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.
Thank God also taught us that thanks . thank meets the blessings and rewards mazidk glory we have no knowledge except what you have taught you Alim hakim , not counted praise you as yourself praised and pray and to recognize the envoy mercy to the worlds , prophet Mohammed and his family and companions and guided to the day of judgment .
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Aware of the interpretation of the most important science needed by Muslims because God Almighty sent down the Quraan to be a way of the life for Muslims is subject to a healing for what is in the breasts and it slaham and flaham and has spared the nation from crisisThe stats of the monks , like other verses talking about Christians and Jews and what they have invented in the religion o
Leishmania is the causative agent of leishmaniasis, a widely distributed disease. Amastigote forms of Leishmania are intracellular and reside within the macrophage of the vertebrate host. Previous studies showed that certain Leishmania species may scavenge host factors for survival, specially sphingolipids, the key element of the eukaryotic membranes. In this study we have investigated the survival of new world L. mexicana amastigotes in murine macrophage cell-line in the presence and absence of foetal bovine serum (FBS). Results showed that there was no significance in the infectivity of amastigotes and also the number of parasite per cell; such findings suggest that L. mexicana amastigotes have its own pathway of sphingolipid intake and c
... Show MoreThe study was trail to treated secondary hydatid cysts in white micepost-infection with Echinococcosis of sheep origin, by immunization with a mixture of CFAgs/PSAgs prepared from haydatid Cyst Fluid antigens (CFAgs) and Proto scolices antigens (PSAgs) respectively, two concentrations (7.5 &15 mg/ml) in addition to two derivatives of benzimidazole; albendazole (A) and mebendazole (M) 10 and 40μg/gm body weight, respectively, one week after challenged dose with protoscolices. to determine the efficacy of immunization and chemotherapy simultaneously in reduction the number of growing cysts, then measured both humoral and cell-mediated immunity. Results: elevation the immune responses that reflected decrease number and diameter of hydatid cys
... Show MoreLinguistic studies present a distinguished place among modern human studies, as we find this clear in the scientific research institutions of the developed nations, it is the main pillar in the strengthening of links and consolidation pillars between individuals and groups. It is a language and between people's thoughts, feelings and actions, and has been able to show that language is not only a tool of expression but is closely linked to the intellectual, emotional and social life of these people individuals and groups.
The derivation is a major step in Arabic in classifying formulas into weights with special morphological values; these are of great importance in sentences and structures that are the domain of the searc
The purpose of this study is discuss the effect of Corporate Governance in the Tax Planning, has been made in a sample of Iraqi Industrial contribution Companies listed in Iraqi Stock Exchange Market (ISE) , for the period from 2008 to 2012.The study used the" Experimental Research Approach" . Also used the (Modified Jones Model, 1995) in order to measure the corporate governance, to measure the extent of the practice of corporate governance in the samples companies. While it use to measure tax planning, the model that used by studies and researches of tax that adopted in discussions of tax reform, by analyzing the financial statements of companies to reach a measurement for the two variables of the study. T
... Show MoreLimited importance of research in a stand on the most important difficulties faced by both faculty and parents to communicate with each process to follow up on their children, and the analysis and inventory of the obstacles that hinder the educational process, and work to develop a vision of how to address these constraints and the important role of technology in the treatment of problems of the society so as to develop frameworks future to minimize the errors and the problems they face, and the development outlook for future generations in order to promote the educational level, especially that Iraq is going through a change in conditions in all sectors. Through the questionnaire, which includes questions set that was made on a sample o
... Show MoreBackground: Abdominal symptoms are possibly the most frequent of all symptoms encountered in surgical practice. Pain is the most common of all abdominal symptoms. Causes of acute abdominal pain include both medical and surgical. Most symptoms arise from intra-abdominal organs or systems while some may originate extra abdominally and are then referred to the abdomen. Medical causes of abdominal pain are encountered more frequently.
Objective: To study the causes of acute abdominal pain in patients attending emergency department in Al- Imamain Al- Kadhimain Medical City.
Type of the study: A prospective cross sectional study
Meth
... Show More40 blood sample were taken from children infected with kala-azar at age less than ten years, who were admitted to El-Eskan child hospital, and central health laboratory in Baghdad. At the same time 15 sample collected from healthy child for comparing. During research estimated immunoglobulins level ( IgG, IgM, IgA) and (IFAT) IFAT test recorded a higher indicate antibodies level witch was synergistic with infected severity, the stander level of antibodies arrange between 1/16, 1/32 and 1/64 that means it graduate from the lowest one 1/16 into the highest one 1/64 within groups. During infectious the IgG ,IgM level recorded the higher level (2012.9 mg/dl) and (154.3 mg/dl) compared to the control group (874.3 mg/dl),
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