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 to identify the effect of teaching-learning design based on the constructivism theory on the life skills of middle stage students. The sample consisted of (60) students from one of the middle schools in Baghdad's governorate. The experimental group and control group consisted of 30 students for each group, the research tool was the life skills scale composed of (78) items. The scale proved its validity and reliability, which was found to be (0.85). The results showed a statistically significant difference in life skills between the two groups of research in favor of the experimental group, which studied the educational design according to models of constructivism theory compared to the usual method of teaching.
Algae have been used in different applications in various fields such as the pharmaceutical industry, environmental treatments, and biotechnology. Studies show that the preparation of nanoparticles by a green synthesis method is a promising solution to many medical and environmental issues. In the current study, the green alga Stigeoclonium attenuatum (Hazen) F.S. Collins 1909 was isolated and identified from the Al-Hillah River (Governorate of Babylon) in the middle of Iraq. The green synthesis by the aqueous extract of algae was used to prepare the nanoflakes of ZnO. Nanoflakes of ZnO are characterized by X-Ray diffraction (XRD) and scanning electron microscope (SEM) with flakes shape and dimensions ranging be
... Show MoreThe problem of present study is determined by answering the following questions:
1) What is the effect of using the oral open- ended questions on Students' achievement in the third-stage of Arabic department in the college of Education? 2) What is the effect of the oral open-ended questions on developing the creative thinking of students in
... Show MoreThe present study aimed to asspssment the nutrition a program to sample of student from internal departments of Baghdad University (AL-Jadiriya Complex) and the University of AL-MustanSiriya four grades and aged (19-24) year study included 150 male and female students by (75) male and (75) of female register height, weight nd body mass index were study habits and food pattern of the same sample (150) and by aspecial form and take the personal information interviews and record information on food intake during 24 hour .noted adifference practie in the weights and longths of male and female (sample).
BMI rates were within the normal weight as the value of BMI for males aged (19- 21)and (22-24) and (22.21) and (23,37),respectively and th
Strategic decision making is considered one of the important processes for senior management in contemporary business organizations and service organizations due to the properties of the service such as intangibility, concomitance and mortality. Decision-making has three approaches according to the opinions of most of the writers and researchers in the administrative area: an analytical approach, intuitive approach and behavioral approach. This research is trying to discover the nature of the relationship in terms of the link between the impact of each of these approaches and efficiency of marketing services by selecting an intentional sample of 58 researches from the Directorate General of Traffic, one of the Iraqi Interior Ministry ins
... Show MoreThe study is carried out by using personal dosimeters (film badge). The films are irradiated to absorbed dose of range (0.01-10000 rad). The calibration curves are drawn by using the ordinary method taking into account the filtration effects in three regions (D (Pb/Sn),D(Du),D(300). The calibration films are stored in ambient condition. It is found that the optical density increases, which is attributed to the photodegradation of the films may induce localized states in the energy gap causing increasing in optical absorption, but optical density decreases, which attributed to the photodegradation of the films may cause some cracks at the film surface during the first month, whereas at the rest months we see clear stability in optical d
... Show MoreThe present paper focuses on the nature of the different interactions between cometary nucleus and tail with solar wind. The dynamics of the comet will impose many features that provide unique behavior of the comet when entering the solar system. These features are reviewed in this paper and few investigations are made. The calculations made in this work represent the analysis and interpretation of the different features of the comet, such as perihelion and eccentricity dependence on the gas production rate, and the dependence of the latter on the composition of the comet nucleus. The dependences of the heliocentric, bow shock, contact surface, and stand-off distances with gas production rate for many types of comets that cover linear and n
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