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.
Natural convection heat transfer is experimentally investigated for laminar air flow in a vertical circular tube by using the boundary condition of constant wall heat flux in the ranges of (RaL) from (1.1*109) to (4.7*109). The experimental set-up was designed for determining the effect of different types of restrictions placed at entry of heated tube in bottom position, on the surface temperature distribution and on the local and average heat transfer coefficients. The apparatus was made with an electrically heated cylinder of a length (900mm) and diameter (30mm). The entry restrictions were included a circular tube of same diameter as the heated cylinder but with lengths of (60cm, 120cm), sharp-edge and
... Show MoreSickle cell disease (SCD) is a hereditary ailment that can cause severe pain and suffering to people who are affected. However, with continued investment in research and treatment options, we can make progress towards improving the lives of those with SCD. Over 40% of patients experience painful vaso-occlusive crises (VOCs), so we must work towards finding solutions and providing support for those living with this condition, These episodes, a hallmark of SCD, significantly contribute to morbidity, mortality, and a diminished quality of life, while also incurring substantial healthcare costs. Chronic pain particularly affects older adolescents and adults with SCD, with over half reporting daily discomfort. Opioid-based analgesics, though sti
... Show MoreThe comparative method plays a major role in Maupassant’s novel (A woman’s Life).This is due to a good theme choice and smooth writing style characterized by simplicity, spontaneity and brevity.
The author uses the comparative method in the introduction of his novel where he compares the monastery’s closed world to the open world of the countryside of La Normandie, which represents the dream life of the heroine Jeanne.
The present paper is an attempt to answer the question regarding the importance of applying the comparative method in the novel (A Woman’s Life) by Maupassant. The paper stresses the fact that the novelist employs the comparative method in his book for certain features .One of these features is the
... Show MoreThe construction of development is required to develop various economic sectors with the necessity to meet the various requirement of both individuals and institutions , or through the import process , which must be commensurate with the needs of the market and the economy and development. But in fact , we found that the process of import in Iraq after 2003 took a turn dangerous excesses on limits of philosophy and objectives of the import , which reflected the level of national production as well as the policy of dumping and given to the lack of matching a lot of goods and materials imported for Standards and Measures of quality and stands behind it causes many of them exposure to the market and weak sectors with an o
... Show MoreBackground: Little is known about asymmetry of children's dental arches, the purpose of this study was to verify the presence of asymmetry of dental arches among Iraqi children in the mixed dentition stage. Materials and methods: The sample included 52 pairs of dental casts, 27 pairs belong to males and 25 pairs for females. Three linear distances were utilized on each side on the dental arch: Incisal-canine distance, canine-molar distance and incisal-molar distance, which represent the dental arch segmental measurements using the digital sliding calipers, which is accurate up to 0.02 mm. Results: No significant sides' differences with high correlation coefficient were found between the right and left incisal-canine, canine-molar and in
... Show MoreNonalcoholic fatty liver disease in a group of Iraqi obese children attending children welfare teaching hospital
The increase in population resulted in an increase in the consumption of water. The present work investigates the performance of a recycling solar- powered greywater treatment system for the purposes of irrigation, used to reduce the amount of waste grey water and reduce electricity consumption and reduce the costs of constructing large scale water treatment plants. The system consumes about 3814W per hour and provides water treatment about 1.4 m3 per day. The proposed system is designed to residential, office and governmental buildings application. Tests are conducted in an office building at the Ministry of Science and Technology site in Baghdad. Laboratorial water samples testing analyses are co
... Show MoreThe current research aims to evaluate liquidity (as an independent variable) to improve the bank’s profitability (as a dependent variable ), by the bank’s ability to maximize its profits from its business results without excessive bank’s liquidity, so that may affect negatively affects the bank’s reputation and it’s dealers confidence in facing their financial obligations. and this may lead trying to come out among other recommendations including contributing to obtain, the bank’s ability to achieve liquidity balance to maximize its profits. This research has been applied to the sample induced intentionally by choosing three Iraqi private banks. The researcher used financial indicators to assess the bank’s liq
... Show MoreThe moral aspect is an important one in the structure of personality , and the lack of moral aspect is responsible for what we suffering today from problems . there is no exaggeration to say that many of our current problems are moral problems , and reflects the lack of moral growth.
The goal of research is to build scale in order to detect the level of moral reasoning among junior high school students in Baghdad , The researcher followed the procedures in the construction of scientific standards in order to measur
... Show MoreEfficacy of Oregano Essential Oil Mouthwash in Reducing Oral Halitosis: A Randomized, Double-Blind Clinical Trial, Mohamed Saeed M Ali, Ayser Najah Mohammed*