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.
Let R be a 2-torision free prime ring and ?, ?? Aut(R). Furthermore, G: R×R?R is a symmetric generalized (?, ?)-Biderivation associated with a nonzero (?, ?)-Biderivation D. In this paper some certain identities are presented satisfying by the traces of G and D on an ideal of R which forces R to be commutative
With the increasing rates of cancer worldwide, a great deal of scientific discourse is devoted to arguments and statements about cancer and its causes. Scientists from different fields try to seize any available chance to warn people of the risk of consuming and exposing to carcinogens that have, unfortunately, become essential parts of modern life. The present paper attempts to investigate the proximization strategy through which scientists construct carcinogen risk to enhance people’s preventive actions against these carcinogens. The paper targets the construction which depends on producing the conflict between the values of the people themselves and the contrasting values assigned to carcinogens. To achieve this aim, Cap’s (2
... Show MoreSubstantial research has been performed on Building Information Modeling (BIM) in various topics, for instance, the use and benefit of BIM in design, construction, sustainable environment building, and Facility assets over the past several years. Although there are various studies on these topics, Building Information Modeling (BIM) awareness through facilities management is still relatively poor. The researcher's interest is increased in BIM study is based heavily upon the perception that it can facilitate the exchange and reuse of information during various project phases. This property and others can be used in the Iraqi Construction industry to motivate the government to eliminate the change resistance to use innovat
... Show MoreAbstract The aim of this paper is to shed light on the theme of Gender Struggle and Women’s Predicament in Tennessee Williams’ A Street Car Named Desire .The paper tries to show William's dealings with the critical social themes like Men's Brutality and women's predicament. The paper exposes the complete shift of the balance of power between the genders in America after the two world wars. Williams illustrates society’s changing attitudes towards masculinity and denounces the society's attitudes towards women in America at that time. He rebels against the cruelty of the modern age and regrets the disintegration of the values of the south and their being replaced by the disruptive forces of modern life. In the end of the play, brutalit
... Show MoreWhen exercising their authority in the jurisprudence, judges are subject to a set of restrictions that they must adhere to, as they do not want their jurisprudence to be accepted and welcomed by law practitioners in general, and legal scholars in particular, and in contrast to it, the arrows of criticism and defamation will extend to that jurisprudence, and then they will have to reverse them . Perhaps the most important of those restrictions imposed on judges is their observance of justice between the parties to the lawsuit through their lack of bias for one of the parties at the expense of the other, in addition to their observance of public order and public morals, as well as their observance of the legal texts that they work under its u
... Show MoreMusic and singing are always associated with the movement of society and the emergence of cultural and artistic activities other.
The social and political transformations of the 1930s helped to disseminate the study Music and music in the city of Baghdad and across Iraq This is the beginning of a new era of musical art alongside other arts.
While achieving musical arts A new step was advanced by publishing a technical study among the younger generation they were looking for to contribute to the musical field On the other hand, the city of Baghdad during the period of research many musical and musical performances Egyptian teams have provided many artistic activities and events which have had a significant impact on the development
Purpose: The main objective of this paper is, to determine the optimal no. of technicians’ men in a workshop crew of an Industrial System. Theoretical framework: The purpose of applying these tools is to explore their ability to reduce costs and improvements that can be obtained in the process of providing services to the end customer. Design/methodology/approach: The literature structure review was built from analyzing 12 of scientific papers and books, from web sciences and the Elsevier database. The papers were analyzed from descriptive, methodologic, and citation characteristics. Finding: By applying the equation model of the paper, the optimal no. of technician men in the crew of the workshop can be determined when
... Show MoreToday, the role of cloud computing in our day-to-day lives is very prominent. The cloud computing paradigm makes it possible to provide demand-based resources. Cloud computing has changed the way that organizations manage resources due to their robustness, low cost, and pervasive nature. Data security is usually realized using different methods such as encryption. However, the privacy of data is another important challenge that should be considered when transporting, storing, and analyzing data in the public cloud. In this paper, a new method is proposed to track malicious users who use their private key to decrypt data in a system, share it with others and cause system information leakage. Security policies are also considered to be int
... Show More
