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.
In recent years, Wireless Sensor Networks (WSNs) are attracting more attention in many fields as they are extensively used in a wide range of applications, such as environment monitoring, the Internet of Things, industrial operation control, electric distribution, and the oil industry. One of the major concerns in these networks is the limited energy sources. Clustering and routing algorithms represent one of the critical issues that directly contribute to power consumption in WSNs. Therefore, optimization techniques and routing protocols for such networks have to be studied and developed. This paper focuses on the most recent studies and algorithms that handle energy-efficiency clustering and routing in WSNs. In addition, the prime
... Show MoreConflict is a common but complicated phenomenon. It has been extensively researched in many domains, including philosophy, sociology, psychology, and linguistics. Using the Critical Discourse Approach, this study examines the issue of self-society conflict in The Handmaid’s Tale. The significance of this work lies in the identification and explanation of the discursive strategies that force the ideological polarization of the positively portrayed self versus the negatively portrayed other. The purpose of this study is to answer two questions: what are the discursive strategies used in The Handmaid’s Tale to create a positive or negative representation, and how are these strategies implemented? Five extracts from The Handmaid’s
... Show MoreFish are regarded as a crucial indicator of alterations in the aquatic environment due to their position at the apex of the food chain. Monitoring these alterations is crucial for identifying modifications in the aquatic ecosystem. The principal elements influencing fish health are temperature, pH, dissolved oxygen, salinity, pesticide contamination, microplastics, and algal presence. These elements substantially influence fish health regarding development, reproduction, respiration, oxygen stress, and the internal enzymes associated with digesting and other metabolic functions. Alterations in global environmental conditions and anthropogenic pollutants result in modifications to fish populations, their lives, and their behavior and
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The research aims to diagnose the reality of applying the eighth requirement (operation) of the business continuity management system according to the international standard (ISO 22301: 2019), in the General Tax Authority, which is related to planning, implementing and controlling specific processes and procedures to address risks and opportunities, and the research adopted the checklist of the standard ( ISO 22301: 2019), in obtaining information, to measure the extent of application and documentation, the percentages and the weighted arithmetic mean were relied upon, and the research reached a set of result
... Show MoreAthletics are different from other games as a competition between individuals to show their competence and physical ability to achieve new record numbers in the various activities and various between the boards, jumping and throwing and each type of these activities in particular performance so found the researcher to find the method of training resistors in the development of special power and achievement In the effectiveness of javelin, where the researchers chose the sample of the athletes from the specialized school of athletics to effectively throw the spear at the ages of 15-17 years and carried out the tests of the research, which includes the strength of the speed of the arms and explosive power and The various resistance exercise
... Show MoreWelcome to International Journal of Research in Social Sciences & Humanities (IJRSSH). It is an international refereed journal of Social Sciences, Humanities & Linguistics in English published quarterly, both print and online.
A new method is characterized by simplicity, accuracy and speed for determination of Oxonuim ion in ionisable inorganic acid such as hydrochloric (0.1 - 10) ,Sulphuric ( 0.1 - 6 ),nitric ( 0.1 - 10 ), perchloric ( 0.1 - 7 ), acetic (0.1 - 100 ) and phosphoric ( 0.1 - 30 ) ( mMol.L-1 )acids. By continuous flow injection analysis. The proposed method was based on generation of bromine from the Bro-3-Br-- H3O+. Bromine reacts with fluorescein to quenches the fluorescence . A sample volume no.1 (31μl) and no.2 (35μl) were used with flow rate of 0.95 mL.min-1 using H2O line no.1as carrier stream and 1.3 mL.min-1 using fluorescein sodium salt line no.2. Linear regression of the concentration ( mMol.L-1 ) Vs quenched fluorescence gives a correla
... Show MoreThe research aimed at identifying the effect of the think, pair, and share strategy by using educational movies on learning jumping opened legs and closed legs skills on vault in artistic gymnastics for women. It also aimed at identifying the group that learned better the skills understudy. The researcher used the experimental method on second-grade College of Physical Education and Sport Sciences female students. Twelve female students were selected from each of the two sections to form the subjects of the study. The main program was applied for eight weeks with one learning session per week. The data was collected and treated using SPSS to conclude that the think, pair, and share strategy and the traditional program have positive effects
... Show MoreThis research is qualitative in nature. It aims to investigate descriptively, analytically, and comparatively the modern AK model represented by the Sudan Open University Series, and the European framework, the common reference for Teaching Foreign Languages, to uncover what was achieved in them in terms of communication and language use. Accordingly, an integrated, multi-media approach has been adopted to enable the production and reception activities, and the spread of Arabic in vast areas of the world. Such a spread helps Arabic language to be in a hegemonic position with the other living languages. The study is based on getting benefit from human experiences and joint work in the field of teaching Arabic to non-Arabic speakers to mee
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