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.
When we talk about the foresight in films, it is necessary to talk about dreams because foresight represents one of its distinct types. The Precognitive vision has become a possible material in dealing with as subjects in the film industry that adopt these ideas with their philosophical and scientific orientations, because they represent the imagination that predictors are specialized with. It can be invested through the introduction of a vision of another kind to achieve its goals and ambitions in the film industry and in particular the huge institutions of production as in Hollywood. The cinema works in the light of those concepts of production which found the prognostic dream (the foresight) as a distinctive genre in its films,
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In the last decades, using mineral admixture in concrete became very necessary to improve concrete properties and reduce CO2 emissions associated with the cement production process. Subsequently, more sustainable concrete can be obtained. Ternary blended cement containing two different types of mineral admixture can achieve ambitious steps in this trend. In this research, the synergic effects of mineral admixtures in ternary blended cement and its effects on concrete fresh properties, strength, durability, and efficiency factors of mineral admixture in ternary blended cement, were reviewed. The main conclusion reached after reviewing many literature pieces is that the concrete with ternary blended cement
... Show MorePoliteness strategies are of significant importance to maintain the face of the addressee. Senders of formal congratulatory letters seek to create a positive image in the minds of their addresses by performing particular illocutionary acts and face-saving acts (FSAs) in the form of written texts. To the best knowledge of the researcher, this topic received little attention from linguistic researchers, especially on the pragma-stylistic level. The importance of this study arises from the fact that congratulatory formal letters are an effective tool in the successful performance of foreign relations and thus deserve investigation. The current study investigates the pragmastylistic aspects of illocutionary acts and FSA Politeness Stra
... Show MoreThe paper discusses the lack of a uniform definition of politeness due to the constant tension between its universality and language specificity, and argues that some of the theoretical debate could be resolved if the distinction between politeness as a commonsense notion and politeness as a theoretical construct were clearly addressed and acknowledged in the research.
Understanding energy metabolism and intracellular energy transmission requires knowledge of the function and structure of the mitochondria. Issues with mitochondrial morphology, structure, and function are the most prevalent symptoms. They can damage organs such as the heart, brain, and muscle due to a variety of factors, such as oxidative damage, incorrect metabolism of energy, or genetic conditions. The control of cell metabolism and physiology depends on functional connections between mitochondrial and biological surroundings. Therefore, it is essential to research mitochondria in situ or in vivo without isolating them from their surrounding biological environment. Finding and spotting abnormal alterations in mitochondria is the
... Show MoreNovel has recently received the attention of readers and writers greatly, because of the role they play, and this indicates an important rule, which is whenever there is an art or creativity, there must be a respective criticism, and this criticism is certainly not less important than the author. So there are critics who have a prestigious literary position in the follow-up story development, and trying to describe the transformation of its elements. One of these critics is professor Fadhel Thamer, and who wants to approach one of the elements of the novel exploring, must stop on the visions of this critic about it , and that’s why we take the (character) element following the most important opinions of this critic about
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