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.
Background : The hepatopulmonary syndrome (HPS) is defined as the triad of liver disease, arterial deoxygenation, and pulmonary vascular dilatation. The reported prevalence of HPS in cirrhotic patients varies between 5% -17.5%.Objective : To estimate the prevalence of hepatopulmonary syndrome among patients with chronic liver disease and portal hypertension and to study the correlation between HPS and the severity of liver disease.Patients and methods : Thirty patients were studied for the presence of HPS using transthoracic contrast echocardiography for detection of pulmonary vasodilatation. Arterial oxygen saturation (SaO2) was determined in erect and supine position using a pulse oximeter , (SaO2 ≤ 92 % in supine position and/or a d
... Show MoreMK Al-Janabi, NA Nasir, RK Jaber, AO Oleiwe, Iraqi Postgraduate Medical Journal, 2018 - Cited by 7
The City of Ember is a very interesting novel that is although intended for young readers, have so many layers and messages that are misunderstood. In this research, both the novel and the film adaptation are studied with the intent to decode the warning messages that the novelist and the director tried to introduce to the audience. The research studies four vital messages; the first message is that history repeats itself for the novel has many allusions to the history of Jews and their painful holocaust and even goes back in history the days of Moses and the Exodus, the second message tackles the conspiracy theory that states nothing happens by accident and that everything is planned and connected hence comes the third message
... Show MoreObjective : Sciatic nerve block (popliteal approach) and femoral N block is a new technique other than general anesthesia in below knee surgery because it provides adequate muscle relaxation, with good intraoperative and post-operative analgesia. Nefopam is non opioid, non-respiratory depressant and non-sedative was mixed with local anesthetics drug to study the effects. This study was done to compare the onset and duration of sensory and onset time and duration of action of motor block following administration of either bupivacaine alone with administration of bupivacaine and Nefopam in patients undergoing below knee lower limb surgeries under ultrasound guided regional anesthesia.
Methods: 100 patients with American society of anest
One of the globalization results is (VAT) , so it is important to consider its results and impact on the tax system.
The Iraqi economy having wittnisd an acute transition period , still in need for a better care in aim to back it, especialy from the tax system.
The research is concerned with the (VAT) and its details –And for five chapters all the problomes connect are displayed .But yet the new system does not comply with the modern development and this is one of the defects of (VAT) in Iraq.
The history of (VAT)was also studied mentiorned and studied.
As a conclusion (VAT) is one of the m
... Show MoreThe plant Conyza canadensis, which belongs to Asteraceae (Compositae) family and known as Canadian horseweed. It was used as traditional medicine in China, Pakistan, India, and Africa for the treatment of various diseases causing by bacteria, fungi, or viruses. The plant has antimicrobial, antioxidant, anticoagulant, anti-inflammatory, and anticancer pharmacological activity. This study provides the first phytochemical investigation of the plant in Iraq and is concerned with extraction, fractionation, isolation, and purification of some of the important phytochemicals detected in the plant-like phenolic acids, flavonoids, and alkaloids. Also, the literature survey has revealed that the plant has a substantial antimicrobial activity, so it w
... Show MoreThe objective of study was determining the most prevalent Salmonella spp. and their antimicrobial susceptibility in broilers and laying chickens and their feed and drinking water in five chicken farms in Karbala, Iraq over the period from August to October 2020. A total of 289 samples, including 217 cloaca swabs, 46 water and 26 feed samples were collected. Salmonella spp. was identified firstly by routine diagnostic methods, followed by applying the API 20E kit, the Vitek2 system, and serology. There was significant differences in Salmonella prevalence among different types of samples, mainly cloaca swabs reported a high isolation rate (21.7%). In contrast, feed samples were completely free of contamination. The highest rate of isolation w
... Show MoreThe regular job of a reservoir engineer is to put a development plan to increase hydrocarbon production as possible and within economic and technical considerations. The development strategy for the giant reservoir is a complex and challenging task through the decision-making analysis process. Due to the limited surface water treatment facility, the reservoir management team focuses on minimizing water cut as low as possible by check the flow of formation and injected water movement through the Mishrif reservoir. In this research, a representative sector was used to make the review of water injection configuration, which is considered an efficient tool to make study in a particular area of the entire field when compared with the ful
... Show MoreThe research studies the main variables for the concept of sharing in knowledge in one of the most important control agencies in Iraq, which is (The Federal Board of Supreme Audit). Also, the quality of the controlling businesses by the Board in light of the major challenges that facing the fight against signs of cheating and administrative and financial corruption for offices submitted to controlled and auditing, with the increasing and intensification of these appearances. In order to enable the Board to cope with this situation, has to be thinking hard about how to achieve excellence, progress and development to face these situations, through the application of sharing in knowledge for the financial controller, and then achiev
... Show MoreThis study aims to test whether the institutions listed on the Iraq Stock Exchange have a significant correlation between the level of conservative accounting practice with the level of market share returns during the Coronavirus pandemic period as one of the policies to confront the economic repercussions of the Coronavirus pandemic. Furthermore, the sample included institutions listed on the Iraq Stock Exchange during the 2019 and 2020 years, i.e., the period before the Coronavirus pandemic and during the Coronavirus pandemic for the purpose of comparison. The market value to book value model was used, and the study found that conservative institutions had achieved the highest level of market share prices compared to non-conservat
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