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.
Health insurance and its benefits are of great importance and impact on the employees who represent the human capital of each organization because they are related to the health reality. The study took into account the most important and the last of his writing of the concepts and literary reviews and enriched the theoretical part of the practical side has addressed the financial data and analysis for the period from 2013 to 2017 to know the impact and the relationship between the variables that They were reviewed on the theoretical side. The study came out with a number of results, on the basis of which practical conclusions were drawn and reflected what was observed on the basis of which the recommendations were formulated
The current research aims to investigate the effect of a specimen of Daniel in the acquisition of concepts for the Arabic language curricula material to the students of the third phase of the Faculty of Basic Education Department of Arabic Language. The sample consists of (93) applications and a student of (47) students in the Division (A), which represents the experimental group which studied the use of a specimen of Daniel, and (46) students in the Division (B), which represents the control group, which studied the traditional way. The subject of unified two groups, which subjects the Arabic language curricula which includes six chapters.
The duration of the experiment is a full semester. The researchers also prepared a tool for mea
The division partitioning technique has been used to analyze the four electron systems into six-pairs electronic wave functions for ( for the Beryllium atom in its excited state (1s2 2s 3s ) and like ions ( B+1 ,C+2 ) using Hartree-Fock wave functions . The aim of this work is to study atomic scattering form factor f(s) for and nuclear magnetic shielding constant. The results are obtained numerically by using the computer software (Mathcad).
This growing interest of the international scientific specialized commissions is due to the role that the audit committee can play, as one of companies’ governance tools, to increase the accuracy and transparency of the financial information disclosed by the companies, through its oversight role on the process of preparing financial reports, its supervision on the internal audit function within the companies, and supporting its independency, as well as coordinating the efforts between the internal control unites and the external auditor represented by the (Board of Supreme Audit) to clear the observations and irregularities in order to reduce the fraud cases.
This research was built on an applied sample of audit committee works
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The current research included " Diagnosis of the reality of the gap for the requirements of Business Continuity Management System According to International Standard (ISO 22301: 2012) in Midland Refineries Company (Daura Refinery) " , for development of an administrative system for Business Continuity is considered a priority in the present day, and in the light of the organizations dependence on computers and information technology in work and communication with others . the international legitimacy (represented by the international organization for standardization (ISO)) remains the basis for matching and commitment , and the importance of the application of Business Continuity Management Syst
... Show MoreThe tax base is one of the bases of the technical organizing of taxes, and that a good selection of the tax base effects the outcome of the tax and its fairness, and with the expansion of the tax range results a dangerous phenomenon called tax evasion, which became threaten the economies of countries and this phenomenon prevents the achievement of the state to its economic, political and social objectives which seeks to resolve this phenomenon and identifying all human and material potential and realize the real reasons that lie behind it. The researcher found that tax authorities are weak in terms of it the technical material and financial abilities, the analysis of data show that then is a significant reve
... Show MoreThe research aims at evaluating the illustrations images and determining the availability of good image standards in the illustrations images of the content of the second intermediate stage computer's book for the academic year (2019-2020) as seen by computer teachers. The sample was randomly selected, (30) teachers who are actually teaching the subject in schools within the geographical area of the province of Baghdad (Karkh III). To achieve this goal, ten standards were identified: scientific accuracy, suitability for the level of students, image clarity, image freshness, quality of coloring, suitability of its location of the subject, Matching their content glimpsed, The subject matter is appropriate in terms of area, matching its tit
... Show MoreThe aim of the research is to assess the practice of tax administration to diminish the strategic direction of (proactive, analytical, defensive, response) and the nature of its relationship to organizational excellence represented by (leadership, strategic planning, focus on taxpayers, information and analysis and knowledge management, focus on operations, focus on forces. The questionnaire was adopted as a main tool in collecting data and information from the sample members of the General Authority for Taxes (110) who are in the site (m. Second Division Manager, Ms The statistical program (SPSS) was used to calculate (mean, standard deviation, difference coefficient, correlation coefficient, t-test). The research reached a number
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