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.
Purpose: The purpose of the study is to compare and evaluate Earnings Management in Tunisia and Iraq. Theoretical framework: Earnings Management is an important topic that has been studied by a significant number of researchers, as well as those who are interested in the accounting profession. Earnings Management has gotten a lot of attention from academics, professionals, and other interested parties in recent years (e.g. Kliestik et al., 2020; Rahman et al., 2021; Gamra &Ellouze, 2021) Design/methodology/approach: The sample includes ten banks listed on the Bourse of Tunisia and Iraq Stock Exchanges for the year 2017. We have used a model of Kothari et al., (2005) as a tool to measure Earnings Management in both mark
... Show MoreThe exploitation of obsolete recyclable resources including paper waste has the advantages of saving resources and environment protection. This study has been conducted to study utilizing paper waste to adsorb phenol which is one of the harmful organic compound byproducts deposited in the environment. The influence of different agitation methods, pH of the solution (3-11), initial phenol concentration (30-120ppm), adsorbent dose (0.5-2.5 g) and contact time (30-150 min) were studied. The highest phenol removal efficiency obtained was 86% with an adsorption capacity of 5.1 mg /g at optimization conditions (pH of 9, initial phenol concentration of 30 mg/L, an adsorbent dose of 2 g and contact time of 120min and at room temperature).
... Show MoreBackground:This is a prospective study of three children presented to us in the Orbital clinic in AL ShahidGazi Al Hariri Hospital with painless proptosiswith suspension of Hydatid disease.Objectives: : Orbital hydatid disease is a rare lesion accounting for less than 1% of the total lesions of the body (1, 2). Orbital cysts presented as a primary lesion in our study which is rare to have such lesion without involvement of other organs (3). Humans represent the intermediate host where the commonly affected organ are liver and the lung (10-15%) (4). Methods:This is a prospective study of three Children presented to us in the Orbital clinic in Al Shahid Ghazi Alhariri Hospital with painless proptosis with suspension of Hydatid disease, dep
... Show MoreIntegrated project delivery is collaboratively applying the skills and knowledge of all participants to optimize the project's results, increase owner value, decrease waste, and maximize efficiency during the design, fabrication, and construction processes. This study aims to determine IPD criteria positively impacting value engineering. To do this, the study has considered 9 main criteria according to PMP classification that already covers all project phases and 183 sub-criteria obtained from theoretical study and expert interviews (fieldwork). In this study, the SPSS (V26) program was used to analyze the main criteria and sub-criteria priorities from top to bottom according to their values of the Relative Importance In
... Show Moreالمستخلص
يهدف البحث إلى وضع إطار معرفي ومفاهيمي شامل لموضوع البحث, واغناء القارئ والمستفيد بالمعلومات الوافية عنه وتقليص الفجوات المعرفية للمهتمين به وقياس مدى ما هو متوفر وغير متوفر من المتطلبات الأساسية والضرورية لإنشاء صناديق التحوط في البيئة العراقية, وتمثلت صناديق التحوط بالمتغير الرئيس للبحث اما المتغيرات الفرعية فشملت (المتطلبات المالية, المتطلبات البشرية, البيئة التشريعية, الب
... Show MoreThe phenomenon of the social movements of researchers, based on the scope of their influence on political events, and the nature of the wide role played, and its ability to influence, through its activities and various activities and various. It has practiced its activities through new and non-traditional peaceful means, with clear slogans and specific objectives. And was able to mobilize activists from different strata of the Iraqi people, and its categories and social strata. As the demands focused on freedoms, rights, dignity and social justice
There are many applied Economic studies that have found positive nexus between financial development and poverty reduction in developing countries. Iraq has witnessed an increasing rate of poverty during the period 1980-2010 due to many internal and external factors such as wars, economic sanctions, inflation, a high rate of unemployment, and political and security instability. Therefore, the investigation about the solutions to reduce poverty becomes very necessary, and enhancing the financial development in Iraq is one of these options. This is due to that the financial development could reduce the poverty rates through two channels: the first is direct via the offering of the loans and other financial facilities to the poor, a
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The concept of joint integration of important concepts in macroeconomic application, the idea of cointegration is due to the Granger (1981), and he explained it in detail in Granger and Engle in Econometrica (1987). The introduction of the joint analysis of integration in econometrics in the mid-eighties of the last century, is one of the most important developments in the experimental method for modeling, and the advantage is simply the account and use it only needs to familiarize them selves with ordinary least squares.
Cointegration seen relations equilibrium time series in the long run, even if it contained all the sequences on t
... Show MoreKeys to four genera and twelve species of the subfamily Phlaeothripinae (Phlaeothripidae) were constructed, these are: Haplothrips; Karnyothrips; Phlaeothrips; and Dolicholepta ,and the species are: Haplothrips cerealis Priesner; Haplothrips tritici kurdjumov, Haplothrips hukkineni Priesner; Haplothrips subtilissimus (Haliday) ؛ Haplothrips reuteri Karny; Haplothrips jasonis Priesner; Haplothrips sallloumensis Priesner ; Haplothrips pharao Priesner ; Phlaeothrips sycomri Priesner ; Karnyothrips flavipus (Jones); Karnyothrips melaleucus (Bagnall) ; Dolicholepta micrurus (Bagnall). These were collected from Baghdad
... Show MoreThe study showed that there are (28) plant families present in Al-Razzaza Lake. The families are (Amaranthaceae, Amaryllidaceae, Aizoaceae, Apiaceae, Apocynaceae, Asteraceae, Brassicaceae, Boraginaceae, Capparaceae, Caryophyllaceae, Cistaceae, Colchicaceae, Convolvulaceae, Cynomoriaceae, Fabaceae, Frankeniaceae, Lamiaceae, Liliaceae, Malvaceae, Orobanchaceae, Plantaginaceae, Poaceae, Polygonaceae, Ranunculaceae, Solanaceae, Tamaricaceae,Typhaceae, Zygophyllaceae). Asteraceae family is the largest number of species found in abundance in this lake, followed by the Fabaceae family.