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.
The toxicological risks and lifetime cancer risks associated with exposure to disinfection by-products (DBPs) including Halloacetic acids (HAAs) and trihalomethanes (THMs) compounds by drinking water in several districts in Wassit Province were estimated. The seasonal variation of HAAs and THMs compounds in drinking water have indicated that the mean values for total HAAs (THAAs) and total THMs (TTHMs) ranged from 43.2 to 72.4 mg/l and from 40 to 115.5 mg/l, respectively. The World health organization index for additive toxicity approach was non-compliant with the WHO guideline value in summer and autumn seasons and this means that THMs concentration has adverse toxic health effects. The multi-pathway of lifetime hu
... Show MoreIn this research we been estimated the survival function for data suffer from the disturbances and confusion of Iraq Household Socio-Economic Survey: IHSES II 2012 , to data from a five-year age groups follow the distribution of the Generalized Gamma: GG. It had been used two methods for the purposes of estimating and fitting which is the way the Principle of Maximizing Entropy: POME, and method of booting to nonparametric smoothing function for Kernel, to overcome the mathematical problems plaguing integrals contained in this distribution in particular of the integration of the incomplete gamma function, along with the use of traditional way in which is the Maximum Likelihood: ML. Where the comparison on the basis of the method of the Cen
... Show MoreRegression Discontinuity (RD) means a study that exposes a definite group to the effect of a treatment. The uniqueness of this design lies in classifying the study population into two groups based on a specific threshold limit or regression point, and this point is determined in advance according to the terms of the study and its requirements. Thus , thinking was focused on finding a solution to the issue of workers retirement and trying to propose a scenario to attract the idea of granting an end-of-service reward to fill the gap ( discontinuity point) if it had not been granted. The regression discontinuity method has been used to study and to estimate the effect of the end -service reward on the cutoff of insured workers as well as t
... Show MoreThe stratigraphic sequence of Cenomanian-Early Turonian is composed of Ahmadi, Rumaila, and Mishrif formations in the Rifai, Noor and Halfaya Oil Fields within the Mesopotamian Zone of Iraq, which is bounded at top and bottom by unconformity surfaces. The microfacies analysis of the study wells assisted the recognition of five main environments (open marine, basinal, shallow open marine, Rudist biostrome, and lagoon); these microfacies were indicative of a normal lateral change facies from shallow water facies to deeper water and open marine sediments.
Ahmadi Formation (Early Cenomanian) is characterized by open marine sediments during the transgressive conditions, and would be
... Show MoreVerbal Antonyms: A research in the relationship in meaning Between the words in Arabic language
The aim of this research is to identify the level of health services provided in the health centers operating in the family medicine system in Baghdad, and to determine the extent to which these health centers are applied to the internationally recognized standards , "Defining the quality of service gap between health care centers operating in the family medicine system and the standards adopted by the corresponding international centers (Al-Shabab Model Family Medicine Center, Al-Jahad Family Health Center, Al-Adhamiya Family Health Center, Al-Zawiya Family Health Center), and in view of what our health institutions are facing. The family of primary health care centers has difficulties, obstacles and challenges such as the diffi
... Show MoreThe present study included the physico-chemical parameters of Lesser-Zab river and its effects on Tigris river. Monthly water samples were taken from the two rivers during January to October 1999.There were no signifcant difference in water temperatures. Both rivers were fresh to oligohalin, alkaline and very hard. Close values were determined in total suspended solids in both rivers with little increasing during rainfall period and high discharge. Water was well areated and over saturation was recorded in several occasions. Dissolved oxygen values of Tigris river were influenced by Lesser-Zab. Cations were more dominant than anions in both rivers. In Lesser-Zab, the anions were increased during spring season and declined in summer which t
... Show MoreObjective of the study was to rate and analyze the physical fitness of female students from Iraq and Russia to find similarities, differences and regularities. Sampled for the study were 44 female non-sporting students: 20 students from Pedagogical University in Bagdad; and 24 students from Russian State University of Physical Education, Sport, Youth and Tourism in Moscow. The study was designed to obtain the joints flexibility, coordination, speed-strength and static endurance rates. The Iraqi students were tested with higher coordination abilities than their Russian peers, whilst the latter were ranked higher in the speed-strength, shoulder joints and spine flexibility tests, albeit lower than their Iraqi peers in the hip flexibility test
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