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.
The aim of the present study is to evaluate the effectiveness of using Art as therapy to reduce the symptoms of Attention Deficit Hyper Activity Disorder (ADHD), in primary school children.
A clinical approach was used to test the validity of the hypothesis of our study, conducted on two second and fourth-year primary school pupils from Algiers, aged 7 and 9 years respectively.
In addition to the clinical observation and interview, we made use of the "Conners" scale for a (pre and post intervention) ADHD assessment, consisting of a combination of Art media in the form of mosaic works on purposely prepared panels. After 10 therapy sessions, results revealed the effectiveness of Art therapy in reducing ADHD in primary education
The study of services in villages is one of the imperative matters that must be focused on, because it leads to increased attention, which reduces the differences between the countryside and the urban. The extent of its.
It is well known that community services need to be reached by a person, unlike the anchor services that reach people, here the population distribution plays an important and prominent role in signing these services, so the dispersed distribution pattern and the gathering pattern appeared in the distribution, thus an effect on the time and distance that the person walked to obtain The services are community-based. Therefore
... Show MoreThis paper reports an experimental study regarding the influence of vertical oscillations on the natural convection heat transfer from a vertical channel. An experimental set-up was constructed and calibrated; the vertical channel was tested in atmosphere at 25o
C. The channel-to-ambient temperature difference was varied with the power supply to the electrical heater ranging between
15W to 70W divided into five levels. Data sets were measured under different operating condition from a test rig under six vibrating velocities (VVs) levels ranging from (5-30 m/s) in addition to the stationary state. The results show that the maximum heat transfer enhancement factor (E) occurs at Rayleigh number (Ra=2.328×103 ) and vibrational Reynol
This paper is concerned with the blow-up solutions of a system of two reaction-diffusion equations coupled in both equations and boundary conditions. In order to understand how the reaction terms and the boundary terms affect the blow-up properties, the lower and upper blow-up rate estimates are derived. Moreover, the blow-up set under some restricted assumptions is studied.
The research aims to determine the impact of Human Resources Accounting (HRA) on employee’s performance. The research’s problem was embodied in the lack of interest in HRA, which was reflected on the performance of employees in the Ministry of Education; the research adopted the descriptive-analytical approach, and the research community included the directors of departments and people at the headquarters of the Ministry of Education. The sample size was (224) individuals from the total community of 533. The questionnaire was adopted as the main tool for collecting data and information, as well as the interviews that were conducted by the researcher. In order to analyze t
... Show MoreA comparison between the resistance capacity of a single pile excited by two opposite rotary machines embedded in dry and saturated sandy soil was considered experimentally. A small-scale physical model was manufactured to accomplish the experimental work in the laboratory. The physical model consists of: two small motors supplied with eccentric mass 0·012 kg and eccentric distance 20 mm representing the two opposite rotary machines, an aluminum shaft with 20 mm in diameter as the pile, and a steel plate with dimensions of (160 × 160 × 20 mm) as a pile cap. The experimental work was achieved taking the following parameters into consideration, pile embedment depth ratio (L/d; length to diameter) and operating freq
... Show MoreSince the emergence of the science of international relations as an independent academic scientific field, various theories and trends have appeared and have tried to understand and explain the international reality and give a clear picture of what is happening within the international system of interactions and influences and the search for tools for stability and peace in international relations. Among these theories is the feminist theory, which is a new intellectual trend on the level of international relations theories, which tried to give an explanation of what is happening in world politics and in international relations in particular. The main issue that feminist theory is concerned with is the lack of women’s subordination
... Show MoreThis paper deals with the ideological positioning of the English poet John Donne in a selected poems of his i.e Holy Sonnet X, as regards the theme of death found therein. The researchers adopt an emerging branch of stylistics, called Critical Stylistics, as proposed by Jeffries (2010) in order to uncover the ideologies of the author regarding the topic concerned and how linguistic choices are used to slant ideas. The model is comprised of ten tools of analysis which, upon being applied to the selected data, have shown how the poet exploits language resources in order to pass his ideology and influence his readers. In this paper, the workings of only one tool are presented as applied to a certain portion of the data.
It is very necessary for the political theater to be within the space of every theatrical performance, so that the theater carries the diverse and enlightened values and cultures of this world. political theatre. In the first chapter, the researcher dealt with (the methodological framework), which includes the research problem identified by the researcher with the following question (the functional diversity of the directorial vision in the political theater)
Importance, purpose, limits and seal by defining terminology.
In the second chapter, the researcher dealt with the theoretical framework on two topics, the first (transformations of directorial vision in theatrical performance) and the second topic (aesthetic experiences i