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 almighty Al-Bari imposed on Muslims easy and accessible worshipers for every individual who is eligible to commission, so whoever performed it rightfully, God rewarded it with the best reward. From the Muslim, the Almighty made the Almighty to the types of acts of worship and acts of righteousness as a reason for the remission of sins that were advanced and late, so I chose a topic (from the hadiths of righteous deeds mentioned in the atonement of sins) as a research drawn from the master’s thesis called (the hadiths of the atoners of sins that were presented and delayed - An analytical study- ), And collect in this research kinds of acts of righteousness that bring the mercy of God Almighty to His servants and be a reason for the
... Show MorePraise be to God alone, and after:
This is a research entitled: “A fundamental study of judicial jurisprudence rules and their applications in the Hanbali school of thought,” in which the researcher studied eight legal jurisprudential rules considered by the Hanbalis and others.
At the conclusion of his research, the researcher reached a number of results, including: the importance of taking care of judicial rules, and the need for judges and their assistants to them, including: the need for students of science in Hanbali jurisprudence to study these rules according to the doctrine, and to highlight their applications to them, including: the importance of the rules under study, and their impact on rulings Jurisprudenc
... Show MoreBackground: Nanotechnology represents a new science that promises to provide a broad range of uses and improved technologies for biological and biomedical applications. One of the reasons behind the intense interest is that nanotechnology permits synthesis of materials that have structure is less than 100 nanometers. The present work revealed the effect of zinc oxide nanoparticles (ZnO NPs) on Streptococcus mutans of Human Saliva in comparison to de-ionized water. Materials and methods: Streptococcus mutans were isolated from saliva of forty eight volunteers of both sexes their age range between 18-22 years and then purified and diagnosed according to morphological characteristic and biochemical tests. Different concentrations of ZnO NPs w
... Show MoreSUMMARY. – Nanocrystalline thin fi lms of CdS are deposited on glass substrate by chemical bath deposited technique using polyvinyl alcohol (PVA) matrix solution. Crystallite size of the nanocrystalline films are determining from broading of X-ray diffraction lines and are found to vary from 0.33-0.52 nm, an increase of molarity the grain size decreases which turns increases the band gap. The band gap of nanocrystalline material is determined from the UV spectrograph. The absorption edge and absorption coefficient increases when the molarity increases and shifted towards the lower wavelength.
The theme of this Study presents analysis and discuss to the "Share the framework for assessing inflation," a practical study in a sample of joint stock companies listed on the Iraq Stock Exchange for the years (2009-2013). To determine the extent of the disparity between the nominal value of shares (Nominal Value) before deducting inflation and the real value (Real Value) per share, after deducting inflation in the case of zero growth. The study relied on annual reports of the companies of the research sample of the Iraq Stock Exchange, as well as the Iraqi Securities Commission. Besides the annual reports issued by the Ministry of Planning, as well as annual reports and statistical bulletin issued by the Central Bank of Iraq. It is fra
... Show MoreThe current research aims at finding out how to properly and correctly manage waste and solid waste and reduce the difficulties faced by all countries. However, it is becoming increasingly acute in developed cities because their economies are growing rapidly. It is necessary to identify the modern methods used in developed countries in managing wastes. The use of modern waste management techniques is a coordinated effort by international agencies within the borders responsible for them. The problem of the study can be identified in the lack of clarity of environmental management procedures in place. The importance of the research contributes to providing greater capacity to the administrative and technical leadership in the municipality
... Show MoreMost of us are tired of the circumstances that surround us because of their deficiency, deprivation, and sullenness, even though troubles and pains are the soil in which the seeds of strong personality sprout.
The content of the research is summed up in the fact that there is no need to frown, so let our face be free, and our word good and tolerant, so that we can be the most loving people of those who give them, and the Messenger of God (may God’s prayers and peace be upon him and his family) was known to be the heaviest concerns of people, but he was most smiling of people, by smiling, we buy lives, so we should get used to it, because that gives us hope and finds the world in our hands, an
... Show MoreObjective: This project aimed to study the morphological description and histological structure of ileum in Iraqi black partridge (
Abstract
The aim of the research is to demonstrate the role of uncertainty in adopting the general requirements for the strategic environmental assessment of service departments in Babil Governorate and the Environment Department. By focusing on a range of environmental problems, despite the efforts exerted to deal with the environme
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