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.
A field experiment was conducted on the form of the Dept. of Field Crop Sci. / College of Agriculture / University of Baghdad in spring and fall seasons of 2009 and 2010 . Ten inbreds of maize were planted and crossed to each other to produce single crosses . In the second season, single crosses were planted along with thin parent to produce three – way and double crosses . In the third seasons panet and crosses were planted . Crosses were selfed to produce F2 seeds and increase seeds of inbreds . In the fourth season, all grin types were planted , and their agronomic traits were evaluated . Values of P of inbreds , F1 and F2 were calculated for agronomic traits . The new formula to predict inbreeding depression ( ID ) F2 plant without gr
... Show MoreAbstract The research investigates in detail the fascinating story of its title character, which may work as an allegory for Africa itself in its past. Ama Ata Aidoo is miscellaneous writers who wrote in different literary genre like drama , short stories novel and , poetry and criticism . She is also an active feminist. Aidoo is against the colonial practice and its influence on African minds. Aidoo's play Anowa confronts painful issues in Africa's past, mostly those of the slave trade. She goes further to tackle issues of patriarchal domination and African feminism, like the relationships between individuals and society, women and motherhood, men and women, husbands and wives, mothers and daughters, and above all the future invasion
... Show MoreThis paper aims to add to the growing body of cognitive translation studies that deal with the translation of emotions and the factors of evaluating the translation process-oriented. Cognitive appraisal is one of the tokens that includes three paradigms of assessing the performance of translation, it can be addressed from the perspective of emotions, intuitions, and individual styles of the SL and the method of transfer into TL. The study hypothesized that translators create a similar emotional charge due to their mental capability to build the same emotional effect in the TL audience. The study also proposed that the applicability of cognitive appraisal is a valuable method of evaluating the translation process, as pertinent to TPR. The
... Show MoreIn recent days, the escalating need to seamlessly transfer data traffic without discontinuities across the Internet network has exerted immense pressure on the capacity of these networks. Consequently, this surge in demand has resulted in the disruption of traffic flow continuity. Despite the emergence of intelligent networking technologies such as software-defined networking, network cloudification, and network function virtualization, they still need to improve their performance. Our proposal provides a novel solution to tackle traffic flow continuity by controlling the selected packet header bits (Differentiated Services Code Point (DSCP)) that govern the traffic flow priority. By setting the DSCP bits, we can determine the appropriate p
... 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 MoreHarold Pinter’s The Caretaker(1959) clearly portrays a lack of communication among the characters of the play which refers to the condition of modern man. This failure of communication led Harold Pinter to use a lot of pauses and silences in all the plays he wrote instead of words. Samuel Beckett preceded Pinter in doing so in his plays and one way to express the bewilderment of modern man during the 20th century is through the use of no language in the dramatic works. Language is no more important to modern man; instead, he uses silence to express his feelings. Silence is more powerful than the words themselves. That’s why long and short pauses can be seen throughout all Pinter’s plays.
In this play, th
... Show MoreThis paper signifies the contradictory point of view in John Clare’s poetry. Clare (1794-1864) is an English romantic poetry in the nineteenth century, who writes more than ten volumes about nature. So, this study highlights the concept of Psychoanalytic theory which is ‘ambivalence’ and how through this theory can interpret any literary text on the basis of utilizing psychoanalytic methods to literary texts in order to reveal the author's inner emotions such as motives, dreams, as well as wishes. Consequently, the concept of ‘ambivalence’ has a lot in common with the human psyche and its struggles. Sometimes the reader finds the author/poet talking about something real or a notion with pleasant sentiments
... Show MoreThe objective review is to inspect the involvement of Interleukin-6 (IL-6) in rheumatoid arthritis (RA) and to highlight the role of IL-6 and its variants in the pathogenesis of RA and response to anti-IL-6 agents. Several genetic and environmental risk factors and infectious agents contributed to the development of RA. Interleukin-6 is engaged in self-targeted immunity by modifying the equilibrium between T regulatory (T-reg) and T helper-17 (Th-17) cells. The evidences reported that IL-6 parti
