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.
Background: The purposes of this study were to determine the photogrammetric soft tissue facial profile measurements for Iraqi adults sample with class II div.1 and class III malocclusion using standardized photographic techniques and to verify the existence of possible gender differences. Materials & methods: Seventy five Iraqi adult subjects, 50 class II div.1 malocclusion (24 males and 26 females), 25 class III malocclusion (14 males and 11 females), with an age range from 18-25 years. Each individual was subjected to clinical examination and digital standardized right side photographic records were taken in the natural head position. The photographs were analyzed using AutoCAD program 2007 to measure the distances and angles used in t
... Show MoreThe City of Ember is a very interesting novel that is although intended for young readers, have so many layers and messages that are misunderstood. In this research, both the novel and the film adaptation are studied with the intent to decode the warning messages that the novelist and the director tried to introduce to the audience. The research studies four vital messages; the first message is that history repeats itself for the novel has many allusions to the history of Jews and their painful holocaust and even goes back in history the days of Moses and the Exodus, the second message tackles the conspiracy theory that states nothing happens by accident and that everything is planned and connected hence comes the third message
... Show MoreBackground: Lymphomas are a group of diseases caused by malignant lymphocytes that accumulate in lymph nodes and cause the characteristic clinical features of lymphadenopathy. Intercellular adhesion molecule-1 (ICAM-1) (CD54) is a transmembrane glycoprotein belonging to the immunoglobulin superfamily of adhesion molecules. Cortactin was first identified as one of the major substrates for src kinase. because it localized to Cortical actin structures, The aims of this study was to evaluate and compare the immunohistochemical of ICAM-1 expression as cell adhesion molecule marker and Cortactin expression as invasive marker. Material and Methods: This study was performed on (68) formalin-fixed, paraffin-embedded blocks, histopathologically diagn
... Show MoreBackground: Accurate detection of thyroid autoantibodies by enzyme linked immunosorbant assay technique namely thyroglobulin antibody, thyroid peroxides antibody is crucial in the differentiation of autoimmune thyroid disorders from other form of thyroid diseases.
Objective: Evaluation of the detection of thyroglobulin antibody and thyroid peroxides antibody in different thyroid diseases using enzyme linked immunosorbant assay technique.
Methods: - Seventy-five patients admitted to Surgical Units of Baghdad Medical City Hospital for the period between "October 2010 to June 2011" they were waiting to do thyroidectomy. They were chosen nonselectively for serological evaluation of above autoantibodies , and correlation of the results
Background: Acute appendicitis is regarded as one of the most common inflammation that needs surgical intervention. Different scoring systems have been used for diagnosing of acute appendicitis. ALVARADO score is one of the most widely used score in diagnosing of acute appendicitis, but the accuracy of the latter is insufficiently low in Middle-East patients. Thus a new scoring system called RIPASA score has been designed for diagnosing of acute appendicitis in those patients. The aim of this study is to use RIPASA score and compare its result with ALVARADO score in diagnosing of acute appendicitis.
Subjects and Methods: The study includes 200 patients with symptoms and signs of
... Show MoreThe need for cloud services has been raised globally to provide a platform for healthcare providers to efficiently manage their citizens’ health records and thus provide treatment remotely. In Iraq, the healthcare records of public hospitals are increasing progressively with poor digital management. While recent works indicate cloud computing as a platform for all sectors globally, a lack of empirical evidence demands a comprehensive investigation to identify the significant factors that influence the utilization of cloud health computing. Here we provide a cost-effective, modular, and computationally efficient model of utilizing cloud computing based on the organization theory and the theory of reasoned action perspectives. A tot
... Show MoreBackground: Complete removal of filling material from the root canal is an essential requirement for endodontic retreatment. The purpose of the present study is to evaluate and compare the dissolving capabilities of various solvents (Xylene, Eugenate Desobturator, Eucalyptol, EDTA and Distilled water (as a control)) on four different types of sealer (Endofill, Apexit Plus, AH Plus and EndoSequence bioceramic sealer). Materials and method: Eighty samples of each sealer were prepared according to the manufacturers' instructions and then divided into ten groups (of 8 samples) for immersion in the respective solvents for 2 and 5 min immersion periods. Each sealer specimen was weighed to obtain its initial mass. The specimens were immersed in
... Show MoreThis study illustrates the impact of non-thermal plasma (Cold Atmospheric Plasma CAP) on the lipids blood, the study in vivo. The lipids are (cholesterol, HDL-Cholesterol, LDL-Cholesterol and triglyceride) are tested. (FE-DBD) scheme of probe diameter 4cm is used for this purpose, and the output voltage ranged from (0-20) kV with variable frequency (0-30) kHz. The effect of non-thermal atmospheric plasma on lipids were studied with different exposure durations (20,30) sec. As a result, the longer plasma exposure duration decreases more lipids in blood.
Health insurance and its benefits are of great importance and impact on the employees who represent the human capital of each organization because they are related to the health reality. The study took into account the most important and the last of his writing of the concepts and literary reviews and enriched the theoretical part of the practical side has addressed the financial data and analysis for the period from 2013 to 2017 to know the impact and the relationship between the variables that They were reviewed on the theoretical side. The study came out with a number of results, on the basis of which practical conclusions were drawn and reflected what was observed on the basis of which the recommendations were formulated