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.
Objective: The current study aimed to prepare a measure for comprehensive knowledge marketing management. In the Iraqi sports institutions under study, identifying the extent of each dimension of comprehensive knowledge marketing management. Research methodology: This study relied on appropriate scientific methods, mainly represented by the descriptive method and the analytical method, and on the case study method because it suits the nature of the study. The study population was determined from the administrative cadres in the Iraqi Sports Federation, and the research sample numbered (86) and was represented as follows: The preparation sample numbered (50) and a percentage amounted to (58.13%), the sample of the exploratory experim
... Show MoreThe current research aims at finding out how to properly and correctly manage waste and solid waste and reduce the difficulties faced by all countries. However, it is becoming increasingly acute in developed cities because their economies are growing rapidly. It is necessary to identify the modern methods used in developed countries in managing wastes. The use of modern waste management techniques is a coordinated effort by international agencies within the borders responsible for them. The problem of the study can be identified in the lack of clarity of environmental management procedures in place. The importance of the research contributes to providing greater capacity to the administrative and technical leadership in the municipality
... Show Morehis study aimed to evaluate the effects of different doses of melatonin on liver function in adult rats. Eighteen Wistar adult albino rats (Rattus norvegicus), approximately 13–16 weeks old and weighing 230 ± 10 g, were randomly divided into three groups (n=6 per group) and treated orally for 30 days as follows: Group A1 received 10 mg/kg body weight (B.W) of melatonin; Group A2 received 20 mg/kg B.W of melatonin; and the control group (Group A) received distilled water. At the end of the treatment period, blood samples were collected via cardiac puncture, and serum was separated for biochemical analysis. Parameters assessed included oxidative stress markers (malondialdehyde (MDA), reduced glutathione (GSH)) and liver enzymes (aspa
... Show MoreThe Histo-mrphology were directed on the pneumonic alveoli of 6 male goats. The respiratory portion is composed of typical cuboidal epithelial cells with Clara cell, however, alveolar ducts are lined by simple squamous epithelium and alveoli were generally circular structures that opened into the alveolar conduits and alveolar sacs or respiratory bronchioles. Alveoli were made out of two kinds of cells for example Type-I pneumocytes and Type-II pneumocytes. Previous framed the mainlining epithelial cells of alveoli which were squamous in sort having noticeable perinuclear territory and central found the core, while the last were cuboidal fit as a fiddle with the midway found core and periodically found among the Sort I cells in the
... Show MoreJournalistic discourse is a fertile through which most of the segments of the society interact in all their platforms: intellectual, cultural, social, and various settings between the vital structures of the state; which makes it the link between the groups and segments of the society.
The role of discourse, moreover, engages in a vital way by establishing a culture of debate on controversial issues that provided a space in the different visions and differing perceptions on how to formulate the discourse and the magnitude of vocabulary for the diagnosis of these issues. Since there is no system of any community empty of the emergence of issues reflecting the public interest which is necessary is reflected in the context discourse
... Show MoreMost of us are tired of the circumstances that surround us because of their deficiency, deprivation, and sullenness, even though troubles and pains are the soil in which the seeds of strong personality sprout.
The content of the research is summed up in the fact that there is no need to frown, so let our face be free, and our word good and tolerant, so that we can be the most loving people of those who give them, and the Messenger of God (may God’s prayers and peace be upon him and his family) was known to be the heaviest concerns of people, but he was most smiling of people, by smiling, we buy lives, so we should get used to it, because that gives us hope and finds the world in our hands, an
... Show MoreThe current research aims to identify the level of strategic orientation and its dimensions (vision, mission, goals, and values) in the Iraqi National Security Service (INSS). The researchers followed the descriptive analytical approach as one of the forms of analysis and organized scientific interpretation to describe a specific phenomenon or problem, adopting the form questionnaire being the main source in collecting data and preparing for this. Based on the program of the Statistical Package of Social Sciences (SPSS 26) to analyze the data and come up with the final research results to identify the opinions of the intended sample on the subject of research, and the questionnaire of (20) paragraphs included the search variable, and was
... Show MoreRhythm is considered one of the creative concepts in the recent architectural thought; it has emerged clearly as a mean of creating the highest levels of creativity in architecture, especially in contemporary architectural movements. The importance of rhythm has emerged, especially, when the architecture , its beginnings concentrated on the principle of the links with poetic structures. Many architectural studies deal with concept of rhythm in architecture with different ways various according to the trend of each study, this show the importance of studying the concept of rhythm in the architectural field in general. This study try to focus on the utilization of rhythm as creative system in architecture of heritage and contemporary
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