching and dimensions of the high ball for football goalkeepers. Methods. The researchers used the experimental method, and the sample consisted of (4) male goalkeepers under 15 years of age, one of the research procedures was to determine the biomechanical variables affecting the development of the
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Current research has sought to apply the criteria of potential for altmizalaorbi model EFQM 2013 in assessing the performance of the Inspector General's Office/Ministry of health, so as to keep up with a modern and advanced management methods in the evaluation of performance, as well as to link performance to a citizen's life, and it takes him beyond the accepted service capabilities today, but of budget duties between dealers servicing responsibilities and future planning, financial control, competitiveness, human resources needs and maintaining quality and development, as well as the constant quest for continuous improvement, is the spirit of the principle underpinning the European Foundation Quality managemen
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