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 tax revenues achieved through projects of transition to private sector are regarded as an important source for using in achieving political, economic and social objectives. Since Iraq is heading towards free market economy, new strategies should be adopted to reform the taxation system from by a qualified taxation management office and to activate the taxation policy and to reconsider legislation in relation to the aware of the legible to the importance of disclosure of their taxable real income in order to arrive at contribution of privatization in the taxation revenues for the important role effect on economic activities. In the light of the above, the research is based upon a hypothesis which stipulates that privatization contribu
... Show MoreAbstract- Plasma parameters in a planar dc-sputtering discharge in argon were measured by cylindrical electrostatic probe (Langmuir probe).Electron density, electron temperature, floating potential, and space potential were monitored as a function of working discharge pressure. Electrostatic probe and supporting circuit were described and used to plot the current – voltage characteristics. Plasma properties were inferred from the current-voltage characteristics of a single probe positioned at the inter-cathode space. Typical values are in the range of (10-16 -10-17) m-3 and (2.93 – 5.3) eV for the electron density and the electron temperature respectively.
Background: Little is known about asymmetry of children's dental arches, the purpose of this study was to verify the presence of asymmetry of dental arches among Iraqi children in the mixed dentition stage. Materials and methods: The sample included 52 pairs of dental casts, 27 pairs belong to males and 25 pairs for females. Three linear distances were utilized on each side on the dental arch: Incisal-canine distance, canine-molar distance and incisal-molar distance, which represent the dental arch segmental measurements using the digital sliding calipers, which is accurate up to 0.02 mm. Results: No significant sides' differences with high correlation coefficient were found between the right and left incisal-canine, canine-molar and in
... Show MoreThe increase in population resulted in an increase in the consumption of water. The present work investigates the performance of a recycling solar- powered greywater treatment system for the purposes of irrigation, used to reduce the amount of waste grey water and reduce electricity consumption and reduce the costs of constructing large scale water treatment plants. The system consumes about 3814W per hour and provides water treatment about 1.4 m3 per day. The proposed system is designed to residential, office and governmental buildings application. Tests are conducted in an office building at the Ministry of Science and Technology site in Baghdad. Laboratorial water samples testing analyses are co
... Show MoreThe comparative method plays a major role in Maupassant’s novel (A woman’s Life).This is due to a good theme choice and smooth writing style characterized by simplicity, spontaneity and brevity.
The author uses the comparative method in the introduction of his novel where he compares the monastery’s closed world to the open world of the countryside of La Normandie, which represents the dream life of the heroine Jeanne.
The present paper is an attempt to answer the question regarding the importance of applying the comparative method in the novel (A Woman’s Life) by Maupassant. The paper stresses the fact that the novelist employs the comparative method in his book for certain features .One of these features is the
... Show MoreThe Dynamic Load Factor (DLF) is defined as the ratio between the maximum dynamic and static responses in terms of stress, strain, deflection, reaction, etc. DLF adopted by different design codes is based on parameters such as bridge span length, traffic load models, and bridge natural frequency. During the last decades, a lot of researches have been made to study the DLF of simply supported bridges due to vehicle loading. On the other hand, fewer works have been reported on continuous bridges especially with skew supports. This paper focuses on the investigation of the DLF for a highly skewed steel I-girder bridge, namely the US13 Bridge in Delaware State, USA. Field testing under various load passes of a weighed load vehicle was u
... Show MoreBackground: Esthetic correction represents one of the clinical conditions that required the use of laminate veneers in premolars region. Aim of the study: The purpose of this study was to evaluate the fracture strength of the laminate veneers in maxillary first premolars, fabricated from either composite (direct and indirect techniques) or ceramic CAD/CAM blocks. Materials and Methods: Fifty sound human maxillary premolar teeth were used in this in vitro study. Teeth were divided randomly into one control group and four experimental groups of ten teeth each; Group A: Restored with direct composite veneer (Filtek Z250 XT), Group B: Restored with indirect composite veneers (Filtek Z250 XT), Group C: Restored with lithium disilicate ceramic CA
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