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.
In The Name of Allah Most Gracious Most Merciful
It is no secret to everyone that the endowment is an important nucleus for the prosperity of Islamic civilization, especially in the fields of education, health, economy, and defensive military actions that fall within the door of jihad, and so on. Al-Ashraf, Qom Al-Quds, Cairo, and other parts of the Islamic world. What we will see in the research.
The objective of study was determining the most prevalent Salmonella spp. and their antimicrobial susceptibility in broilers and laying chickens and their feed and drinking water in five chicken farms in Karbala, Iraq over the period from August to October 2020. A total of 289 samples, including 217 cloaca swabs, 46 water and 26 feed samples were collected. Salmonella spp. was identified firstly by routine diagnostic methods, followed by applying the API 20E kit, the Vitek2 system, and serology. There was significant differences in Salmonella prevalence among different types of samples, mainly cloaca swabs reported a high isolation rate (21.7%). In contrast, feed samples were completely free of contamination. The highest rate of isolation w
... Show MoreGeophysics is one of the branches of Earth sciences and deals with studying the Earth's interior by studying the variation of physical properties within rock layers. Applied geophysics depends on procedures that involve the measurements of potential fields, such as the gravitational method. One of the significant oil fields in southern Iraq is represented by the Nahr Omar structure. A power spectrum analysis (SPA) technique was used to collect gravity data within the chosen oil field area in order to confirm the salt dome in the subsurface layers. The analysis of SPA resulted from six surfaces representing the gravity variation values of the depths (m)14300, 3780, 3290, 2170, 810, and 93.5. Gravity surfaces have been converted to de
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... Show MoreThe regular job of a reservoir engineer is to put a development plan to increase hydrocarbon production as possible and within economic and technical considerations. The development strategy for the giant reservoir is a complex and challenging task through the decision-making analysis process. Due to the limited surface water treatment facility, the reservoir management team focuses on minimizing water cut as low as possible by check the flow of formation and injected water movement through the Mishrif reservoir. In this research, a representative sector was used to make the review of water injection configuration, which is considered an efficient tool to make study in a particular area of the entire field when compared with the ful
... Show MoreThe research studies the main variables for the concept of sharing in knowledge in one of the most important control agencies in Iraq, which is (The Federal Board of Supreme Audit). Also, the quality of the controlling businesses by the Board in light of the major challenges that facing the fight against signs of cheating and administrative and financial corruption for offices submitted to controlled and auditing, with the increasing and intensification of these appearances. In order to enable the Board to cope with this situation, has to be thinking hard about how to achieve excellence, progress and development to face these situations, through the application of sharing in knowledge for the financial controller, and then achiev
... Show MoreThe main parameter that drives oil industry contract investment and set up economic feasibility study for approving field development plan is hydrocarbon reservoir potential. So a qualified experience should be deeply afforded to correctly evaluate hydrocarbons reserve by applying different techniques at each phase of field management, through collecting and using valid and representative data sources, starting from exploration phase and tune-up by development phase. Commonly, volumetric calculation is the main technique for estimate reservoir potential using available information at exploration stage which is quite few data; in most cases, this technique estimate big figure of reserve. In this study
Hypertension is a major health problem throughout the world because of its high prevalence and its association with increased risk of cardiovascular diseases. It is defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. The aim of this study was to compare the efficacy, safety and cardiovascular disease risk lowering ability, of three antihypertensive drug regimens.
A retrospective study was carried out on 66 hypertensive patients, divided in to three groups based on their antihypertensive drug regimens (ACE inhibitors, β-blockers treated and combination antihypertensive therapy, the combination therapy consist of two or more of the following antihypertensive drugs ACE inhibitor di
... Show MoreThis study aims to test whether the institutions listed on the Iraq Stock Exchange have a significant correlation between the level of conservative accounting practice with the level of market share returns during the Coronavirus pandemic period as one of the policies to confront the economic repercussions of the Coronavirus pandemic. Furthermore, the sample included institutions listed on the Iraq Stock Exchange during the 2019 and 2020 years, i.e., the period before the Coronavirus pandemic and during the Coronavirus pandemic for the purpose of comparison. The market value to book value model was used, and the study found that conservative institutions had achieved the highest level of market share prices compared to non-conservat
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