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.
Human cerebral cortex is the outer folded neuronal layer and represents major part of the cerebrum with enormous functions. It is a laminar structure, easily visualized grossly. Previous studies showed that the Superior Temporal gyrus is one of the thickest cerebral cortex regions, reaching (about 4 mm). The Electron microscope study was made on 6 samples taken to measure the neuronal soma dimension of the large pyramidal cells present in the internal pyramidal cortical layer V in different age groups and gender. Aging process was obvious on the large pyramidal cells of the cerebral cortex, in which their neuronal soma dimensions showed shrinkage with age progression. But statistically there was no differences in the values between males an
... Show MoreThe research aims to identify the impact of using the electronic participatory learning strategy according to internet programs in learning some basic basketball skills for middle first graders according to the curricular course, and the sample of research was selected in the deliberate way of students The first stage of intermediate school.As for the problem of research, the researchers said that there is a weakness in the levels of school students in terms of teaching basketball skills, which prompted the researchers to create appropriate solutions by using a participatory learning strategy.The researchers imposed statistically significant differences between pre and post-test tests, in favor of the post tests individually and in favor of
... Show Moreيتعرض قانون الموازنة العامة الاتحادية للطعن بعدم الدستورية كغيره من القوانين، بل أن الطعن فيه يكاد يكون سنوياً حال نشره في الجريدة الرسمية ، وتوجه إليه المطاعن بعدم الدستورية إما عن إجراءات تشريعه أو لمضامينه المتعارضة مع الدستور نصاً أو روحاً ، ولكنّه إذا كانت مدة الطعن بعدم دستورية القوانين كافة متاحة دون قيد زمني محدد ولا تتطلب سوى إجراءات إقامة الدعوى العامة وأخصها قيام شرط المصلحة في حالة الدعوى ال
... Show MoreThe sports field is one of the fields that are concerned with the various methods and methods because of their positive impact on the development of actual training, the investment of the exerted effort in time, and through the follow-up of the researcher in the field and academic field, I noticed that there is a weakness in explosive ability, which affects performance and skill level during training and competition Therefore, the researcher decided to prepare maximum physical exertion exercises according to the anaerobic threshold as a principle of development in many physical and skill variables because good physical performance leads to reaching the best achievements and since the skill of shooting by jumping high - either constitutes a
... Show MoreThe purpose of this research is to demonstrate the impact of deposit insurance to reduce banking risks, as banks in various countries of the world face a variety of risks that led to banking and financial crises that led to the failure and bankruptcy of many of its bank, which led to the banks to find quick and appropriate solutions to get rid of these difficulties These solutions include the use of bank deposit protection system for the many risks and sequences of crises that accompanied the Iraqi banking work of thefts, forgery, embezzlement and changing and unstable circumstances. The importance of studying the subject of research through the theoretical framework of banking risks as well as the framework of consideration In order to
... Show MoreThe provided research paper offers a thorough analysis of the semiotic analysis present in tobacco-free initiative advertisements from the year 2021. The study delves into the intricate process of decoding the diverse signs, symbols, and visual components integrated into these anti-smoking campaigns. The core aim of this investigation is to comprehend and explore the semiotic tactics that underlie these advertisements, with a particular emphasis on visual communication as a pivotal tool in shaping the public's attitudes and behaviors towards tobacco usage. The research introduces a significant theoretical framework, the "Taxonomy of Image-Text Relations and Functions" theory, as proposed by Emily E. Marsh and Marilyn Dom
... Show MoreUnderstanding energy metabolism and intracellular energy transmission requires knowledge of the function and structure of the mitochondria. Issues with mitochondrial morphology, structure, and function are the most prevalent symptoms. They can damage organs such as the heart, brain, and muscle due to a variety of factors, such as oxidative damage, incorrect metabolism of energy, or genetic conditions. The control of cell metabolism and physiology depends on functional connections between mitochondrial and biological surroundings. Therefore, it is essential to research mitochondria in situ or in vivo without isolating them from their surrounding biological environment. Finding and spotting abnormal alterations in mitochondria is the
... Show MoreCharacterization is commonly known in stylistics to be the cognitive process in the readers' minds when comprehending a fictional character in a literary work .In one approach, it is assumed that characters are the outcome of the interaction between the words in the text on the one hand and the contents of our heads on the other. This paper is an attempt to understand how characterization is achieved by applying Culpeper’s (2001) model which seems to be to present a method of analysis that is more objective and more systematic in analyzing characters. Two characters are selected for discussion; Ralph and Jack from Golding’s (1954) Lord of the Flies. The novel talks about the corruption of human beings and the capacity of evil th
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