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.
Service companies always working to increase their competitiveness and efficiency of the survival, growth and development in the present and the future, including insurance companies, so as to increase competition, especially after the emergence of the civil companies dramatically after 2003, has become the goal of recent studies carried out by the organizations is the human capital, because its success and excellence and achievement its objectives depends on the human, and this does not mean that the other components are not important, but also rely on the rights which has increased interest in the search for the way in which they can guide the behaviors and values and their own language in line with the organization's strategy an
... Show MoreNever the less, banking compliance function became one of the most important functions in banking sector according to its characteristics that considered as an interior control tools to control (executive management, departments, subsidiaries…etc) in any bank; and their compliance towards applying rules, recommendations and legislations. In addition to, estimating the risks and limited them; and controlling the anti-money laundering. Thus, these functions that covered the main concept of (Banking Compliance) would avoid the bank to be under the control of any sanctions.
Using an electrochemical polymerization technique at room temperature, poly nicotine amide (PNA) was produced from the monomer nicotine amide (NA) in aqueous solution. The structure of polymer layer generated on the stainless steel surface (316 L) (working electrode) is investigated by Fourier Transmission Infrared Region (FT-IR). The anti-corrosion activity of polymer coating on the stainless steel (SS 316 L) is investigated by electrochemical polarization in 0.20M solution of HCl at 293-323K. The graphene -modified polymer film-coated SS had greater protection efficiency (PE percent) when compared to Nano ZnO -modified polymer film-coated SS. For the corrosion process of SS 316 L, kinetic and thermo-dynamic parameters of activatio
... Show MoreThis study attempts to test the interactive role played by organizational agility in enhancing the effect of organizational anomie on the behavior of planned human resources. The study of organizational anomie has increased because of the moral and legal pressures facing the organization by the external environment within its framework. To adapt to all external developments faced by these organizations, the behavior of human resources planned reflects the ability of individuals to control their behavior in different situations and situations that face them in the work.
The problem of the research indicates that there is a clear lack of understanding of what is meant by the variables studied in the sample
... Show MoreIsobaric Vapor-Liquid-Liquid equilibrium data for the binary systems ethyl acetate + water, toluene + water and the ternary system toluene + ethyl acetate + water were determined by a modified equilibrium still, the still consisted of a boiling and a condensation sections supplied with mixers that helped to correct the composition of the recycled condensed liquid and the boiling temperature readings in the condensation and boiling sections respectively. The VLLE data where predicted and correlated using the Peng-Robinson Equation of State in the vapor phase and one of the activity coefficient models Wilson, NRTL, UNIQUAC and the UNIFAC in the liquid phase and also were correlated using the Peng-Robinson Equation of State in both the vapo
... Show MoreThe research aims to shed light on the obstacles that hinder the use of taxpayers' commercial books covered by provisions of the amended commercial book-keeping system No. 2 of 1985 and ways to address these obstacles. On this basis, the main null hypothesis was formulated that there is no statistically significant relationship between the obstacles to the adoption of the commercial books and taxable income.
The research data were collected on the base of three applied case studies of registered taxpayers in the General Commission of Taxes, GCT, together with the use of a questionnaire distributed to a sample of taxpayers ( companies ). The collected data were analyzed, the result were presented and the hypothesis was
... Show MoreSet dietary program for some of dietary supplements and training for badminton young players, and identifying effect of taking some of the dietary supplementary for badminton young players. The research population :( badminton young players group (Arminian club). For age group (16-18) years the sample is divided in to two experimental groups within each group (6) players, and two for the exploratory experiment which was within the research sample, they were divided in to two groups, the first group take some of the dietary supplements (multivitamin creating) .the set exercises by the researchers in the main part of the training unit and the second group (amino acids, vitamins) and the set exercises by the researcher. The scientific approach
... Show MoreImpact Resistance training with and against the trajectory of the motor in some physical abilities and the BioA 100-meter, mechanical racing run for young people. That Training Jogging for different distances Melt -Rubber ropes According to direction and reversed movement With Obligations To the border of scientific of components Pregnancy Training represents to a training trend Aimed To Events Developments In The link between Starting and running, According to the specific mechanical requirements Have It Of Development of force Explosive and quick and their components which To give Border To the level Special speed for Stages Sprint run 100 m and amounts Efforts Required instantaneous powers. Noted Researcher In That Over there Repeat For
... Show MoreIn the present work, Response Surface Methodology (RSM) was utilized to optimize process variables and find the best circumstances for indirect electrochemical oxidation of mimicked wastewater to remove phenol contaminants using prepared ternary composite electrode. The electrodeposition process is used for the synthesis of a ternary composite electrode of Mn, Co, and Ni oxides. The selected concentrations of metal salts of these elements were 0.05, 0.1, and 1.5 M, with constant molar ratio, current density, and electrolysis time of 1:1:1, 25 mA/cm2, and 2 h. Interestedly, the gathered Mn-Co-Ni oxides were deposited at both the anode and cathode. X-ray diffraction (XRD) and scanning electron microscopy (SEM) facilitated the qualitative char
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