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.
When we talk about the foresight in films, it is necessary to talk about dreams because foresight represents one of its distinct types. The Precognitive vision has become a possible material in dealing with as subjects in the film industry that adopt these ideas with their philosophical and scientific orientations, because they represent the imagination that predictors are specialized with. It can be invested through the introduction of a vision of another kind to achieve its goals and ambitions in the film industry and in particular the huge institutions of production as in Hollywood. The cinema works in the light of those concepts of production which found the prognostic dream (the foresight) as a distinctive genre in its films,
Th
Understanding energy metabolism and intracellular energy transmission requires knowledge of the function and structure of the mitochondria. Issues with mitochondrial morphology, structure, and function are the most prevalent symptoms. They can damage organs such as the heart, brain, and muscle due to a variety of factors, such as oxidative damage, incorrect metabolism of energy, or genetic conditions. The control of cell metabolism and physiology depends on functional connections between mitochondrial and biological surroundings. Therefore, it is essential to research mitochondria in situ or in vivo without isolating them from their surrounding biological environment. Finding and spotting abnormal alterations in mitochondria is the
... Show MoreSoil wetted pattern from a subsurface drip plays great importance in the design of subsurface drip irrigation (SDI) system for delivering the required water directly to the roots of the plant. An equation to estimate the dimensions of the wetted area in soil are taking into account water uptake by roots is simulated numerically using HYDRUS (2D/3D) software. In this paper, three soil textures namely loamy sand, sandy loam, and loam soil were used with three different types of crops tomato, pepper, and cucumber, respectively, and different values of drip discharge, drip depth, and initial soil moisture content were proposed. The soil wetting patterns were obtained at every thirty minutes for a total time of irrigation equ
... Show MoreThe concept of education is not actually restricted to children or school students, but rather every person should be educated and followed up if he is intended to grow and prove, with effort and time allocation as to fulfill that goal. Thus , the current paper aims to a thinking education and to educate that thinking in teacher and it is not new to deal with the personal characteristics of teacher in the different scientific , and educational researches . But ,these research did not address the necessity of acquiring the skill of thinking, especially as it affects teacher's presentation of the content of the curriculum or even content outside the curriculum, and therefore, there is n
... Show MoreIn this paper, we have examined the effectiveness exchange of optical vorticity via three-wave mixing (TWM) technique in a four-level quantum dot (QD) molecule by means of the electron tunneling effect. Our analytical analysis demonstrates that the TWM procedure can result in the production of a new weak signal beam that may be absorbed or amplified within the QD molecule. We have taken into account the electron tunneling as well as the relative phase of the applied lights to assess the absorption and dispersion characteristics of the newly generated light. We have discovered that the slow light propagation and signal amplification can be achieved. Our results show that the exchange o
The provided research paper offers a thorough analysis of the semiotic analysis present in tobacco-free initiative advertisements from the year 2021. The study delves into the intricate process of decoding the diverse signs, symbols, and visual components integrated into these anti-smoking campaigns. The core aim of this investigation is to comprehend and explore the semiotic tactics that underlie these advertisements, with a particular emphasis on visual communication as a pivotal tool in shaping the public's attitudes and behaviors towards tobacco usage. The research introduces a significant theoretical framework, the "Taxonomy of Image-Text Relations and Functions" theory, as proposed by Emily E. Marsh and Marilyn Dom
... Show MoreDBN Rashid, Talent Development & Excellence, 2020
The novel has recently received great attention from readers and before them writers, due to the role it is playing, and this indicates an important rule, which is whenever there is art or creativity, there must be a criticism of its own, and this criticism is certainly no less important than its owner, so we find There are critics who have their distinguished literary position in following up the narrative development, and trying to describe the transformation of its elements, including Professor Fadel Thamer, and whoever wants to approach an element of the novel as an explorer, he must stand on the visions of this critic about it, and this is what made us take the element (personality) Tracking the most important opinions of the critic
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Research summary
Backbiting pronouns have gained great importance in contemporary textual linguistic studies, as they play a coordinating function in the text and link its parts.
Interpreters did not overlook the role of backbiting pronouns in achieving the function of consistency and coherence in the Qur’anic text, as they referred to this, including Ibn Ashour, who had many analytical practices related to referral issues and their complexities. The Qur'anic reference to the pronouns of backbiting, so the researcher traced these phenomena and their evidence in the Holy Qur'an, aiming to clarify their role in enriching the significance and in the coherence and harmony
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