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 form a clear theoretical philosophy and perceptions about strategic Entrepreneurship through the relationship between high Involvement management practices, the basis in creating that leadership and high-performance work systems as a support tool in achieving them according to the proposals (Hitt et al, 2011), in an attempt to generalize theoretical philosophy and put forward how to apply it within The Iraqi environment, and on this basis the problem of the current research was launched to bridge the knowledge gap between the previous proposals and the possibility of their application, aiming to identify the practices of high Involvement management and the possibility of high-performance work systems and thei
... Show MoreBackground: White-spot lesion is one of the problems associated with the fixed orthodontic treatment. The aims of this in-vitro study were to investigate enamel damage depth on adhesive removal when the adhesive were surrounded by sound, demineralized or demineralized enamel that had been re-mineralized prior to adhesive removal using 10% Nano-Hydroxy apatite and to determine the effect of three different adhesive removal techniques. Materials and methods: Composite resin adhesive (3M Unitek) was bonded to 60 human upper premolars teeth which were randomly divided in to three groups each containing ten sound teeth and ten teeth with demineralized and re-mineralized lesions adjacent to the adhesive. A window of 2 mm was prepared on the bucca
... Show MoreBackground: Thermocycling simulates the temperature dynamics in the oral environment. This in vitro study done to measure and compare the effect of thermocycling on the shear bond strength of stainless steel and sapphire brackets bonded to human enamel teeth using light cured orthodontic adhesive and debonded at various time, and to measure adhesive remnant index after debonding. Materials and Methods: one-hundred-twenty extracted upper first premolars for orthodontic reason were used in this study; depending on weather thermocycled or not, the sample was divided into two main groups, then within each group 30 teeth were used for stainless-steel brackets (Bionic®) and for sapphire brackets (Pure®). Both groups were subdivided into three
... Show MoreA total number of 33 isolates of Pseudomoans aeruginosa were collected from different clinical samples, such as: burn, wound and urine from patients attending Al-Yarmouk teaching hospital and some private clinical laboratories in Baghdad city through the period from October to December 2016. On the other hand, 21 isolates of P. aeruginosa were collected from 38 different food samples; such as: vegetables and fruits, from different local markets in Baghdad city during the period from November to December 2016. All isolates were identified by using different bacteriological and biochemical assays and confirmed by Vitek-2 identification system. The antimicrobial susceptibility test for clinical and food isolates towards 17 antimicrobial a
... Show MoreDiabetic mellitus is one of the main risk factors of fungal infections because poor glycemic control is associated with a high level of glucose in blood and saliva which could be treated as nutrient to fungi. This study aimed to isolate and identification of pathogenic fungi from diabetic patient. 140 samples were taken from different places of human body from the national center of diabetic patients that related to Mustansiriyah University / college of medicine and Al-yarmuk Hospital in Baghdad. 84 sample (60%) tested positive to fungi and 56 sample (40%) tested negative to fungi. The most frequented fungi isolated have been chosen for molecular identification by PCR (Millerozyma farinosa and Candida orthopsilosis) using specific pri
... Show MoreThis study aims to identify the amount of the effect of the ability to learn the individuals within the organization on the accumulation of intellectual capital and the role it plays in improving the performance of the organization, and to achieve that, the researcher designed a questionnaire to collect data and information from the surveyed respondents and analyzed using SPSS software, the study concluded after testing hypotheses to have a direct impact between the capacity for organizational learning and the accumulation of intellectual capital, which in turn affects the accumulation of intellectual capital as a positive and direct impact on the performance of the organization, al
... Show MoreAim of the study: Is to evaluate the effect of myrrh oil local application on the healing process of skin wounds histologically , histomorphometrically and , histochemically. Materials and methods:Twenty male white New Zealand rabbits were used in this study. An incisional wounds with full thickness depth and of 2 cm length were done on both sides of the cheek skin of each rabbit. The left sided incisions (the control group) were irrigated with distilled water (10µL). The right sided incisions (the experimental groups) were treated with myrrh oil (10µL). Each group was subdivided into 4 subgroups according to the healing interval into 1,3,7 and 14 days(5 rabbits for each group). Results: Histological findings of our current study s
... Show MoreBackground : Although development and progress in various diagnostic methods, but still identification of remnants of skeletal and decomposing parts of human is one of the most difficult skills in forensic medicine . Gender and age estimation is also considering an important problem in the identification of unknown skull. The aims of study: To estimate volume and dimension of maxillary sinus in individuals with dentate and edentulous maxillae using CT scan, and to correlate the maxillary sinus volume in relation to gender and age. Materials and Methods : This study included 120 patients ranged from (40-69 years), divided into two groups, dentate group with fully dentate maxilla and edentulous group with complete edentulous maxilla, and e
... Show MoreBackground: Enterococcus faecalis is emerging as an important endodontic pathogen, which can persist in the environment for extended periods after treatment and may cause endodontic failure. It is known to produce biofilms, a community of bacteria enclosed within a protective polymeric matrix. This study aimed to establish whether the biofilm formation by Enterococcus faecalis can be inhibited with steralium, co+steralium, and 5% sodium hypochlorite in the root surface environment. Materials and Methods: Extracted human teeth were biomechanically prepared, vertically sectioned, placed in the tissue culture wells exposing the root canal surface to E. faecalis to form a biofilm. At the end of the 3rd and 6th weeks, all groups were treated fo
... Show More