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 research aims to identify the impact of using the electronic participatory learning strategy according to internet programs in learning some basic basketball skills for middle first graders according to the curricular course, and the sample of research was selected in the deliberate way of students The first stage of intermediate school.As for the problem of research, the researchers said that there is a weakness in the levels of school students in terms of teaching basketball skills, which prompted the researchers to create appropriate solutions by using a participatory learning strategy.The researchers imposed statistically significant differences between pre and post-test tests, in favor of the post tests individually and in favor of
... Show Moreيتعرض قانون الموازنة العامة الاتحادية للطعن بعدم الدستورية كغيره من القوانين، بل أن الطعن فيه يكاد يكون سنوياً حال نشره في الجريدة الرسمية ، وتوجه إليه المطاعن بعدم الدستورية إما عن إجراءات تشريعه أو لمضامينه المتعارضة مع الدستور نصاً أو روحاً ، ولكنّه إذا كانت مدة الطعن بعدم دستورية القوانين كافة متاحة دون قيد زمني محدد ولا تتطلب سوى إجراءات إقامة الدعوى العامة وأخصها قيام شرط المصلحة في حالة الدعوى ال
... Show MoreThe sports field is one of the fields that are concerned with the various methods and methods because of their positive impact on the development of actual training, the investment of the exerted effort in time, and through the follow-up of the researcher in the field and academic field, I noticed that there is a weakness in explosive ability, which affects performance and skill level during training and competition Therefore, the researcher decided to prepare maximum physical exertion exercises according to the anaerobic threshold as a principle of development in many physical and skill variables because good physical performance leads to reaching the best achievements and since the skill of shooting by jumping high - either constitutes a
... Show MoreThe purpose of this research is to demonstrate the impact of deposit insurance to reduce banking risks, as banks in various countries of the world face a variety of risks that led to banking and financial crises that led to the failure and bankruptcy of many of its bank, which led to the banks to find quick and appropriate solutions to get rid of these difficulties These solutions include the use of bank deposit protection system for the many risks and sequences of crises that accompanied the Iraqi banking work of thefts, forgery, embezzlement and changing and unstable circumstances. The importance of studying the subject of research through the theoretical framework of banking risks as well as the framework of consideration In order to
... Show More<span lang="EN-US">In the last years, the self-balancing platform has become one of the most common candidates to use in many applications such as flight, biomedical fields, and industry. In this paper, the physical prototype of a proposed self-balancing platform that described the self-balancing attitude in the (X-axis, Y-axis, or biaxial) under the influence of road disturbance has been introduced. In the physical prototype, the inertial measurement unit (IMU) sensor will sense the disturbance in (X-axis, Y-axis, and biaxial). With the determined error, the corresponding electronic circuit, DC servo motors, and the Arduino software, the platform overcame the tilt angle(disturbance). Optimization of the proportional-integral-
... Show MoreWe consider the outflow of water from the peak of a triangular ridge into a channel of finite depth. Solutions are computed for different flow rates and bottom angles. A numerical method is used to compute the flow from the source for small values of flow rate and it is found that there is a maximum flow rate beyond which steady solutions do not seem to exist. Limiting flows are computed for each geometrical configuration. One application of this work is as a model of saline water being returned to the ocean after desalination. References Craya, A. ''Theoretical research on the flow of nonhomogeneous fluids''. La Houille Blanche, (1):22–55, 1949. doi:10.1051/lhb/1949017 Dun, C. R. and Hocking, G. C. ''Withdrawal of fluid through
... Show MoreIn context of this paper we prepare high purity powder ZnO nanostructures by chemical method at low temperature solution and study the effect off annealing at high temperature, ZnO nanoparticles have been successfully synthesized by chemical method at 0Cᵒ solution. In this method, suddenly reaction is occurred between zinc acetate solution and sodium hydroxide solution at 0Cᵒ, annealing temperature of powder product surfactant plays an important role in morphological changes. The nanostructures have been characterized by X-ray diffraction (XRD), Scanning Electron Microscope (SEM), differential scanning calorimetry(DSC) and UV-visible .analysis Effect of annealing temperatures on the morphology , structure and optical properties is di
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The objective of this research is to analyze the relationship between the strategic planning for human resources and career path, and I have tested Search the Ministry of Health and some health centers headquarters in the Karkh district, that is applied in sample Consist of (45) Deputy Director, Head of Depts, Departmental Manager, and health center Manager.
Find interested in studying the two subjects are important and vital, at the level of organizations at the present time, namely the strategic planning of human resources and career path. To achieve the objectives of the research was designed Qusestionnair (31) items to collect Primary data. and collected t
... Show MoreThe primary objective of the present research is to diagnose the most mportant imensions of quality of work life in a sample of individuals working in the Northern Gas Filling Company in Nynawa. The study sample consisted of 140 employees of the Northern Region Filling Company in even ,Through a questionnaire prepared for this purpose. The study concluded that there are five main factors that are considered to be measure of the quality of working life and are based on their importance: Empowerment, organizational health, internal work environment, motivation, development and training of workers. The study recommended that the organization should payattentio
... Show MoreThe ability of insurance companies to achieve goals depends on their ability to meet customers' requirements, and this requires them to identify target markets and respond to needs and wishes of the markets, the skill is to convince the company to operate what is in the interest of the customer if he is convinced the customer service provided to him, he would repeat to deal with, and where the cost of maintaining existing customers is less than the cost of attracting new customers, the insurance companies that is working hard to maintain their customers, the more customer satisfaction with the services provided has increased loyalty and weakened the ability of competitors lured.
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