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 current research aims through its chapters to verify the relationship and impact of strategic leadership as an independent variable in the marketing performance as a respondent variable, in a leap cement plant, and try to come up with a set of recommendations that contribute to enhancing the practice and adoption of the two variables in the organization under discussion. And based on the importance of the research topic to the community, and to the researched organization and its members, the analytical and analytical approach was adopted in the completion of this research, and the research community included a leap cement plant in Anbar Governorate, while the research sample was represented by (department heads, and people o
... Show MoreIt sheds light on the cultural dimension in the decentralized administration experience in Iraq as evaluation tool by adding a new dimension in studying decentralization in addition to the administrative, political and legal dimensions .The proposal of study is that without the civil political culture ,the administrative decentralization in Iraq which remains weak and it may be imposed to a set of problems. - The study includes an introduction, conclusion and a set of political and cultural issues , its components and it may have the political analysis of this culture and its role in determining the movement of the administrative decentralized movement in Iraq post 2003.
The photoconductivity and its dependence on light intensity have been investigated in a-Ge20Se80 thin films as a function of temperature between (293–323)K. The result showed that the photoconductivity and photosensitivity increase with increase of annealing temperature. This behavior is interpreted in terms of the dispersive diffusion –controlled recombination of localized electrons and holes.
Fish are regarded as a crucial indicator of alterations in the aquatic environment due to their position at the apex of the food chain. Monitoring these alterations is crucial for identifying modifications in the aquatic ecosystem. The principal elements influencing fish health are temperature, pH, dissolved oxygen, salinity, pesticide contamination, microplastics, and algal presence. These elements substantially influence fish health regarding development, reproduction, respiration, oxygen stress, and the internal enzymes associated with digesting and other metabolic functions. Alterations in global environmental conditions and anthropogenic pollutants result in modifications to fish populations, their lives, and their behavior and
... Show MoreOne of the troublesome duties in chemical industrial units is determining the instantaneous drop size distribution, which is created between two immiscible liquids within such units. In this work a complete system for measuring instantaneous droplet size is constructed. It consists of laser detection system (1mW He-Ne laser), drop generation system (turbine mixer unit), and microphotography system. Two immiscible liquids, water and kerosene were mixed together with different low volume fractions (0.0025, 0.02) of kerosene (as a dispersed phase) in water (as a continuous phase). The experiments were carried out at different rotational speed (1180- 2090 r.p.m) of the turbine mixer. The Sauter mean diameter of the drops was determined by la
... Show MoreIn recent years, Wireless Sensor Networks (WSNs) are attracting more attention in many fields as they are extensively used in a wide range of applications, such as environment monitoring, the Internet of Things, industrial operation control, electric distribution, and the oil industry. One of the major concerns in these networks is the limited energy sources. Clustering and routing algorithms represent one of the critical issues that directly contribute to power consumption in WSNs. Therefore, optimization techniques and routing protocols for such networks have to be studied and developed. This paper focuses on the most recent studies and algorithms that handle energy-efficiency clustering and routing in WSNs. In addition, the prime
... Show MoreAddressed the problem of the research is marked (experimentation in caves fee) concept and its role in experimentation deviate Display Num formal charges caves. The search came in four sections: general framework for research and identified the research problem and the need for him. With an indication of the importance of his presence. Then specify the search for the goals of (revealed the nature and role of experimentation in determining the nature of Manifesting fee documented on the walls of caves), followed by the establishment of the three search limits (objectivity, the temporal and spatial) were then determine the terms related to the title. Then provide the theoretical framework and indicators that resulted from academic theorizi
... Show MoreObjectives: The demand for orthodontic treatment is nowadays increasing significantly for aesthetic improvement and to correct various kinds of malocclusion, yet the prolonged treatment time remains the main obstacle. This review aimed to demonstrate various orthodontic techniques and highlight the evidence-based successful approaches used for acceleration of orthodontic tooth movement. Materials and Methods: Data and sources of information pertaining to accelerated orthodontic tooth movement premised on English-written articles were searched using electronic databases including Google Scholar, Scopus, PubMed and MEDLINE. Results: This review demonstrated the availability of different surgical and non-surgical methods to enhance tooth movem
... Show MoreThe theory of Pilgrims in the Magra is based on Dekru's view that the mgha is considered a pilgrim, and that the pilgrims are pilgrims
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Or formulas that allow for the presentation of a pilgrimage to a writer in addition to the content of the news, and the guidance of the recipient
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