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.
Records of two regionalized variables were processed for each of porosity and permeability of reservoir rocks in Zubair Formation (Zb-109) south Iraq as an indication of the most important reservoir property which is the homogeneity , considering their important results in criterion most needed for primary and enhanced oil reservoir .Z and F tests that were calculated for the two above mentioned properties of pair units of Zubair Formation have shown the difference in depositional energy and different diagenesis between units IL and AB , DJ and AB , and the similarity in grains size , sorting degree , depositional environment and pressure gradients between IL and AB units , LS and IL units ; also the difference in the properties above betw
... Show MoreAn experimental study was performed to estimate the forced convection heat transfer performance and the pressure drop of a single layer graphene (GNPs) based DI-water nanofluid in a circular tube under a laminar flow and a uniform heat flux boundary conditions. The viscosity and thermal conductivity of nanofluid at weight concentrations of (0.1 to 1 wt%) were measured. The effects of the velocity of flow, heat flux and nanoparticle weight concentrations on the enhancement of the heat transfer are examined. The Nusselt number of the GNPs nanofluid was enhanced as the heat flux and the velocity of flow rate increased, and the maximum Nusselt number ratio (Nu nanofluid/ Nu base fluid) and thermal performance factor
... Show MoreThe recognition of the dynamic organizational capabilities in their actual and influential extent in the work environment achieves a set of positive data that can fall under the addition axes, particularly with regard to the organization's ability to manage human talents in them, so the researchers sought to identify the level of contribution of dynamic organizational capabilities in the management of human talents in terms of Keep them away in the research organization by indicating the level of relationship and impact between them. The presidency of Mosul University was chosen as a field for the current study, and data were collected by adopting the questionnaire form as the main tool for the study. The study used a deliberate
... Show MoreActual and effective organizational dynamic capabilities in the work environment contribute to a number of factors that contribute to the organization's ability to manage its human talents. Thus, the study sought to identify the level of contribution of organizational dynamic capabilities to human talent management based on their dimensions in the investigated organization by determining the level of relationship and impact between these variables. The presidency of Mosul University was chosen as a field for the current study, and data were collected by adopting the questionnaire form as the main tool for the study. The study used a deliberate sample of (42) administrative leaders in the investigated organization and adopte
... Show MoreThis study aims to impact statement played by banking governance according to the decisions of the Basel Committee in achieving the strategic objectives of the banks, But order to achieve the this goal has been the adoption of two hypotheses in addition to the two main hypotheses as sub answered preliminary The study seeks to verify their health and two (no correlation relationship and impact between Banking governance and achieve strategic objectives), has been tested hypotheses. Study has reached
... Show MoreThis study aimed identify the teachers of sociology. In the development of creative thinking. I have students in middle school .llvra literary. In schools. Second Karkh From the perspective of the teachers and the students themselves numbered (41), a teacher and a school. As The study population encompassed of some students the fourth and fifth preparatory stage in the Karkh II schools, totaling 200 male and female students. As the study sample were consisted of (7) and a teacher (34) and accented (85) of male students (115) were female student The researcher the questionnaire which consisted of (39) items And to achieve the objectives of the study it was ascertained sincerity And stability. And
... Show MoreMK Al-Janabi, NA Nasir, RK Jaber, AO Oleiwe, Iraqi Postgraduate Medical Journal, 2018 - Cited by 7
Background: Rituximab is a chimeric IgG1 kappa immunoglobulin that has been genetically modified to incorporate human constant region sequences together with murine light- and heavy-chain variable region sequences. People use it to treat rheumatoid arthritis and certain malignancies. Objective: The study aimed to assess the potential association between the serum levels of Factor I, CD59, interleukins (IL)-6, and interferon-gamma (IFN)-γ and the response to Rituximab treatment in Iraqi rheumatoid arthritis patients. Methods: A cross-sectional study was conducted at the rheumatology center at Baghdad Teaching Hospital. Ninety adult patients who have been diagnosed with rheumatoid arthritis and are receiving Rituximab intravenous i
... Show MoreBackground: Type 2 diabetes mellitus is a condition characterized by an elevation of oxidative stress, which has been implicated in diabetic progression and its vascular complications. Aim: Assessing the impact of gliclazide modified release (MR) versus glimepiride on oxidative stress markers, glycemic indices, lipid profile, and estimated glomerular filtration rate in uncontrolled type 2 diabetic patients on metformin monotherapy. Methods: This was an observational comparative study conducted in Thi-Qar specialized diabetic, endocrine, and metabolism center. Sixty-six patients were randomized into two groups based on the addition of the sulfonylureas (SUs). Group 1 (33 patients) was on gliclazide MR, whereas Group 2 (33 patients)
... Show MoreAbstract Depending on their protective properties against different cases of Colorectal Cancer (CRC), vitamins C, D, and E are the main focus of this research. CRC is one of the global public health concerns. 30 healthy individuals provided serum samples, whereas the group of CRC patients was divided into three, totaling 90 individuals. Group I consisted of 30 newly diagnosed cases of CRC. Group II 30 consisted of consisted of 30 CRC patients who were administered three cycles of chemotherapy. Group III consisted of 30 diagnosed CRC patients who also have non-alcoholic fatty liver disease (NAFLD). The concentrations and groups of vitamins C, D, and E were evaluated using ELISA. The levels of Vitamin C were significantly lower (p &l
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