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.
This present work is concerned with one of the syntactic issues that has been researched by many linguists, grammarians, and specialists in Islamic studies, the estimated answer to a condition. However, this topic is researched this time by examining Imam Al-Qurtbi’s opinions in interpreting related ayas from the holly Quraan in his book (Collector of Quranic Rules) or its transliteration (Al-Jami’ Li Ahkam Al-Quran). Such a step involves commenting on, tracking what Al-Qurtbi said in this regard, discussing it from the points of view of other grammarians, and judging it accordingly, taking into account the apparent surface structures of the examples collected. To achieve this objective, the inductive analytical approach has be
... Show MoreObjectives To tailor composites of polyethylene–hydroxyapatite to function as a new intracanal post for the restoration of endodontically treated teeth (ETT). Methods Silanated hydroxyapatite (HA) and zirconium dioxide (ZrO2) filled low-density polyethylene (LDPE) composites were fabricated by a melt extrusion process and characterised using infrared spectroscopy (FTIR), differential scanning calorimetry (DSC) and dynamic mechanical analysis (DMA). The flexural strength and modulus were determined in dry state and post ageing in simulated body fluid and fractured surfaces analysed by SEM. The water uptake and radiographic appearance of the experimental composites were also measured and compared with a commercially known endodontic fibre
... Show MoreIf the State attaches great importance to its foreign relations and intends to strengthen them in order to ensure the achievement of the highest national goals and interests. External relations between countries are one of the most prominent features of foreign policy, which depends on a combination of internal and external factors, the modern relations between Tunisia and Tunisia, which goes back to the pre-independence of Tunisia, when Iraq was a supporter of Tunisia's independence from France in the 1940s, Although these relations did not cause any disturbance by the two countries, but they remained weak relations did not develop in all areas except the sports and cultural field, which we will determine the reasons and the pos
... Show MoreThis research was conducted to measure the safety of heat stable enterotoxin a (STa) produced by enterotoxigenic Escherichia coli, through studying its toxic effect on mice since it showed a promising effect in reducing the proliferation of colorectal cancer cells. The cytogenetic effect was determined after giving five different doses (100, 200, 400, 800 and 1600)μg/Kg in comparison with negative (phosphate buffer saline / PBS) and positive (mitomycin C/ MMC, at doses of 2 and 5μg/Kg) controls on mouse bone marrow cells by employing the following parameters: mitotic index, chromosomal aberrations and micronucleus, also, the serum level of liver functional enzymes (GOT, GPT, ALP) was recorded. In addition, lethal dose 50 (LD 50) with cert
... Show MoreThe performance of job effectively requires narrowing the meaningful routine activities and attempting employing the job procedures in favor of public welfare through adding the green impact as well as removing them from the red tapes which reflect the firmness of procedures, to enable the job parties to make their job independently, and pushing them to gain priority in the competition layer. This is not attaining easily amidst the regulatory problems expressed by the complication of procedures, the thing which make identifying the problem of the study through the following question:
Should we make the complex of procedures and their firmness a way to adopt the idea of the green regulatory tapes supportin
... Show MoreThe unemployment is considered from the most danger problems that our society face them in current time & in the near future , because it makes prodigality for element of human being , particularly age of youth who have ability to work & producing , that resulted in negative effects forecast to dire consequences social and economical dangers . In the same time as will be stated in our explanation in the following in our research , because the unemployment has ability to help to prepare good environment to grow crime , actions of violence that mostly are main cause to decrease living level of majority of citizens & in increasing numbers who became under poverty , the unemployment is economical problem as it is psycholo
... Show MoreThere is a mutual relationship between the form of a text and its meaning so as separating these two or devaluating the role of one of them leads to the absence of the value therein. Thus, a translation is important as to how it relates the details of a text. That is, the text has special features which go beyond form, and these set out its distinctiveness. Here, we tackle Saleh al-Jafari's Arabic translation of "Rubbayat al-Khayyam" of Naysapour descriptively and analytically by depending on extracts from the original text. This translation is evaluated on the basis of Spanish critic Maria Carmen Valero Garces. Herein, we discuss the effectiveness of this theory in the criticism of literary texts. It has been concluded that al-Jaf
... Show MoreThis study focuses on the biodegradation of oxymatrine insecticide by some soil fungi isolated from four agriculture stations. The results showed that the highest degradation rate 94.66% was recorded by Ulocladium sp. at 10 days and A. niger recorded the lowest degradation rate 45.86%, while at 20 days Ulocladium sp. also showed the highest degradation rate 94.98% and the lowest degradation rate reached to 82.49% with A.niger. The mix (Exerohilum sp.+Ulocladium sp.) recorded the highest degradation rate of oxymatrine insecticide 90.22%, 88.51%, 85.34% at 4, 8 and 12 ppm.The use of mixed isolates enhanced the biodegradation process. There is no study of oxymatrine biodegradation
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