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.
Patient satisfaction and dental anxiety considered as an important factors in dental health care and treatment because they greatly affect the patient's cooperation with the dentist and the extent to which follows the guidelines, treatment and preventive instruction. The present study investigates the relationship between patient satisfaction and dental anxiety, as well as their relation to demographic variables such as gender, age, number of visits, and cultural level. The study was applied on a random sample of dental clinics in Baghdad city with total of (200) patient (108 male and 92 female). Two scales were used in this study, patient satisfaction scale PSS (included 9 aspects, constructed by authors) and Iraqi dental anxiety scale
... Show MoreOne of the scientific education aims, preparing a student able to keep up with the scientific developments and innovations around him and make him contribute, adapt, investment and continue development. The concepts of nanotechnology from scientific innovation open up an important area of thinking and intervention in the field of chemistry applications in daily life, the technological changes lead to social, political and economic changes which result that the students to have the knowledge, understanding, awareness, appreciation and sense in applications of modern technology for their use optimally, in order to cope with these scientific and technological changes. The research aims at finding out the correlation between the acquisi
... Show MoreLos nombres propios nombran a un ser o a un objeto, distinguiéndolo de los demás seres de su misma clase, se escriben siempre con letra mayúscula a principio de palabra. Los lingüistas hacen mayor hincapié en las divergencias de referencia, entre nombres propios y nombres comunes. Así, suele decirse que el sustantivo propio no tiene como referente ningún concepto. El asunto de la traducción de los nombres propios parecería una cuestión de gusto personal del traductor pero vemos también que en algunas épocas es más frecuente traducirlos, y en otras, por el contrario, se prefiere dejar esos nombres en su forma original, tal vez con algunas adaptaciones ortográficas. Parecería entonces cuestión de modas. Pero, eviden
... Show MoreBackground: Dorsal plication on each side of the penis at the 2 and 10-o’clock positions had been a mainstay for correction of ventral penile curvature. However, because only the 12-o’clock position proved to be a nerve-free zone, dorsal plication at the 12-o’clock position can be advocated.
Objectives: To evaluate tunica albuginea plication with and without neurovascular bundle mobilization in patients with ventral penile curvature. Type of the study: A prospective study.
Methods: A 34 patients with a mean age of (4.8 ± 0.54) years, Who still
This work is licensed under a Creative Commons Attribution 4.0 International License. Abstract This study examines the working capital management
This research attempts to shed light on a topic that is considered one of the most important topics of HRMs management, which is the Employee centric approach by examining its philosophy and understanding . To achieve the goal, the research relied on the philosophical analytical method, which is one of the approaches used in theoretical studies. The research reached a set of conclusions, the most important of which are the theoretical studies that addressed this entry in the English language and the lack of it in the Arabic language, according to the researcher's knowledge. The research reached a set of recommendations, the most important of which was that this approach needs more research, analysis and study at the practical and th
... Show MoreThe Audit evedances represent the reconciliation tools between the Financial data shown on financial statements, and the level of satisfaction level of the Auditor about these statements. According that, the Auditor try to achieve the highest quantity of These evidances, and the most satisfactive of it…, but that will be so hard sometimes, when the internal controlling system is not good, and when the Auditor had some satisfied evidences, but not sharp… So, this research comes to inspect the relation between the quantity, and the level of satisfaction, and argument to prove that evidences gives. This research assumes that getting enough evidences leads to reduce faults, improves the auditing operation, and avoids risks. The research
... Show MoreBackground: Gingivitis is one of the most common and widely spread oral diseases in adolescents after dental caries occur in both developed and developing countries. Dental plaque is the main etiological factor of gingivitis. Another oral problem is enamel defect. The aim of this study was to estimate the oral hygiene (dental plaque), and determine the prevalence and severity of gingivitis and enamel defects among 16-17 years old secondary school female students in urban areas of Kirkuk city/Iraq. Materials and methods: A representative sample included in this study consisted of 750 secondary school female students distributed into 387 for the age sixteen and 363 for the age seventeen, they were selected randomly from different female secon
... Show More