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 paper aims to explain the effect of the taxes policy including direct & indirect taxes on supporting the domestic Investment in Iraq. This could help the official planners for drawing the future policies that help provoking (istumlating) the domestic investment in Iraq the quantitative analysis approach was adopted using regression model. The results showed the significance of the effects of both direct & indirect taxes policies on domestic as a simple correlation coefficient ( r ) of ( 0.6 ) , ( 0.64 ) respectively.
Abstract
Public debt has posed a major challenge to both developing and developed countries, which has focused attention on the optimal limits (threshold of debt) and its determinants.
The study examines the effect of the Public bank debt on the foreign reserves and the work of the foreign reserve as a limitation on the process of bank debt (part of the internal debt) for the period (2017-2004), in addition to finding the type and nature of the relationship between them according to the hypotheses of the study, Public bank debt and foreign reserves.
The study was based on data from the Iraqi banking sector, which showed that Iraq has a foreign reserve in line with internat
... Show MoreThe public budget is on the same time an art and a science .As an accountable science it seeks balance between public income and public expenditure for an accountable year. And as an accountable art it seeks to achieve economic balance by distributing equitable income in order to reach sustainable development .This is the optimal use of all natural and human resources to address scarcity of natural resources facing the increase need of human resources by spending on education, health, environment, housing, agriculture and industry to achieve social justice for the current generation and future generations. Since the first budget in Iraq on 1921 an accounting budget, is balancing the sections and items has been adopted and since the publi
... Show MoreTo deduct the childhood status in Iraq, it was important manner to use statistical tools and approaches concerned with interpreting the causal relationships and their attitudes and use classification method for the important effects (variables) to draw an obvious picture of the phenomena under study in order to make it useful through investing, updating and improving it in by demographic studies in the future. Two statistical methods had been used in the field of analyzing data of multivariate analysis namely, Cluster Analysis and Factor Analysis.
The present study focuses on four fundamental axes .The nutrition axis, health axis, Educational axis, and the social axis. The study has ca
... Show MoreCongenital anomalies commonly occur in humans, possibly visible. If these anomalies appear in visible parts in human body such as face, hands and feet. They may only appear after utilizing a number of special tests in order to show by means of the anomalies that occur in the internal organs of the body such as heart, stomach and kidneys.
Research data have comprised accessible information in the anomalies birth statistics form situated of Health and Life Statistics section at the Ministry of Health and environment, where the number of anomalies births involved in the study (2603 anomalies birth) in Iraq, except Kurdistan region, at 2015. A two way-response logistic regression analysis h
... Show MoreThe geochemical study of the Oligocene-Miocene succession Anah, Euphrates, and Fatha formations, western Iraq, was carried out to discriminate their depositional environments. Different major and trace patterns were observed between these formations. The major elements (Ca, Mg, Fe, Mn, K, and Na) and trace elements (Li, V, Cr, Co, Ni, Cu, Zn, Ga, Rb, Sr, Zr, Cs, Ba, Hf, W, Pb, Th, and U) are a function of the setting of the depositional environments. The reefal facies have lower concentrations of MgO, Li, Cr, Co, Ni, Ga, Rb, Zr, and Ba than marine and lagoonal facies but have higher concentrations of CaO, V, and Sr than it. Whereas dolomitic limestone facies are enriched V, and U while depletion in Li, Cr, Ni, Ga, Rb, Sr, Zr, Ba, an
... Show MoreThe Developing economies of countries have witnessed essential changes to words the development of tourism industry in the 21st century . in addition to adopting same of policies and strategies to grow up with the tourism sector to make it one of the important economic sector to compete the tourist cal developments in the wear .
As for the tourism sector in Iraq ,it's still afresh one , has many of elements which can be in vested ,needs a wide strategies of tourist cal in statutes and variety completive services and change of success for the locale and forgin investor ,the essential aim after this research is to prompt the national economic through the tourism industry and making concisen
... Show MoreWith the spread of the use of liquefied petroleum gas (LPG) in developing countries for use in domestic cooking with the increase in the expansion and distribution of gas pipelines for residential buildings, the 2002 World Summit focused on sustainable development in clean energy for natural gas (NG) and LPG. The research aims to focus on the important aspects of design sustainability from an environmental point of view to reduce gas leakage, accidents, and explosions that occur socially to expand the distribution of LPG and motivate the consumers to use it instead of natural gas and other fuels, and from an economic point of view to take into account the annual cost and aesthetic imp