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 genera and species of Liliaceae show a considerable structural diversity of leaves and especially stems. This paper presents a morphological and anatomical study of the leaves and stems of Asphodelus microcarpus. The results showed that the investigated species had typical morphological characters. and also that it could be distinguished from another plant not only by its morphological but anatomical characters as well.
Alloy of (HgTe) has been prepared succesful in evacuated qurtz ampoule at pressure 4×10-5torr, and melting temperature equal to 823K for five days. Thin films of HgTe of thickness 1μm were deposited on NaCl crystal by thermal evaporation technique at room temperature under vacuum about 4×10-5torr as well as investiagtion in the optical porperties included (absorption coefficient , energy gap) of HgTe films and The optical measurements showed that HgTe film has direct energy gap equal to 0.05 eV. The optical constants (n, k, εr, εi) have been measured over will range (6-28)μm.
In the present work, Response Surface Methodology (RSM) was utilized to optimize process variables and find the best circumstances for indirect electrochemical oxidation of mimicked wastewater to remove phenol contaminants using prepared ternary composite electrode. The electrodeposition process is used for the synthesis of a ternary composite electrode of Mn, Co, and Ni oxides. The selected concentrations of metal salts of these elements were 0.05, 0.1, and 1.5 M, with constant molar ratio, current density, and electrolysis time of 1:1:1, 25 mA/cm2, and 2 h. Interestedly, the gathered Mn-Co-Ni oxides were deposited at both the anode and cathode. X-ray diffraction (XRD) and scanning electron microscopy (SEM) facilitated the qualitative char
... Show MoreSet dietary program for some of dietary supplements and training for badminton young players, and identifying effect of taking some of the dietary supplementary for badminton young players. The research population :( badminton young players group (Arminian club). For age group (16-18) years the sample is divided in to two experimental groups within each group (6) players, and two for the exploratory experiment which was within the research sample, they were divided in to two groups, the first group take some of the dietary supplements (multivitamin creating) .the set exercises by the researchers in the main part of the training unit and the second group (amino acids, vitamins) and the set exercises by the researcher. The scientific approach
... Show MoreThe research aims to shed light on the obstacles that hinder the use of taxpayers' commercial books covered by provisions of the amended commercial book-keeping system No. 2 of 1985 and ways to address these obstacles. On this basis, the main null hypothesis was formulated that there is no statistically significant relationship between the obstacles to the adoption of the commercial books and taxable income.
The research data were collected on the base of three applied case studies of registered taxpayers in the General Commission of Taxes, GCT, together with the use of a questionnaire distributed to a sample of taxpayers ( companies ). The collected data were analyzed, the result were presented and the hypothesis was
... Show MoreThe present research aims to test the effect of cognitive complexity as an independent variable in organizational agility as a responsive variable among the leaders working at the headquarters of the Iraqi Petroleum Products Distribution Company.
To conclude a number of recommendations that contribute in the organizational agility in the company, and due to the importance of this research in public organizations and its notable role in community organizations. The research was carried out on a random sample of 101 individuals out of a total of 308, which represents the high leaders in the company (general managers, head of departments, and division officials). A questionnaire was used as information
... Show MoreThe introduction of the research on the science of training and the physiology of sports was addressed from important sciences, where the physical effort drew the attention of scientists since the past centuries when they studied how the body performs its functions when performing physical exertion and observe the changes that occur in it and write down and study especially the positive effects of the practice of daily sports The aim of the study was to investigate the effect of plank exercises on the lipid component and the metabolic rate (bmr) of the female students of the Higher Institute for Security and Management Development. As for the third chapter, the two researchers used the experimental method on a sample of the female s
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