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 was aimed to explore the impact of social concepts about tribe, clan and women, on internal audit performance. These concepts are considered to be components of the organizational culture and performance of internal audit practice, with respect to the individual and collective performance within the institution. The study, furthermore, was intended to investigate and understand the role of the organizational culture of the tribal, clan and women components with regard to their role in society, in Qatar.
To achieve these objectives, the researcher followed the descriptive analytical approach, using a questionnaire directed to experts and staff working in the banking sector, with the view to test
... Show MorePhonological metathesis can be defined as an alternation in the normal sequence of two sounds under certain conditions. The present paper is intended to give a detailed synchronic description of phonological metathesis in Iraqi Arabic dialect. For data collection, the researchers have adopted two naturalistic techniques, viz., observation and notes taking. A synchronic analysis is carried out to provide some evidence that describe the sequential change of phonological metathesis in the dialect under investigation. Such sequential changes of metathesized sounds are presented and tabulated. The study concludes with the following finding that this process is not limited to cases where two consonant sounds are transposed, but three consonant
... Show MoreOne of the artificial lightweight aggregates with a wide range of applications is Lightweight Expanded Clay Aggregate. Clay is utilized in the production of light aggregates. Using leftover clay from significant infrastructure development projects to manufacture lightweight aggregates has a favorable environmental impact. This research examines the expanded clay aggregate production process and the impact of processing parameters on its physical and mechanical qualities. It also looks at secondary components that can be used to improve the qualities of concrete with expanded clay aggregates. The effect of the quantity of expanded clay aggregate on the fresh, hardened, and durability qualities of concrete is also studied.
... Show MoreBackground: Osteoid osteoma(OO) is a relatively common benign skeletal neoplasm of unknown etiology that is composed of osteoid and woven bone, usually seen in adolescent and young males Although, the clinical, radiological and scintigraphic features of OO have been well described, these features may be misleading or altered in the cases of lesser trochanter of the femur which is relatively uncommon location for OO with a few number of cases reported up to date. Case Presentation: We report a case of a 20-year-old man who presented with painful limpThe pain had begun six months earlier and was made worse by walking and by exercise., with normal initial X-rays .The diagnosis was made after six months when typical Computed tomography, magneti
... Show MoreWhen industrial and constructional renaissance started in the world, the great interest was going on towards the equipment’s, which was the first mean for production. After industry was settled the interest was going on towards the men ship which manpower on which the production depends. It was approved that it represents the basic part in all of the processes and the protection of those individuals against dangers of these equipment’s, industry and its accidents was the basic things which was studied in many researches until it crystallized in general principles for all industries and other take care in each industry.
The professional safety is concerned as restrict which
... Show MoreNeurolinguistics is a new science, which studies the close relationship between language and neuroscience, and this new interdisciplinary field confirms the functional integration between language and the nervous system, that is, the movement of linguistic information in the brain in receiving, acquiring and producing to achieve linguistic communication; Because language is in fact a mental process that takes place only through the nervous system, and this research shows the benefit of each of these two fields to the other, and this science includes important topics, including: language acquisition, the linguistic abilities of the two hemispheres of the brain, the linguistic responsibility of the brain centers, and the time limit for langua
... Show MoreBackground: Swine influenza (also Called pig influenza, swine flu, hog flu and pig flu) is an infection by any one of several types of swine influenza virus (SIV) or S-OIV (Swine-Origin influenza virus) is any strain of the influenza family of viruses that is endemic in pigs. Patients and Methods:- Ninety patients with there families suspected of swine flu who were admitted to Central Teaching Hospital of Pediatric in Baghdad seventy one from Baghdad Al-Kerkh, twelve from Baghdad Al-Rasafa and seven other Iraqi Governorate (1 in Suleimaniya, 2 in Baquba, 4 in Anbar) they were included in a prospective study started from the 1st October till the 30 th of November 2009. Results:- The study revealed from )90( suspected cases the H1N1 Virus Pos
... Show MoreCloud computing is a newly developed concept that aims to provide computing resources in the most effective and economical manner. The fundamental idea of cloud computing is to share computing resources among a user group. Cloud computing security is a collection of control-based techniques and strategies that intends to comply with regulatory compliance rules and protect cloud computing-related information, data apps, and infrastructure. On the other hand, data integrity is a guarantee that the digital data are not corrupted, and that only those authorized people can access or modify them (i.e., maintain data consistency, accuracy, and confidence). This review presents an overview of cloud computing concepts, its importance in many
... Show MoreBackground: Osteoid osteoma(OO) is a relatively common benign skeletal neoplasm of unknown etiology that is composed of osteoid and woven bone, usually seen in adolescent and young males Although, the clinical, radiological and scintigraphic features of OO have been well described, these features may be misleading or altered in the cases of lesser trochanter of the femur which is relatively uncommon location for OO with a few number of cases reported up to date.Case Presentation: We report a case of a 20-year-old man who presented with painful limpThe pain had begun six months earlier and was made worse by walking and by exercise., with normal initial X-rays .The diagnosis was made after six months when typical Computed tomography, magne
... Show More