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.
Abstract
Objectives: To find out the association between enhancing learning needs and demographic characteristic of (gender, education level and age).
Methods: This study was conducted on purposive sample was selected to obtain representative and accurate data consisting of (90) patients who are in a peroid of recovering from myocardial infarction at Missan Center for Cardiac Diseases and Surgery, (10) patients were excluded for the pilot study, Data were analyzed using descriptive statistical data analysis approach of frequency, percentage, and analysis of variance (ANOVA).
Results: The study finding shows, there was sign
... Show MoreIsolation of fungi was performed from February to July, 2019. One hundred clinical specimens were collected from King Abdullah Hospital (KAH) Bisha, Saudi Arabia. Samples were collected from twenty patients of different ages (30 - 70 years old) ten males and ten females. The samples were collected from patients with the two types of diabetics. Specimens included blood, hair, nail, oral swabs and skin. Specimens were inoculated on Sabourauds Dextrose agar containing chloramphenicol. Thirteen fungal species were isolated and identified. The isolated species were: Aspergillus flavus, A. niger, A. terrus, A. nidulans, A. fumigatus, Candida albicans, C. krusei, C. parapsilosis, C. Tropicalis, Curvularia lunata, Fusarium solani, Penicill
... Show MoreThis paper presents a computer simulation model of a thermally activated roof (TAR) to cool a room using cool water from a wet cooling tower. Modeling was achieved using a simplified 1-D resistance-capacitance thermal network (RC model) for an infinite slab. Heat transfer from the cooling pipe network was treated as 2-D heat flow. Only a limited number of nodes were required to obtain reliable results. The use of 6th order RC-thermal model produced a set of ordinary differential equations that were solved using MATLAB - R2012a. The computer program was written to cover all possible initial conditions, material properties, TAR system geometry and hourly solar radiation. The cool water supply was considered time
... Show MoreThis study aims to find out the effectiveness of a cognitive-behavioral counseling program in enhancing self-management in reducing the academic procrastination of tenth-grade male students. The sample consisted of (26) male students divided into an experimental group of (13) students and a control group of (13) students. Two scales of self-management and academic procrastination were used, prepared by the researcher. The counseling program was prepared by the researcher. The results showed the program's effectiveness in enhancing self-management and reducing academic procrastination in the posttest, as it showed the continuation of this enhancement in self-management and the increase in the reduction of procrastination in the follow-up
... Show MoreThe banking sector is a cornerstone of the national economy because of its large role of economic development of a country, which requires the advancement of this vital sector and interest in all the accompanying changes to him in order to survive and grow and continue Accordingly dealt Find reversal (organizational culture, on the quality of banking service ) sought search to achieve a number of cognitive and practical goals by selecting (10), especially among the working banks in Iraq Iraqi banks and the period is the surveyed period (2005-2014) embodied the research problem in the dialectical relationship between the (organizational culture) and its impacts on banking service quality.
Through a set of
... Show MoreIraq suffers from serious pollution with harmful particles that have important direct and indirect effects on human activities and human health. In this research, a system for detecting pollutants in the air was designed and manufactured using infrared laser technology. This system was used to detect the presence of pollutants in the dust storms that swept the city of Baghdad which could have a negative impact on human health and living organisms.
The designed detection system based on the use of infrared laser (IR) with a wavelength of 1064 nm was used for the purposes of detecting pollutants based on the scattering of the laser beam from these pollutants. The system was aligned to obtain the best signal for the scattered rays, w
... Show MoreThe influence of 5-10 kHz audio frequency on the power dissipation in ac discharge of argon gas was studied experimentally, at pressures 50-80 mTorr and electrodes separation 10 cm (pd range 0.5-0.8 Torr.
cm). The measurements have shown that the discharge behavior in the ac circuit is equivalent to a series RC circuit. It is observed that the variation curve of discharge power P with the frequency f is approximately has a Gaussian shape. It is also observed that the curve of Pm- pd is the inverse of Paschen curve, where Pm is the maximum power in the frequency range. The time of breakdown is estimated from the curve of P- f.
Background: Genioglossus advancement is a surgical procedure to advance the tongue in some patients with obstructive sleep apnea syndrome.The important step in this procedure is that of accurately capturing the bone segment attached to the genioglossus muscle to avoid complications such as mandibular fracture, devitalization of the inferior incisor roots, and incomplete incorporation of the genioglossus Materials and Method: Computed tomography scans were taken for 53 Iraqi adult patients (28 male and 25 female) range from (18-35) years with skeletal class I classification and intact anterior mandible dentition included in this study using sagittal and axial sections. The measurements were done for genial tubercle and anterior mandibular re
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