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.
Groundwater modelling is particularly challenging in arid regions where limited water recharge is available. A fault zone will add a significant challenge to the modelling process. The Western Desert in Iraq has been chosen to implement the modelling concept and calculate the model sensitivity to the changes in aquifer hydraulic properties and calibration by researching 102 observations and irrigation wells. MODFLOW-NWT, which is a Newtonian formulation for MODFLOW-2005 approaches, have been used in this study. Further, the simulation run has been implemented using the Upstream-Weighting package (UPW) to treat the dry cells. The results show sensitivity to the change of the Kx value for the major groundwater discharge flow. Only abo
... Show MoreThe objective review is to inspect the involvement of Interleukin-6 (IL-6) in rheumatoid arthritis (RA) and to highlight the role of IL-6 and its variants in the pathogenesis of RA and response to anti-IL-6 agents. Several genetic and environmental risk factors and infectious agents contributed to the development of RA. Interleukin-6 is engaged in self-targeted immunity by modifying the equilibrium between T regulatory (T-reg) and T helper-17 (Th-17) cells. The evidences reported that IL-6 parti
Collaborative learning is a way that prepares students practically for real-world applications. Working together as teamwork to execute various writing skills is essential in most professions since it increases the level of experience. Thus, the current study aims to identify the role collaborative writing in developing students' level of performance in writing. It is qualitative in nature since the researcher depended on the extant literature in achieving the objective of the study. The researcher touched upon related theories that addressed Collaborative learning, categories, and problems .It concluded that collaborative writing increases the students’ self-confidence, self-esteem, creativity, and motivation through the interact
... Show MorePsychosocial Alienation is a modern concept that arises from the capitalist and materialistic conceptions of individuals. The evergrowing competitive nature of domestic societies crystallised the concept in its modern form. The intensity of the rapid changes in the urbanised societies prevents the individuals from exploring their inner selves. Thus, a new generation is created with an alienation crisis which is reflected inward towards the self and outwards toward society. Alan Ayckbourn (1939), A British playwright, presents Alienated characters inspired by his life on and off stage. He explores their Alienation and their path toward recovery and self-realization. A Brief History of Women (2017) Ayckbourn explores the depth of the individu
... Show MoreA field experiment was conducted on the form of the Dept. of Field Crop Sci. / College of Agriculture / University of Baghdad in spring and fall seasons of 2009 and 2010 . Ten inbreds of maize were planted and crossed to each other to produce single crosses . In the second season, single crosses were planted along with thin parent to produce three – way and double crosses . In the third seasons panet and crosses were planted . Crosses were selfed to produce F2 seeds and increase seeds of inbreds . In the fourth season, all grin types were planted , and their agronomic traits were evaluated . Values of P of inbreds , F1 and F2 were calculated for agronomic traits . The new formula to predict inbreeding depression ( ID ) F2 plant without gr
... Show MoreHarold Pinter’s The Caretaker(1959) clearly portrays a lack of communication among the characters of the play which refers to the condition of modern man. This failure of communication led Harold Pinter to use a lot of pauses and silences in all the plays he wrote instead of words. Samuel Beckett preceded Pinter in doing so in his plays and one way to express the bewilderment of modern man during the 20th century is through the use of no language in the dramatic works. Language is no more important to modern man; instead, he uses silence to express his feelings. Silence is more powerful than the words themselves. That’s why long and short pauses can be seen throughout all Pinter’s plays.
In this play, th
... Show MoreDespite the principle of separation of powers brought by the French Revolution, which entrusted the task of drafting legislation and its amendment to the legislative authority and the task of settling disputes and settling them in the judiciary. However, since that date, the French judiciary has played a major role in the development of French civil law (In spite of all the economic and social developments that have taken place in French society throughout these years) since its promulgation until February of 2016, the date of the Legislative Decree No. 131 of the year 2016 A modification is the largest in the history of the French Civil Code (which was the judicial precedents in which a significant impact), was assisted by the French judic
... Show MoreThe general crisis of research methods in the social sciences
Research methodology: philosophy and techniques, founded by philosophers and applied by scientists, and no accurate application of techniques except with a deep understanding of philosophy, as a prerequisite. This fact is almost completely absent from the Iraqi and Arab academic mentality. This constituted one of the dimensions of the double crisis - theoretical and applied - of research methods in the social sciences. As first, there is no philosophy of science, neither as an independent material nor as an introductory subject, but not even an oral confirmation. Secondly, the advancement of quantitative research methods are presented without a background philosophy, as sol
The cyanobacterial neurotoxin