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: Radiologic evaluation of breast lesions is being achieved through several imaging modalities. Mammography has an established role in breast cancer screening and diagnosis. Still however, it shows some limitations particulary in dense breast.
Methods : Magnetic resonance imaging is an attractive tool for the diagnosis of breast tumors1 and the use of magnetic resonance imaging of the breast is rapidly increasing as this technique becomes more widely available.1 As an adjunct to mammography and ultrasound, MRI can be a valuable addition to the work-up of a breast abnormality. MRI has the advantages of providing a three-dimensional view of the breast, performing wit
... Show MoreThe porosity of materials is important in many applications, products and processes, such as electrochemical devices (electrodes, separator, active components in batteries), porous thin film, ceramics, soils, construction materials, ..etc. This can be characterized in many different methods, and the most important methods for industrial purposes are the N2 gas adsorption and mercury porosimetry. In the present paper, both of these techniques have been used to characterize some of Iraqi natural raw materials deposits. These are Glass Sand, Standard Sand, Flint Clay and Bentonite. Data from both analyses on the different types of natural raw materials deposits are critically examined and discussed. The results of specific surface are
... Show MoreThe effectiveness of (200 m) of the events of extreme intensity and this is characterized by training in the anaerobic energy system prevailing in the result of this privacy as these are based on the physical abilities and functional indicators identified in this direction and hence the importance of research in the evaluation of training programs on the basis of physical abilities and some indicators of the functionality of the hostile 200 m . The study aimed to: 1. Evaluation of training programs according to physical abilities and some functional indicators of hostile men.The researchers used the descriptive analytical method to suit the nature of the research. The researchers selected them research sample by the deliberate method of the
... Show MoreA new ligand complexes have been synthesis from reaction of metal ions of MnII , CoII , NiII , CuII , ZnII , CdII and PdII with schiff base [(E)-1-((2-amino-5-(3, 4, 5-trimethoxybenzyl) pyrimidin-4-ylimino) methyl) naphthalen-2-ol [HL)]. The prepared [HL] was characterized by FT-IR, UV-Vis spectroscopy, 1H13CNMR spectra Mass spectra and melting point. The compounds were characterized by techniques UV-Vis and FT-IR spectral studies, micro analysis (C.H.N), determination of atomic absorption, chloride content, molar conductivity measurements, magnetic susceptibility and melting point. The ligand acts as a monobasic tridentate, coordinating through deprotonated phenolic O and azomethine N atoms. The compounds are neutral electrolytic in dimeth
... Show MoreThis study is conducted to investigate the validity of using different levels of Rustumiya sewage water for irrigation and their effects on corn growth and some of the chemical properties of the soil such as electrical conductivity and soil pH in extract soil paste , the micro nutrient content in soil and plant which are ( Fe , Mn , Zn , Cu , Cd , Pb ). Three levels of sewage water ( 0 , 50 , 100 )% in two stages were used ,the three levels of wastewater ( without soil fertilization ) were used in the first stage , Where 80 Kg N /D+50Kg P2O5 /D was added to the soil as fertilizer in the control (0%) treatment and 40 Kg N/D+25Kg P2O5/D were added to 50 and 100% levels in the second stage .Corn seeds were planted in 12kg plastic pots in Com
... Show MoreThe current study aims at identifying the impact of using learning acceleration model on the achievement of mathematics for third intermediategrade students. Forachieving this, the researchers chose the School (Al-Kholood Secondary School for Girls) affiliated to the General Directorate of Babylon Education / Hashemite Education Department for the academic year (2021/2021), The sample reached to (70) female students from the third intermediate grade, with (35) female students for each of the two research groups. The two researchers prepared an achievement test consisting of (25) objective items of multiple choice type, The psychometric properties of the test were confirmed, and after the completion of the experiment, the achievement test wa
... Show MoreGuanine has a variety of roles in chemistry, from its basic function in the storing and transferring genetic information to its usages in synthetic chemistry and other fields. Because of its distinct structure and biological importance, it is a fundamental component of contemporary study in organic chemistry and molecular biology. In this review, we focused on covering the synthetic pathways of various derivatives of guanine from the year 2000 until the present. As a result of the guanine molecule containing multiple functional groups, this gives us the ability to prepare several guanines such as O6-alkylating guanines, O6-benzylguanines, 8-aza-O6-benzylguanines, 9-substituted guanines, guanine-azo derivatives, guanine Schiff bases, guanin
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