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.
Our research comes to shed light on Iraqi literature as literature that arose in special circumstances alongside foreign literature. Using comparative research methods, we chose to highlight two distinguished writers, who have their mark in the world of literature. The first is the Iraqi writer Maysaloun Hadi, who is considered an icon of Iraqi feminist literature, and the second is the French writer Le Clézieu, who won the Nobel in 2008. We will see through the research how the two authors expressed their views of modernity and urbanism. And how each of them separately portrayed the psychological and moral projections that formed the essence of man today.
Résumé
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... Show MorePhysical and chemical adsorption analyses were carried out by nitrogen gas using ASTM apparatus at 77 K and hydrogen gas using volumetric apparatus at room temperature, respectively. These analyses were used to determine the effect of coke deposition and poisoning metal on surface area, pore size distribution, and metal surface area of fresh and spent hydrodesulphurization catalyst Co-Mo\Al2O3 . Samples of catalyst (fresh and spent) used in this study are taken from AL-Dura refinery. The results of physical adsorption shows that surface area of spent catalyst reduced to third compare with fresh catalyst and these catalysts exhibit behavior of type four according to BET classification ,so, the pores of these samples are cylindrical, an
... Show MoreThe aim of this research is to collect the semantically restricted vocabulary from linguistic vocabulary and make it regular in one wire with an in-depth study. This study is important in detecting the exact meanings of the language. On the genre, as shown in this research, and our purpose to reveal this phenomenon, where it shows the accuracy of Arabic in denoting the meanings, the research has overturned more than sixty-seven words we extracted from the stomachs of the glossaries and books of language, and God ask safety intent and payment of opinion.
The scientific and practical importance of this study lies in analyzing the phenomena of commercial blocs as a means of managing the future struggle as Zbigniew Brzhenski in his book Our of Control which was translated into Arabic under the title of (chaos) in 1993. The most important phenomenon of the 21th century is the geopolitical phenomenon presented by the international blocs. That is, the new regime will be united in the form of economic blocs and political alliance. Consequently, the future struggle will be economic in nature under the chaos which the new order is living. Under the retreat of the economy that effected the industrial countries and the world countries which have become unable to treat the crisi
... Show Moredrosophila larvare of diffrent speces were subjected to this in order study the structure of cephalopharyngeal armature and mouth more hooks dentition the lines number among
The Esterification kinetics of acetic acid with ethanol in the presence of sulfuric acid as a homogenous catalyst was studied with isothermal batch experiments at 50-60°C and at a different molar ratio of ethanol to acetic acid [EtOH/Ac]. Investigation of kinetics of the reaction indicated that the low of [EtOH/Ac] molar ratio is favored for esterification reaction, this is due to the reaction is catalyzed by acid. The maximum conversion, approximately 80% was obtained at 60°C for molar ratio of 10 EtOH/Ac. It was found that increasing temperature of the reaction, increases the rate constant and conversion at a certain mole ratio, that is due to the esterification is exothermic. Activity coefficients were calculated using UNIFAC progra
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This research paper aims to unveil a fertile and vivid aspect, which is one of the many aspects of the multiple linguistic concern of the deceased professor Ahmed Matloob, mercy be upon him; that is the terminological study aspect. For in spite of the abundance of literature written about various directions of his rhetorical, literary, critical, and linguistic activities, and in spite of the illumination, variation, and abundance of his terminological study, I could not find a research study that includes or investigates all his theoretical and applied efforts in this field. Therefore, I decided to achieve this task, first for the sake of knowledge, and second to return back to the deceased s
... Show MoreIn the name of God the Merciful
After .....
This is discussed in the hadeeth of Shaaban's speech, in which there is much talk in modern terms about the ruling
It has to be corrected, improved, weakened or denied, and it has a title (modern)
Shaaban's sermon is a modern study). It is an attempt to judge me after I come
In the text and then came out of the books and works that mentioned the sermon in its verses and then a statement of the ruling
And then I studied the rules and ruled them according to the rules
Followed by the scientists wound and amendment, and then the conclusion and deposited the most important results that came out
He accepts this purely for his generous consideration of this humble research, an
Physical and chemical adsorption analyses were carried out by nitrogen gas using ASTM apparatus at 77 K
and hydrogen gas using volumetric apparatus at room temperature respectively. These analyses were used for
determination the effect of coke deposition and poisoning metal on surface area, pore size distribution and
metal surface area of fresh and spent hydrodesulphurization catalyst Co-Mo\Al2O3 .
Samples of catalyst (fresh and spent) used in this study are taken from AL-Dura refinery.
The results of physical adsorption shows that surface area of spent catalyst reduced to third compare with
fresh catalyst and these catalysts exhibit behavior of type four according to BET classification ,so, the pores
of these sample