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 research tacklets the role of risks arising from the excessive use of derivative contracts for trading in financial crises, including the recent global financial crisis in (2008) which is known the mortgage crisis.
In order to prove the hypothesis of the research, the risk index of derivative contracts has been chosed as expressed in the measure of (value at risk) to be the main field for testing the hypothesis of research. The duration of the contract has been also chased for (15) years between the years (2001- 2015), the period preceding the global financial crisis, while the second represents the period of time that followed. The research reached a number of conclusions, bu
... Show MoreBackground: This in vitro study evaluated the fracture resistance of weakened endodontically treated premolars with class II MOD cavities restored with different composite restorations (Low-shrinkage Filtek P90, nanohybrid Filtek Z250 XT and SDR bulk fill). The type and mode of fracture were also assessed for all the experimental groups. Materials and Method: Fifty human adult maxillary premolar teeth were selected for this study. Standardized extensive class II MOD cavities with endodontic treatment were prepared for all teeth, except those that were saved as intact control. The teeth were divided into five groups of ten teeth each (n=10): (Group 1) intact control group, (Group 2) unrestored teeth with endodontic treatment, (Group 3) resto
... Show MoreThe study aimed to evaluate educational programs efficiency in applying the best educational practices to educate students from the dangers of indecent behaviors, in line with higher education policy and the appropriateness of educational program dimensions to spread awareness among students to not fall into the indecent behaviors clutches. The study adopted the inductive exploratory approach through structural equation modeling and the descriptive analysis of the collected data from randomly selected sample (n=385) from educational academics at Northern Border University in the Saudi Arabia using a specially designed survey tool to meet study purposes to evaluate dimensions of teaching methods, evaluation tools, training courses, course
... Show MoreImportance of accounting standards belong to be the instructor and the advisor for accountant in performing his work . For each invironment a group of political, social, economical and cultural factors which distinguish it about other environments . In order to perform its aim in produsing accouting information helps in making decisions on different levels, accounting standards should established in a form that harmonized with the environment that apply in it . Establishing international accounting standards comes with the same direction and then it has put influential with standards some states that have influence on international accounting standards committee. So because of the big changes that happened in the inte
... Show MoreCopper (Cu) is an essential trace element for the efficient functioning of living organisms. Cu can enter the body in different ways, and when it surpasses the range of biological tolerance, it can have negative consequences. The use of different nanoparticles, especially metal oxide nanoparticles, is increasingly being expanded in the fields of industry and biomedical materials. However, the impact of these nanoparticles on human health is still not completely elucidated. This comparative study was conducted to evaluate the impacts of copper oxide nanoparticles (CuO NPs) and copper sulphate (CuSO4 0.5 (H2O)) on infertility and reproductive function in male albino mice BALB/c. Body weight, the weight of male reproductive organs, mal
... Show MoreThe study aims to determine the organizational monitoring mechanism in target organization as well as knowing the suffocation of work. The study depends on a questionnaire as a tool of collecting data on distributed random sample involved (45) person from different levels in manufacturing isphelt Dohuk. The study depends on some hypothesis, the most significant one is that there is not impact of organizational monitoring of suffocation especially on the target organization.
Of the new concepts introduced by the decree of the amendment of the French Civil Code No. 131-2016 issued on 10 February 2016, which raised a debate in jurisprudence both at the level of French jurisprudence or the Arab, the concept of (the content of the contract), which seems to have emerged from the appearance of new legal articles ( 1162-1171) is the cornerstone of the contract and the contract in the contract, the two pillars which, over the course of 200 years and a half, have been one of the main pillars of the codification of Napoleon. Is that the decree of amendment has already abandoned these two pillars, or most of what he did is a change in terminology while preserving the content of these two pillars implicitly, this is what w
... Show MoreThe study aimed to analyze the effect of meteorological factors (rainfall rate and temperature) on the change in land use in the marshes of the Al‐Majar Al‐Kabir region in southern Iraq. Satellite images from Landsat 7 for 2012 and Landsat 8 for 2022 were used to monitor changes in the land coverings, the images taken from the Enhanced Thematic Mapper Plus (ETM+) and Operational Land Imager (OLI) sensors of the Landsat satellite. Geometric correction was used to convert images into a format with precise geographic coordinates using ArcMap 10.5. The maximum likelihood classification method was used to examine satellite image data using a supervised approach, and the data were analyzed statistically. We obtained clear images of the area,
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