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 primary issue addressed in this research revolves around identifying the interactive elements provided by the Twitter platform and understanding their utilization by digital newspapers with official accounts. These newspapers broadcast content in line with their policies. This study is classified within descriptive research that employed a survey method and content analysis tool. The methodology relies on the "how was it said?" approach to categorize the analysis. The research yielded the following results:
Twitter utilized numerous interactive elements for disseminating tweets, which include "text, branching links, hashtags, digital images, digital videos, digital audio, and digital polls." However, thes
This study seeks to identify the possibility of achieving the property of faithful representation of accounting information and measure it by using the standard approach based on mathematical and statistical equations by comparing two financial periods before and after the application of (IFRS-15) Revenue from contracts with customers, during the period. (2014-2018), for the financial statements of the mixed joint stock companies listed on the Iraq Stock Exchange, which is one of the main pillars of the economic structure of the country, as a joint investment between the state and the private sector, and has importance in many aspects, including support for projects of public companies, S Absorption and employment of labor, as well as ra
... Show MoreAbstract:
The aim of the present research is to evaluate the child’s nutritional
method (2-5 years old) which is based on his resistance of the food highly rich
with nutritional elements and his acceptance of the food of a low nutritional
value in addition to his having forbidden food with other mates and making
use of all mates when having food, in establishing the sound social values and
affection since child hood. The required statistical equation have been used
by the researcher namely (Z test).
The sample of the present study consists of (26) children who were selected
intentionally and randomly from the kindergartens of Al-Bayaa region and the
college of Education for women. The questionnaires were d
Nonmissile penetrating traumatic brain injuries (pTBIs) are low-velocity injuries which can be caused by a variety of inflicting tools and represent a rare entity in children. Poor outcome has been attributed with an initial admission Glasgow Coma Scale (GCS) of <5, asymmetrical pupil size, and specific initial computed tomography scan findings including brainstem injury.
We report a case of an 11-year-old boy who presented to our ER with a GCS of 6 after being assaulted on his head by a 30 cm length metallic tent hook penetrating his forehead reaching down to the central skull bas
Manipulation is a discursive concept which plays a key role in political discourse by which politicians can impose some impact on their recipients through using linguistic features, most prominent of which are personal pronouns (Van Dijk, 1995). The aim of this study is to investigate how politicians utilize the personal pronouns, namely; We and I and their possessive forms as a tool of manipulating the audience's mind based on Van Dijk's "ideological square" which shows positive-self representation and negative-other representation (Van Dijk,1998:p.69). To this end, American President Donald Trump's 2020 State of the Union speech was chosen to be the data of analysis. Only (8)
... Show MoreWith time progress importance of hiding information become more and more and all steganography applications is like computer games between hiding and extracting data, or like thieves and police men always thieve hides from police men in different ways to keep him out of prison. The sender always hides information in new way in order not to be understood by the attackers and only the authorized receiver can open the hiding message. This paper explores our proposed random method in detail, how chooses locations of pixel in randomly , how to choose a random bit to hide information in the chosen pixel, how it different from other approaches, how applying information hiding criteria on the proposed project, and attempts to test out in code, and
... Show MoreThe general trend in Iraqi banks is focused towards the application of international financial reporting standards, especially the international financial reporting standard IFRS 9 “Financial Instruments”, in addition to the directives issued on the Central Bank of Iraq’s instructions for the year 2018 regarding the development of expected credit losses models, and not to adhere to a specific method for calculating these losses and authorizing the banks’ departments to adopt the method of calculating losses that suits the nature of the bank’s activity and to be consistent in its use from time to time. The research problem revolves around the different methodologies for calculatin
... Show MoreBackground: Malignant lymphoma is a term that describes primary tumors of the lymphoreticular system, almost all of which arise from lymphocytes.MMP-1 is the most ubiquitously expressed interstitial collagenase, a subfamily of MMPs that cleaves stromal collagens. It is also called collagenase-1.TIMPs which inhibits MMP activity and thereby restrict extracellular matrix breakdown, TIMP-1 is a stromal factor that has a wide spectrum of functions in different tissues. Material and Methods: This study was performed on (68) formalin-fixed, paraffin-embedded blocks, histopathologically diagnosed as lymphoma (head and neck lesions). Immunohistochemical staining of MMP1and TIMP1 was performed on each case of the study sample. Results: The expressio
... Show MoreThis study examined the problematic of the ambiguous relationship between the media and terrorism and the problems that result from press coverage of terroristic incidents. The paper sought to show the classification and confrontation of such incidents had been established from the point of view of a sample of media professionals, researchers and writers who are frequenters of Al-Mutanabi Street in Baghdad. The media outlets that carry this coverage would not give up their media mission as well as the terrorists would not be given an opportunity to take advantage of this coverage in achieving their goals and objectives. Furthermore, the terrorist organizations would have no chance to exploit these means to deliver their terroristic messa
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