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 current research seeks to achieve several objectives, including knowing the extent of the audit directorate of the Ministry of Construction, Housing and General Municipalities of the International Standard (ISO19011:2018) regarding determining the efficiency and evaluation of auditors and diagnosing the gap between requirements and application and knowing the reasons for not applying some of the items in the standard, starting from the problem, The field raised the following question (Does the audit directorate determine the efficiency and evaluation of auditors according to the standard ISO19011:2018?), and the importance of research lies in determining the return that can be achieved by the directorate through its application of stand
... Show MoreThis study aimed to know the impact of the capital structure measured by the ratio of financing to short-term capital and the ratio of financing to long-term capital on the profitability of companies, as measured by the rate of return on assets and the rate of return on equity. The study was applied to industrial sector companies listed in the Iraq Stock Exchange. The financial number of (14) companies, and (4) companies were selected that met the conditions for selecting the study sample. The study methodology relies on the analytical method as it is more appropriate to the nature, scope and objectives of the study, and the ready-made statistical program "SPSS" will be used to analyze the relationships and influence between the
... Show MoreThe e-commerce is one of the best achievements of the twentieth century, since the conduct commercial transactions via the Internet may be the consumer easy selection process and purchase convenient manner different from traditional methods, and with the beginnings of the new millennium impose the emergence of e-commerce term significant challenges to the insurance industry as an important economic sectors Generally, and insurance companies in particular as a result of scientific development, which has led to a reduction in costs and innovation in the production, which led to intense competition on both levels local or global. The insurance industry is a vital part of the economy and it has a varied impact to the community and individual
... Show MoreThis study presents a rapid, sensitive, and straightforward approach to measure chlorpheniramine maleate (CPM) by using turbidity CFIA. The method involves CPM reacting with sodium nitroprusside (Nitropress) to produce a pale white precipitate. The NAG-SSP-5S1D analyzer was used to measure turbidity at 0°–180° angle to detect the attenuation of incident light as a result of collision on the surfaces of the precipitate particles. The linear range of CPM measurements was between 0.008 and 11 m.mol/L, with correlation coefficient of 0.9983 and R2% = 99.65. The limit of detection was determined to be 0.0328 µg/sample from the lowest concentration in the calibration curve, and the repeatability of the method (RSD%) was less than 0.4% (n = 6
... Show MoreThe present article discusses the synthesis of tetradentate Schiff base complexes formed by the condensation reaction of 2-hydroxy benzaldehyde and phthalohydrazide. The ligand (LH2) was detected using FT-IR spectra, 1H, 13C-NMR, UV-Vis spectroscopy, elemental microanalysis CHN, and mass spectrometry. The obtained solid complexes have been assessed using physicochemical and spectroscopic techniques, including UV-Vis, FT-IR, nuclear magnetic resonance (1H-NMR, 13C-NMR), mass spectrometry, thermal gravimetric analysis (TGA), and atomic absorption, in addition to complex conductivity and magnetic moment measurements. The infrared results demonstrated that ligands functioning as tetradentate ligands are chelated to metal ions via the ph
... Show MoreThe current world seeks to supply the most of the fruits of human knowledge and tries hard to search for the most important scientific facts, programs, means and advanced devices in various fields, including the sports field, and among these means is the use of various and advanced training devices and programs for the purpose of achieving the desired goal, which is to reach the desired level, the basketball game is one of the sports that need high technology in training according to scientifically studied principles because it is one of the games that relate to the abundance of its variables, composition and speed of change, all of which require a technical and high training depth and the players ’possession of different physical charact
... Show MoreFiber‐reinforced elastic laminated composites are extensively used in several domains owing to their high specific stiffness and strength and low specific density. Several studies were performed to ascertain the factors that affect the composite plates’ dynamic properties. This study aims to derive a mathematical model for the dynamic response of the processed composite material in the form of an annular circular shape made of polyester/E‐glass composite. The mathematical model was developed based on modified classical annular circular plate theory under dynamic loading, and all its formulas were solved using MATLAB 2023. The mathematical model was also verified with real experimental work involving the vibration test of the f
... Show MoreRespiratory tract infections in sheep are among the important health problems that affect all sheep ages around the world. Nine bacterial isolates obtained from sheep with respiratory tract infections were selected to be used in the current study. The isolates included 3 Staphylococcus aureus, 4 Klebsiella pneumoniae, and 2 Pseudomonas aeruginosa. Following the primers design by the Primer3Plus software tool and optimization of the conventional polymerase chain reaction (PCR), the primers were validated for their use in the multiplex PCR experiments. The MFEprimer program was used to check the suitability of the primer set combinations for multiplex PCR. The MFEprimer software was successful in designing the multiplex-PCR experiments and de
... Show MoreThe research aims to study the administrative problems in the sports management of the members of the administrative bodies of the first-class clubs of the province of Baghdad in football. The researchers used the descriptive approach (survey study) for its relevance to the nature of the research. The research community is represented by first-class football players, who numbered (176) players. The research sample was chosen by the deliberate method, as the basic research sample reached (136) individuals from the total research community. The researchers used the questionnaire to collect the necessary data to achieve the goal of the research by applying a questionnaire that aims to ident
... Show More