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.
Many letters and theses written on the subject of consensus, as well as in measurement,
But we tried to address a topic of consensus
Building a blind measuring guide.
We have tried to explain the meaning of convening, then the statement of consensus in language and terminology and then the statement of measurement
Also, we have shown the types of consensus mentioned by the jurists, and this is how much was in the first topic, either
The second section included the statement of the doctrines of the blind in the matter, and then the evidence of each doctrine and discussed.
We followed it with the most correct opinion statement and concluded the research with some of the conclusions we reached through
search.
The aims of the lecture should be clearly defmed. These will help to define the teaching methods and the structure. If, for example, the purpose of the lecture is to introduce new knowledge and concepts, then a classic lecture structure might be most appropriate. On the other hand, if the purpose is to make the students aware of different approaches to a particular clinical problem, a problem oriented design in which alternative approaches are presented and discussed might be a more appropriate fonnat.
Lectures are still a common teaching methOd in both undergraduate and postgraduak medical education. Properly done, the lectwe is a creative and personal work by the teachll:l modeled upon his intellectual scaffolding. Few other fonns o
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In this study we try to make a first step for making a new list for fauna and flora of Kurdistan in particular and Iraq in general. This is very important study of biodiversity of Iraq. We recognize 52 migratory and resident birds including Alectoris chukar asoica which is recently described. Also, 20 amphibians and reptiles including two snakes recently recorded Zamenis hohenackeri and Platyceps ladacesis, a new form of Asaccus sp. and sub- species of Varanuns griseus caspeius for the first time in Iraq, with many rare specimens. Thirteen different species of mammals were recognized, with comme
... Show MoreThe research aims to investigate the possibility of joint auditing in improving the market value of Iraqi companies listed on the Iraq Stock Exchange. The sample was represented by 10 Iraqi companies listed in the Iraq market for the period from 2014-2017 (2 years before implementation and 2 years after implementation) and the research was based on the idea that joint auditing enhances investor confidence and raises their level of security as a result of providing quality and reliable reports, and thus This indicates good news in the market that reflects on the performance of stocks and the market value of companies that adopt joint auditing. The results of the analysis indicate an improvement in the market value, but this improv
... Show MoreThis study appears GIS techniqueand remote sensing data are matching with the field observation to identify the structural features such as fault segments in the urban area such as the Merawa and Shaqlawa Cities. The use of different types of data such as fault systems, drainage patterns (previously mapped), lineament, and lithological contacts with spatial resolution of 30m was combined through a process of integration and index overlay modeling technique for producing the susceptibility map of fault segments in the study area. GIS spatial overlay technique was used to determine the spatial relationships of all the criteria (factors) and subcriteria (classes) within layers (maps) to classify and map the potential ar
... Show MoreThe survey was carried out From January to April of 2018 on macrofungi samples collected from different places in Halabja province located in north eastern parts of Iraq-Kurdistan region. This region is rich in forest trees and pasture lands with diversity of shrubs and herbs and is expected to support the growth of several macro fungal species. However, this part of Kurdistan in Iraq is still unexplored from macrofungal point of view. In this paper three species from Pezizaceae and Pyronemataceae families that belonging to (Pezizales, Ascomycota), were reported from Iraqi Kurdistan. These macrofungal species are recorded for the first time from Iraq. Also the species were identified and showing their locations distributed on a map prepared
... Show MoreSeasonal variations of the species composition and abundance of Cladocera were studied in two stations at the end of the Tigris River and one station at the confluence of the Tigris with Euphrates area, at the beginning of the Shatt Al-Arab River in Al-Qurnah North of Basrah Province, from October 2015 to August 2016. Samples of zooplankton were collected by plankton net 100-µm. mesh size. The population density of Cladocera ranged between 1 Ind /m³ during summer and 211 Ind./m³ during winter at station 1 (Al-Jewaber Bridge). A total of 16 species of Cladocera belonging to 12 genera were recorded in the study. The average density of Cladocera ranged from 23.2 ind./m3 at Station 2 (Hamayon Bridge) to 53.7 Ind./m3
... Show MoreThe study aimed to show the concept and importance of accounting Conservatism, Persistence and volatility of earnings of companies listed in the Iraqi market for securities have been selected 35 companies for the period between 2013 to 2107 used the scale of book value to market value to measure the Conservatism while the current profit regression model was used to measure future profits Eviews 9 was used for the purpose of testing the two hypotheses. The results of the study found that there is a statistically significant relationship between accounting Conservatism and Persistence of earnings. The relationship is inverse with no statistically significant relationship between Conservatism and earnings volatility.
Interested in this research shed light on the reality of foreign trade to Iraq Who suffers from a marked deterioration due to poor economic diversification of the country And increase the degree of economic exposure , Which creates a state of extreme caution towards the question of accession to the (WTO) , As controls Iraq's foreign trade commodity , a president of one oil As well as the contribution of this item , and by a large formation in GDP , And that such a large and dangerous decline in the degree of economic diversification will create negative effects On overall economic activity components&
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