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.
This study examined the relationship between the reporting lag (the timeliness of corporate financial reporting) and several independent variables: (1) Audit reporting lag,(2)Company Size,(3) Profitability of the company,(4)Company Age,(5) Sector Type.(6)Audit’s Opinion,(7) Market Type,(8) Gearing,(9) Concentration of ownership,(10) Audit Firm Size(11)Profit or Loss Company(12) Companies Listed lag on the PEX. In order to achieve the objectives of the study and testing its hypotheses, the data Obtained through actual data of a financial reports, and based on me
... Show MoreValues and ideals are two basic pillars in human life, and high societies have been keen throughout their ages to adhere to and establish them so that man can distinguish good and evil, right and wrong, as they are a balance of actions that give man a higher value. Many of the followers of Abbasid literature, poetry and prose – it is noted that many imams and writers have been keen to highlight these values and make them material for their poetry and literature, courage, generosity, chastity and....All meanings of human values and there is no doubt that one of the texts abounding in this field is what was reported from the people of the house of infallibility pure (peace be upon them), including we touch it in the visit of Imam Jaafar al-
... Show MoreThe current research is summarized by studying and understanding the imagination and what resulted from it in postmodern arts, specifically Pop Art. The research was focused spatially (America) between the year 1950-1975 AD and it defined the research problem by asking about what factors and variables that established the social imagination in culture Al-Gharbia, which in turn crystallized the Western cultural product to appear in its form, which is historically called "pop art". Two studies were adopted in the second chapter. The first one was the cultural structure of the social imagination. The second topic was concerned with the stylistic diversity of pop art, and the third chapter included research and accreditation procedures. Ther
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Natural convection in an annular space provided with metal foam fins attached to the inner cylinder is studied numerically. The metal foam fins made of copper were inserted in different axial sections with three fins in each section. The temperature of the inner cylinder is kept constant while the annular outer surface is adiabatic. The thickness effect of the inner pipe wall was considered. Naiver Stokes equation with Boussinesq approximation is used for the fluid regime while Brinkman-Forchheimer Darcy model is used for metal foam. In addition, the local thermal non-equilibrium condition in the energy equation of the porous media is presumed. The effect of Rayleigh numb |
Background: Successful root canal therapy depends on thorough chemo mechanical debridement of pulpal tissue, dentin debris and infective microorganisms. Objective: This study aimed to investigate the antibacterial effect of silver nanoparticles, sodium hypochlorite and chlorhexidine in reducing the bacterial infection of the root canals. Materials and Methods: The root canals of 55 single-rooted teeth were cleaned, shaped, and sterilized. All the teeth samples were inoculated with Enterococcus faecalis and incubated at 37°C for 2 weeks. Then, the teeth were divided into four groups. Group I (n=15): 100 ppm silver nanoparticles, Group II (n=15): 2.5 sodium hypochlorite, Group III (n=15): 2% chlorhexidine, IV (n=10): Normal saline as a contr
... Show MoreThis study aims to show, the strength of steel beam-concrete slab system without using shear connectors (known as a non-composite action), where the effect of the friction force between the concrete slab and the steel beam has been investigated, by using finite element simulation.
The proposed finite element model has been verified based on comparison with an experimental work. Then, the model was adopted to study the system strength with a different steel beam and concrete slab profile. ABAQUS has been adopted in the preparation of all numerical models for this study.
After validation of the numerical models, a parametric study was conducted, with linear and non-linear Regression analysis. An equation re
... Show MoreThe study highlighted the transformation of value systems and educational patterns between past and present, especially with the introduction of modern variables and means, such as mobile phones, the internet, social media, and others. These factors have contributed both positively and negatively to the study. The study highlights the integral role of the school in collaboration with the family in guiding and educating children. It also emphasizes the active role of the school in developing students' abilities and skills, either attracting them to school or vice versa. This includes an examination of the essential skills required in education and their role in achieving a state of psychological well-being and systematically developing child
... Show MoreCommercial banks represent the main pivot in financing national economic activity and its development. The capital represents safety margin to depositors and represents a defense line that protects bank work from dangers. Basel committee requirements represent protection and comprehensive supervision to bank activities for depositors, debtors and the bank. It provides trust in bank dealings and tackles activities of high dangers. The most prominent of these requirements are capital adequacy that concerns bank management and supervision and auditing bodies such as the central bank and protecting banks that suffer weakness in its vital important borrowing activity that reflects weakness in implementing borrowing policy .The purpose
... Show MoreBaghdad (the capital of the Abbasid Caliphate, and his legacy oldest civilizations in history, with glory ethyl). 1. benediction this city landmarks archaeological evidence of their own Kkabbab mosques and forms gates and (Aelchenachel) 2, which adorn the walls of buildings and Chaababeckha high and palm trees, all these vocabulary inspired artists embody Baghdad warmest dissolved in their artwork and all those who lived and grew up in Baghdad embodied in his memory for the nights Beauties and their lights and Hoa_khasha. Ceramic Arts art one who embodied the most important symbols that represent the beauty and credited with Baghdad. And many Iraqis potters inspired single Baghdadi in their work, notably ceramists late arrows Saudi which
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