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.
Is a high degree of economic freedom an important part in the development of the economies of developing countries in the last decade of the twentieth century and the beginning of the twentieth century and the atheist. This is because a test subject (deltoid analysis of the relationship between the degree of economic freedom and foreign trade of selected developing countries for the period
( 1990 -2005) to determine the degree of economic freedom in foreign trade promotion in Singapore and Turkey. The research recommends a number of recommendations, the most important is the responsibility of the Ministry of Planning in Iraq that is providing the necessary data for the Fraser Institute, the aim of increasing cooperation
Mixture experiments are response variables based on the proportions of component for this mixture. In our research we will compare the scheffʼe model with the kronecker model for the mixture experiments, especially when the experimental area is restricted.
Because of the experience of the mixture of high correlation problem and the problem of multicollinearity between the explanatory variables, which has an effect on the calculation of the Fisher information matrix of the regression model.
to estimate the parameters of the mixture model, we used the (generalized inverse ) And the Stepwise Regression procedure
... Show MoreThe simulation have been made for 3D flow structure and heat transfer with and without
longitudinal riblet upstream of leading edge vane endwall junction of first stage nozzle guide vane .The research explores concept of weakening the secondary flows and reducing their harmful effects.Numerical investigation involved examination of the secondary flows ,velocity and heat transfer rates by solving the governing equations (continuity, Navier -stokes and energy equations ) using the known package FLUENT version (12.1).The governing equations were solved for three dimentional, turbulent flowe, incompressible with an appropriate turbulent model (k-ω,SST) .The numerical solution was carried out for 25 mode
... Show MoreThe banking sector is currently facing great challenges resulting from intense competition in the financial environment, and this is what makes the supreme audit bodies and the Central Bank audit as the highest supervisory authority on banks in order to achieve profit and not be exposed to loss, and this requires identifying the banking strengths and risks that constitute points Weakness that affects the future performance and the life of the bank, which requires special supervisory care, and from this point of view, the research aims to use the CAMELS model as a control tool in banks, through the use of its six indicators: capital adequacy, asset quality, management quality, profits, liquidity And sensitivity to market risks, th
... Show MoreThis study deals with the Spatial and Periodical Variation of the Economical Activities for the
Population of Al – Anbar Province on the level of districts , according to the Population
Computation for the period 1987 and 1997 and the results of determinations and numberings
for the year of 2011 .
This study depends on the Details Classifications of the 17th Activities for 1997 and 2011
beside the Triple Classification of the Economical Activities for the three study years .
The study proves that there is a spatial and periodical variation on the level of study area , and
that’s because of many factors , one of the most important of them was the distribution of
economical siege, as well as the weakness of the
Design of experiments (DOE) was made by Minitab software for the study of three factors used in the precipitation process of the Sodium Aluminate solution prepared from digestion of α-Al2O3 to determine the optimum conditions to a produce Boehmite which is used in production of ɤ-Al2O3 during drying and calcination processes, the factors are; the temperature of the sodium aluminate solution, concentration of HCl acid added for the precipitation and the pH of the solution at which the precipitation was ended. The design of the experiments leads to 18 experiments.
The results show that the optimum conditions for the precipitation of the sodium aluminate solution which
... Show MoreIn this study Microwave and conventional methods have been used to extract and estimate pectin and its degree of esterification from dried grapefruit and orange peels. Acidified solution water with nitric acid in pH (1.5) was used. In conventional method, different temperature degrees for extraction pectin from grape fruit and orange(85 ,90 , 95 and 100?C) for 1 h were used The results showed grapefruit peels contained 12.82, 17.05, 18.47, 15.89% respectively, while the corresponding values were 5.96, 6.74, 7.41 and 8.00 %, respectively in orange peels. In microwave method, times were 90, 100, 110 and 120 seconds. Grapefruit peels contain 13.86, 16.57, 18.69, and 17.87%, respectively, while the corresponding values were of 6.53, 6.68, 7.2
... Show MoreThe importance of websites appears as a modern tool that helps people connect with each other and exchange information rapidly. An increase number of new websites have been created in public or private spheres, which benefit individuals and society as a whole. This research aims to design a website specialized in marketing sustainable fashion that meets the needs of the Saudi market. It followed a descriptive and analytical approach. A survey has been conducted on a random sample of e-marketing users. The sample number is 101 users. The study resulted in: Determining the effectiveness of e-marketing, studying consumer purchasing tendencies, and designing a website for sustainable fashion based on the survey’s results. The study recomme
... Show MoreThe differential cross section for the Rhodium and Tantalum has been calculated by using the Cross Section Calculations (CSC) in range of energy(1keV-1MeV) . This calculations based on the programming of the Klein-Nashina and Rayleigh Equations. Atomic form factors as well as the coherent functions in Fortran90 language Machine proved very fast an accurate results and the possibility of application of such model to obtain the total coefficient for any elements or compounds.