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 study highlighted the transformation of value systems and educational patterns between past and present, especially with the introduction of modern variables and means, such as mobile phones, the internet, social media, and others. These factors have contributed both positively and negatively to the study. The study highlights the integral role of the school in collaboration with the family in guiding and educating children. It also emphasizes the active role of the school in developing students' abilities and skills, either attracting them to school or vice versa. This includes an examination of the essential skills required in education and their role in achieving a state of psychological well-being and systematically developing child
... Show MoreThe results of theoretical and experimental investigations carried out to study the effect of load and relative sliding speed on the abrasive wear behavior in drilling bit teeth surfaces of an insert tungsten carbide bit have been presented. Experimentally, an apparatus for abrasive wear tests conducted on the modified ASTM-G65 was modified and fabricated to facilitate loading and measurement of wear rate for the sand/ steel wheel abrasion test, which involves two cases of contact; first is at dry sand and second is under wet condition. These tests have been carried under varied operating parameters of normal load and sliding speed. A theoretical model based upon the Archard equation has been developed for predicting wear simulation by u
... Show MoreIn subterranean coal seam gas (CSG) reservoirs, massive amounts of small-sized coal fines are released during the production and development stages, especially during hydraulic fracturing stimulation. These coal fines inevitably cause mechanical pump failure and permeability damage due to aggregation and subsequent pore-throat blockage. This aggregation behavior is thus of key importance in CSG production and needs to be minimized. Consequently, such coal fines dispersions need to be stabilized, which can be achieved by the formulation of improved fracturing fluids. Here, we thus systematically investigated the effectiveness of two additives (ethanol, 0.5 wt % and SDBS, 0.001 and 0.01 wt %) on dispersion stability for a wide range of condit
... Show MoreThis study aims to show, the strength of steel beam-concrete slab system without using shear connectors (known as a non-composite action), where the effect of the friction force between the concrete slab and the steel beam has been investigated, by using finite element simulation.
The proposed finite element model has been verified based on comparison with an experimental work. Then, the model was adopted to study the system strength with a different steel beam and concrete slab profile. ABAQUS has been adopted in the preparation of all numerical models for this study.
After validation of the numerical models, a parametric study was conducted, with linear and non-linear Regression analysis. An equation re
... Show MoreThe present study aimed to asspssment the nutrition a program to sample of student from internal departments of Baghdad University (AL-Jadiriya Complex) and the University of AL-MustanSiriya four grades and aged (19-24) year study included 150 male and female students by (75) male and (75) of female register height, weight nd body mass index were study habits and food pattern of the same sample (150) and by aspecial form and take the personal information interviews and record information on food intake during 24 hour .noted adifference practie in the weights and longths of male and female (sample).
BMI rates were within the normal weight as the value of BMI for males aged (19- 21)and (22-24) and (22.21) and (23,37),respectively and th
This study sought to determine the impact of spreading the culture of quality in improving the quality of tourism service in some hotels in Erbil governorate. The theme of excellence in providing service and attention to it has become the concern of most organizations in general and tourism service organizations in particular. Tourists try to establish the mental status of customers about their tourism organizations had to pay attention to the quality of service provided to the customer and work to develop them to the advanced stages of satisfaction and happiness of customers and this will certainly positively affect the improvement of service in the tourism sector, Of the research variables were examined statistically by distrib
... Show MoreThe research aims to show the effect of some short-term debt instruments (central treasury transfers, cash credit granted to the government by commercial banks) on the production of the wheat crop in Iraq, through its effect on money supply during the period (1990-2018), As the study includes two models according to the statistical program (Eviews9), the first model included measuring the effect of short-term debt instruments on money supply, and the second measuring the extent of the money supply's impact on Wheat crop production, as the results of the standard analysis showed that the short-term debt instruments used in the model were Significant effect on wheat crop production indirectly through its effect on money supply, As
... Show MoreThe present study attempts to identify some of the differences between the skull bones of two species Cyprinus carpio and Carassius carassius, which belong to the Cyprinidae family. The study is a taxonomic diagnostic study between the two species which are considered local fish abundant in the Iraqi aquatic environment
Background: 37% phosphoric acid (PA) is the traditional enamel etching technique prior to bracket adhesion, yet it has been implicated in numerous enamel injuries. The purpose of the current study was to create a calcium phosphate (CaP) etching paste in a simplified capsule formula that can underpin clinically adequate bracket bond strength without jeopardizing the integrity of enamel upon the debracketing procedure. Materials and Methods: micro-sized hydroxyapatite (HA) powder was mixed with 40% PA solution to prepare experimental acidic CaP paste. Sixty human premolars were assigned into two groups of 30 each. Enamel conditioning was accomplished using 37% PA-gel for control group and CaP paste for e
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