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.
Research includes three axes, the first is the average estimate time of achievement (day) to work oversight, to five supervisory departments in the Office of Financial Supervision Federal and then choose the three control outputs and at the level of each of the five departments above, and after analyzing the data statistically back to us that the distribution of the times of achievement It is the exponential distribution (Exponential Distribution) a parameter (q), and the distribution of normal (Normal Distribution) with two parameters (μ, σ2), and introduced four methods of parameter estimation (q) as well as four modalities parameter to estimate (
... Show MoreThis study is concerned with organizational learning and its impact on total quality management in the education sector. Organizational learning is a process that provides the educational sector with the ability to adapt and respond rapidly to developments and changes in a better way according to its main dimensions (Mental Models, Personal Mastery, Team Learning, Shared Vision, System Thinking) by adopting the philosophy of Total Quality Management (TQM) in accordance with its basic dimensions (leadership, customer satisfaction, participation of workers, continuous improvement, training and education). The main purpose of this study is to know (the impact of the Senge model of organizational learni
... Show MoreObjecte The study aims to test the effect of using the appropriate quantitative method of demand forecasting in improving the performance of supply chain of the aviation fuel product ( The study sample), One of the products of the Doura refinery (The study site), By testing a set of quantitative methods of demand forecasting using forecasting error measurements, and choosing the least faulty, most accurate and reliable method and adept it in the building chain.
Is the study of problem through a starting with the fol
... Show MoreThe current study aims to investigate the effect of strategic knowledge management practices on an excellent performance at the Institution of Industrial Development and Research- the Ministry of Iraqi Industry (IDRMII). The present research is designed according to the descriptive method. To achieve the mentioned research objective, the researchers used the questionnaire as the main data collection tool. The research sample was 150 managers who are working at the top and middle management levels. To analyses the data gathered and reaching the results, several statistical techniques were used within AMOS.V25, SPSS.V21Software, This study reached a set of results, the most important of which is the existence of a positive correlat
... Show MoreThe concept of forming the living space in the American strategic thought has an
important position it is regarded as an strategic movement that it supports the American
United States with the huge capabilities in its own concern that enables it to approach of
American administration , we find that of different historical periods it works to establish that
the geopolitical dimension which is accompanied with the ability of American response for
the evens that in its own turn enables the American united states to seize the growing chances
in the global strategic environment This study includes five chapters :
- Chapter one: The idea of living space.
- Chapter two: Geopolitical dimension of living space theory.
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Non-steroidal anti-inflammatory drugs (NSAIDs) contain free –COOH which thought to be responsible for the GI irritation associated with all traditional NSAIDs. The esterification of this group is one of an approach to ultimate aim for reduce the gastric irritation; so in this study we synthesized and preliminarily evaluated new ester compounds as new analogues with expected selectivity toward COX-2 enzyme. Synthetic procedures have been successfully developed for the generation of the target compounds (III a and b). The synthetic approach involved multi-steps procedures which include: Synthesis of 4-hydroxy benzene sulphonamide ( I b ), synthesis of Naproxen and Ibuprofen acyl chloride and then reacting them with 4-hydroxy benzene sulphon
... Show MoreAbstract:
Research Topic: Ruling on the sale of big data
Its objectives: a statement of what it is, importance, source and governance.
The methodology of the curriculum is inductive, comparative and critical
One of the most important results: it is not permissible to attack it and it is a valuable money, and it is permissible to sell big data as long as it does not contain data to users who are not satisfied with selling it
Recommendation: Follow-up of studies dealing with the provisions of the issue
Subject Terms
Judgment, Sale, Data, Mega, Sayings, Jurists
The Noble Qur’an is the book of God, the Blessed and Exalted, in which is the teachings of God Almighty’s religion, which is Islam, in order for people to unite it and establish servitude to it. The individual and the society alike saw it appropriate to make my opinion alerting the seriousness of this matter, so the research was entitled (The Impact of Sins and Disobedience on the Individual and Society in the Holy Qur’an - Objective Study), knowing that we touched upon some of the effects, which we found it appropriate to mention in this research in the service of the good. Its details came in the Holy Qur’an without referring to others, noting their arrangement in the Holy Qur’an..