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 central marshes are one of the most important wetlands/ecosystems in the southern area of Iraq. This study evaluates the bed soil's mechanical, physical, and chemical properties at certain southern Iraqi central marshes sites. This was conducted to investigate their types and suitability for enhancing the agricultural reality of most field crops and for construction purposes. Soil samples were collected from 15 sites at 10-100 cm depth. Hence, numerous parameters were determined: index properties, unconfined compressive strength, direct shear strength, consolidation, texture, and sieve analysis, water content, specific gravity, dry density, permeability, pH, total soluble salts (TSS), organic materials (OM) and total
... Show MoreMulti-nationalities companies are the main companies in the progressed
countries that improve the current technology and, thus, become the main source of it.
These companies, in the first place, aim to increase the profits of its
investments to satisfy stock holders in the original countries to which these companies
belong.
It is a mean to interfere in the economic of countries especially the growing
ones and exploit their important natural resources. Since this research focus on the
dangers of these companies, mechanism of its work and its dangers on the most
important natural resources of our country which is oil; therefore, the research
confirm that this important natural treasure must be under an Iraqi cont
A3D geological model was constructed for Al-Sadi reservoir/ Halfaya Oil Field which is discovered in 1976 and located 35 km from Amara city, southern of Iraq towards the Iraqi/ Iranian borders.
Petrel 2014 was used to build the geological model. This model was created depending on the available information about the reservoir under study such as 2D seismic map, top and bottom of wells, geological data & well log analysis (CPI). However, the reservoir was sub-divided into 132x117x80 grid cells in the X, Y&Z directions respectively, in order to well represent the entire Al-Sadi reservoir.
Well log interpretation (CPI) and core data for the existing 6 wells were the basis of the petrophysical model (
... Show MoreReceipt date: 8/8/2020 acceptance date: 9/11/2020 Publication date: 31/12/2021
This work is licensed under a Creative Commons Attribution 4.0 International License.
The American-Iranian relations have been characterized by tensions since the arrival of the guardian jurist regime in Iran to leadership in 1979, as it was considered a turning point not only in the cont
... Show MoreMandali Basin is located between latitudes (33◦ 39' 00" and 33◦
54' 55") to the north and longitudes (45ο 11' 00" and 45ο 40' 00") to the
east; to the east of Diyala province at the Iraqi-Iranian border; the
basin area is approximately 491 km2.
From the study of climate reality of the basin between 1990-
2013and assessment of the basic climate transactions, it was found
that the annual rate of rainfall is 253.02 mm, the relative humidity
(44.4%), the temperature (21.3 ◦C), wind speed (2.08 m /sec.),
sunshine (8.27 h/day) and evaporation of the basin class (a) (271.98
mm) and corrected potential evapotranspiration (80.03 mm). The
results of the data analysis show that, there are
Based on collections made during March to September 2012. A totals of 58 species belong to 33 genera were identified from extra north to extra south of Erbil governorate, among them 30 species are registered as a new record to flora of Iraq. Most attention was paid to the most common and abundant lichens that present almost in most locations, which were Collema cristatum, Diploschistes scruposus, Lecanora dispersa, Lecanora murales, Pertusaria flavicunda, Placidium lacinulatum, Thelomma californicum and Verrucaria Maura.
Regression Discontinuity (RD) means a study that exposes a definite group to the effect of a treatment. The uniqueness of this design lies in classifying the study population into two groups based on a specific threshold limit or regression point, and this point is determined in advance according to the terms of the study and its requirements. Thus , thinking was focused on finding a solution to the issue of workers retirement and trying to propose a scenario to attract the idea of granting an end-of-service reward to fill the gap ( discontinuity point) if it had not been granted. The regression discontinuity method has been used to study and to estimate the effect of the end -service reward on the cutoff of insured workers as well as t
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