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 research aims at considering the reality of cognitive bias and organizational inertia as determinants of strategic change in a sample of companies listed in Amman Stock Market. To achieve objectives of the research, a model consisting of two independent variables has been designed, namely:
(1) The cognitive bias resulting from (escalating commitment, analogy, previous assumptions, representative generalization, command and control, convergent thinking), and (2) Organizational inertia due to (Icarus discrepancy, power distribution, rooted organizational culture), and a dependent variable, strategic change in (leadership patterns, strategy, the organization per se).
From the model two main hypotheses were derived;
... Show MoreBackground: A Catheter-associated with candidiasis infection is the most common nosocomial infection and the objective of this work is to isolate and identify Candida species from catheterized patients by ordinary culture and PCR.Objective:To study the isolation and identification of Candida species from catheterized patients by culture media and polymerase chain reaction(PCR).Methods: One hundred and thirty five Candida species isolates were obtained from urine culture of catheterized specimens from male and female patients , During the period between October 2011 to April 2012 , attending AL-Ramadi general teaching Hospital. A quantitative urine culture for isolation and identification of Candida species was. The isolation of Candida s
... Show MoreThe research aims to formulate a model for research on the dimensions of the Leader-member exchange theory according to the ideas and thoughts of Liden /Maslyn, Hammer and impact on job satisfaction and measure these dimensions at asiacell communications to identify the extent of convergence between theoretical dimensions share leader – member Exchange (LMX) with leadership style used in this company, we have been building scale contains two variables, independent variable Leader-member exchange theory five dimensions (effect , Loyalty, contribution, respect professional, and support) the certified job satisfaction variable dimensions (job security, The Style of management, organizational climate, appreciation, and work itself)
... Show MoreThe current study, which extended from February 2020 to June 2021 at the University of Thi- Qar\ College of Education for Pure Sciences, aimed to follow the changes in external morphological features at different Embryonic Developmental stages in pregnant mice treated with different doses of Rapamycin (Rapa). Use In this study, 32 pregnant mice were divided randomly into four groups, each of which had eight pregnant mice. Each group received different dose of Rapa via intraperitoneally injection at different gestation days until the end of the specified periods, whereas the control group received a DMSO. Mice were administered under the same circumstances and dosages were determined based on body weight, as specified in pharmaceutical const
... Show MoreThis Research aim to identify the factors affecting the strategic implementation of sewage projects and to seek to activate the real follow-up of projects to identify the factors that accompany their implementation, The study included a sample of the projects of the investment plan implemented for the Directorate General of sewage in the governorates of Iraq, which was completed during the six years period (2010-2016). The sample of the research was four projects: The project of implementation and processing of the treatment plant and the lifting station and the conveyor line for the project of IMARA/The third stage/Al-Sanaf marshland , The project of the processing and implementation of the treatment plant with the
... Show MoreHere, a high sensitive method for biomarker identification according to nanostructure, using enzyme-linked immunosorbent assays (ELISAs), called Nano-ELISA, was presented. Different shapes of gold nanostructures (star and sphere; GNSs and GNPs) with a particle size of 40 nm for sphere particles were altered with a monoclonal antibody (Ab) as a detector Ab. To amplify the optical signal, gold nanostructures were employed as carriers of the signaling specific antibody against insulin growth factor binding protein- 3 (IGFBP-3). The substrate was catalytically oxidized by the Horseradish Peroxidase (HRP) conjugated gold nanostructure, and HRP also enhanced the optical signals, reflecting the amount of the targeting IGFBP-3. In comparison to t
... Show MoreObjective. This study aimed to evaluate and compare the force degradation of two types of elastomeric chains following different periods of immersion in zinc-containing mouthwashes. Materials and Methods. Four hundred and forty pieces of Elasto-Force and Super Elasto-Force elastomeric chains were divided into two control and eight experimental groups. The pieces were stretched to 25 mm on pins mounted on an acrylic block and stored in distilled water at 37°C. The experimental groups were immersed in four different types of mouthwash for one minute twice a day throughout the test period. Ten continuous thermocycles per day between cold and hot water baths (5–55°C) were carried out. Forces were measured at six-time intervals (in
... Show MoreBackground: The elimination of the microorganisms from the root canal systems, an important step for the successful root canal treatment. This study was conducted to evaluate the antibacterial effectiveness of the photoactivated disinfection by using the toluidine blue O and a low- energy light emitting diode (LED) lamp . Materials and method: Sixty single rooted extracted teeth were decoronated, instrumented, irrigated, sealed at the apex and contaminated with endodontic anaerobic bacteria for 7 days to form biofilms in prepared root canals. Group I. Twelve teeth were medicated by photosensitizer (toluidine blue O) solution activated by diode lamp (FotoSan; CMS Dental, Copenhagen, Denmark).Group II. Twelve teeth were medicated by the tricr
... Show MoreThin films of ZnSe arc deposited on glass substrates by thermal evaporation in vacuum with different thickness (1000, 2700, 4000) A° temperature (293-373) °K are studies the electrical properties before and after annealing. The result show decrease D.0 conductivity and increasing the activation energy Eat.