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 art of postmodernism has undergone a number of changes in the course of art and art schools, as art has left the traditional means and paved the way for this artistic transformation to change the materials, techniques, methods and visions as a result of the changes that occurred in the thought and this change played an important role in the artist's vision, To demolish and destroy all of the above and to reconsider the formal systems and intellectual contexts and expressive modes, so it is necessary for the whole art to keep up with the variables of the era and its elements. The current research aims to: "Detect the transformations of form in postmodern art in the projects of students of the Department of Art Education".
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... Show MoreThe Child's theatre was and still is the most investing art for masks of all kinds (partial and total) for suspense, aesthetic and artistic purposes that meet the requirements of those performances. Here the actor's performance is associated with two tools, i.e. the body and the mask, where it has become a must to search for the performance transformations required in order to achieve the highest level of the right performance through this dualism. This urged the researcher to address this problem. Thus, the researcher has put forward an objective to identify the transformations of the character's performance between the body and the mask in the child's theatre shows. The research consists of a methodological framework and a theoretical
... Show MoreST segment, T wave changes, QT interval changes, and QTc dispersion are among the parameters used to diagnose ischemic heart disease. The increase in the QT dispersion can be caused by myocardial ischemia, among other heart diseases, whereas cardiac diseases such as coronary artery disease (CAD) can be diagnosed by observing an abnormally high QTc dispersion. This study aimed to evaluate the variations in the QTc dispersion (depolarization and repolarization) of surface electrocardiography as a result of percutaneous coronary intervention (PCI) in patients with chronic total occlusion. This study took place in the Iraqi Center for Heart Disease from October 2020 to February 2021. 110 patients who suffered from chronic occlusion of t
... Show MoreBackground: Vascular tumors and malformations, comprising a broad category of lesions often referred to as vascular anomalies. Hemangioma, represents a variety of vascular lesions (both malformations and tumor), while lobular capillary hemangioma is a common vascular lesion of the skin and mucous membranes that occurs mainly in children and young adults. Lymphangiomas are malformations of the lymphatic system. At the level of light microscopy the small lymphatics vessels may be similar to capillaries and sometimes are only tentatively identified by the nature of their contents or by immunohistochemical staining procedure. This study aimed to assess the vascular and lymphatic vessels density in benign vascular lesions using CD34 and D2-40 im
... Show MoreDBN Rashid, 2012 - Cited by 2
This study aims to examine the technologies of education and their importance, shedding light on their reality and status in Sudan especially in the secondary stage. It has become necessary to invest these technologies and include them in different aspects of the technical education curricula. Such a step helps cope with the innovative scientific development in the advanced countries, qualify professors and technicians, develop the factories and workshops, and create an attractive technical educational environment to the pupils. Thus, the researcher has adopted a descriptive analytical approach that is based on conducting pilot visits to certain technical schools in Al-Khartoum state. Different aspects of such schools were examined
... Show MoreBackground: Prophylaxis methods are used to mechanically remove plaque and stain from tooth surfaces; such methods give rise to loss of superficial structure and roughen the surface of composites as a result of their abrasive action. This study was done to assess the effect of three polishing systems on surface texture of new anterior composites after storage in artificial saliva. Materials and methods: A total of 40 Giomer and Tetric®N-Ceram composite discs of 12 mm internal diameter and 3mm height were prepared using a specially designed cylindrical mold and were stored in artificial saliva for one month and then samples were divided into four groups according to surface treatment: Group A (control group):10 specimens received no surfa
... Show MoreThis research dealt with the subject of auditing bank credit risks in accordance with international auditing standards and aims to develop procedures and design a credit risk audit program in accordance with international auditing standards and demonstrate their impact on the truth, truthfulness and fairness of financial statements and on their overall performance and continuity in the banking sector Its importance lies in relying on international auditing standards to assess and measure bank credit risk and its impact on the financial situation as well as the ability to predict financial failure. A set of conclusions have been reached, the most important of which is that the bank faces difficulties in measuring credit risk in accordance
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