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.
Abstract
This research aims to determine the role of the quality of higher education in achieving organizational excellence at the universities of Baghdad and Al-Nahren, was based on research on the main hypothesis is:First:- There is correlation and between the quality of higher education dimensions (continuous improvement, measurement and analysis, the culture of the organization, optimal use of resources , customer satisfaction) and organizational excellence dimensions (strategic planning, focusing on the market and the customer, information and analysis, the effectiveness of operations, processes and resources), Second:- Second, there is the impact of relationship sig
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The purpose of the subject of Total quality management is an important management style in organizations including hospitals through the achievement of this method of success in the administration to include this approach describes the provision of health services and make adjustment and suggestions that help to improve the quality of health care on an ongoing basis . Hence the idea of the study to shed light on the reality of the application of principles of Total quality management and to highlight the quality of health services provided in al-kindi hospital / Baghdad health department rusafa and the staff at the hospital were included to find out the appl
... Show MoreZanthoxylum L. 1753 belongs to the family Rutaceae. The plant, with its forest green color and with its distinctive fragrance attracted the attention of the study, specially it was an exotic to the environment of Iraq. Zanthoxylum is an exotic plant produced to Iraq and planted in gardens as an ever-green aromatic plant named (BUKHUR HINDI), as it is known among sellers and farmers in Iraq, because of the aromatic smell that emanated from the leaves and resembles Indian incense. The plant adapted to environmental conditions and succeeded in growing and blooming. It was examined and diagnosed for the first time in Iraq as Zanthoxylum beechyanum K. Koch. (Chinese pepper tree). Morphological characteristics and anatomical characteristi
... Show MoreObjective: The descriptive study was used to evaluate nursing staff performance in cardiac care units at teaching
and non teaching hospitals in kirkuk city: A comparative study.
Methodology: A descriptive study was used to evaluate nursing staff performance in cardiac care units. The study
was conducted from December 29th
, 2013 up to the 27th of Apr. 2014. A non-probability (purposive) sample of
(44) nurses who work in cardiac care unit at Azady teaching Hospital and Kirkuk general Hospital was evaluated by
a questionnaire which consisted of two parts; the first part is concerned with the demographic characteristics of
the nurses and the second part concerned Observation check list for evaluation nursing staff Perfo
In globalization, the world became open area to competition for the attractive of investment, and the abilities of each country to win the confidence of investors depend upon the preparation to optimize circumstances. The competitiveness is an essential means of expanding the capacity of developed to coexist in an international environment characterized by globalization. While competition describes the market structure, the behavior of investors and business, competitiveness is interested in the evaluation of business performance or countries and compare them in the conditions of competition available in these markets. Regarding Malaysia, which is depend on FDI-Export- Led Growth strategy, it has taking on diffe
... Show MoreThe investigation of machine learning techniques for addressing missing well-log data has garnered considerable interest recently, especially as the oil and gas sector pursues novel approaches to improve data interpretation and reservoir characterization. Conversely, for wells that have been in operation for several years, conventional measurement techniques frequently encounter challenges related to availability, including the lack of well-log data, cost considerations, and precision issues. This study's objective is to enhance reservoir characterization by automating well-log creation using machine-learning techniques. Among the methods are multi-resolution graph-based clustering and the similarity threshold method. By using cutti
... Show MoreWireless sensor networks (WSNs) represent one of the key technologies in internet of things (IoTs) networks. Since WSNs have finite energy sources, there is ongoing research work to develop new strategies for minimizing power consumption or enhancing traditional techniques. In this paper, a novel Gaussian mixture models (GMMs) algorithm is proposed for mobile wireless sensor networks (MWSNs) for energy saving. Performance evaluation of the clustering process with the GMM algorithm shows a remarkable energy saving in the network of up to 92%. In addition, a comparison with another clustering strategy that uses the K-means algorithm has been made, and the developed method has outperformed K-means with superior performance, saving ener
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