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.
Specialized banks provide their banking activities to their customers at interest rates that are determined according to the approved bank policy, which is almost similar to most or most banks. To satisfy the financial desires of customers and at the same time it is a source of the bank's profits, However, these banks have been introduced to new services that they provide with the funds of the Central Bank initiative launched at the beginning of (2016) to address the economic stagnation that befell the country due to the (financial security) crisis that the country faced in 2014. To put forward initiatives amounting to nearly (15) trillion dinars, which were put forward through private commercial and Islamic banks and specialized
... Show MoreCyprinidae species are the most abundant and widely distributed fish species in the inland waters of Iraq. Cyprinids are complex species, and it is difficult to identify them on the basis of morphology. Thus, the morphological characteristics must be achieved and confirmed by molecular analysis. Twenty specimens of Cyprinion kais Heckel, 1843 (Piscies, Cypriniformes, Cyprinidae) were collected from two localities at Tigris River in the middle of Iraq: five specimens from Al-Tharthar Lake, Saladin Province, and 15 specimens from Al- Zubaydiyah sub-district, Wasit Province. The DNA sequences of C. kais were done using the mitochondrial DNA cytochrome b (cytb) gene. After analysis, the sequences were compared with sequences of ot
... Show MoreThe environmental contamination by the polycyclic aromatic hydrocarbons (PAHs) and heavy metals (Pb, Cu, Ni, Cr, and Cd) concentrations in the leaves of plant Eucalyptus camaldulensis were determined at the city of Kirkuk in 15 selected locations using GPS. The pickings up of samples were carried out in two periods October 2010 and March 2011. Compared with results of other studies, the concentration levels of determined heavy metals show values within these studies results. The average total concentration of polycyclic aromatic hydrocarbons (PAHs) in the leaves of Plant Eucalyptus camaldulensis indicated 37.1 ppb in October, while in March 165.2 ppb.
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... Show MoreBackground: The success and maintenance of indirect dental restorations is closely related to the marginal accuracy, which is affected by many factors like preparation design, using of different fabrication techniques, and the time of taking final impression and pouring it. The purpose of this in vitro study was to evaluate the effect of different pouring time of conventional impression on the vertical marginal gap of full contour zirconia crowns in comparison with digital impression technique. Materials and Methods: Forty sound recently extracted human permanent maxillary first premolar teeth of comparable size and shape were collected. Standardized preparation of all teeth samples were carried out to receive full contour zirconia crown re
... Show MoreBackground: The success and maintenance of indirect dental restorations is closely related to the marginal accuracy, which is affected by many factors like preparation design, using of different fabrication techniques, and the time of taking final impression and pouring it. The purpose of this in vitro study was to evaluate the effect of different pouring time of conventional impression on the vertical marginal gap of full contour zirconia crowns in comparison with digital impression technique. Materials and Methods: Forty sound recently extracted human permanent maxillary first premolar teeth of comparable size and shape were collected. Standardized preparation of all teeth samples were carried out to receive full contour zirconia crown re
... Show MoreThis study aims to answer a significant problem of social sciences and philosophy: How do we construct an institutional reality such as diplomacy with an objective recognizable existence? The study assumes that the ability to build institutional reality is based on our biological capacity, as it takes different forms in all the institutions we construct. The study takes the theory of the American philosopher John Searle as an approach to examining the assumption. The study sums up important findings; cultures, although they share the biological capacity on which they produce institutional realities, differ in the form of the value standards on which the institutional realities are based. The study recommends the need of Arab social resea
... Show More The TV has the ability to combine sound and picture, which makes it of a direct impact on the recipient as it is a rich communicative tool with various artistic forms that display through this small screen programs and films, so that the TV has become superior over many other means of communication.
This research is concerned with the technical and artistic ability in the production of programs owned by the TV as a means of attraction of educated children aged between 5-12 years old, which makes it an educational supplement for the school that helps them in providing knowledge, acquiring skills and being informed about the different sciences through educational programs. It is known that the child at this stage enjoys when wa
The study intends to explore the obstacles that encounter a program of rehabilitating released prisoners as perceived by prisoners themselves in tubas' province. To this end, the researcher used a questionnaire as an instrument which was applied on (150) prisoner had chosen randomly to collect the study data. The findings revealed no significant differences among obstacles the encounter program regarding to the following variables: age, detention period, and number of detention, additionally, the findings found that there is a variance of obstacles mean according to the prisoners themselves, rehabilitation program, and the facility of that program.