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.
Praise be to Allaah.
My research has included the following: The field of application of semantics when fundamentalists are the book and the Sunnah. Imam Ibn Hajar agreed with the majority of fundamentalists that what is meant from the year (one word denotes one side on two things onwards), and agreed that the significance of the year specific to the rest of its members is not a definite and definite formulas of the public has the singular known as (the) Astragharism, and the plural known as ( The nationality stating that dumping, pluralism is defined as (add), and nakra, if it occurs in the context of the condition, denial and prohibition, the names of the condition, the connected names, and the word (all - all). And the year in whic
This study aims to design unified electronic information system to manage students attendance in Lebanese French university/Erbil, as a system that simplifies the process of entering and counting the students absence, and generate absence reports to expel students who passed the acceptable limit of being absent, and by that we can replace the traditional way of using papers to count absence, with a complete electronically system for managing students attendance, in a way that makes the results accurate and unchangeable by the students.
In order to achieve the study's objectives, we designed an information syst
... Show MoreAbstract Background: The lifestyle of an individual significantly influences health-promoting behaviors. The World Health Organization defines health promotion as a mechanism enabling people to increase control over and improve their health. This study aimed to evaluate the health promoting lifestyle profile of medical staff working in primary health care centers of Al-Rusafa, Baghdad.
Engineering equipment is essential part in the construction project and usually manufactured with long lead times, large costs and special engineering requirements. Construction manager targets that equipment to be delivered in the site need date with the right quantity, appropriate cost and required quality, and this entails an efficient supplier can satisfy these targets. Selection of engineering equipment supplier is a crucial managerial process .it requires evaluation of multiple suppliers according to multiple criteria. This process is usually performed manually and based on just limited evaluation criteria, so better alternatives may be neglected. Three stages of survey comprised number of public a
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Abstract
Due to the momentum of winning in the streets of the city of Baghdad as a result of the large number of checkpoints so felt researcher to conduct a field visit to find out the main reasons that led to this congestion and to find practical solutions to mitigate wastage winning the arrival time citizen to where you want the least possible time.
This research aims to overcome the difficulties experienced by citizens to reach their places of work and reduce waste at the time of service and waiting time as well as reduce the cost of waiting.
Has emerged study a set of conclusions, including the use of model queue (G / G / C) and the mome
... Show MoreWithin this paper, we developed a new series of organic chromophores based on triphenyleamine (TPA) (AL1, AL-2, AL-11 and AL-22) by engineering the structure of the electron donor (D) unit via replacing a phenyle ring or inserting thiophene as a π-linkage. For the sake of scrutinizing the impact of the TPA donating ability and the spacer upon the photovoltaic, absorptional, energetic, and geometrical characteristic of these sensitizers, density functional theory (DFT) and time-dependent DFT (TD-DFT) have been utilized. According to structural characteristics, incorporating the acceptor, π-bridge and TPA does not result in a perfect coplanar conformation in AL-22. We computed EHOMO, ELUMO and bandgap (Eg) energies by performing frequency a
... Show MoreBackground :Evening preparation for colonoscopy is often unsatisfactory and inconvenient. This study was performed to compare the efficacy of bowel preparation at two different timings: night before and morning of endoscopy and to compare the cecal intubation rate and disturbance of sleep hours between these two groups.
Methods: In this prospective randomized endoscopist- blinded trial, 150 patients were enrolled between March 2010 and August 2011. Patients aged between 18 to 80 years needing colonoscopy were included. Patients with prior bowel surgery, suspected bowel obstruction or those who didn't completely fulfill the preparation instructions were excluded. Patients received polyethyelen glycol electrolyte preparation in a mornin
The problem of the research is focused on importance limited of Iraq industrial companies in application of scientific measurements of supply chains performance, The research sought to achieve a group of goals, the most important are , identifying the strengths and weaknesses in the reality of supply chain in General Company for Cotton Industries, The data and information required are gathered from the dependence company, records through the field observations and personal interviews, the research used some quantitative indicators to measure of supply chain performance, The research reached to many conclusions , the most outstanding among them is the existence of a strong inverse correlatio
... Show MoreThe commercial job is one of the most important businesses in the cities as there is no city can exist without commercial markets to offer service to its inhabitants. This study aims to distribute the commercial function in Abu Tayara Street located in the municipality of Al-Dora by highlighting the size of such businesses in this street. It focuses on analyzing the change that has occurred due to the usages of the commercial land not only in the residential areas, but also in various aspects associated with the growth of the population in the city. Both expansion and development of the economic and social aspects in the area have increased the demand for commercial services. So, the research focuses on the aspects of functional speciali
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