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.
ABSTRACT— In primary teeth, root canal treatment is a time consuming and challenging procedure, particularly during the most important step in endodontic treatment which is the preparation of the canal. Pulpectomy is the treatment of choice in all the necrotic primary teeth. For better treatment protocol, advancing technology brought the rotary system to reduce the manual dexterity and improve the quality of treatment for pulpectomy. This study aimed to compare and assess the efficacy of cleaning and the time required for the instrumentation during the preparation of root canals of the primary molars using the rotary and the manual (conventional) systems. Thirty root canals of primary teeth were selected. These teeth submitted to a
... Show MoreThe present study took up the different ways to cultivate the species Epipremnum aureum by two habitat water and soil and comber the anatomical features of the root, stem, and leaf. The results showed amazing significant anatomical features to the ecosystem. The root and stem anatomy showing decrease in all characters that studied but the leaf anatomy showing increase of palisade, spongy tissue thickness, midrib thickness, number of vessels in the xylem also the long and width of stomata of the soilless plants than soil ones. The upper epidermis empty from the stomata for the two treatment and the stoma diffuse in the lower epidermis, the type of it paracytic type. Also the total of flavonoids in the plant that were growth in soil reached 1
... Show MoreIn this research study the effect of fish in alternating electrical properties at room temperature copper oxide membranes and fish prepared in a manner different thermal spraying chemical on a thin glass bases and heated
Background: The study aimed to investigate the effect of different techniques of en masse retraction on the vertical and sagittal position, axial inclination, rate of space closure, and type of movement of maxillary central incisor. Materials and methods: A typodont simulation system was used (CL II division 2 malocclusion). Three groups were used group 1(N=10, T-loop), group 2(N=10, Time-Saving loop), and group 3(N=10, Microimplant). Photographs were taken before and after retraction and measurements were made using Autodesk AutoCAD© software 2010. Kruskal-Wallis one-way analyses of variance and Mann-Whitney U test (p?0.05) were used. Results: The rate of space closure showed no significant difference among the three groups (p?0.05), whi
... Show MorePlacenta previa refers to placenta which is totally or partly implanted in lower segment of the uterus. Mortality and morbidity of mother increase with placenta previa due to the increase in the incidence of bleeding during pregnancy. This study aims to define placenta previa prevalence among pregnant women at AL-Fallujah teaching hospital and to determine the risk factors and their association with placenta previa incidence in al-Fallujah city population. This retrospective cohort study investigated medical registry of 6339 gravid women in al-Fallujah teaching Hospital in Iraq. We find 13 cases of placenta previa (0.21%) amongst the 6339 cases registered. The risk factors that strongly appeared to affect the complication of pregnancy with
... Show MoreThe Study was achieved adjectives physical and chemical water wells in the district of
Samarra , where a study has 42 sample groundwater in different regions of the judiciary
randomly distributed all over the judiciary and examined in vitro.
The study showed that the quality of groundwater in the general area of study
Kipritateh punctuated Klordih water quality and other quality Bicarboonatih.
Varied the key components of groundwater in the study area in concentrations
between periods of rain and drought, especially because of the cation ion exchange processes
as well as mitigation as a result of filtering rain water and dominated the calcium ion,
followed by sodium.
As for the negative ions has dominated ion s
The aim of this study to investigate the tongue morphology and histology in house gecko Hemidactylus flaviviridis using light and scanning electron –microscopy (SEM ) technique.The morphology result revealed the presence of three parts : apex , body and lingual root .The light microscopy result showed that the tongue is covered with mucous membrane composed of non keratinized stratified squamous epithelium based on lamina propria which contain bundles of striated muscles its fibers in different directions including connective tissue , blood vessels and nerves. The lingual mucosa of the dorsal surface is covered with different pattern of lingual papillae which are widely distributed all over the dorsal surface except the apex. Noticed on t
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