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.
This study examined the phenomenon of unemployment in Iraq and the extent of the contribution of these loans granted by banks to finance small and medium enterprises in reducing their rates. The temporal boundaries of the study included the period between (2012-2018). The spatial boundaries consisted of random sampling of six Iraqi banks) Where the government banks included (Rafidain, Rasheed and industrial), private banks included (the Iraqi Islamic Bank and the Gulf Commercial Bank and the Bank of the Middle East). In order to achieve the objective of the research in the light of the hypotheses drawn up, the research divided into three topics, the first section highlighting the reality of small and medium enterprises in Iraq and the lo
... Show MoreThis research aims to identify the level of extension administration performance under comprehensive quality standards from the perspective of the working staff in agricultural extension at the level of the general extension body and agricultural directorates and agricultural division.this was to identify the extension administration performance under comprehensive quality standards from the perspective of vegetables growers , random sample was selected from the central region governorates Baghdad , Diyala , Babel , karbala and Al-Najaf , a random sample from the workers in the general body numbered 56 employee , sample of staff working in agricultural extension was selected at the level of agricultural directorates in proportion
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The aerial part of Ephedra foliata Family Ephedraceae have long been used in traditional medicine and now Ephedra species have medicinal, ecological, and commercial value. The variety of pharmacological actions of this plant is due to its chemical constituents. Ephedrine and
related alkaloids; are the newly potential medicinal value of Ephedra supplements for weight loss or performance improvement. Other pharmacological actions like antibacterial and antifungal effects of the phenolic acid compounds, the immunosuppressive action of the polysaccharides, and the antitumor action of flavonoids. The genus of this plant wildly distributed t
Abstract
There has been a heated controversy over the role the financial policy plays and how sufficient it is in affording the financial burden. This burden is known as the operational current expenses which the governments of various countries mainly afford, despite the discrepancy in the government’s economic policy. After the deterioration and deficit in the state budget in all countries nowadays, it was necessary to find an appropri
... Show MoreThe study aimed at identifying the strategic gaps in the actual reality of the management of public organizations investigated to determine the strategy used based on the study model. The study relied on the variable of the general organization strategy in its dimensions (the general organization strategy, the organization's political strategy and the defense strategy of the organization) The sample of the study was (General Directorate of Traffic, Civil Status Directorate and Civil Defense Directorate), formations affiliated to the Ministry of the Interior, for the importance of the activity carried out by these public organizations by providing them In order to translate the answers into a quantitative expression in the analysi
... Show MoreThe objective of this study is to determine the concentration of copper and lead (mg/L) in drinking water by using absorption spectrophotometic and Atomic Absorption spectrophotometric method from different area in Baghdad and with different intervals , The results show that the concentration of copper and Lead ( mgL) in tap water which remains motionless in plumbing system for following periods one hours, 3 hours, 6 hours, 12 hours, 24 hours, 7 days and 14 days are (1 , 2.2 , 4 , 5.3 , 7.5 , 10 and 16 mgL copper ) & ( 0.3, 0.5 , 0.8 , 1 , 2.5 , 3 , 3.8 mg /L lead ) respectively .from these results its clear that high levels of copper & Lead occur if tap water comes in contact with copper - lead plumbing and copper lead -containing fix
... Show MoreIn this research, the researchers attempted to reveal the non-verbal language in the Holy Qur'an through the hurt of the eye, its communicative effect, and its psychological significance in order to demonstrate the importance of this language. Fold the search ..
A study carried out for study effect of furfural that extracted from corn cobs by using specialized reaction system laboratory on phytopathogenic fungi: Pythium aphanidermatum, Rhizoctonia solani, Macrophomina phaseolina and Fusarium solani in addition to biocontrol fungus Trichoderma viride were isolated from infected plants and from their rhizosphere . The preparation results of different concentrations from stock solution in concentration 1% of furflural showed that The concentration was 100 ppm of furfural was inhibited the growth of P. aphanidermatum46.7 % and the was in concentration 400 ppm. while the concentration 500 ppm caused inhibition 50% and 41.1% of R. solani and F. solani respectively. Whereas the concentration 500 pp
... Show MoreRotaviruses, a major cause of gastroenteritis in children worldwide accounts for around half a million deaths annually. Vaccine against the virus has been recommended by the WHO to be involved in the national immunization program.To evaluate the genetic characterization of rotavirus among children with acute gastroenteritis in Babylon province is warranted. Children complained of diarrhea with rotavirus infection detected in their stool were involved in the study. The age range was 10 months to 60 months and with retrogradechecking of rotavirus vaccine history. Rotavirus genotypes were detected by reverse transcription-polymerase chain reaction (RT-PCR).A total number of 40 children with rotavirus gastroenteritis were used to examine the
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