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: Tubal ligation, recognized as a surgical intervention that ensures permanent contraception, has established itself as an option for women seeking a definitive solution for family planning. Objective: To assess the psychosexual implications of tubal ligation in a sample of women in Baghdad, Iraq. Methods: A prospective cohort study was conducted in a teaching hospital for 2 years, from the first of January 2022 to the end of December 2023, in which 203 women who underwent tubal ligation were included. Results: In the present study, we found that 158 (77.8%) had no depression, mild depression presented in 27 (13.3%), and moderate depression in only 15 (7.4%). While 163 (80.3%) of women did not suffer from anxiety, 32 (15.8
... Show MoreGroundwater modelling is particularly challenging in arid regions where limited water recharge is available. A fault zone will add a significant challenge to the modelling process. The Western Desert in Iraq has been chosen to implement the modelling concept and calculate the model sensitivity to the changes in aquifer hydraulic properties and calibration by researching 102 observations and irrigation wells. MODFLOW-NWT, which is a Newtonian formulation for MODFLOW-2005 approaches, have been used in this study. Further, the simulation run has been implemented using the Upstream-Weighting package (UPW) to treat the dry cells. The results show sensitivity to the change of the Kx value for the major groundwater discharge flow. Only abo
... Show MoreDespite the principle of separation of powers brought by the French Revolution, which entrusted the task of drafting legislation and its amendment to the legislative authority and the task of settling disputes and settling them in the judiciary. However, since that date, the French judiciary has played a major role in the development of French civil law (In spite of all the economic and social developments that have taken place in French society throughout these years) since its promulgation until February of 2016, the date of the Legislative Decree No. 131 of the year 2016 A modification is the largest in the history of the French Civil Code (which was the judicial precedents in which a significant impact), was assisted by the French judic
... Show MoreThe power generation of solar photovoltaic (PV) technology is being implemented in every nation worldwide due to its environmentally clean characteristics. Therefore, PV technology is significantly growing in the present applications and usage of PV power systems. Despite the strength of the PV arrays in power systems, the arrays remain susceptible to certain faults. An effective supply requires economic returns, the security of the equipment and humans, precise fault identification, diagnosis, and interruption tools. Meanwhile, the faults in unidentified arc lead to serious fire hazards to commercial, residential, and utility-scale PV systems. To ensure secure and dependable distribution of electricity, the detection of such ha
... Show MoreRecent reports of new pollution issues brought on by the presence of medications in the aquatic environment have sparked a great deal of interest in studies aiming at analyzing and mitigating the associated environmental risks, as well as the extent of this contamination. The main sources of pharmaceutical contaminants in natural lakes and rivers include clinic sewage, pharmaceutical production wastewater, and sewage from residences that have been contaminated by drug users' excretions. In evaluating the health of rivers, pharmaceutical pollutants have been identified as one of the emerging pollutants. The previous studies showed that the contaminants in pharmaceuticals that are widely used are non-steroidal anti-inflammatory drugs, ant
... Show MoreAnimation is an industry that is expanding more quickly than ever. Every child’s favorite activity is watching cartoons. Therefore, it is essential to be cautious of the kinds of cartoon films children and teenagers tend. Because children and teenagers are the target audience for these films. This study aims at exposing a hidden enactment, namely racism, in a well-known cartoon film, Lion King, which has been selected accurately by the researchers because it shapes a set of ideas about black people and constructs prejudiced beliefs in their minds. This study is to answer the inquiry ‘Is the ideology of racism imposed in Lion King? And how?’ The significance of the present paper lies in highlighting the educational function of
... Show MoreIn this work, a simulated study was carried out for designing a novel spiral rectangular patch of microstrip antenna that is used in ultra-wideband applications by using a high frequency structure simulator software (HFSS). A substrate with dielectric constant of 4.4 and height 2.10 mm (commercial substrate height available is about 0.8-1.575 mm) has been used for the design of the proposed antenna. The design basis for enhancing bandwidth in the frequency range 6.63 - 10.93 GHz is based on increasing the edge areas that positively affect the antenna's efficiency. This design makes the designed antenna cost less by reducing the area of the patch. It has been noticed that the bandwidth of the antenna under this study is increasing to 4.30
... Show MoreCollaborative learning is a way that prepares students practically for real-world applications. Working together as teamwork to execute various writing skills is essential in most professions since it increases the level of experience. Thus, the current study aims to identify the role collaborative writing in developing students' level of performance in writing. It is qualitative in nature since the researcher depended on the extant literature in achieving the objective of the study. The researcher touched upon related theories that addressed Collaborative learning, categories, and problems .It concluded that collaborative writing increases the students’ self-confidence, self-esteem, creativity, and motivation through the interact
... Show MoreAbstract
People are supposed to use language harmoniously and compatibly. However, aggression may characterize much of human communication. Aggression has long been recognized as a negative anti-social issue that prevails in most personal interactions. If it abounds in familial communications, it is more dangerous due to its harmful effects on individuals, and consequently on societies. Aggression refers to all the instances in which we try to get our way without any consideration for others. Moriarty’s novel (2014), Big Little Lies, is argued to represent the patterns of aggressive communications. This study aims to find out the motivations behind aggressive language in familial communication in this
... Show MoreCatalytic wet air oxidation of aqueous phenol solution was studied in a pilot plant trickle bed reactor using copperoxide catalyst supported on alumina and silica. Catalysts were prepared by impregnating method. Effect of feed solutionpH (5.9, 7.3, and 9.2), gas flow rate (20%, 50%, 80%, and 100%), WHSV (1, 2, and 3 h-1), temperature (120°C, 140°C,and 160°C), oxygen partial pressure (6, 9, 12 bar), and initial phenol concentration (1, 2, and 4 g/l).Generally, theperformance of the catalysts was better when the pH of feed solution was increased. The catalysts deactivation is relatedto the dissolution of the metal oxides from the catalyst surface due to the acidic conditions. Phenol oxidation reactionwas strongly affected by WHSV,
... Show More