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 paper studies the investment project evaluation under the condition of uncertainty. Evaluation of investment project under risk and uncertainty is possible to be carried out through application of various methods and techniques. The best known methods are : Risk-adjusted discount rate , certainty equivalent method , Sensitivity analysis and Simulation method The objective of this study is using the sensitivity analysis in evaluation Glass Bottles project in Anbar province under the condition of risk and uncertainty.
After applying sensitivity analysis we found that the glass bottles project sensitive to the following factors (cash flow, the cost of investment, and the pro
... Show MoreCentric study on the interest of the Directorate General of Training and Development / Ministry of Electricity to consolidate the concept of process and enhancement of knowledge in the areas of organizational change، it reached a sample of the study (44) people who are highly heads of departments، technicians and administrators in different sections of the Directorate and by using the correlation coefficient (Spearman) & coefficient of simple regression been tested correlations between variables and the impact of the study، as has been reached to integrate the role of cognitive processes with the areas of organizational change and relationships that were significant at the level of overall dimensions and subsidiary organs.
... Show MoreThe research aims to identify and diagnose the public relations strategies in its digital online communications by the United Nations High Commissioner for Refugees (UNHCR) in managing the crisis of Iraqi refugees in Turkey. A content analysis form was designed for the digital content of the UNHCR's website dedicated to topics and issues concerning Iraqi refugees that were covered by the site, adopting a comprehensive enumeration approach. The study covered the period from 01/03/2022, to 30/06/2022. The research yielded several key findings, including the predominant use of media, advertising, and education strategies in managing the crisis of Iraqi refugees in Turkey. News and reports ranked first among the media
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The most famous thing a person does is talk. He loves and hates, and continues with it confirming relationships, and with it, too, comes out of disbelief into faith. Marry a word and separate with a word. He reaches the top of the heavens with a kind word, with which he will gain the pleasure of God, and the Lord of a word that the servant speaks to which God writes with our pleasure or throws him on his face in the fire. Emotions are inflamed, the United Nations is intensified with a word, and relations between states and war continue with a word.
What comes out of a person’s mouth is a translator that expresses the repository of his conscience and reveals the place of his bed, for it is evidence of
... Show MoreThe aim of the research is to use this technique and to determine the effect of this method in reduce cost per unit of the company. The traditional method used in the company the research sample to determine the indirect costs, the definition of the concepts and characteristics of the method of cost-based activity and the cost method based on time-driven activity and justifications applied to companies. In order to achieve the research objectives, the main hypotheses were formulated. That was represented: (The applied of (TDABC) Time driven activity based costing method in reducing indirect costs, leads reduce cost per unit than the use of the traditional method of allocating indirect costs in the research sample company).&nb
... Show MoreBreast cancer is the most common malignancy affecting women's health, with an increasing incidence worldwide. This study aimed to measure the intracellular concentration of the hypoxia-inducible factor 1 α (HIF-1α), tumor suppression protein p53, and estradiol (E2) in tumor tissues of adult females with breast cancer and their relation to tumor grade, tumor size, and lymph node metastases (LNM). The study was conducted on 65 adult female participants with breast mass admitted to the operating theater in Al-Hussein Teaching Hospital and Al-Habboby Teaching Hospital in Nasiriyah, Iraq, from January to November 2021. Fresh breast tumor tissues were collated and homogenized for intracellular biochemical analysis using the enzyme-linked immuno
... Show Moreم. د. ولاء طارق حميد, Al. Qadisiya journal for the Sciences of Physical Education, 2017
The aim of t his p aper is t o const ruct t he (k,r)-caps in t he p rojective 3-sp ace PG(3,p ) over Galois field GF(4). We found t hat t he maximum comp let e (k,2)-cap which is called an ovaloid, exist s in PG(3,4) when k = 13. Moreover t he maximum (k,3)-cap s, (k,4)-cap s and (k,5)-caps.
This study confirms the ubiquitin conjugating enzyme 2B (Rad6) plays a significant role in the DNA repair pathway also because the ubiquitin-conjugating pathway. The DNA repair pathway could be a variety of bypass repair mechanism where the broken base pair is bypassed by permitting the replication fork to labor under the site of injury. This is often done by a shift mechanism wherever deoxyribonucleic acid enzyme - δ is switched with DNA enzyme - η (DNAP - η). Site of DNAP - η is massive enough to permit the broken ester to labor under, and so bypass the broken nucleotide. However, this is often potential solely through the involvement of Proliferating cell nuclear antigen (PCNA) that could be a processivity issue and it acts as a plat
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