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 present research included synthesis of silver nanoparticle from(1*10-3,1*10-4 and1*10-5) M aqueous AgNO3 solution through the extract of M.parviflora reducing agent. In the process of synthesizing silver nanoparticles we detected a rapid reduction of silver ions leading to the formation of stable crystalline silver nanoparticles in the solution.
Acromegaly is ametabolic disorder characterized by an acquired progressive somatic disfigurement, mainly involving the face, extremities and many other organs, that are associated with systemic manifestations, caused by excessive secretion of growth hormone and a resultant persistent elevation of insulin-like growth factor-I concentrations. In more than 90% of cases originates from a monoclonal benign pituitary adenoma. Aim of this study to assess the level of insulin-like growth factor-I (IGF-I) in saliva of acromegalic patients, and to compare it with the basal levels of serum IGF-I. Sixty specimens of serum and saliva collected from two groups of subjects (forty acromegalic patients and twenty healthy persons). The specimens were
... Show MoreRheumatoid arthritis (RA) is a common inflammatory disease that associated with increased morbidity and mortality due to accelerated atherosclerosis. Rosuvastatin is a unique hydroxy methyl glutaryl Co A (HMGCoA) reductase inhibitor that has anti inflammatory effects.
The aim of this study was to evaluate the effect of rosuvastatin as adjuvant therapy to methotrexate (MTX) on lipid profile and its possible cardioprotective effect in RA patients. A double blinded placebo controlled clinical trial with 8 weeks follow up periods at which 40 patients with active RA using MTX were randomized into 2 groups to receive either rosuvastatin 10mg or placebo as adjuvant therapy to MTX. In addition to twenty healthy subjects as control group.
... Show MoreThe aim of this study to survey the leaf miner Phytomyza Fallen of Iraq, many leaf plants which infested by leaf miners were collected from several regions of Iraq. The paper showed there are four species of this genus during the work: Phytomyza horticola Gourear,1840; Ph. atricornis Meigen, 1838; Ph. rufipes Meigen,1830; Ph. ranunculi (Schrank,1803)
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 MoreReceipt date: 8/8/2020 acceptance date: 9/11/2020 Publication date: 31/12/2021
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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 MoreTwelve species of Tubuliferous thrips, of the family Phlaeothripidae had been reported from Iraq. Two of these were reported previously, Haplothrips cerealis Priesner, by El-Haidari and Daoud 1971 and Haplothrips tritici kurdjumov by Al-Ali 1977 and the rest were recorded for the first time: these are Haplothrips hukkineni Priesner; Haplothrips subtilissimus (Haliday); Haplothrips reuteri Karny; Haplothrips jasonis Priesner; Haplothrips sallloumensis Priesner; Haplothrips pharao Priesner; Phlaeothrips sycomri Priesner; Karnyothrips flavipus (Jones); Karnyothrips melaleucus (Bagnall); Dolicholepta micrurus (Bagnall). Number of insec
... Show MoreThe present study included the physico-chemical parameters of Lesser-Zab river and its effects on Tigris river. Monthly water samples were taken from the two rivers during January to October 1999.There were no signifcant difference in water temperatures. Both rivers were fresh to oligohalin, alkaline and very hard. Close values were determined in total suspended solids in both rivers with little increasing during rainfall period and high discharge. Water was well areated and over saturation was recorded in several occasions. Dissolved oxygen values of Tigris river were influenced by Lesser-Zab. Cations were more dominant than anions in both rivers. In Lesser-Zab, the anions were increased during spring season and declined in summer which t
... Show MoreSara and other kid's Agony: - Back to Innocence to Save Iraq