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 whole world and the Arab world, especially an important part of this international system, is undergoing a radical transformation at all levels. This mosaic of political, economic, social and military relations and alliances, whether based on the special interests of the major Powers or on the basis of mutual interests, The major transformations to social, economic, political and military conflict and these transformations still bear more surprises, at all levels, nothing remains constant, all changed, relations changed and alliances changed and loyalties fell and the principles of the M changed and the spectacular imperial economies collapsed and the will of the masses was no longer fixed.
The research aims to indicate the relationship between lean production tools included seven {constant improvement , and Just in time (JIT), and the production smoothing , and quality at the source, and standardized work, Visual management, and activities 5S } and Mass Customization strategy for the model (Pine & Gilomer, 1997) {collaborative, adaptive, cosmetic, transparent}, as well as providing a conceptual framework and applied for variables search to clarify how they will choose a Mass Customization strategy through the lean production tools, , and recognize the reality of the practices of Iraqi industries in such a field. Moreover, aims to highlight the positive aspects that accrue to companies a
... Show MoreThe sustainable development according to the United Nation, listed firms throughout globally now routinely provide sustainability data. However, there is not enough information on Sustainability Performance Quality (SPQ) in the majority of emerging economies, including Malaysia. This study looks at how the SPQ of the top 100 Malaysian-listed businesses is affected by factors as connected with corporate governance (e.g., board meeting, board size, and board ethnic diversity). Utilizing 500 firm-year data, a longitudinal sample of 500 nonfinancial firms on the Bursa Malaysia for 2015-2019 is employed in this study. The findings from the analysis using the panel regression demonstrated that: ethnic diversity and board siz
... Show MoreAn experimental and numerical study has been carried out to investigate the forced convection heat transfer by clean or dusty air in a two dimensional annulus enclosure filled with porous media (glass beads) between two vertical concentric cylinders. The outer cylinder is of (82 mm) outside diameters and the inner cylinder of (27 mm) outside diameter. Under steady state condition; the inner cylinder surface is maintained at a high temperature by applying a uniform heat flux and the outer cylinder surface at an ambient temperature. The investigation covered values of input power of (6.3, 4.884, 4.04 and 3.26 W), Reynolds number values of (300, 700, 1000, 1500, and 2000) and dust ratio values (density number N) of (2, 4, 6 and 8). A comput
... Show MoreBackground: Osteoporosis is a skeletal defect manifested by a reduction of bone strength as a result of reduced bone mass to the extent that there is a higher risk of fracture even on minor trauma. Hysterectomy in a premenopausal woman is a well known cause of ovarian failure resulting in an increased risk of osteoporosis.
Objective : To clarify bisphosphonate's preventive effect on osteopenia and osteoporosis in premenopausal women after hysterectomy.
Type of the study: Cross –sectional study.
Method: 84 premenopausal females post hysterectomy aged between 40 – 50 years, were enrolled in this randomized controlled double blinded trail a
... Show MoreEndometriosis is a painful disease that affects around 5% of women of reproductive age. In endometriosis, ectopic endometrial cells or seeded endometrial debris grow in abnormal locations including the peritoneal cavity. Common manifestations of endometriosis include dyspareunia, dysmenorrhea, chronic pelvic pain and often infertility and symptomatic relief or surgical removal are mainstays of treatment. Endometriosis both promotes and responds to estrogen imbalance, leading to intestinal bacterial estrobolome dysregulation and a subsequent induction of inflammation.
In the current study, we investigated the linkage be
Asthma is a condition characterized by bronchial spasms, inflammation, and mucous hypersecretion which leads to difficulties in respiration. Asthmatic patients are usually presented with recurrent attacks of coughing, wheezing, and shortness of breath which could be life-threatening. More than three million cases of asthma in the United States are diagnosed annually. Resveratrol, a polyphenolic stilbene, is known to be useful in controlling asthmatic attacks via different molecular mechanisms within the lung epithelium and infiltrating immune cells. However, few studies mentioned the effect of resveratrol on the microbiome in ovalbumin-induced asthma mouse model. In this study, we ind
In spite of the disappearing of a clear uniform textbook for teaching ESP at different departments and different colleges in both scientific and humanistic studies, the practitioners at those departments and colleges have to teach translation as one of the important requirements to pass the English language exam. The lack of defined translation activities is a noticeable problem therefore; the problem of teaching translation is diagnosed in that the students lack the ability to comprehend the text in English language and other translation knowledge and skills.
The study aims to suggest a translation strategy and then find out the effect of the translation strategy on ESP learners’ achievement in translation. A sample of 50 stud
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