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 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
... Show MoreThe present theoretical study analyzes the legacy of the Chicago School of Urban Sociology and evaluates it in the light of the growth and development of Chicago City and the establishment of sociology in it. Sociology has become an academic discipline recognized in the United States of America in the late nineteenth century, particularly, after the establishment of the first department of sociology in the University of Chicago in 1892. That was during the period of the rapid industrialization and sustainable growth of the Chicago City. The Chicago School relied on Chicago City in particular, as one of the American cities that grew and expanded rapidly in the first two decades of the twentieth century. At the end of the nineteenth centur
... Show MoreThe research topic was chosen as a result of the importance of human resource in business organizations in general and the industrial process in particular. Without the human resource, business organizations cannot continue and achieve success and excellence, and the research problem has been diagnosed in the lack of sales of General Cement Company’s northern products, despite their distinctiveness, standing, and reputation in The market and its products with standard specifications, and through this problem, the following questions were raised: &nbs
... Show MoreThe present study aimed to investigate the effects of alcohol and hot aqueous extracts for leaves of Adhatoda vasica on, first larval instars Musca domestica. They were exposed to the suggested concentrations of alcoholic extract which were (500, 1000, 1500, 2000) PPM while the suggested concentrations of the hot aqueous extracts (500, 1000, 1500, 2000, 2500)PPM. The alcoholic (Methanol) extract of leaves was much effective on to killing the first larval instars of the M. domestica than hot aqueous extract.
A simulation study is used to examine the robustness of some estimators on a multiple linear regression model with problems of multicollinearity and non-normal errors, the Ordinary least Squares (LS) ,Ridge Regression, Ridge Least Absolute Value (RLAV), Weighted Ridge (WRID), MM and a robust ridge regression estimator MM estimator, which denoted as RMM this is the modification of the Ridge regression by incorporating robust MM estimator . finialy, we show that RMM is the best among the other estimators
The current research aims to identify the extent to which cognitive economics skills are included in the content of the chemistry textbook for the third intermediate grade, and the research sample was represented in the chemistry textbook for the third intermediate grade. A list of knowledge economy skills was prepared (6) main skills (basic skills, communication skills, thinking skills, work skills Group, information-gathering skill, behavioral skills (and (20) sub-skills) (reading, writing, operations, computer skills and employability, oral expression and written communication, dialogue, persuasion, influence and arousal, analysis, problem-solving, decision-making, suggestions and hypotheses and employing them. Controlling, directing
... Show MoreThe purpose of this paper is to preparing exercises for using the (Blazepod) device for advanced basketball players, and then identifying the effect of using the (Blazepod) device in developing some of the player's defensive movement for advanced basketball players. 12 players from the Adhamiya Sports Club, the category of applicants for the 2022/2023 sports year, where they were chosen in a deliberate manner from the community of origin represented by clubs, and the researchers used the defender player's movement test, and the results of the study showed that the special exercises prepared by the researcher using the (Blazepod) device affected the development Defensive skills (the movement of the defending player) greatly increased among a
... Show Moren this paper, we formulate three mathematical models using spline functions, such as linear, quadratic and cubic functions to approximate the mathematical model for incoming water to some dams. We will implement this model on dams of both rivers; dams on the Tigris are Mosul and Amara while dams on the Euphrates are Hadetha and Al-Hindya.