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.
The current study aims to examine the experience of female students with disabilities who studying in university in kingdom of Saudi Arabia. To this end, the researcher used semi-structured interview as an instrument to collect the study data which regards as one of the descriptive approach tools. The sample comprised (12) disabled-female students from multidiscipline within both college of arts and college of education. To analyze the collected data, the author utilized a thematic analysis method following six steps as stated by (Braun and Clark, 2006). The findings revealed that disabled students have a high self-confidence which push them forward to take part in activities that hold on campus. Besides, significant variation were shown
... Show MoreBackground: Hypothyroidism is a clinical syndrome prevalent in women, even those of reproductive age. Ovarian reserve can be defined as the number and quality of follicles in the ovary at any given time. Evaluation of ovarian reserve is recommended for patients at risk of decreased ovarian reserve. Objective: This study aims to evaluate the effect of hypothyroidism on ovarian reserve in Iraqi women by hormonal measurements of serum anti-mullerian hormones AMH, FSH, and LH. Subjects and methods: This case–control study was carried out at the Department of Biochemistry, College of Medicine, University of Baghdad, in collaboration with Endocrinology and Diabetes Clinic, Baghdad Teaching Hospital, and National Center for Teaching Labo
... Show MoreWidespread use of antihypertensive agents in clinical practice necessitates the knowledge of their pleiotropic effects. At the present time there are no sufficient evidences of positive effect of these medications on bone coming from randomized controlled trials; knowledge of additional effects of those drugs on the bone metabolism will allow doctors to choose optimal treatment of hypertension, taking into account the state of bone tissue. At the same time it will also allow to prevent osteoporosis in patients having osteoporosis risk factors or initial signs of bone loss.
Ten elderly hypertensive women age > 60 years old (64.2±3.6) treated with captopril for a 5-6 years ago while they attending Al Yarmouk Teaching Hospital i
... Show MoreBackground: The bond strength of the root canal sealers to dentin seems to be a very important property for maintaining the integrity and the seal of root canal filling. The aim of this study was to evaluate the shear bond strength of four different obturation systems using push-out test. Materials and methods: Forty straight palatal roots of the maxillary first molars teeth were used in this study, these roots were instrumented using crown down technique and ProTaper system, instrumentation were done with copious irrigation of 2.5% sodium hypochlorite and 17% buffered solution of EDTA was used as final irrigant followed by distilled water, roots were randomly divided into four groups according to the obturation system (ten teeth for each g
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Informing means informing and informing, which is conveying information to someone and confirming his narration with it. Accordingly, information is its main content..and it has multiple means, including visual, audio and read, and it has become the dominant role in the process of socialization, and much of what we hear, read, or watch in the media is not devoid of a goal, and expresses that scientifically as “charged with values” ( Value Loaded)..Values that are: the set of beliefs that the individual holds towards things, meanings, and various aspects of activity, which direct his desires and attitudes towards them, and determine for him acceptable and unacceptable behavior, right and wrong, and all of this
... Show MoreThe study aims to identify the concept of empowering women from the point of view of experts in the Palestinian society, specifically in Gaza, as well as to explore the foundations of their formation of this concept. Additionally, the study seeks to clarify the most important challenges facing the empowerment of women in Palestinian society. The study used the design of a grounded theory that seeks to build the theory through deep analysis of the data, as qualitative data were collected through holding two focus groups and six in-depth interviews with the study sample, who were selected by the method of targeted sampling. The sample included (16) individuals (9 female experts, 7 male experts) holding academic and community leadership pos
... Show MoreThe steady state laminar mixed convection and radiation through inclined rectangular duct with an interior circular tube is investigated numerically for a thermally and hydrodynamicaly fully developed flow. The two heat transfer mechanisms of convection and radiation are treated independently and simultaneously. The governing equations which used are continuity, momentum and energy equations. These equations are normalized and solved using the Vorticity-Stream function and the Body Fitted Coordinates (B.F.C) methods. The finite difference approach with the Line Successive Over-Relaxation (LSOR) method is used to obtain all the computational results. The (B.F.C) method is used to generate the grid of the problem. A computer program (Fortran
... Show MoreThe Logic of Freezers and Animals in the Holy Quran
This aims tackles the importance of the organizational energy of the hotel organizations that search the success in the business field to penetrate in the whole tourist markets, and to draw the policies and firm rules which must be framed with the administrative strategies that contributed in creativity and achievement the targets besides provide a future vision due to its position among the competitive henceforth achieving the activity. This is what the chapters tackle in the theoretical side. Also many general questions have been arisen to determinate the importance of the research and many other special questions that express the problem of the study. To limit the levels of study alter
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