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.
Colonialism as a movement was very popular in Europe more than two centuries before. It aimed at controlling and exploiting several countries in Africa and Asia in addition to imposing their power and control on uninhabited islands. It received adherence and criticism as well. There also appeared activists and nations who stood against it and its practices. English novels discussed this notion greatly by pointing out the bad practices of the colonizers and how the colonized received them. This paper explores two narrative fictions that tackle the different aspects of the term. While Defoe, in Robinson Crusoe (1719), shows a colonial European figure who expresses his superiority, Wells, in “The Country of the Blind” (1904), deconstructs
... Show MoreCrises affect the economic growth of the country in general and the banking sector in particular. Given the importance of this sector, it is necessary to evaluate the performance of banks from time to time and monitor the liquidity of each bank and how to organize its management to overcome any crisis or emergency situation that may befall it. The research seeks to diagnose the level of impact of crisis management. In the liquidity of Iraqi private banks, using liquidity indicators, as the research community represents the banks listed in the Iraq Stock Exchange As for the research sample, it is represented by (10) pri
... Show MoreThe aim of the research is to diagnose the level of awareness and response of the researched sample to the concept of enlightened leadership and strategic alignment, as well as to measure the strength and weakness of the relationships between the independent variable of enlightened leadership and the dependent variable of strategic alignment with its dimensions. Thus, the research problem was defined by the main question of identifying the role played by enlightened leadership in achieving strategic alignment in a number of private Iraqi commercial banks. In light of this, the hypothetical research model was designed, embodying the relationship between the research variables. The descriptive analytical approach was adopted, and a ques
... Show MoreAbstract
The research stems from the problem that focuses on a number of questions. They are as follows: What is the extent of interest in the topic of efficiency by the banks and their role in raising the efficiency of the banking business and its development? Is the banking efficiency used in Iraqi banks clear and specific for the Iraqi banking sector? How the banking sector efficiency is measured and what are the approaches adopted in determining the banking inputs and outputs? What is the level of efficiency in the research sample of the banks and what are the causes of its decline or rise in private banks individually and in the Iraqi banking sector in general?
The re
... Show MoreThe research aims to shed light on the ethics of information systems and their role in achieving banking excellence for a sample of private banks in the province of Baghdad. It is important to focus on studying the ethics of banking information systems, which has become one of the most important basic and strategic resources that banks rely on to achieve outstanding performance. Achieving banking leadership in the Iraqi banking market. The researchers adopted the descriptive analytical approach to the research, and the questionnaire was considered as a main tool for collecting information in addition to personal interviews. The research reached the most important results that there is an acceptable correlation relationship between the ethic
... Show MoreThe corrosion behavior of mild sleet in saturated aerated and de-aerated Ca(OH)2 solution was investigated using electrochemical measurements. The work was carried out with small coupons immersed in solutions containing different quantities of NaCl in presence of various NaN02 concentrations as corrosion inhibitors. It has been found thal:(1 ) In presence of NaCl, the time required to reach O2 evolution potential in de-aerated Ca(OH)2 polarized at 10μA/cm 2 is function of inhibitor concentration and it becomes lass as NaN02 increases compared with zero presence indicating the effectiveness of N
... Show MoreThe Knowledge Workers is The Largest And Most Powerful Resource Of The Organizational Excellence it is A Precious Treasure, Therefore Find Organizations at present is looking for them and seek to invest their ideas For achieving excellence, creativity and access to the excellence Organizational , As a result of their importance in terms of engagement and influence in the success or failure of the as an organizational Of The Research is Measuring The Correlation And Impact Between Knowledge Workers And Organizational Excellence in Sample Of Companies Iraqi Industrial By Standing The Dimensions Of Knowledge Workers ( Characteristics , Skills , Roles , Competencies ) And
... Show MoreThe concept of forming the living space in the American strategic thought has an
important position it is regarded as an strategic movement that it supports the American
United States with the huge capabilities in its own concern that enables it to approach of
American administration , we find that of different historical periods it works to establish that
the geopolitical dimension which is accompanied with the ability of American response for
the evens that in its own turn enables the American united states to seize the growing chances
in the global strategic environment This study includes five chapters :
- Chapter one: The idea of living space.
- Chapter two: Geopolitical dimension of living space theory.
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Non-steroidal anti-inflammatory drugs (NSAIDs) contain free –COOH which thought to be responsible for the GI irritation associated with all traditional NSAIDs. The esterification of this group is one of an approach to ultimate aim for reduce the gastric irritation; so in this study we synthesized and preliminarily evaluated new ester compounds as new analogues with expected selectivity toward COX-2 enzyme. Synthetic procedures have been successfully developed for the generation of the target compounds (III a and b). The synthetic approach involved multi-steps procedures which include: Synthesis of 4-hydroxy benzene sulphonamide ( I b ), synthesis of Naproxen and Ibuprofen acyl chloride and then reacting them with 4-hydroxy benzene sulphon
... Show MoreAbstract:
Research Topic: Ruling on the sale of big data
Its objectives: a statement of what it is, importance, source and governance.
The methodology of the curriculum is inductive, comparative and critical
One of the most important results: it is not permissible to attack it and it is a valuable money, and it is permissible to sell big data as long as it does not contain data to users who are not satisfied with selling it
Recommendation: Follow-up of studies dealing with the provisions of the issue
Subject Terms
Judgment, Sale, Data, Mega, Sayings, Jurists