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 study focused on the treatment of real oilfield produced water from the East Baghdad field affiliated to the Midland Oil Company (Iraq) using an oil skimming process followed by a coagulation/flocculation process for zero liquid discharge system applications. Belt type oil skimmer was utilized for evaluating the process efficiency with various operating conditions such as temperature (17-40 °C) and time (0.5-2.5 hr.). Polyaluminum chloride (PAC) coagulant and polyacrylamide (PAM) flocculant was used to investigate the performance of the coagulation/flocculation process with PAC dosage (5-90 ppm) and pH (5-10) as operating conditions. In the skimming process, the oil content, COD, turbidity, and TSS decreased with an increase in tempera
... Show MoreThe enrollment of students in the university represents a new stage in their life that differ from the previous educational stages that student has previously established. It should be noted that students with special needs at the University of Baghdad are not large numbers. It appears that these students have an excel role in their colleges most often, That is, the handicap was not a barrier to their scientific progress, but rather an incentive for them to excel. The most important conclusion reached by the researcher is that the University of Baghdad had no role in caring for people with special needs and caring for them financially, socially, psychologically, healthily and economically, they need to pay attention to them and take care
... Show MoreAbstract Background: The prevalence of heart failure (HF) continues to increase with an increase in the aging population. Palliative care should be integrated into routine disease management for all patients with serious illness, regardless of settings or prognosis. Objectives: The purposes of this study were to determine the level of knowledge of nurses concerning palliative care for patients with heart failure after implementation of instructional program. Design: The study was a quasi-experimental study and consists of 60 nurses. Setting: The study was conducted between17th November 2021, to 10th February 2022, at three teaching hospitals in Baghdad city, Iraq. Method: A non-probability (purposive) sample was utilized, nurses who agreed
... Show MoreThe adsorption of copper ions onto produced activated carbon from banana peels (with particle size 250 µm) in a single component system with applying magnetic field has been studied using fixed bed adsorber. The fixed bed breakthrough curves for the copper ions were investigated. The adsorption capacity for Cu (II) was investigated. It was found that 1) the exposure distance (E.D) and strength of magnetic field (B), affected the degree of adsorption; and 2) experiments showed that removal of Cu ions and accumulative adsorption capacity of adsorbent increase as the exposure distance and strength of magnetic field increase.