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.
Phonological 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 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 MoreLorraine Hansberry’s A Raisin in the Sun (1959) appeared at the beginning of renewed political activity on the part of the blacks; it is a pamphlet about the dream of recognition of black people and the confusion of purposes and means to reach such recognition. It embodies ideas that have been uncommon on the Broadway stage in any period. Situations such as a black family moving into an all-white neighborhood were not familiar before this time; they were just beginning to emerge. In depicting this so realistically, Hansberry depends more on her personal experience as an African American embittered by social prejudices and discrimination.
It included the introduction to the research and its importance, as the knee joint is one of the important joints in the human body that are susceptible to injury, and among these injuries is the roughness of the knee that occurs as a result of weakness and imbalance in the work of the quadriceps muscle, so its treatment is through rehabilitation exercises to treat weakness and gain flexibility and strength.Hence the importance of the research by developing rehabilitation exercises with different resistances in the water medium and restoring flexibility and muscular strength for patients with knee roughness for ages from 30-40 years, and the experimental method was used to solve the research problem, and the research sample included (6) of
... Show MoreThis research aims to modify the components of stainless steel alloy by the method of surface engineering through the single diffusion coating technique in order to obtain new alloys with high efficiency in resisting harsh environmental conditions. Steam a mixture of sodium chloride ( ) and sodium sulfate ( ) at a temperature of 900 and then compare it with the base alloy. The results showed that the alloys produced in this way are very efficient. The results showed that the aluminum coating showed high efficiency in resisting oxidation and provided better protection for a longer time compared to the uncoated alloy due to the oxide crust layer formed with high adhesion as well as the aluminum-rich phases, whether the phase
... Show MoreThese deposits take many forms like current acc, deposits in order to growth and serve national economy Various in varicose perspectives .
The problem of this paper its concern with un applied the mathematical models that used in profitability analysis of current acc , and deposits in view of risk, profit efficiency and financial leverage for this reason the paper discussion use the cumulate mathematical model to solve these problem, that content three variables that be used to measuring profitability by consequent replacement method by stable base and by moving base for 2007 – 2009 applied the data collect from Iraq middle east bank. &nbs
... Show MoreSurveys has done for collecting Sunn Pest which been parasitized by oophagous parasitoids
in infested wheat fields of villages around Erbil, Sulimanya and Dohuk governorates from
April to the end of May 2010, the result showed that a high rat of eggs hatching was 96.3%
within Erbil governorate and its cleared from results that not all laid eggs had been hatched
normally . The percentage ratio of egg parasitism in general was low in most studied villages.
In this study: Trissolcus grandis Thompson, Trissolcus semistriotus Nees., and Telenomus sp.
on sunn pest eggs has been observed. Identification keys supported with figures were
formulated to identify of these species.