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.
Background: Spleen is a hemopoietic organ which is capable of supporting elements of different systems. It is affected by several groups of diseases; inflammatory, hematopoietic, reticuloendothelial proliferation, portal hypertension and storage diseases. Ultrasound (US) may detect mild splenomegaly before it is clinically palpable. Knowledge of the normal range of spleen size in the population being examined is a prerequisite. Racial differences in splenic length could result in incorrect interpretation of splenic measurements and such differences would make it difficult to standardize expected splenic length and to determine non- palpable splenic enlargement.Objectives: To measure the normal values of splenic lengthin Iraqi subjects an
... Show MoreThe research amid to measure the extent of the Suggested procedures of the internal control in accordance with the updated COSO framework in improving the procedures for internal control work in Iraqi oil companies. As the research problem was represented in suggesting procedures for internal control according to the updated COSO framework and finding out the relationship of correlation and influence between the suggested procedures and the internal control procedures that are done in the Iraqi oil companies. The research followed the quantitative approach to handling and analysing data by designing a Questionnaire to represent the research tool for collecting data. The study population was represented in the Iraqi oil companies,
... Show MoreThis study aimed to recognize and understand the concept of strategic management accounting (SMA) and how it's the effect on the competitive advantage for industrial companies in Jordan. The study's importance arises due to the lack of Arab studies that dealt with this topic, in addition to the important and vital role of strategic management accounting on companies that represent the artery of the decision-making process, and to identify the benefits associated with SMA technology. The necessary data were collected through the literature review and theoretical study of the references that relevant to the study subject, in addition to a questionnaire developed for this purpose, the study used (124) out of (250) questionnaires tha
... Show MoreThis research aims to study the methods of reduction of dimensions that overcome the problem curse of dimensionality when traditional methods fail to provide a good estimation of the parameters So this problem must be dealt with directly . Two methods were used to solve the problem of high dimensional data, The first method is the non-classical method Slice inverse regression ( SIR ) method and the proposed weight standard Sir (WSIR) method and principal components (PCA) which is the general method used in reducing dimensions, (SIR ) and (PCA) is based on the work of linear combinations of a subset of the original explanatory variables, which may suffer from the problem of heterogeneity and the problem of linear
... Show MoreThe current study performed in order to detect and quantify epicatechin in two tea samples of Camellia sinensis (black and green tea) by thin layer chromatography (TLC) and high performance liquid chromatography (HPLC). Extraction of epicatechin from black and green tea was done by using two different methods: maceration (cold extraction method) and decoction (hot extraction method) involved using three different solvents which are absolute ethanol, 50% aqueous ethanol and water for both extraction methods using room temperature and direct heat respectively. Crude extracts of two tea samples that obtained from two methods were fractionated by using two solvents with different polarity (chloroform and
... Show MoreIn situ gel can be defined as a polymer solution administered as a liquid and when exposed to some physiologic condition such as thepH, ionic, temperature modulation or solvent and UV induced gelation undergo to phase transition to a semisolid gel. Ketotifenfumarate belongs to the histamine H1 receptor antagonists, and Ketotifen fumarate is used in the treatment of allergic conditions likeconjunctivitis and rhinitis. This work aims to study the natural polymer effects (xanthan gum,gellan gum) on the properties of pH-trigger in situ ocular gel, then compared the drug-releasing rate of optimized formula with the market ketotifen eye drop. Eightformulations (F1-F8) were prepared using different concentrations of xanthan gum, gellan gum with ca
... Show MoreHead nurses are vital in understanding and encouraging knowledge sharing among their followers. However, few empirical studies have highlighted their contribution to knowledge-sharing behaviour in Online Health Communities (OHCs). In addition, scant literature has examined the moderating role of knowledge self-efficacy in this regard.
This study examines the moderating role of self-efficacy between the association of four selected individual factors of head nurses (i.e., Trust, Reciprocity, Reputation, and Ability to Share) and their knowledge-sharing behaviour in OHCs in Jordan.
<Chronic lymphocytic leukaemia (CLL) patients display a highly variable clinical course, with progressive acquisition of drug resistance. We sought to identify aberrant epigenetic traits that are enriched following exposure to treatment that could impact patient response to therapy.
Epigenome-wide analysis of DNA methylation was performed for 20 patients at two timepoints during treatment. The prognostic significance of differentially methylated regions (DMRs) was assessed in independent cohorts of 139 and 1
A simple, low cost and rapid flow injection turbidimetric method was developed and validated for mebeverine hydrochloride (MBH) determination in pharmaceutical preparations. The developed method is based on forming of a white, turbid ion-pair product as a result of a reaction between the MBH and sodium persulfate in a closed flow injection system where the sodium persulfate is used as precipitation reagent. The turbidity of the formed complex was measured at the detection angle of 180° (attenuated detection) using NAG dual&Solo (0-180°) detector which contained dual detections zones (i.e., measuring cells 1 & 2). The increase in the turbidity of the complex was directly proportional to the increase of the MBH concentration
... Show MoreDNA methylation is one of the main epigenetic mechanisms in cancer development and progression. Aberrant DNA methylation of CpG islands within promoter regions contributes to the dysregulation of various tumor suppressors and oncogenes; this leads to the appearance of malignant features, including rapid proliferation, metastasis, stemness, and drug resistance. The discovery of two important protein families, DNA methyltransferases (DNMTs) and Ten-eleven translocation (TET) dioxygenases, respectively, which are responsible for deregulated transcription of genes that play pivotal roles in tumorigenesis, led to further understanding of DNA methylation-related pathways. But how these enzymes can target specific genes in different malignancies;
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