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.
The function of internal auditing has become an important function that aims at achieving objectives that are compatible with these developments and changes that have occurred in many countries in the world, which required the emergence of professional associations and institutes in the profession of internal auditing. Improve the guideline of the internal audit units issued by the Federal Audit Bureau to enhance the efficiency of internal audit performance in Iraqi government units. The researchers adopted the statistical method of proving the hypothesis by constructing a questionnaire that included three main axes: supporting the senior management in adopting the current guide, and the second being the importance of improving t
... Show MoreThe problem of research is that there are differences between learners in processing in formation in general and there is variation at the learners level perform scrolling skill of the passes up and down by the volley ball .Therefore the researchers decided to conduct astudy through which identify the relationship between information processing and the skill of scrolling from the top and bottom by the volleyball. The researchers used the descriptive approach by themethod of interconnectivity .Asampleconsist of21 students from first staye in collage of physical education and sports science for Girls(university of Baghdad) and attest has been applied(process information and scroll up and down) on the research sample after the required
... Show MoreThree-dimensional nonlinear thermal numerical simulations are conducted for the friction stir welding (FSW) of AA 7020-T53. Three welding cases with tool (rotational and travel) speeds of 900rpm-40mm/min, 1400rpm-16mm/min and 1400rpm-40mm/in are analyzed. The objective is to study the variation of transient temperature in a friction stir welded plate of 5mm workpiece thickness. Based on the experimental records of transient temperature at several specific locations during the friction stir welding process for the AA 7020-T53, thermal numerical simulation is developed. The numerical results show that the temperature field in the FSW process is symmetrically distributed with respect to the welding line, increasing travel speed decreasing tran
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The study aims to know the degree of secondary school managers' practice of servant leadership in Gaza from their teachers’ perspective. It further aims to examine whether there are any statistically significant differences at (α 0.05≥) between the means of the study sample’s members attributed to variables such as (gender, educational qualification, and years of experience). To achieve the objectives of the study, the study adopted the descriptive survey method, using a questionnaire consisting of (30) items distributed to four domains: (workers service, ethical dealing, motivation & influence, and building an organized, integrated society). Then, the questionnaire was distributed to t
... Show MoreThe study aims to set an image to the mechanisms of the skills of the 21st century in the educational competencies of the basic education stage. To achieve this aim, a qualitative research design has been adopted in its analytical content analysis way. The study has arrived to the following conclusions: the availability of: the communicative and team work skills with a percentage of 25.9%, linguistic competency with a percentage of 24.6%, the skills of local and global citizenship, creativity, and problem solving with a percentage of 13.6%, critical thinking with a percentage of 10.38%, technological culture with a percentage of 5.8%, pioneerism and initiativeness with a percentage of 10.38%, technological culture with a percentage of
... Show MoreA robust and sensitive analytical method is presented for the extraction and determination of six pharmaceuticals in freshwater sediments.
One of the contemporary trends in education and training is the use of educational, competitive and digital games, because one of the most important goals of games is (motivation and challenge). Thus, it ensures the expected reaction from the recipient’s interaction with the game, so we seek his interaction with the content he receives. It is no secret that games distance him from boring content and introduce him to the world of motivation by integrating them with magical elements that make an attractive and desirable game. Naturally, in the case of stimuli and motives that activate the recipient within the context of the educational process procedures, the return is high and especially enjoyable. The aim of the research is to pre
... Show MoreThe aim of the study is to reveal the effect of the constructivist learning Model on the achievement and reflective thinking of the fifth grade literary Preparatory students in History subject. A random sample was chosen which consisted of 64 students divided into experimental and control groups, each group consisted of 32 students. The experimental group was taught via the constructivist learning model, and the control group was taught via the traditional method. The experiment was lasted for Eight weeks, each week taught two lessons. The researcher adopted the experimental design with partial control. The two groups were equalized statistically. The researcher used two instruments, the achievement test and the reflective thinking test.
... Show MoreThis research aims to clarify the importance of an accounting information system that uses artificial intelligence to detect earnings manipulation. The research problem stems from the widespread manipulation of earning in economic entities, especially at the local level, exacerbated by the high financial and administrative corruption rates in Iraq due to fraudulent accounting practices. Since earning manipulation involves intentional fraudulent acts, it is necessary to implement preventive measures to detect and deter such practices. The main hypothesis of the research assumes that an accounting information system based on artificial intelligence cannot effectively detect the manipulation of profits in Iraqi economic entities. The researche
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