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
A new type of solar air heater was designed, fabricated, and tested in Baghdad, Iraq winter conditions. The heater consists of two main parts. The horizontal section was filled with the black colored iron chip while the vertical part has five pipes filled with Iraqi paraffin wax. A fan was fixed at the exit of the air. Two cases were studied: when the air moved by natural convection and when forced convection moved it. The studied air heater has proven its effectiveness as it heated the air passing through it to high temperatures. The results manifest that using little air movement makes the temperatures, stored energies, and efficiencies of the two studied cases converge
... Show MoreFind cares studying the aesthetics of environmental art, one of the topics that is one of the problems of the aesthetic side in the arts of postmodernism, so this research came as an attempt to get to know the aesthetic concepts of environmental art that can be learned from functional testing in the formation of the post-modern control. The research involved four chapters: The first chapter discusses the general framework of the research methodology, as it was displayed in itThe research problem and its importance and define its objective to identify the aesthetics of environmental art at the level of the body, meaning, the receiver .ozlk in Iraq and America as the spatial limits of the time limits are period stretching from 1970 to 2006
... Show MoreThe present paper focuses on the nature of the different interactions between cometary nucleus and tail with solar wind. The dynamics of the comet will impose many features that provide unique behavior of the comet when entering the solar system. These features are reviewed in this paper and few investigations are made. The calculations made in this work represent the analysis and interpretation of the different features of the comet, such as perihelion and eccentricity dependence on the gas production rate, and the dependence of the latter on the composition of the comet nucleus. The dependences of the heliocentric, bow shock, contact surface, and stand-off distances with gas production rate for many types of comets that cover linear and n
... Show MoreThe poet (Ahmed Safi Najafi), who came to the poet was a fabric alone, and gathered all the writers and critics who wrote in his poetry as a phenomenon worthy of research, study and meditation as he turned to poetic topics, some strange did not pay attention to poets who preceded him and went to poetic horizons not worn by other poets Those who lived in his time, he refused to gain poetry and attacked hypocrisy and his poets and critics, and rejected the festivals of poetry (festivals on the sidewalk is held) and called for renewal and renunciation of tradition, and ushered in a new world predominant humanism, and gave money to his companions, and played for women and the world, and married Alaqqam and pain, and sincerest For his hair, T
... Show MoreThis is a survey study that presents recent researches concerning factional controllers. It presents several types of fractional order controllers, which are extensions to their integer order counterparts. The fractional order PID controller has a dominant importance, so thirty-one paper are presented for this controller. The remaining types of controllers are presented according to the number of papers that handle them; they are fractional order sliding mode controller (nine papers), fuzzy fractional order sliding mode controller (five papers), fractional order lag-lead compensator (three papers), fractional order state feedback controller (three papers), fractional order fuzzy logic controller (three papers). Finally,
... Show MoreAfter studying the reality of application to occupational safety in new Iraqi building projects and sampling the situation wilt that in developed and neighboring countries, researcher found that there is a big gap in the level of safety application conditions, this indicates the need fora quick and clear reference for local engineers to use it on site for safety conditions in their projects . As a case study the monitors work the researcher studied a huge project in the United Arab Emirates.This project considered for safety requirements to highest grades. This case study may be far away from the projects in Iraq, but we hope to rise the Iraqi work level in the near future. After seeing the way of administration work and how they were ra
... Show MoreThe aim of the research is to use this technique and to determine the effect of this method in reduce cost per unit of the company. The traditional method used in the company the research sample to determine the indirect costs, the definition of the concepts and characteristics of the method of cost-based activity and the cost method based on time-driven activity and justifications applied to companies. In order to achieve the research objectives, the main hypotheses were formulated. That was represented: (The applied of (TDABC) Time driven activity based costing method in reducing indirect costs, leads reduce cost per unit than the use of the traditional method of allocating indirect costs in the research sample company).&nb
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The most famous thing a person does is talk. He loves and hates, and continues with it confirming relationships, and with it, too, comes out of disbelief into faith. Marry a word and separate with a word. He reaches the top of the heavens with a kind word, with which he will gain the pleasure of God, and the Lord of a word that the servant speaks to which God writes with our pleasure or throws him on his face in the fire. Emotions are inflamed, the United Nations is intensified with a word, and relations between states and war continue with a word.
What comes out of a person’s mouth is a translator that expresses the repository of his conscience and reveals the place of his bed, for it is evidence of
... Show MoreThis paper studies the investment project evaluation under the condition of uncertainty. Evaluation of investment project under risk and uncertainty is possible to be carried out through application of various methods and techniques. The best known methods are : Risk-adjusted discount rate , certainty equivalent method , Sensitivity analysis and Simulation method The objective of this study is using the sensitivity analysis in evaluation Glass Bottles project in Anbar province under the condition of risk and uncertainty.
After applying sensitivity analysis we found that the glass bottles project sensitive to the following factors (cash flow, the cost of investment, and the pro
... Show MoreThis study included the isolation and diagnosis of Pseudomonas aeruginosa from cases of burns samples. 100 samples were collected from resident patients at Al-Kindi Teaching Hospital, who suffer from different types of burns. Pseudomonas aeruginosa was isolated and diagnosed with 39% of the total samples. The cold and hot aqueous and alcoholic extract of flaxseeds oil was prepared and its inhibitory efficacy has been studied on the growth of isolated Pseudomonas aeruginosa. It is revealed that both extracts of flaxseeds oil had a high inhibitory effect on Pseudomonas aeruginosa growth. The Minimum Inhibitory Concentration (MIC) of flaxseed oil on the studied bacteria was also estimated, which was 25 mg/ml. In conclusion, the efficacy of fla
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