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.
Our research comes to shed light on Iraqi literature as literature that arose in special circumstances alongside foreign literature. Using comparative research methods, we chose to highlight two distinguished writers, who have their mark in the world of literature. The first is the Iraqi writer Maysaloun Hadi, who is considered an icon of Iraqi feminist literature, and the second is the French writer Le Clézieu, who won the Nobel in 2008. We will see through the research how the two authors expressed their views of modernity and urbanism. And how each of them separately portrayed the psychological and moral projections that formed the essence of man today.
Résumé
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... Show MoreThe high bounce activity according to the fosbery way is regarded as of the difficult sports concerning its way of training and perfection due to hard technique of its performance on one hand and because it depends on the player’s ability to overcome body weight resistance against the gravity. In addition to the strong ability to control the body posture when leaving the land and flying over the barrier. This activity needs to high plosion power at the moment of bouncing and this plosion depends on the period of bouncing, so the two researchers aimed to use a mechanical bouncing platform and an electronic one through several training by one foot and both feet in different directions and positions in order to reduce the time of bouncing an
... Show MoreLas diferencias entre el pretérito perfecto simple y el imperfecto son uno de los temas más complejos de la lengua española, no sólo para el estudiante, sino para el profesor, puesto que sistematizar los casos y hacerlos fácilmente comprensibles al alumno es tarea difícil. Los profesores de lengua, cuyas investigaciones han dado lugar a una serie de teorías y de corrientes metodológicas y didácticas que permiten enfocar la enseñanza de una lengua extranjera de manera muy distinta a como se hacía tradicionalmente. Vamos a repasar muy brevemente cuáles son estas teorías.
En primer lugar es necesario señalar en qué consiste el aprendizaje de una segunda lengua:
"El aprendizaje de una segunda lengua (L2) es el
... Show MoreThis research seeks to study the role of proactive leadership as an essential element that helps all federations that lead the wheel of sports, including the Iraqi Handball Federation, so that it builds a correct environment that helps manage the organizational errors that the Handball Federation may fall into, and this in turn helps in early detection of errors and obstacles that may occur. It is likely that the Federation will fall into the process of managing and organizing the Iraqi Handball League, in addition to increasing the clubs’ ability to assist the Iraqi Handball Federation by being proactive so as not to make mistakes. The research community included the administrative bodies of the clubs participating in the Iraqi E
... Show MoreThe development taking place on the sports field at the general level and in the game of football at the private level, being the most popular game in the world, has reached very advanced stages. The use of modern aids and technology has contributed greatly to this development from the collective and individual aspects, as the goalkeeper is the most important position in the team, the use of devices gave objective readings about the goalkeeper’s ability in terms of skill and physical aspects, as the importance of the research lies in designing an electronic device to measure the degree of bending of the knee angle because of its great importance in developing the skill of catching and dimensions of the high ball for football goalkeepers.
... Show Moreيعتبر "تاج الأشواك" أو نبات شوكة المسيح، وهو من نباتات الزينة الطبية ، ينتمي إلى جنس يوفوربيا. E. milii يحتوي كميات وفيرة من المركبات الفينولية ، التربينات، الستيرويدات والقلويدات. كانت الأهداف الرئيسية لهذه الدراسة هي فحص مستخلصات الفلافونويد والنانو فلافونويد ضد نوعين من خطوط الخلايا السرطانية. تم تصنيع مركبات الفلافونويد النانوية عن طريق تفاعل مركب الكيتوسان والماليك اسد. تم تحليل مركبات الفلافونويد ال
... Show MoreSince the beginning of 21st century, the prices of Agricultural crops have increased. This Increases is accompanied with that increases of crude oil prices and fluctuation of a dollar exchange rate as a dominant currency used in the global trade. The paper aimed to analysis the short run and long run cointegration relationships between prices of some of Agricultural crops imported by Iraq such as wheat and rice crops and both the crude oil prices and the Iraq dinar exchange rate a gained America dollar using ARDL model. The results show the long run equilibrium between they three variable throng the error correction mechanizem. The results also show the significant and economically sound effects of cru
... Show MoreBackground: Many types of instruments and techniques are used in the instrumentation of the root canal system. These instruments and techniques may extrude debris beyond the apical foramen and may cause post-instrumentation complications. The aim of this study was to evaluate the amount of apically extruded debris resulted by using 4 types of nickel-titanium instruments (WaveOne, TRUShape 3D conforming files, Hyflex CM, and One Shape files) during endodontic instrumentation. Materials and methods: Forty freshly extracted human mandibular second premolar with straight canals and a single apex were collected for this study. All teeth were cut to similar lengths. Pre-weighted glass vials were used as collecting containers. Samples were randoml
... Show MoreWe consider the outflow of water from the peak of a triangular ridge into a channel of finite depth. Solutions are computed for different flow rates and bottom angles. A numerical method is used to compute the flow from the source for small values of flow rate and it is found that there is a maximum flow rate beyond which steady solutions do not seem to exist. Limiting flows are computed for each geometrical configuration. One application of this work is as a model of saline water being returned to the ocean after desalination. References Craya, A. ''Theoretical research on the flow of nonhomogeneous fluids''. La Houille Blanche, (1):22–55, 1949. doi:10.1051/lhb/1949017 Dun, C. R. and Hocking, G. C. ''Withdrawal of fluid through
... Show More<span lang="EN-US">In the last years, the self-balancing platform has become one of the most common candidates to use in many applications such as flight, biomedical fields, and industry. In this paper, the physical prototype of a proposed self-balancing platform that described the self-balancing attitude in the (X-axis, Y-axis, or biaxial) under the influence of road disturbance has been introduced. In the physical prototype, the inertial measurement unit (IMU) sensor will sense the disturbance in (X-axis, Y-axis, and biaxial). With the determined error, the corresponding electronic circuit, DC servo motors, and the Arduino software, the platform overcame the tilt angle(disturbance). Optimization of the proportional-integral-
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