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.
This paper is concerned with introducing and studying the new approximation operators based on a finite family of d. g. 'swhich are the core concept in this paper. In addition, we study generalization of some Pawlak's concepts and we offer generalize the definition of accuracy measure of approximations by using a finite family of d. g. 's.
ABSTRACT: Oxadiazole ring is a heterocyclic molecule with an oxygen and two nitrogen atoms spread throughout its five-membered structure. There are four different isomers that have been discovered, Because of their wide applications in a range of sectors, including medications . Some of these biological activity are; anticonvulsant capacity, anticancer as well, antibacterial, antiviral, antifungal, antimalarial, antitubercular, anti-asthmatic, antidepressant, antidiabetic, antioxidant, antiparkinsonian, analgesic and anti-inflammatory, are just some of the therapeutic uses that have drawn attention to drug candidates containing an oxadiazole moiety. This review, we will examine the various methods of oxadiazole synthesis. The mo
... Show MoreBackground: Secretory Immunoglobulin A (SIgA) is a subclass of Immunoglobulin A (IgA), It is an antibody that plays an important role in mucosal immunity. It is the main immunoglobulin found in mucous secretions from mammary glands, tear glands and salivary glands, every pathologic process in the body involves the immune system, and periodontal inflammation is one of them and is not an exception. Material and methods: this study was consisted of 60 healthy male participants of an age ranged between (35-50) years old ; 25 of them with generalized moderate chronic periodontists(Clinical Attachment Loss equal to 3-4mm at ≥ 30% of the sites; 20 participants with plaque induced gingivitis and 15 participants had clinically healthy pe
... Show MoreInefficient wastewater disposal and wastewater discharge problems in water bodies have led to increasing pollution in water bodies. Pollutants in the river contribute to increasing the biological oxygen demand (BOD), total suspended solids (SS), total dissolved solids (TDS), chemical oxygen demand (COD), and toxic metals render this water unsuitable for consumption and even pose a significant risk to human health. Over the last few years, water conservation has been the subject of growing awareness and concern throughout the world, so this research focused on review studies of researches that studied the importance of water quality of wastewater treated disposal in water bodies and modern technology to management w
... Show MoreHistorically, medicinal herbs have been utilized as an important origin of chemicals with particular therapeutic potentials, and they continue to be a great place to find new medication candidates. Parthenocissus quinquefolia L. is a member of the grape-growing family Vitaceae. It is indigenous to Central and North America. It is widely dispersed in Iraqi gardens and plant houses from north to south. Traditionally, it has many uses, like relieving constipation, treating jaundice, expectorant, emetic, and others. At the same time, its proven activities include antioxidant activity, antimicrobial, anti-diabetic, thrombin inhibitor effect, and medicine for treating eyelid eczema. Parthenocissus quinquefolia contains valuable phytochemicals lik
... Show MoreThe preparation of composite metal oxide to attain high efficiency in removing phenol from wastewater has a great concern. In the present study, the focus would be on adopting antimony-tin oxide coating onto graphite substrates instead of titanium; besides the effect of SbCl3 concentration on the SnO2-Sb2O3 composite would be examined. The performance of this composite electrode as the working electrode in the removal of phenol by sonoelectrochemical oxidation will be studied. The antimony-tin dioxide composite electrode was prepared by cathodic deposition with SnCl2 . 2H2O solution in a mixture of HNO3 and NaNO3, with different concentrations of SbCl3. The SnO2-Sb2O3 deposit layer’s structure and morphology were examined and the 4 g/l Sb
... Show MoreThe present research is descriptive and analytical by nature; it practically presents the method of implementing the standard pattern in an unconventional way using the bias-cut line. The study aims at investigating the variables of bias-cut and their suitability for fitting large-shaped Iraqi ladies. It also aims at exploring the artistic and innovative features of the bias-cut. Therefore, one needs to understand the rules and basics of clothing and the nature of the body to reach the maximum degree of control.Consequently, the study is to answer the following questions: What is the effectiveness of tailoring on the bias-cut in fitting a standard template of a large-shaped Iraqi ladies? Is it possible to obtain from the offered possibil
... Show MoreThe theme of love has been and still is the interest of authors and writers for it is closely related to people’s lives. That great passion has helped them express genuine thoughts pertinent to that theme that has given rise to many debates, some are vague and others controversial. In his (strait is the gate), (La Porte étroite), André Gide has sought to shed light on his characters perspective of love and its relationship with sacredness and divine happiness. Indeed these characters have found often themselves restrained, chained and exhausted, by tough religious commands that have imposed on them spiritual commitments and duties too hard to break.
André Gide has revealed a protestant deviation from the perfection theme tha
... Show MoreThe health care provided by health institutions and all kinds suffers from many problems, and since the health services provided are related to human life, it is necessary to shed light on this activity and identify the causes of these problems. This research aims to Definition of health institutions (hospitals) Performance audit of these institutions according to the latest indicators, which are the standards of health accreditation for hospitals, specifically the basic standards issued by the Health Care Accreditation Council (HCAC) to reach the level of performance and Knowledge of Constraints that lead to in an acceptable manner consistent with the approved standards. In theoretical and practical study, a number of conclusions were r
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