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.
Abstract
The changes that happened in the environment of business have great effects upon organizations with different activities specially the banks which requires the existence of an able opinion resources can adapt with the changes . Accordingly importance put upon intellectual capital which become one of the basic resources for organizations and one of success and growth elements with the availability of expertise , skills and capability of making essential changes in different process due to the presentation of innovations and creations of the to support banks activities .Therefore the intellectual capital represents the more r
... Show MoreThe aim of this study is to evaluate oxidative stress in diabetes mellitus (DM) Type1 by the measurement of Glucose-6-phosphate Dehydrogenase (G-6-PD), an enzyme expressed in human RBCs, is important in the generation of reduced glutathione which is the key product in oxidative stress controls. The Study was carried on 80 samples of blood and serum of National Diabetes Center (NDC). The study groups under fasting conditions and they divided as:20 samples of diabetes mellitus patients without complications and 20 samples of diabetes mellitus with cardiovascular (CV) complications and 20 samples of diabetes mellitus with Nephropathy (Neph) complications compared with 20 control group with average age (13-67) years.. The results sh
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The purpose of this research is to develop a proposed framework for achieving the Integration of the Target Cost and Resource Consumption Accounting Techniques and to show the role they play in reducing products costs and supporting the competitive advantage to cope with contemporary changes. To achieve this goal, the researchers followed the analytical method using the statistical questionnaire as a means of collecting data from the research sample include accounting, administrative, technical, engineering staffs and others. The research sample consists of (56) individuals and for the purpose of conducting statistical analysis of the data and testing hypotheses, the statistical program (SPSS) wa
... Show MoreItem Difficulty and Item Discrimination Coefficient for School and College Ability Tests (SCAT) Advanced Form in Classical Test Theory (CTT) and Item Response Theory (IRT) and the Correlation among Them Mohammad moqasqas Haifa T. Albokai Assistant Professor of Measurement and Evaluation Associate Professor of Measurement and Evaluation College of Education, Taibah University The aim of this study was to study the item difficulty and item discrimination of the SCAT (advance form) with CTT, and IRT, and to study the correlation among them. To do this, the researchers used the data of their previous study, which conducted in (2011). It consisted of (3943) subject. Then, they used two-statistical programs (TAP, Bilog-MG-3) to obtain the item
... Show MoreThe research aimed to prepare a measure of the importance of enlightenment, academic education, and applied skills for third-stage female students, including teaching methods from their point of view/College of Education and Sports Sciences/University of Baghdad/Al-Jadriyah. The researchers used descriptive description in the comprehensive research procedures, an appropriate methodology in achieving the research objectives, sufficient for interpretations, how important is the academic teacher’s knowledge of teaching methods for student learning, what are the roles that the learners have acquired from the academic teacher. The scale of importance and horror consists of 15 items. The research population includes female students of t
... Show Morebstract This study was performed to isolate and identify the Burkholderia cepacia from rhizosphers of different plants and study their ability to produce Siderophore, the study was also aimed to assess the antifungal activity of the bacterial filtrate and extracts of the isolates against some pathogenic fungi. The isolate which showed higher inhibitory effects was selected for extraction of some active metabolites produced by it, and evaluate the activity in vitro, via inhibition of the growth of the fungi using different concentrations of extract (50, 100, 200 )µL/ml , The results showed that out of (250) samples of soil , (8) isolates (3.2%) gave positive
... Show MoreThe research aims to examine the evaluation of educational quality management and the ways to improve it in the College of Education for Women at the University of Baghdad from the point of view of the academic staff. The research community consisted of (288) participants comprising all members of the academic staff in the College of Education for Women at the University of Baghdad for the academic year (2019-2020). As for the questionnaire, it was distributed to the academic staff of the scientific departments according to their affiliation for the purpose of identifying the availability of the requirements of the quality of the teaching service provided to them by the educational institution. The researcher adopted a questionnaire deve
... Show MoreThis piece of research work aims to study one of the most difficult reaction and determination due to continuous and rapid variation of reaction products and the reactants. As molybdenum (VI) aid in the decomposition of hydrogen peroxide in alkaline medium of ammomia, thus means a continuous liberation of oxygen which cuases and in a continuous manner a distraction in the measurement process. On this basis pyrogallol was used to absorbe all liberated oxygen and the result is an a clean undisturbed signals. Molybdenum (VI) was determined in the range of 4-100 ?g.ml-1 with percentage linearity of 99.8% or (4-300 ?g.ml-1 with 94.4%) while L.O.D. was 3.5 ?g.ml-1. Interferring ions (cations and anions) were studied and their main effect was red
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