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 shortage in surface water quantities led to a shift in dependence on the groundwater as an alternative water source in southern parts of Iraq. The groundwater is decreasing in quantity and water quality is degrading due to different factors. Therefore, it is important to assess the groundwater quality of the Missan Governorate of the country by analyzing the physicochemical parameters and distinguishing the probable sources of contaminants in the area. The present study used water quality diagrams and statistical methods such as factor analysis and agglomerative cluster analysis to determine the sources of chemical ions in the forty-four groundwater samples collected from wells in the study area. In addition, the Water Quality Index (WQ
... Show MoreThe present study aimed to asspssment the nutrition a program to sample of student from internal departments of Baghdad University (AL-Jadiriya Complex) and the University of AL-MustanSiriya four grades and aged (19-24) year study included 150 male and female students by (75) male and (75) of female register height, weight nd body mass index were study habits and food pattern of the same sample (150) and by aspecial form and take the personal information interviews and record information on food intake during 24 hour .noted adifference practie in the weights and longths of male and female (sample).
BMI rates were within the normal weight as the value of BMI for males aged (19- 21)and (22-24) and (22.21) and (23,37),respectively and th
The e-commerce is one of the best achievements of the twentieth century, since the conduct commercial transactions via the Internet may be the consumer easy selection process and purchase convenient manner different from traditional methods, and with the beginnings of the new millennium impose the emergence of e-commerce term significant challenges to the insurance industry as an important economic sectors Generally, and insurance companies in particular as a result of scientific development, which has led to a reduction in costs and innovation in the production, which led to intense competition on both levels local or global. The insurance industry is a vital part of the economy and it has a varied impact to the community and individual
... Show MoreThe current study aims to investigate the effect of strategic knowledge management practices on an excellent performance at the Institution of Industrial Development and Research- the Ministry of Iraqi Industry (IDRMII). The present research is designed according to the descriptive method. To achieve the mentioned research objective, the researchers used the questionnaire as the main data collection tool. The research sample was 150 managers who are working at the top and middle management levels. To analyses the data gathered and reaching the results, several statistical techniques were used within AMOS.V25, SPSS.V21Software, This study reached a set of results, the most important of which is the existence of a positive correlat
... Show MoreThe study is concern on determine the type of Candida spp.in leukemia patients that were infected with oral candidiasis as a result to their immune suppression (weekend immune system) due to their submission to radiation and chemotherapy treatment. The result showed that the most common isolates were C. guillermondii 19 which represent 31.66% of cases, then followed by C. itermedia 11 which represent 18.3%, while the less common isolates were for C. zeylamodes 3 which represent 5%.
Background Direct-acting antivirals (DAAs) combination therapies from various mechanisms of action and families have been revolutionized the management landscape of chronic hepatitis C virus (HCV). Ombitasvir, paritaprevir with ritonavir (OBV/PTV/r) ± ribavirin (RBV) is approved to treat HCV genotype 4 (GT4) infection. Here, our objective was to delineate the efficacy and safety of OBV/PTV/r plus RBV in treating of Egyptian naïve patients infected with HCV GT4.
Methods a cohort of 100 Egyptian patients infected with HCV GT4 was allocated and administered orally OBV/PTV/r with RBV. The primary endpoint of our study was a sustained virological response (HCV RNA < 12 IU/mL) 12 weeks after the c
... Show MoreIdentify the effect of an educational design according to the repulsive (allosteric) learning model on the achievement of chemistry and lateral thinking. The sample consisted of (59) students from third-grade intermediate students. They were randomly distributed into two groups (experimental and control), and the equivalence was done in (chronological age, previous achievement in chemistry, intelligence, lateral thinking). The (30) students from experimental group were taught according to the instructional design, other 29 students from the (control) group were taught according to the usual method. Two tests done, one of them is an achievement test consisted of (30) items of the type of multiple choice, the other was a lateral think
... Show MoreThe - mixing ratios of -transitions from levels in populated in the reactions are calculated in present work using - ratio, constant statisticalTensor and least squares fitting methods The results obtained are in general, in good agreement or consistent, within the associated uncertainties, with these reported in Ref.[9],the discrepancies that occurs are due to inaccuracy existing in the experimental data The results obtained in the present work confirm the –method for mixed transitions better than that for pure transition because this method depends only on the experimental data where the second method depends on the pure or those considered to be pure -transitions, the same results occur in – method