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 research aimed to study the political discourse in the drawings of Faisal Laibi, where it shed light on the discourse in the plastic field - concepts and applications, as well as the representations of discourse in the modern and contemporary plastic field, and to study the experience of Faisal Laibi and the uniqueness of his style in artistic performance. The site has collected more than (210 works) whose sources varied between the artist's website himself on the social network, the Internet, and the published paper publications. The researcher conducted an analysis of some of the drawings to achieve the research objectives. Among the most important results he reached:
1. The political discourse of Faisal Laibi is to direct these
Background: Stress urinary incontinence is a frequent urological disease in women; it has a great influence on an individual’s wellbeing and places a significant economic strain on any health service. The placement of urodynamic diagnostic tests in the evaluation route is an important clinical research concern in this field.
Objective: to find out whether the duration of stress urinary incontinence is associated with the finding of bladder outlet obstruction in urodynamic study or not.
Subjects and Methods: A descriptive study. With enrolled female patients had symptomatic Stress urinary incontinence as their primary complain. All the included patients w
... Show MoreBackground: A Catheter-associated with candidiasis infection is the most common nosocomial infection and the objective of this work is to isolate and identify Candida species from catheterized patients by ordinary culture and PCR.Objective:To study the isolation and identification of Candida species from catheterized patients by culture media and polymerase chain reaction(PCR).Methods: One hundred and thirty five Candida species isolates were obtained from urine culture of catheterized specimens from male and female patients , During the period between October 2011 to April 2012 , attending AL-Ramadi general teaching Hospital. A quantitative urine culture for isolation and identification of Candida species was. The isolation of Candida s
... Show MoreThe research aims to formulate a model for research on the dimensions of the Leader-member exchange theory according to the ideas and thoughts of Liden /Maslyn, Hammer and impact on job satisfaction and measure these dimensions at asiacell communications to identify the extent of convergence between theoretical dimensions share leader – member Exchange (LMX) with leadership style used in this company, we have been building scale contains two variables, independent variable Leader-member exchange theory five dimensions (effect , Loyalty, contribution, respect professional, and support) the certified job satisfaction variable dimensions (job security, The Style of management, organizational climate, appreciation, and work itself)
... Show MoreIraq has seen many changes at the social, economic and political levels. This led to cause many shifts in the structure of its society and imposed great challenges reflected in the behavior and awareness of that society in general and youth in particular.
Those changes made the Iraqi society undergoing the transformation of value and culture aspects formed a political awareness that caused cultural and political diversity within the family and society. A greater openness to the outside world caused by the communication revolution, as the world has witnessed during the past two decades, has helped in making that change. Iraq had its share of media and political openness, which were included after the US occupation in 2003. As a re
... Show MoreThe tourism industry has become, currently, an art, an industry and a science. It is also one of the components that make up touristic regions. Tourist attractions are no longer the exclusive visits of museums and archeological sites, but also involve other service facilities. It is, therefore, imperative that the authorities should become aware of the degradation of tourist resorts and prevent them from getting worse. Moreover, the authorities should take a set of decisions concerning the protection of the urban aspect with its historical, social, and environmental dimensions, as well as, adapting it to the modern requirements that can bring comfort to the citizens and tourists at physical and psychological levels.
Aneurysms of the cortical branches of the middle cerebral artery (MCA) are rare. They usually are secondary to traumatic or infectious etiologies and are rarely idiopathic. The specific characteristics of idiopathic aneurysms in such location are not well defined in the literature. The authors report a rare case of a ruptured giant idiopathic cortical MCA aneurysm with review of the available literature on this clinical entity.
A 24-year-old female presented with headache, disturbed level of consciousness, and right-sided weakness. Imaging studies showed a left frontoparietal intracer
Dylan Thomas (1914-1953) is a modern poet belongs to the apocalyptic movement of the 1940's.This movement is influenced by the doctrines and techniques of surrealism. Poetry for him should not be primarily concerned with man in society, but with the celebration of spiritual truth. It should bring to light the hidden causes, hence his personal interest is to strip darkness and explore the inward motives. To do this he uses a cluster of images: a constant building up and breaking down of images. His poetry depends on the romantic spontaneity, suggestiveness of the Symbolists and the the surrealists' mysterious liberation of the unconsciousness and the emotional involvement in the dynamics of life. In "Light Breaks
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