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 insurance Sector of important vessels saving that work on the accumulation of capitals which contribute to the financing of economic and social development plans of countries, in order to achieve of marketing superiority in presenting the insurance services it would require insurance companies focus their marketing efforts and increased interest in internal customer to recruitment new customers and keep of current customers, so the research aims to release the impact of the dimensions of the internal marketing of (the company's vision, training and development, incentive and, motivation, internal communication) in the dimensions of the marketing superiority (to keep the customer, service quality, customer satisfaction, customer, valu
... Show MoreThe research aims to identify the effect of teaching according to the augmented reality on the technique of the visual thinking skills among scientific fifth-grade students in a biology course. In order to achieve the goal of the research, the researcher adopted the experimental approach with the partial set of the two equal groups with the dimensional test of visual thinking skills, The research population represented all the scientific students of the fifth grade for morning government schools affiliated to the General Directorate of Education of Baghdad / Karkh II, alshakerin preparatory for boys was chosen intentionally, in which two groups were chosen for this study, one group is chosen randomly as the control group via lottery, whe
... Show MoreNew complexes were synthesized with Schiff base tetradentate ligand (L). The ligand was synthesized by the condensation reaction of the dimedone with 2-hydroxybenzohydrazide. The formula of complexes [M(L) (H2O)2].Cl2, where M represents Mn(II), Ni(II) Cu(II), [Co(L)Cl.H2O]Cl and [Zn(L)(H2O)2]Cl2.2H2O. The ligand was identified using m.p., UV-Vis, FT-IR, Mass, 1H-NMR, and C.H.N. These complexes were characterized using techniques including infrared, UV-Vis absorption, magnetic susceptibility, molar conductivity, elemental analyses, thermogravimetric analysis (TGA), chloride content determination using Mohr’s method, and atomic absorption spectroscopy. The measurements revealed that the complexes are electrolytic. FT-IR results dem
... Show MoreThe current research aims to train students to take benefit of their studies to analyze and taste the artistic works as one of the most important components of the academic structure for students specializing in visual arts; then to activate this during training them the methods of teaching. Consequently, the capabilities of mind maps were employed as a tool that would be through freeing each student to analyze a model of artistic work and think about his analytical principles according to what he knows. Then, a start-up with a new stage revolves around the possibility of transforming this analysis into a teaching style by thinking about how the student would do. The same person who undertook the technical analysis should offer this work
... Show MoreIn order to advance the education process and raise the educational level of the players, it became necessary to introduce new educational aids, programmed education in the education process, through which the basic skills to be learned are explained and clarified, and immediate feedback is provided that would enhance the information of the learner, and Reaching the goal to be achieved, taking into account the individual differences between the players, and thus it is possible to move away from the educational methods used in learning skills, which requires great effort and time, in addition to that the open playground may not perform the skill accurately and the player looks from one side, while when using the computer you look from severa
... Show MoreThe effectiveness of upward training with weights to develop explosive power, characterized by speed and some functional variables for young volleyball players Many efforts of sports laboratories in various countries have been devoted to laying scientific foundations and rules in caring for the physical, skilled, planning, and psychological preparation of players and creating the conditions and requirements for reaching players to higher standards. The research aims to:1- Preparing an ascending training program with weights to develop explosive strength, which is characterized by speed and some functional variables for volleyball players.2- Identify the effect of the training program with upward training in weights to develop explosive stre
... Show MoreNanoparticles of humic acid and iron oxide were impregnated on the inert sand to produce sorbent for treating groundwater contained of cadmium and copper ions by technology of permeable reactive barrier (PRB). Sewage sludge was the source of the humic acid to prepare the coated sand by humic acid—iron oxide (CSHAIO) sorbent; so, this work is consistent with sustainable development. For 10 mg/L metal concentration, batch tests at speed of 200 rpm signified that the removal efficiencies are greater than 90% at sorbent dosage 0.25 g/ 50 mL, pH 6 and contact time 1 h. The kinetic data was well described by the Pseudo first-order model indicating that physicosorption is the predominant mechanism. The maximum adsorption capacities (qmax) were c
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