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.
Background: Orthodontic tooth movement is characterized by tissue reactions, which consist of an inflammatory response in periodontal ligament and followed by bone remodeling in the periodontium depending on the forces applied. These processes trigger the secretion of various proteins and enzymes into the saliva.The purpose of this study was to evaluate the activity of alkaline phosphatase (ALP) in saliva during orthodontic tooth movement using different magnitude of continuous orthodontic forces. Materials and Methods: Thirty orthodontic patients (12 males and 18 females) aged 17-23 years with class II division I malocclusion all requiring bilateral maxillary first premolar extractions were randomly divided into three groups according to t
... Show MoreAsthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. The treatment guidelines recommend theuse of a second controller drug in addition to medium doses of inhaled corticosteroids (ICSs) rather than the use of high doses ICS alone in the treatment of moderate-severe persistent asthma. This study was conducted to compare the clinical efficacy and safety of three treatment regimens in Iraqi patients with moderate-severe persistent asthma.The study included three groups; each group included 15 patients. Patients were administered beclomethasone inhaler alone 1500-2000 μg/day, beclomethasone inhaler 750-1000 μg/day plus oral controlled release aminophylline tablets 450 mg/day or
... 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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The phenomenon of financial failure is one of the phenomena that requires special attention and in-depth study due to its significant impact on various parties, whether they are internal or external and those who benefit from financial performance reports. With the increase in cases of bankruptcy and default facing companies and banks, interest has increased in understanding the reasons that led to this financial failure. This growing interest should be a reason to develop models and analytical methods that help in the early detection of this increasing phenomenon in recent year . The research examines the use of
... Show MoreThe present study is considered a pioneer investigation that deal with the terrestrial brown garden snail Cornu aspersum (Müller), in Iraq. Cornu aspersum however is considered an exotic species in many parts of the world ,The species is most probably infiltrates with plants transferred from one place to another. The species has gained importance in many ways. Nutritionally, the species is consumed as food item in many countries, but in other cases it is considered as pest for the damage it causes when feeding on valuable plant shoots. It also has medical importance for its role and ability in healing wounds, burns and remedy of other skin problems. This snail species however may act as a vector for some parasitic nematodes that
... Show MoreLaser skin wound soldering offers many distinct advantages over conventional closure and laser welding techniques. Objective : to compare the histological effects of human skin wound soldering using 50 % human albumin solder and compound charcoal photosensitiser with 980 nm diode laser acting in various modes of action and parameters. Study Design/Materials and Methods: In this in vitro experimental study , Multiple 3-4 cm long full thickness incisions in a specimen of human skin were soldered using a 4 mm spot diameter beam of 980 nm diode laser(at different laser parameters and modes of action) with 50 % human albumin solder mixed with the compound charcoal at 5 % W/V concentration .After obtaining a successful wound soldering , the wo
... Show MoreBackground: Spices and herbs have been used by many cultures to enhance the flavor and aroma of food and for their medicinal value. Black cardamom is one of these spices widely used in cooking because of its unique taste and powerful flavor. The aim of study was to test the effect of black cardamom on Mutans Streptococci in comparison to chlorhexidine gluconate (0.2%) and de-ionized water. Materials and methods: Dried fruits of black cardamom were extracted by using alcohol (70% ethanol). Saliva was collected from seven volunteers. Agar well technique with different concentrations of black cardamom extracts was used to test the sensitivities of Mutans Streptococci, as well black cardamom extracts effect on viable counts of Mutans Streptococ
... Show MoreABSTRACT Background: One of the challenges to use chlorhexidine is its effect on the amount of microleakage after restoration; however, use of the materials with antibacterial properties after tooth preparation and before restoration has been widespread. The objective of this, in-vitro, study was to evaluate the influence of consepsis (chlorhexidine gloconate disinfectant) application on microleakage in class II cavities restored with light cured composite using universal adhesive system; etch and rinse technique –self etch technique. Materials and Methods: Forty class II cavities were prepared on mesial and distal surfaces of 20 non-carious mandibular third molars. The cavities were divided into four groups; (n =10 for each group).
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