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.
This work aims to show the nature of the relationship between management by walking around (the independent variable) and strategic renewal (the dependent variable), as well as it shows the effect of the independent variable on the dependent variable. Questionnaire items were considered the main tool for data collection by three basic aspects. The first involved the personal data of the respondents, while the second included items related to management by walking in five dimensions, and the third is strategic renewal items by addressing four dimensions. The tourism sector, while the community has six Excellent grade hotels was taken into account in this wor
... Show MoreThe present study introduced a new description of the last larval instar of the oak tree borer, Latipalpis johanidesi Niehuis, 2002 (Coleoptera, Buprestidae). The larval specimens were collected from the oak trees within the mountainous areas, Erbil governorate, Iraqi Kurdistan Region, during the beginning of April till the end of May 2019.
Schematic sketches were provided to illustrate unclear morphological features, and the results presented importance morphological evidence for confirming the identification of this species in the larval stage precisely.
Objectives: This study explored knowledge, attitude, and practice of infection control by dental students at College of Dentistry/ University of Baghdad, Iraq. Material and Methods: Three hundred dental students participated in this study. A self administrated questionnaire with 21 close ended questions related to use of personal protective equipments, infection control awareness, vaccination status, percutaneous exposures, and attitude towards treatment of patients with hepatitis B (HBV)/ or human immunodeficiency virus (HIV) was distributed to dental students. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21. Fisher exact and Chi-square test were used with significance level set to 0.05. Results: The
... Show MoreThe study aims to identify the theoretical literature for all the variables of the study (ICT, GDP) as well as to identify the practical side of the impact of ICT on the per capita GDP in Iraq for the period (2004-2021). The study was based on the hypothesis that ICT impacts per capita GDP in Iraq. The problem of the study was to answer the question: does ICT contribute to per capita GDP? The study concluded that an increase in the rate of internet users per 100 people by one unit would increase. Increasing the landline telephone rate per 100 people by one unit will increase GDP per capita. In addition, increasing the mobile phone rate per 100 people by one unit will increase GDP per capita. The study recommended adopting rational poli
... Show MoreChukar partridge Alectoris chukar (Gray, 1830) is the only species of the 46 species of the genus Alectoris to be found in Iraq. At least there are fourteen subspecies of chukar were described from east Europe, the Middle East and west Asia, two of them were known to be found in Iraq, A.c. Kurdestanica (Meinertzhagen, 1923) from Alpine bio-geographical zone of altitude more than 2000m high, and A.c. werae Zarundny and Loudon, 1904, from the foothills of altitude not more than 400m. In between these two regions, there is another bio-geographical region known as the Irano-toranian zone 400-2000m high. Using morphological, ecological, behavioural, reproduction and hybridization criteria this study discove
... Show MoreThe predatory bush crickets Saga ephippigera Fischer Von Waldheim, 1846 is the largest Iraqi orthopterans and one of the most active and successful predators in the Kurdistan region. The nymphs and adults prey on all the stages of various species of insects. Twelve adult specimens were collected from Erbil Province during May 2018 and June 2021. Morphological structures of the adult insects were described and illustrated in details; important taxonomic characteristics of body regions with their appendages were chosen; and the results indicated the importance of morphological characteristics which confirmed the identification of this species correctly.
Islamic banks are distinguished by providing banking activities that are unique in providing them from the rest of the other types of banks, and these activities are a group of banking services provided by the bank to its customers, whether these banking activities are tangible or intangible. At the same time, it is a source of bank profits, as Islamic banks impose a percentage of Islamic Murabaha on those banking activities , However, these banks have developed new services that they provide with the funds of the Central Bank initiative launched at the beginning of (2016) due to the economic conditions that befell the country due to the (financial security) crisis that the country faced in 2014. To put forward initiatives, and a
... Show MoreIn recent years, Bitcoin has become the most widely used blockchain platform in business and finance. The goal of this work is to find a viable prediction model that incorporates and perhaps improves on a combination of available models. Among the techniques utilized in this paper are exponential smoothing, ARIMA, artificial neural networks (ANNs) models, and prediction combination models. The study's most obvious discovery is that artificial intelligence models improve the results of compound prediction models. The second key discovery was that a strong combination forecasting model that responds to the multiple fluctuations that occur in the bitcoin time series and Error improvement should be used. Based on the results, the prediction acc
... Show MoreAn energy and exergy thermodynamic analysis using EES program was done for a domestic refrigerator working with R-134a using vapor compression refrigeration cycle. The analysis deals with the system component, i.e. compressor, condenser, evaporator and the expansion device. The analysis depends on the entropy generation minimization approach to improve the refrigerator performance by exploring the optimum design points. These design points were derived from three different theories governing the entropy generation minimization using exergy analyzing method. These theories were first applied to find the optimum balance between the hot inner condenser area and the cold inner evaporator area of the refrigerator and between
... Show MoreA new definition of a graph called Pure graph of a ring denote Pur(R) was presented , where the vertices of the graph represent the elements of R such that there is an edge between the two vertices ???? and ???? if and only if ????=???????? ???????? ????=????????, denoted by pur(R) . In this work we studied some new properties of pur(R) finally we defined the complement of pur(R) and studied some of it is properties