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.
Ten isolates were collected from different clinical sources from laboratory in medicine century . These isolates were belonging to the genus Salmonella depending on morphological and biochemical tests . The antibiotic scussptibility tests against 10 antibiotics were examined , and it was found that the 60% isolates have multiple resistant to antibiotic ,(70%) of isolates were resistant to ampicillin,(50%) were resistant to augmentin ,(40%) were resistant to ceftriaxone ,(20%) were resistant to cefotaxime and (10%) were resistant to ciprofloxacin and tetracycline while all isolates showed sensitivity to piperacillin, imipenem, amikacin and erythromycin .The ability of Salmonela isolates to produce ?-lactamase enzymes were tested usin
... Show MoreThe research aims to shed light on the recent experience in the Iraqi business environment, which is the experience of the merger. To evaluate a recent experience in an important sector of the Iraqi business sectors, namely the industrial sector to enable decision-makers to review that experience to judge the extent of its success and address some of the lapses that experience that by measuring synergies can be judged on the success of the merger experience or not. The research community is the governmental industrial sector. The research sample included six cases of merger (14) companies before the merger. The Holt method was used to predict the net sales and total cost values before the merger as if it were not merged. Th
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The study aims to build a training program based on the Connectivism Theory to develop e-learning competencies for Islamic education teachers in the Governorate of Dhofar, as well as to identify its effectiveness. The study sample consisted of (30) Islamic education teachers to implement the training program, they were randomly selected. The study used the descriptive approach to determine the electronic competencies and build the training program, and the quasi-experimental approach to determine the effectiveness of the program. The study tools were the cognitive achievement test and the observation card, which were applied before and after. The study found that the effectiveness of the training program
... Show MoreIn the age of information and communication revolution, education as one of life aspects has influenced with that revolution by integrating technology in education, which have become as an important learning tools of the whole educational process . Technology, when used appropriately, can help make science classroom a site of active learning and critical thinking, furthering student inquiry and connections with different materials. It is necessary to develop human rights education programs and materials for discretionary and extracurricular activities as it provide them with the skills and tools so that they are empowered to take action to realize their rights. Human rights education is a critical means of instilling the knowledge، skil
... Show MoreThe research topic (The Impact of the Compulsory Reserve on the Banks Credit-an applied research on a sample of Iraqi banks), was chosen on basis of the Iraqi private Banks attempts to increase their credit activities in hope to gain more profits.This coincided with the CBI aim to back the private banking market.It is thus apparent why the CBI issued its regulation to those banks to increase their capitals up to IDB250. On the other hand,the CBI acted as an obstacle in the way of increasing the private banks of their capitals,that is by implementing the quantitive monetary tool so called the compulsory reserve.This is why we intended to overlook at this contradictional problome
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The study aimed to prepare a practical guide for procedures for auditing the strategies of municipal institutions in achieving sustainable development by adopting the idea of the audit matrix through which a classified report is prepared according to the dimensions of sustainable development, by preparing a specialized audit program for the purpose of auditing strategies for achieving sustainable development and emptying the results of the application of each of the paragraphs The program in the audit matrix that was prepared for the purpose of determining the impact of each observation and linkin
... Show MoreSynthesis and study liquid crystalline properties of novel Benzimidazol-8-hydroxyquinoline complexes by reaction of a-Chloro acetic acid with 3,3'-dimethylbiphenyl-4,4'-diamine in 10% aqueous sodium hydroxide to synthesized compound [I] then the later compound reacted with o-phenylenediamine in 4N Hydrochloric acid to synthesized compound N4,N4'-bis((1H-benzo[d]imidazol-2-yl)methyl)-3,3'-dimethyl-[1,1'-biphenyl]-4,4'-diamine =[II] . While the complexes [III],[IV],[V],[VI] and [VII] synthesized from reacted compound [II] , 8-hydroxyquinoline with metal(II) salts { M= Mn(II), Fe(II), Ni (II), Cu(II),and Zn(II)}. Newly synthesized compounds were characterized using melting points, FT-IR, UV-Vis spectra, and some of them 1H NMR spectroscopy. ma
... Show MoreNature and natural beauty have always been the source of inspiration for poets and mystics. For them, nature is one of the most recurrent and celebrated themes. It is a significant symbol of the beauty, righteousness and freshness they are looking for. For religious and mystical poets, it is a reference to God, his beauty, and splendour. Comparing it with the scripture, Thomas Ryan, a Catholic priest and a mystical writer, says ''The Bible is the 'small book', the world of nature is the 'big book'. Both reveal the Creator.''1
For Muslim mystics, God does exist everywhere as the Qur'an states: ''Wherever (Whithersoever) you turn, there is God's face” (Chapter (Surah): 2
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