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.
م. د. ولاء طارق حميد, Al. Qadisiya journal for the Sciences of Physical Education, 2017
Breast cancer is the most common malignancy affecting women's health, with an increasing incidence worldwide. This study aimed to measure the intracellular concentration of the hypoxia-inducible factor 1 α (HIF-1α), tumor suppression protein p53, and estradiol (E2) in tumor tissues of adult females with breast cancer and their relation to tumor grade, tumor size, and lymph node metastases (LNM). The study was conducted on 65 adult female participants with breast mass admitted to the operating theater in Al-Hussein Teaching Hospital and Al-Habboby Teaching Hospital in Nasiriyah, Iraq, from January to November 2021. Fresh breast tumor tissues were collated and homogenized for intracellular biochemical analysis using the enzyme-linked immuno
... Show MoreThe research aims to measure the effect of sensory marketing (visual marketing, audio marketing, olfactory marketing, taste marketing, tactile marketing) in enhancing customer loyalty (behavioral loyalty, situational loyalty, perceptual loyalty) and the mediating role of marketing knowledge (product knowledge, price knowledge, promotion knowledge knowledge of distribution, knowledge of employees, knowledge of physical evidence, knowledge of the process) in a group of large single market markets in Baghdad and the researcher chose it because of the challenges faced by large single market in satisfying the customer and maintaining it as a permanent visitor and enhancing his loyalty, and the research problem was identified with a main
... Show MoreAbstract The aim of this research is to show the grade of implementation of ISO 26000 (Social Responsibility Standard), specifically which related in clause sex (consumer issues), this study was achieved in Market Research and Consumer Protection Center (MRCPC) / University of Baghdad. The seven consumer issues of ISO 26000 was analyzed to show the extent of its implementation in MRCPC depending of using a check list as a principle instrument to collect research data and information. Results analysis was achieved by percentages and mean average. The research was leaded some of results and the most importance one was that the grade of implementation of the center in related to consumer issues given in the standard was medium
Background: Restoration of the gingival margin of Class II cavities with composite resin continues to be problematic, especially where no enamel exists for bonding to the gingival margin. The aim of study is to evaluate the marginal leakage at enamel and cementum margin of class II MOD cavities using amalgam restoration and modern composite restorations Filtek™ P90, Filtek™ Z250 XT (Nano Hybrid Universal Restorative) and SDR bulk fill with different restoratives techniques. Materials and method: Eighty sound maxillary first premolar teeth were collected and divided into two main groups, enamel group and cementum group (40 teeth) for each group. The enamel group was prepared with standardized Class II MOD cavity with gingival margin (1 m
... Show MoreBackground: Recently increasing number of people are using mouthwashes for general and oral care while the primary appeal of a mouthwash is an aid to breath freshness and cleansing the mouth, the majority of mouthwashes also claim to have antiseptic properties. The aim of this study is to determine the antimicrobial effectiveness of eight types of mouthwashes against Streptococcus mutans, Staphylococcus aureus and Candida albicans in vitro. Materials and methods: Agar diffusion technique was used to evaluate the antimicrobial activity of eight types of mouthwashes against Streptococcus mutans, Staphylococcus aureus and Candida albicans isolated from the oral cavities of patients attending dental clinics at college of dentistry - Baghdad Uni
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