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 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
... 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 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 MoreThe environmental contamination by the polycyclic aromatic hydrocarbons (PAHs) and heavy metals (Pb, Cu, Ni, Cr, and Cd) concentrations in the leaves of plant Eucalyptus camaldulensis were determined at the city of Kirkuk in 15 selected locations using GPS. The pickings up of samples were carried out in two periods October 2010 and March 2011. Compared with results of other studies, the concentration levels of determined heavy metals show values within these studies results. The average total concentration of polycyclic aromatic hydrocarbons (PAHs) in the leaves of Plant Eucalyptus camaldulensis indicated 37.1 ppb in October, while in March 165.2 ppb.
The mode
... Show MoreSpecialized banks provide their banking activities to their customers at interest rates that are determined according to the approved bank policy, which is almost similar to most or most banks. To satisfy the financial desires of customers and at the same time it is a source of the bank's profits, However, these banks have been introduced to new services that they provide with the funds of the Central Bank initiative launched at the beginning of (2016) to address the economic stagnation that befell the country due to the (financial security) crisis that the country faced in 2014. To put forward initiatives amounting to nearly (15) trillion dinars, which were put forward through private commercial and Islamic banks and specialized
... Show MoreThis research discusses application Artificial Neural Network (ANN) and Geographical InformationSystem (GIS) models on water quality of Diyala River using Water Quality Index (WQI). Fourteen water parameterswere used for estimating WQI: pH, Temperature, Dissolved Oxygen, Orthophosphate, Nitrate, Calcium, Magnesium,Total Hardness, Sodium, Sulphate, Chloride, Total Dissolved Solids, Electrical Conductivity and Total Alkalinity.These parameters were provided from the Water Resources Ministryfrom seven stations along the river for the period2011 to 2016. The results of WQI analysis revealed that Diyala River is good to poor at the north of Diyala provincewhile it is poor to very polluted at the south of Baghdad City. The selected parameters wer
... Show MoreCyprinidae species are the most abundant and widely distributed fish species in the inland waters of Iraq. Cyprinids are complex species, and it is difficult to identify them on the basis of morphology. Thus, the morphological characteristics must be achieved and confirmed by molecular analysis. Twenty specimens of Cyprinion kais Heckel, 1843 (Piscies, Cypriniformes, Cyprinidae) were collected from two localities at Tigris River in the middle of Iraq: five specimens from Al-Tharthar Lake, Saladin Province, and 15 specimens from Al- Zubaydiyah sub-district, Wasit Province. The DNA sequences of C. kais were done using the mitochondrial DNA cytochrome b (cytb) gene. After analysis, the sequences were compared with sequences of ot
... Show MoreKarbala province regarded one part significant zones in Iraq and considered an economic resource of vegetation such as trees of fruits, sieve and other vegetation. This research aimed to utilize Normalized Difference Vegetation index (NDVI) and Subtracted (NDVI) for investigating the current vegetation cover at last four decay. The Normalized Difference Vegetation Index (NDVI) is the most extensively used satellite index of vegetation health and density. The primary goals of this research are gather a gathering of studied area (Karbala province) satellite images in sequence time for a similar region, these image captured by Landsat (TM 1985, TM 1995, ETM+ 2005 and Landsat 8 OLI (Operational Land Imager) 2015. Preprocessing such gap filli
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