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 present work was aimed to form the baseline data of normal morphological and histological structure features of liver in migratory starling (Sturnus vulgaris). Anatomically, the starling liver bird was dark red -brown in colour and located in the cranial third of the abdominal cavity and consisted of undivided lobes (left and right). The liver right lobe was larger than the left. Histological examination revealed that the liver parenchyma was covered by a connective tissue capsule which appears to be thicker in the rim of liver lobes than other area in the liver lobe. Liver parenchyma was arranged in an unlimited hepatic lobules, which composed of polygonal hepatocytes organized as irregular, radial interconnecting cords or laminae of o
... Show MoreVisceral leishmaniosis is one of the most fatal old-world neglected disease with estimated 90 thousand worldwide cases emerge each year. In Iraq, the cutaneous and visceral form are endemic but available chemotherapies are either toxic with diverse side effects, expensive available drugs or parasite …
Computer modeling has been used to investing the Coulomb coupling parameter ?. The effects of the structure parameter K, grain charge Z, plasma density N, temperature dust grain Td, on the Coulomb coupling parameter had been studied. It was seen that the ? was increasing with increasing Z and N, and decrease with increasing K and T. Also the critical value of ? that the phase transfer of the plasma state from liquid to solid was studied.
Drilling with casing (DWC) can be considered as a modern drilling technique in which both of drilling and casing operations done in the same time by using the casing to transfer the hydraulic and mechanical power to the bit instead of traditional drilling string. To overcome oil well control, minimizing the total cost through enhancing drilling efficiency, drilling with casing was proposed as an enabling technology.
Two surface sections (17 1/2 - and 12 1/4- inch) were drilled successfully in Rumaila oil field with casing strings which reached 655m and 1524m measured depths respectively.
By using DWC technique, the total drill/case phase time was reduced up to 20% comparing to conventional
... Show MorePregnancy- including hypertension(PIH), also known as preeclampsia, is one of the major causes of maternal and fetal death. This study was carried out on 30 pregnant women with preeclampsia and 30 healthy pregnant women as control ranging in age mean ±SD (28.84±3.55) years , BMI (76.80±9.78) Kg/m2 and gestation age(30.82±0.75)week. The aim of this research was studied the plasma Metanephrine level and other biochemical parameters such as Hemoglobin(Hb), serum Protein, S. Albumin, Globulin, Albumin/Globulin ratio (Alb/Glu. ratio), S.Glutamate Pyruvate aminotransferase (GPT), S.Glutamate Oxaloacetate aminotransferase(GOT). The obtained results have been compared with 30 healthy pregnant women as control group. The result showed that ther
... Show MoreBackground: With the increasing demand on esthetic orthodontic appliances, discoloration of clear elastomeric chains and modules remains an issue which concerns both orthodontics and patients. This in vitro study was conducted to evaluate the effect of exposing stretched clear elastomeric chains from six different companies (Ortho Technology, Ormco, Ortho Organizer, American Orthodontics, Opal and G&H companies) to three types of dietary media (tea, coffee and turmeric). Materials and methods: A total of 960 lengths of six modules were cut from short type elastomeric chain; 160 pieces from each brand. The specimens were stretched 50%, placed on plastic boards, and incubated in water at 37°C for 1 day, 7 days, 14 days and 28 days. Once a
... Show MoreThe results of the current study showed that the thyroid gland in an adult domestic cat (Felis catus) is located in the neck area on both sides of the trachea at rings 1–5. The gland consists of two lobes (right and left), and it is surrounded by a capsule of connective tissue consisting of two outer and inner layers, and a layer of fatty tissue overlaps with the outer layer of the capsule. In addition, the results of this study found that the histological structure of the thyroid gland is composed of several follicles that appear in different sizes and shapes. The follicles are lined with simple cuboidal epithelial tissue and sometimes appear lined with high and low simple cuboidal epithelial tissue. The gland is histologically c
... Show MoreThe research dealt with the case stock repurchase policy of Emaar Real Estate Company one of listed companies in Dubai Stock exchange. The research has launched from the cognitive dimensions of repurchasing policy which took great concern in the literatures of financial management, and also this policy became as substitute for distributing the monitory profit in the last three decades in the international financial markets, but it did not get any importance in the Arab Markets such as that of the Arab Gulf in addition to the Iraqi Stock Exchange.
The research summarized a set of conclusions, the most important one was the consistence of analysis result with the test of the major two hypotheses (The first
... Show More1-Alglul is the introduction of after prize or (Booty) secretly before it is divided, and the general sense is an absolute betrayal, and God has forbidden and the Prophet (Peace be upon him) by Muslims; such as bribery and gift-giving and other function by the terminology.
2-The signals and texts Alglul in the Covenant Rashidi and the Umayyad and Abbasid very few, compared to the Covenant of the Prophet, and so by the Quranic verses that were deprived Alglul and other Transmitting booty for the Muslims, and the hadith which magnified Alglul and showed its consequences in this life and the afterlife, and the tutelage of the Prophet (Peace be upon him) its active role in reducing Alglul, it was the great commandments included notificati