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 aim of the present study is to evaluate the change in the levels of glucagon, GLP-1 and GPCR in diabetic patient's and diabetic with dyslipidemia as metabolic syndrome. The study included 75 male aged ranged (30-50) years and with BMI (25-29) kg/m2 which divided into three groups as follows: group one (G1): consist of 25 subjects as healthy control group. Group two (G2): consist of 25 patient's with diabetes mellitus and group three (G3): consist of 25 patient's with diabetic and dyslipidemia as metabolic syndrome. Serum was used in determination of FBG, lipid profile, insulin, glucagon, GLP-1 and GPCR. Whole blood was determination of HbA1c. The results revealed significant elevation in FBG and HbA1c in G2 and G3 comparing to G1. While
... Show MoreThe concept of intertextuality was one of the problems that occupied the attention of critics and critics in targeting the structure of textual intertextuality between texts and their overlap in the process of producing meaning. Until intertextuality became a stable term and it can be monitored in the structure of the theatrical text and determining the mechanisms of this intertextuality between texts through fields and classifications agreed upon by the most important critics who wrote and considered intertextuality. Perhaps our previous research (the approach of exposure in the epistemological hallway to intertextuality) was an attempt to interview a terminology, which the researcher intended to monitor, through the mechanisms of inter
... Show MoreThe rapid reality of events in the information era, and the enormous pressure of forces market, competition, permanent movement of the markets and consumers and the large development unprecedented of technology in all areas make a lot of organizations find it difficult to keep up with this rapid developments .Here was the role of strategic vigilance closer organization to their environment ,and play an active role in providing the necessary information to make decisions and insurance companies are not far from those changes .On this basis the researcher offered studied(Over the awareness of managers of insurance companies for strategic vigilance).Choosing sample of 35 managers in the National Insurance Company to test th
... Show MoreThe technique of plant tissue culture has been used to In vitro micropropagation of Spilanthes acmella (L.) Murr. It is an ornamental and medicinal plant not cultivated in Iraq. Seeds were sterilized and cultuared on full strength Murashige and Skoog medium(1962)(MS). Naphthalene acetic acid (NAA), 6- furfuryl aminopurine (Kin.) growth regulators were used at the Initiation stage.The combination between IAA and Kin. was used in multiplication stage. IAA was used for rooting the shoots. Results showed that 1.5% sodium hypochlorite for 15 min was very effective for disinfecting and survival. Nodes exhibited relatively highest response as compared with apical meristems and leaflets culture. Supplying the culture medium with 1 mg/L.
... Show MoreIn the past years, the Algerian Economy has witnessed various monetary developments characterized by different monetary and banking reforms aimed by monetary authorities to achieve monetary stability and driving overall growth. It should be noted that there is evidence to initiate fundamental changes on the basis of which new monetary, financing and banking policy mechanisms must be formulated in Algeria by enhancing the pursuit of reforming the monetary system, in order to improve monetary and economic indicators.
The study a
... Show MoreThe importance of our research is that it examines the causes and sources of the security challenges in the internal security environment of the GCC countries, and aims to address the most important issues that are of great interest, namely, the issue of inter-GCC differences and addressing the issues of regional security for the Gulf region, After it is one of the most dynamic and more polarized areas for the emergence of threats and challenges because of the multiplicity of sources of threat and their complexity due to the specificity of the strategic environment and the negative repercussions it can have on the Gulf region, especially the issue of regional security of the Gulf Cooperation Council Which has become a magnet for competing i
... Show MoreBackground: the oral cavity is consider to be an open ecosystem, with the balance between the microorganism’s entrance and the defenses of the host. The initiation of periodontitis has been associated with restricted kinds of anaerobic bacteria, such as Aggregatibacter actinomycetemcomitans (A.a) and Porphyromonas gingivalis (P.g) in plaque subgingivally. Ozone has a biological effects on bacteria due to oxidation of bio-molecules and its toxins. The aim is to determine and compare the antimicrobial effect of gaseous ozone and ozonized water on the growth of isolated anaerobic bacteria (A.a and P.g) when exposed to different time intervals. Materials and methods:This experiment is done byozone generator OLYMPIC- III(600mg/hr) to gene
... Show MoreThe aim object of research is to show the computerized services library of Salahaldeen University in Erbil city in Iraq, so the research treatment all side of library such as building, location ,staff ,finance, resource collection and services ,we refer to. problem which face library such as administration and finance through the using Of case study method, reference source ,meeting , online comment and data record .The study focus develop in library departments, users services, management ,staff, the resource collection, building and location.
The study ending with many results and recommendation to develop the library services by using modern Information system to all users inside and outside the university and link them with other
One of the most popular causes for implant infection is dental plaque bacteria. Previous studies have shown the bactericidal effect of CO2 laser irradiation on bacteria associated with soft tissue surrounding the implant materials. No published studies have examined the effect of irradiation by CO2 laser on Streptococcus oralis and Staphylococcus aureus.The aim of this study was to evaluate the bactericidal effect of CO2 laser on bacteria that are causing dental implant infections. This study was carried out on two isolates of bacterial species out of 25 samples, isolated from patients having soft tissue infections around the dental implant. These two pure isolates including Streptococcus oralis and Staphylococcus aureus were identified
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