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.
Background: Molars and premolars are considered as the most vulnerable teeth of caries attack, which is related to the morphology of their occlusal surfaces along with the difficulty of plaque removal. different methods were used for early caries detection that provide sensitive, accurate preoperative diagnosis of caries depths to establish adequate preventive measures and avoid premature tooth treatment by restoration. The aim of the present study was to evaluate the clinical sensitivity and specificity rates of DIAGNOdent and visual inspection as opposed to the ICDAS for the detection of initial occlusal caries in noncavitated first permanent molars. Materials and Methods: This study examined 139 occlusal surface of the first permanent
... Show More
Abstract
Due to the lack of previous statistical study of the behavior of payments, specifically health insurance, which represents the largest proportion of payments in the general insurance companies in Iraq, this study was selected and applied in the Iraqi insurance company.
In order to find the convenient model representing the health insurance payments, we initially detected two probability models by using (Easy Fit) software:
First, a single Lognormal for the whole sample and the other is a Compound Weibull for the two Sub samples (small payments and large payments), and we focused on the compoun
... Show MoreCommercial banks represent the main pivot in financing national economic activity and its development. The capital represents safety margin to depositors and represents a defense line that protects bank work from dangers. Basel committee requirements represent protection and comprehensive supervision to bank activities for depositors, debtors and the bank. It provides trust in bank dealings and tackles activities of high dangers. The most prominent of these requirements are capital adequacy that concerns bank management and supervision and auditing bodies such as the central bank and protecting banks that suffer weakness in its vital important borrowing activity that reflects weakness in implementing borrowing policy .The purpose
... Show MoreBackground: Successful root canal therapy depends on thorough chemo mechanical debridement of pulpal tissue, dentin debris and infective microorganisms. Objective: This study aimed to investigate the antibacterial effect of silver nanoparticles, sodium hypochlorite and chlorhexidine in reducing the bacterial infection of the root canals. Materials and Methods: The root canals of 55 single-rooted teeth were cleaned, shaped, and sterilized. All the teeth samples were inoculated with Enterococcus faecalis and incubated at 37°C for 2 weeks. Then, the teeth were divided into four groups. Group I (n=15): 100 ppm silver nanoparticles, Group II (n=15): 2.5 sodium hypochlorite, Group III (n=15): 2% chlorhexidine, IV (n=10): Normal saline as a contr
... Show MoreBackground: Because of the demands for aesthetic orthodontic appliances have increased, aesthetic archwires have been widely used to meet patient's aesthetic needs. The color stability of aesthetic archwires is clinically important, any staining or discoloration will affect patient’s acceptance and satisfaction. This study was designed to evaluate the color stability of different types of aesthetic archwires after immersion into different types of mouth washes. Materials and methods: Four brands of nickel titanium coated aesthetic arch wires: Epoxy coated (Orthotechnology and G&H) and Teflon coated (Dany and Hubit) were evaluated after 1 week, 3 weeks and 6 weeks of immersion into two types of mouthwashes (Listerine with alcohol and
... Show More|
Natural convection in an annular space provided with metal foam fins attached to the inner cylinder is studied numerically. The metal foam fins made of copper were inserted in different axial sections with three fins in each section. The temperature of the inner cylinder is kept constant while the annular outer surface is adiabatic. The thickness effect of the inner pipe wall was considered. Naiver Stokes equation with Boussinesq approximation is used for the fluid regime while Brinkman-Forchheimer Darcy model is used for metal foam. In addition, the local thermal non-equilibrium condition in the energy equation of the porous media is presumed. The effect of Rayleigh numb |
From different hospitals in Baghdad city, 25 clinical isolates of Proteus spp. were collected from different clinical samples, all isolates were identified as Proteus mirabilis by using bacteriological and biochemical assays in addition to Vitek-2 identification system. 15 (60%) isolates were identifying as Proteus mirabilis. The susceptibility of P. mirabilis isolates towards cefotaxime and ceftazidime was (66.6 %), (20%) consecutively; while extended spectrum β-lactamases producing P. mirabilis percentage was (30.7 %). Because blaVEB-1 was documented as an important indicator for increasing risk of extended spectrum beta ßlactamases producing P. mirabilis isolates that began to spread from many geographic area to Far east which inc
... Show MoreBackground: Osteoporosis affects almost all of the bones in the female body; the most important one in the facial bone is mandible. Menopause is defined as an absence of the menses for one year. During this time, estrongen, progesterone and ovarian androgens production are diminished due to adult onset ovarian failure which leads to osteoporosis. This study aimed to evaluate the use of computed tomography mandibular morphometric indices for the assessment of pre and postmenopausal osteoporotic women. Subjects and material: This study conducted on 50 Iraqi females divided into 2 groups 20 -30years old as a control group and over50 years old as a study group attending Al-Karkh hospital, Department of Computed Tomography.(each group25 female).
... Show MoreBackground: Pharmacists are essential in treating MS. Pharmacists' involvement and patient consultation may improve patient adherence and satisfaction. Aim: To evaluate the influence of pharmacist-led interventions (PLI) on medication adherence and satisfaction in patients with multiple sclerosis receiving disease-modifying therapies (DMTs). Methods: This study was conducted on patients with relapsing-remitting multiple sclerosis who were receiving DMTs and attended a neurological consultant clinic in the medical city of Baghdad. It was a pre-post-intervention study. Each patient underwent two educational sessions: the first session took place at the beginning of the study, after completing the Arabic version of the treatment satisfaction q
... Show More