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.
Abstract:
This research emerged due to the needs of Iraqi social sector for diagnosing the problems ,finding the appropriate solutions,and exploiting the social opportunities to solve these problems .The research problem focused on raising the following question: "Were Iraqi Managers in the Ministry of Labor and Social Affairs able to use their qualifications as social entrepreneurs in the ministry to improve the quality of life of the disadvantaged groups?", In light of that, the importance and objectives of the study were determined, and this research derives its importance from trying to address social problems by measuring the degree of meeting the subjective and objective needs of the custo
Background: The main purpose of this study is to find if there is any correlation between the level of C-reactive protein (CRP) in gingival crevicular fluid with its serum level in chronic periodontitis patients and to explore the differences between them according to the probing depth. Materials and methods: Forty seven male subjects enrolled in this study. Thirty males with chronic periodontitis considered as study group whom further subdivided according to probing depth into subgroup 1 with pocket depth ≤6mm, subgroup 2 with pocket depth >6mm. The other 17 subjects considered as controls. For all subjects, clinical examination where done for periodontal parameters plaque index (PLI), gingival index (GI), bleeding on probing (BOP),
... Show MoreAmino and fatty acids in the liver tissue of Uromastyx aegyptius microlepis during the periods of hibernation (December) and activity (May) were estimate by a high performance liquid chromatography, liver of a lizard during the activity and hibernation seasons, contained 18 amino acids, which include, 10 essential amino acids and 8 non-essential amino acids, and the liver in the male lizard contained five fatty acids during each season, the concentration rates of all the amino acids during the activity season were higher than their counterparts during the hibernation season, the total concentrations of essential and non-essential amino acids during the activity season were 19434.8 µg/ml, which was greater than the total concentrations leve
... Show MoreXanthomonas axonopodis pv glycines (Xag) is a pathogen that causes pustule disease in soybeans. Many
techniques for controlling this disease have been widely developed, one of which is the use of biological agents.
Bacillus sp. from the soybean phyllosphere is a biological agent that has the potential to suppress the
development of pustule disease. One of the biological control mechanisms is through biochemical induction
of plant resistance which includes the accumulation of phenols, salicylic acid compounds, and peroxidase
enzymes. Bacillus subtilis JB12 and Bacillus velezensis ST32 are two bacteria isolated from the soybean
phyllosphere which have previously been known to suppress Xag through an anti
The current study is based on previous findings, where corporate governance (CG) significantly increased corporate social responsibility (CSR) to enhance transparency while reducing the tendency of corporate management to engage in earnings management (EM). A sample of 11 Iraqi banks listed on the Iraq Stock Exchange from 2010 to 2020 was selected. The CG was included in the board size and board independence apart from the variables of Chief Executive Officer (CEOs) gender, majority shareholder ownership, foreign ownership, and institutional ownership. The CSR included the wage growth rate, bank contribution growth rate for social security, training programmes, subsidies, environmental protection, and bank compliance with the law. Specifica
... Show MoreBackground: Polymorphisms in the TNF-α gene affect the development and progression of rheumatoid arthritis. Objective: To investigate the associations between (-806 T/C) and (-857 T/C) SNPs with rheumatoid arthritis severity and susceptibility in a sample of Iraqi patients. Methods: A case-control study was conducted in Baghdad, Iraq. Twenty healthy controls and 63 patients confirmed to be newly diagnosed with rheumatoid arthritis were included. Those are divided into two groups (patients and controls), and the patients were further subdivided into severe and mild-moderate groups. Samples from those participants were analyzed for clinical and inflammatory parameter measurements. Genotyping by the Sanger method was performed to stu
... Show MoreThe objective of the study was to identify the effect of the use of the Colb model for the students of the third stage in the College of Physical Education and Sports Sciences, University of Baghdad,As well as to identify the differences between the research groups in the remote tests in learning skills using the model Colb.The researcher used the experimental method and included the sample of the research on the students of the third stage in the College of Physical Education and Sports Science / University of Baghdad by drawing lots, the third division (j) was chosen to represent the experimental group,And the third division (c) to represent the control groupafter the distribution of the sample splitting measure according to the Colb mode
... Show MoreThe purpose of this paper is to identify the statistical indicators of the searched variables and identify the relationship between the cognitive learning outcome and the performance of the two mastering skills by parallel spherical standing and equilibrium on the balance beam. And the identification of the percentage of the cognitive learning outcome contribution to the performance of the two mastering skills by parallel spherical standing and the equilibrium on the balance beam. The two researchers used the descriptive approach in the survey method and the correlational relations, being the most appropriate to the nature of the research problem. The research community for the second stage students in the College of Physical Education and
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