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.
Context and its influence in direction of reference by Abi Hussein Al Basri
The research studies the melody and rhythmic characteristics in the songs of the Baghdadi quartet, as it is a type of popular singing in Iraq, reviewing its origins, social purposes, special and public events in which it is performed. The methodological framework included the problem of the research, the need for it, its importance, its purpose, and the limits of the research which included the objective limit: the songs of the Baghdadi quartet, the spatial limit: the city of Baghdad and the temporal limit (1960-1980) and identifying the terms included in the research.
The theoretical framework consisted of three items: the first is the popular singing, the second is the Iraqi popular singing and the third is the Baghdadi quartet. It
OBJECTIVE: To evaluate the patient satisfaction to hospital services and identify factors that influences this satisfaction.
Man was closely associated with nature in its various forms, as it represented the incubator for him in all areas of his life, so writers often made it a material for their literature and a fertile ground for their productions, so it appeared in its various forms and man’s need for it, its good and its bad in literature throughout history, and the Arabs are like Other nations, since the pre-Islamic era, nature was an important outlet and a refuge for poets in the production and creativity of literature and to this day, and when we talk about a poet from the Fatimid state, we find that nature - especially spring and its flowers - in that period took its take from literature and represented a phenomenon for many Among the
... Show MoreMany writers and scientists hardly differentiate between the two instruments of use
(If) and (if) to convergence in the meaning, as they perform the meaning of the penalty and condition, as the answer relates to his condition, but when linguistic meditation we find a great difference in use in terms of meaning, so this research came to reveal these meanings and was extrapolated applied in Surat al-Maidah By counting the verses in which (if) and (if) the cops were given and looking at their contexts, the connotation of the cops in most places was within the context of probability, which is the origin of its use, given in twenty places of Surat al-Ma'idah, and it had multiple connotations according to the contexts of the verses received
The study focuses on identifying the reality of administrative creativity of secondary schools' managers in Al-zarqaa province. The descriptive approach was adopted to conduct this study. To achieve the study objective, the author designed a questionnaire composed of (24) items included (4) domains applied on (80) male and female school managers were selected randomly. The results showed that the administrative creativity level of secondary school's managers over all domains were too high which ranked as school management domain followed by public community domain then teacher domain and finally, school environment domain. Additionally, each of male, private sector, and experience over 10 years revealed significant differences.
Shatt al-Arab is the only navigational artery in Iraq, extending from the city of Qurna to its mouth in the Arabian Gulf at the city of Al-Fao within the governorate of Basrah for a length of approximately 204 km. Its width ranges from 400 m to 2000 m, and its depth ranges from 8 m to 20 m. The southern part of it, 93 km long from Umm al-Rassas Island to Ras al-Bisha, represents the international border between Iraq and Iran, where the Thalweg line represents the border between the two countries, which is the deepest point in the riverbed (according to the 1975 Algiers Agreement). The western bank (the Iraqi side) within the common border of Shatt al-Arab is subject to continuous erosion, which leads to the shifting of t
... Show MoreThe aim of this paper is to estimate the concentrations of some heavy metals in Mohammed AL-Qassim Highway in Baghdad city for different distances by using the polynomial interpolation method for functions passing from the data, which is proposed by using the MATLAB software. The sample soil in this paper was taken from the surface layer (0-25 cm depth) at the two sides of the road with four distances (1.5, 10, 25 and 60 m) in each side of the road. Using this method, we can find the concentrations of heavy metals in the soil at any depth and time without using the laboratory, so this method reduces the time, effort and costs of conducting laboratory analyzes.
Adolescence important and sensitive stage in social terms, being a stage where learns teenager bear social responsibilities and composition of their ideas about family life, as well as it is the stage where the teenager looking to himself for an important place in the community to become independent socially people, so it highlights the role of Social Work to do better effort and I believe him in order to prepare for the adolescent stage of adolescence and help him overcome the problems so that makes it adapts to the society in which he lives