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.
Ground water hydrochemical study in Yusufiyah depends upon (25) wells where major cations and anions were obtained as well as trace elements. The hydrochemical properties include the study of (pH, EC, TDS, and TH). The groundwater of the study area is odorless and colorless except the wells (13 and 16) with a salty taste due to the elevated (TDS) concentration in it, where the wells depth ranges between 7-20 meters. Depth of water in these wells was about 25-35 meters above sea level. Groundwater generally flows from east to west and from north east to south west. The resource of groundwater depends upon surface water. Physical specifications are measured in the water samples included temperature, color, taste, odor, pH, electrical condu
... Show MoreWe try through this research to show the relationship between the crescent and the month in the Koran, and then their importance and their relationship to timing, and the timing of this relationship with people, and the significance of these timings, so we gathered verses that spoke about the family and the month, and we tried to study them in a detailed objective study, so this came The research of five subjects was the first topic introductory research and the time and month, while the remaining four detectives on the verses that talked about the timing of the month, and we have explained the relationship of this timing with people and the significance of these times.
Heritage is considered as the civilization and cultural wealth accumulated over the . centuries, whereas architectural heritage is the physical witness of that civilization. Despite the fact that architectural heritage is the most important effort for economic development of any communit,، it suffers from deterioration and neglection especially in the Arab communities. Recently awareness has increased about the importance of investing on architectural heritage generally and sustainable investment particularly. The goal of investment process in heritage areas is to revive economic activity in addition to attempt to revive the heritage and community values. Research aims to examine the relationship between sustainable investment and
... Show MoreThe present study was conducted on the Iraqi Pin-tailed Sandgrouse (Pterocles alchata) to study the lung's morphological description and histological structure. This study was used 5 samples of adult male sandgrouse bird. The birds were dissected. The lungs were removed from the coelomic cavity, cleaned to remove impurities, and photographed to describe their morphological features. The samples were fixed using formalin (10%) solution for 36-48 hours and then preserved in alcohol (70%) to prepare the microscopic slides. The results showed that the lung of the Iraqi sandgrouse bird is red in color, has a trapezoidal shape and has three surfaces (costal, visceral, and vertebral). The costal surface shows ribs impressions that extend f
... Show MoreThis study was aimed to explore the impact of social concepts about tribe, clan and women, on internal audit performance. These concepts are considered to be components of the organizational culture and performance of internal audit practice, with respect to the individual and collective performance within the institution. The study, furthermore, was intended to investigate and understand the role of the organizational culture of the tribal, clan and women components with regard to their role in society, in Qatar.
To achieve these objectives, the researcher followed the descriptive analytical approach, using a questionnaire directed to experts and staff working in the banking sector, with the view to test
... Show MoreRecords 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 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 MoreHashimoto Thyroiditis (HT) is the most common autoimmune thyroid disease and the commonest cause ofhypothyroidism. C-reactive protein (CRP) is synthesized in hepatocyte in response to autoimmune disorders;strongly induced by IL-6. This study aimed to estimate serum IL-6 and CRP levels in autoimmune and non-autoimmune hypothyroidism. The present study included 60 Iraqi female hypothyroid patients divided to 30autoimmune and 30 non-autoimmune, with age ranged between 24-50 years and 30 healthy controls withage ranged between 27-52 years. Serum samples were collected from study groups. The levels of thyroidhormones (TSH, T4 and T3) were determined by using automated Chemiluminescence Immunoassay (CLIA)analysis system. Detection the levels of t
... Show MoreKE Sharquie, AA Noaimi, AS Alaboudi, Journal of Cosmetics, Dermatological Sciences and Applications, 2012 - Cited by 3