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.
Iraq is Suffering nowadays from the criminal triad represented by the fiscal and administrative corruption, money laundering and terrorism, which are intertwined in a very related relations, as each of them support the other . Since the over growth has been one of its characteristics leaving behind a very dangerous negative effects whether it was social , economic or even political impacts . As a result , this trial is now represents a high risk that threatens the present and the future of Iraq . On the political , economic and social level , it is well to mention that the poor direct investment , the increasing rates of poverty , unemployment , inflation as well as the smuggling of goreign currency an
... Show MoreIn this study, the dung beetles Aphodius (Bodilus) ictericus (Laicharting, 1781) and Aphodius (Planolinellus) vittatus Say, 1825 which belongs to the family of Aphodiidae (Order: Coleoptera) are redscribed here as to being found for the first time in Iraq.
The specimens were collected from different regions in the middle of Iraq; the main diagnostic characters and some morphological features of males were drawn and pictured.
Business Ethics play a major role in explaining the behavior of those interested in the management of tourism enterprises in the field of management gains, which sometimes turn to manipulation in the specification of the service of tourism and influence in the technical characteristics at the expense of the brand and market share, as well as misleading beneficiaries about the fact that the performance of the service of tourism, may depend activities tourist dramatically when submitting and sharing various services on the types of mutual relations the framework for moral distinct, in interaction or direct contact between producers of tourism services and tourists or their beneficiaries, in order to provide comfort and recreation a
... Show MoreBackground: Restoration of the gingival margin of Class II cavities with composite resin continues to be problematic, especially where no enamel exists for bonding to the gingival margin. The aim of study is to evaluate the marginal leakage at enamel and cementum margin of class II MOD cavities using amalgam restoration and modern composite restorations Filtek™ P90, Filtek™ Z250 XT (Nano Hybrid Universal Restorative) and SDR bulk fill with different restoratives techniques. Materials and method: Eighty sound maxillary first premolar teeth were collected and divided into two main groups, enamel group and cementum group (40 teeth) for each group. The enamel group was prepared with standardized Class II MOD cavity with gingival margin (1 m
... Show MoreBackground: Tooth eruption is a more general process, however, which includes certain posteruptive tooth movements. There are two fundamental requirements for both tooth eruption to occur: (1) Require soft tissue, intervening between tooth structure and alveolar bone, which plays an important role in regulating the remodeling of adjacent tissues. (2) Require bone turnover that is temporally and spatially regulated to facilitate specific translocations of teeth through alveolar bone These amniotic stem cells are multipotent and able to differentiate into various tissues, which may be useful for human application and recently it used in many medical branches. CD34 is an endothelial marker that is extensively used in immunohistochemistry a
... Show MoreThe present study represent the histological and histochemical structure of the esophagus of laughing dove Streptopelia senegalensis, one of the wild birds, which feed on the seeds( grainvorous).The result showed that the esophagus long tubular quit wide and highly distensible organ situated at the right side of the nick , lie between pharynx and stomach it was divided into cervical and thoracic part , the cervical part longer than the thoracic part, and the crop was merely enlargement fusiform in shape which located at the entrance of the thorax. Esophagus parts showed that composed of four layer ;the mucosa, sub mucosa, muscular and adventitia or serosa, the mucosal layer was arranged in folds which was longer in the c
... Show MoreThis paper is a part of a cytological studies of the genus Bromus L. in Iraq . Cl number for 103 specimens ropro^eming l^species determined . The course of meiosis including an analysis of chromosome configuradon for 27 collections belonging to 8 species were investigated . Meiosis was regular in most species . Tetraploid for B.scoparius L. (new cytotype ) and hexaploid ?'or " Kunth. were re^rted for the first time, cytological findings were supported the view of maintaining the closely related species B.danthoniae Trin. and B.lanceolatus Roth, as distinct species .
The 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 (Fortr
... 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 current study aimed to identify the morphological description and branches of the bronchial tree and lung for the weasel