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 main focus of research is on how to achieve the internal and external dimensions of corporate social responsibility through human resources management strategies, which is a major of research aimed. The main problem of this research was confirmed, which confirms that there is an unclear role for social responsibility, lack of human resources management strategies, and ambiguity of roles in the municipality under study. The diagnose of the problem and determining the gap between the internal and external dimensions of social responsibility and human resources management was identified, which attacked the researcher's attention to navigate in this subject, look for the reasons for the gaps and try to reduce them. The case study
... Show MoreThis research aims to investigate the role of quality management in enhancing the efficiency and effectiveness of settling accounts tax in terms of achieving satisfaction in charge of the hand and the increase of tax revenue on the other hand, by testing the main hypothesis of the study and the sub-hypotheses in the Income and Sales Tax Department in Jordan for the period 2000-20
... Show MoreBackground: Tooth decay is still one of most common diseases of childhood, child’s primary teeth are important even though they aretemporary. This study was conducted to assess the physiochemical characteristic of saliva among caries experience preschool children and compared them with caries free matching in age and gender. Then an evaluation was done about these salivary characteristics to dental caries and evaluated the relation of body mass index to dental caries and to salivary variables. Materials and method: After examination 360 children aged 4-5 years of both gender. Caries-experiences was recorded according to dmfs index by (World Health Organization criteria 1987) during pilot study children with caries experience was di
... Show MoreThis study aimed at identifying how children express the emerging coronavirus in general and according to their age groups (4-13 years) by analyzing 91 of their drawings published online, using the descriptive content analytical approach. The results showed that children's artistic expression of the virus came according to the concepts and ideas they carried about the virus for the age groups of (4-7 years) and (7-9 years), while it came according to visual perception for age groups (9-11 years), and from (11-13) years. Also, most children were aware about the presence of the virus and its widespread around the world, but (99%) of them do not realize the seriousness of the virus. It was confirmed that between (25-34%) of children were su
... Show MoreBACKGROUND: Clavicle fractures are common injuries in young active individuals, the mid third of the clavicle is most commonly fractured part(80% of clavicle fracture) OBJECTIVE: To compare the outcomes of operative and non operative management of displaced and or comminuted closed fracture of the mid third of clavicle in young adults PATIENTS AND METHODS: This prospective observational study of 24 patients of fracture of the mid third of the clavicle was conducted in Alkindy teaching hospital from July 2015 to January 2017 and divided into two groups; one managed by operative treatment with plate and screws and the other by non operative sling immobilization after taking the consent and the patients were seen at 2, 4, 6 weeks,3, 6, and 9 m
... Show MoreThe goals of endodontic preparation were to shape and clean the space of the root canal and remove microorganisms, affected dentin and pulp, the apical foramen and the canal curve should be protected from being transported during endodontic canal preparation. The aim of this study was to evaluate the curve straightening of curved root canals and apical transportation after preparation with four rotary systems. Forty mesial roots of the lower 1st molars teeth only the mesiobuccal canals were used, these roots were immersed into cold clear acrylic , the teeth roots divided into four groups according to rotary system used for preparation of the canals (ten roots for each group):. group I: ProTaper Next rotary system, group II: IRaCe Plus rotar
... Show MoreThe interest of many companies has become dealing with the tools and methods that reduce the costs as one of the most important factors of successful companies, and became the subject of the attention of many economic units because of the impact on the profits of company, and since the nineties of the last century the researchers and writers gave great attention to this subject, especially in light of the large competition and rapid developments in cost management techniques, as well as the wide and significant change in production methods that have been directed towards achieving customer satisfaction, all this and more driven by economic units in all sectors whether it is service or productivity to find methods that would reduc
... Show MoreKE Sharquie, SA Al-Mashhadani, A A Noaimi, RK Al-Hayani, SA Shubber, Iraqi Journal of Community Medicine, 2017 - Cited by 1