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.
هدف البحث التعرف الى اسباب سلوك التنمر لدى طلاب الصف الاول المتوسط من وجهة نظر المدرسين والمدرسات واساليب تعديله، واستعمل الباحثان المنهج الوصفي واختيار عينة عشوائية من المدرسين والمدرسات في متوسطة أرض الرافدين ومتوسطة الرحمن للبنين وكان عددهم (46) مدرساً ومدرسة بواقع (32) مدرساً و(14) مدرسة، واعتمد الباحثان الاستبانة أداة للتعرف الى اسباب سلوك التنمر واساليب تعديله، واشارت نتائج البحث الى تنوع اسباب التن
... Show MoreThe present work focuses on examining the strategy of cognitive trips and the Arabic language teachers’ training needs of such a strategy when teaching Arabic language courses in the Saudi Arabia Kingdom. To achieve the objective of the study, and check whether this strategy is used in lesson planning, lesson teaching, or lesson assessment, a descriptive approach and a questionnaire have been adopted. The researchers used a number of statistical tools, and chose a purposive sample, which consists of (58) Arabic language teachers from Saudi Arabia Kingdom. Results have shown that the training needs of Arabic language teachers for implemining the strategy of cognitive journeys while teaching Arabic language courses came in the following
... Show MoreBackground. The use of modern aids and technology has contributed greatly to football development, the goalkeeper is the most important position in the team, and the use of devices gave objective readings about the goalkeeper's ability in terms of skill and physical aspects. Objectives. The research aimed to prepare exercises using an electronic device to measure the knee bending angle because of its great importance in developing the skill of catching and dimensions of the high ball for football goalkeepers. Methods. The researchers used the experimental method, and the sample consisted of (4) male goalkeepers under 15 years of age, one of the research procedures was to determine the biomechanical variables affecting the development of the
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Current research has sought to apply the criteria of potential for altmizalaorbi model EFQM 2013 in assessing the performance of the Inspector General's Office/Ministry of health, so as to keep up with a modern and advanced management methods in the evaluation of performance, as well as to link performance to a citizen's life, and it takes him beyond the accepted service capabilities today, but of budget duties between dealers servicing responsibilities and future planning, financial control, competitiveness, human resources needs and maintaining quality and development, as well as the constant quest for continuous improvement, is the spirit of the principle underpinning the European Foundation Quality managemen
... Show MoreDiyala Governorate has many unique and diverse geomorphological features that the region enjoys, which are among the attractions for natural tourism, as the natural environment is considered a maker of tourism. The importance of geomorphological aspects as components of natural tourism is due to their association with tourism and entertainment, as a result of the enjoyment of many geomorphological aspects of the beauty of its natural landscape on the one hand, and on the other hand, the association of these manifestations with different types of tourism activity. Any tourist area as it is the main factor for tourist attractions, such as the presence of the Hamrin hills, and sand dunes. Planning for the development of tourism activity in the
... Show MoreThe study aims to identify the effect of training with weight added to different parts of the body in improving the biomechanical variables of the last step and upgrading the high jump for young people, the research was applied to one of the elite high jumpers for young people, and video imaging and kinetic analysis were conducted to extract the variables under study, and then the jumper underwent For the proposed exercises by 3 training units per week for a period of (8) weeks, in which emphasis was placed on improving the rotational forces (moments) of these parts, and then the post-tests were conducted, and the researcher concluded that the exercises applied and the added weights for all parts of the body (leg, thigh, trunk, and arms) le
... Show MoreThe current research aims to identify "the impact of the round table strategies and the question of self-achievement and self-efficacy among students of the Faculty of Education in research methodology course.” The research sample consisted of (75) male and female-third stage students in the department of Life Sciences / College of Education for Pure Sciences / University of Dhi Qar for the academic year (2018-2019. The researcher adopted the experimental approach to achieving the study objectives. The researcher prepared two tools: the achievement test and the self-efficacy scale were applied to the collected sample to obtain the needed data. The result showed that there was a statistically significant difference at the level (0.05) b
... Show MoreSamples of the ovary and uterus of local breed cats used to investigate the histological, histometrical and hormonal features. The paraffin embedding technique was used for processing of tissue that stained by hematoxyline and eosin stain, and massons trichrom stain. Ovary of at proestrus or oestrus phases composed of outer cortex that covered by cuboidal germinal epithelium and inner medulla. Tunica albuginea composed of a thin layer of characterized by fusiform stromal cells. The cortex content groups of Oogonial cells, numerous primordial follicles, little primary, secondary and tertiary follicles in addition for 1-2 follicular cysts and mature corpus letium. In pregnant cat the thickness of ovarian cortex was significantly incre
... Show MoreThere are many harmful acts that occur from drunkards in this case, especially those resulting from car accidents. The world is witnessing dozens or even hundreds of car accidents due to alcohol consumption. These accidents often result in serious injuries that could lead to the death of the drunk driver and those in the car As well as other persons present in the other vehicles with which the incident occurred or pedestrians on the street, as well as damage to private or public property, and if the order of return of the affected persons on the pretext of civil liability (tort) is made as a direct cause of the harmful act, Is entitled Do they like this refer to the liquor seller or their provider as the culprit? Or are they not related to
... Show MoreBiofilms formation by pathogens microbial Control considered important in medical research because it is the hazarded virulence factor leading to becoming difficult to treat because of its high resistance to antimicrobials. Glycopeptide antibiotic a (Vancomycin) and the commercial bacteriocin (Nisin A) were used to comparative with purification bacteriocin (MRSAcin) against MRSA biofilm. One hundred food samples were collected from Baghdad markets from July 2016 to September 2016, including (cheese, yogurt, raw milk, fried meat, grilled meat, and beef burger). All samples were cultures; S. aureus was confirmation by macroscopic culture and microscopic examination, in addition to biochemical tests. Methicillin resistance S. asureus (
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