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 theater can be considered a media that the effectiveness of its tools and the perceptions it produces cannot be abandoned according to patterns or aesthetic artistic trends, and at the same time it carries a large amount of information that can be worked on activating it with conscious directions within the elements of the theatrical performance, and these can be counted The study is an attempt to trace the functioning of the communication and media elements in the structure of the theatrical performance, as the study included: An introduction that defines the research problem and its importance, which crystallized around the following question: Does the media communication through theatrical presentation form its desired effectivene
... Show MoreThis research aims to introduce the importance of electronic marketing and the extent of its impact on the quality of the insurance service in general, and the national insurance company in particular, and the advantages it can achieve, an increase in its competitiveness, as well as contributing to increasing the efficiency of the performance of the insurance company.
The research relied on the questionnaire form as a main tool for obtaining data and information by the 70 questionnaire questionnaires required for the field side of the research, as they were distributed and retrieved in full, and all of them are suitable for analysis. The sample .The questionnaire was designed with three axes, the first wa
... Show MoreThe primary aim of this study was to identify the effect of using the simultaneous electronic presentations strategy in teaching basic skills of basketball to second-grade intermediate students. The present study had a parallel group, pre-post experimental design. In the present study the students of the Salah al-Din Intermediate School for the academic year 2020-2021 constituted the research community. A total of 75 students were present in the research community. Out of 75 students 16 students were selected as the participants for the study. The students falling within the age group of 13-14 years were recruited as the study participants, making up a percentage of 21.33 of the total number. Based on the results of th
... Show MoreThe current paper aims at knowing the effect of Exemplar of Wettli On Acquiring Grammatical Concepts Among Basic 7th Class Female Students in Kurdish Language Grammar.
The current paper is confined to a sample of Basic 7th Class Female Students- Khaniqin –belonged Morning schools for the academic year 2014-2015 . The sample amounted 50 female students distributed on two sections ( A,B) . Section A represented experimental group ( 24) female students studied according to the exemplar of ( Wettli) and (B) represented control group (26) female students who have studied with traditional method. The researcher has qualified between these two groups b
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The current research aims to demonstrate the relationship of correlation and influence between the independent variable strategic control through its dimensions represented by (organizational structure, human resources management, commitment to specialization, defining powers and responsibilities, values and integrity) and the dependent variable the performance of the insurance company, and the degree of arrangement of these dimensions according to their importance, as well as Detection of significant differences in the sample's response to the questionnaire paragraphs in the researched company, and the research problem
... Show MoreA field study aimed to improve administrative performance of the Heads of Departments in Wasit University in light of the administrative functions, a questionnaire constructed was c of 38 items, as have been applied during the academic year 2014/2015 to a group of experts from the deans and assistants, professors and heads of departments using the Delphi method by two rounds the adoption rate of 90% and an agreement was numbered 30 experts and study reached important results have been analyzed and discussed according to fields of study, a planning, organization and direction.
The Accommodation industry in Iraq suffers from many problems, especially after 2003, when the Accommodation industry was exposed to many crises due to the security and political situation in Iraq, which negatively affected the administrative operations inside the industry and created many problems, the most important of which are deterioration, high costs and poor performance, so some hotel administrations sought To find alternative solutions that help in the advancement of hotels, one of the proposals is to go to technology, as technology is currently one of the most important solutions to solve large complex problems, as the world has turned to automation to solve complex problems such as increasing production, reducing costs, and rai
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This research aims to identify the challenges faced by families of children with intellectual disabilities and to identify the impact of the challenges facing them on the mental health of their children with intellectual disabilities. Based on the following questions: What is the nature of the challenges faced by families of children with disabilities and how do these challenges affect the mental health of their children with intellectual disabilities? The study was conducted on a sample of four families of six children with intellectual disabilities, depending on the degree and type of disability. To achieve the study's objectives, the qualitative approach was used, Because of the importance of accessin
... Show MoreThe alfalfa plant, after harvesting, was washed, dried, and grinded to get fine powder used in water treatment. We used the alfalfa plant with ethanol to make the alcoholic extract characterized by using (GC-Mass, FTIR, and UV) spectroscopy to determine active compounds. Alcoholic extract was used to prepare zinc nanoparticles. We characterized Zinc nanoparticles using (FTIR, UV, SEM, EDX Zeta potential, XRD, AFM). Zinc nanoparticle with Alfalfa extract and alfalfa powder were used in the treatment of water polluted with inorganic elements such as Cr, Mn, Fe, Cu, Cd, Ag by (Batch processing). The batch process with using alfalfa powder gets treated with Pb (51.45%), which is the highest percentage of treatment. Mn (13.18%), which is the
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