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.
Background Depression is one of the most common medical illnesses worldwide. Medical students during their training will be subjected to many stressors, both mentally and emotionally. Objectives Assess the prevalence of depressive symptoms among medical students and to identify any association between depressive symptoms and some socio-demographic factors.
This article is part of the bigger project of my PhD thesis which investigates the influence of the British war poetry of the twentieth century on the development of Iraqi poetry in the century/Plymouth University/UK. The article examines the influences of British poetry on the development of the forms of poetry in Iraq after the Second World War. The aim is to shed the light on the creation of the ‘third product’ or the Iraqi poetry that shows the influences of the translated British poetry or the ‘second product’; which was written in prose for it is almost impossible to transfer the rhyme and rhythm of poetry from one language to another. Those who translated the poetry where also the pioneers of the major formal revolution in Ar
... Show MoreAbstract
The present search addressed the "strategic Vigilance and their impact in Organizational success "Where has the objective of strategic Vigilance and Organizational success of increasing importance at the present time, for being fairly modern topics, which have a tremendous impact on the success of organizations. &
... Show MoreThe Diwan of Imam Al-Shafi’i acquires great importance, as Al-Shafi’i is an authority in the language, and when I saw that no one had preceded me in exploring its depths, I took my tool and turned my face towards it intending to study the triple verb in it. I stop at these verbs and the student pauses for their morphological forms, looking at the significance of the triple verb more with one letter, two letters, and three letters, and I found that they are many, and such research cannot contain them all, so the choice came to choose the triple verb more with one letter, and the significance of the increase in it, as the increase in The building necessitates an increase in the meaning, and from here the study was limited to the triple
... Show MoreThe gamma dose rates and specific activity of 137Cs, 60Co and 40K in
samples of soil taken from places near the landfill radiation at Al-
Tuwaitha site were measured using a portable NaI(Tl) detector. The
results of gamma dose rates in samples were ranged from 52.6
nGy.h-1 to 131nGy.h-1. Then the specific activity of 137Cs, 60Co and
40K in soil were determined using high pure germanium (HPGe)
detector. The specific activities were varied from 1.9 to 115500 Bq.
kg-1 for 137Cs, from 6.37 to 616.5 Bq. kg-1 for 60Co, and from 3 to
839.5 Bq. kg-1 for 40K. The corresponding health risk for the annual
effective dose equivalent varied from 1.85×10-14 to 15.7mSv/y. The
results were compared with various internationa
Background: Client satisfaction with the immunization service is used to evaluate the quality of the admitted service and at the same time it affects the goodness of the health care outcome.
Objectives: This study assessed the satisfaction with immunization services offered to children and factors affecting this satisfaction.
Methods: Exit interviews for clients were conducted in Baghdad, Al-Karkh in a representative sample of primary health care centers to assess clients’ satisfaction with immunization services. Clients are companions of children encountered at study settings.
Results: Among the 253 respondent clients, 183 (72.3%) reflected satisfaction with the immunization
... Show MoreA critics ,Shugaa Muslim Al-Aany, has specific critical principles in his branch
classifications for the type of the novel that is linked with its sources and what is adopted
of critical approaches and curriculums. The novel by its type as a literary one has
occupied Al-Any's critical importance very much ,he has divided it historically according
to its historical development ,the impact of dr.Abd Al-Muhassen Tha Badr's divisions on
Al-Any cannot hidden.
In his speech about the origin of novel and story art generally , Al-Any becomes
between the acknowledgement of the affect of Al-Mgma in rising of this art and denied its
affect at last. He has classified the novel also as a stylistic classification:(an impression
Bac kground:
Failure is the state or condition of not meeting a desirable or intended objective, and may be viewed as the opposite of success; students always have a question "Why did I get this grade. On the contrary success leads towards new sources of earning, in fact there are a lot of interacting factors play such extrinsic and extrinsic to reach success.
Objec t i ves :
To explore internal and external factors causing students failure in medical college and to reconnoiter factors improve academic performance.
Methods: A cross-sectional study, conducted in Al Kindy College of Medicine, for the period from November 8th 2012 to May 1st 2013. Formal ethical considerations were obtained about participation and methodology. A