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.
Many managers in geometrical and technical organizations prefer to deal with quantitative values to choose between the available options and choose the best alternative to avoid randomization and bias in decision making. One of them Baghdad Water Department, which seeks to develop the quality of its product (drinking water) and achieve its objectives under increasing growing population and the demand for water, Some of TQM tools, especially the statistical, have this ability because there is chance to use historical data and experiment of employees in Application . Two statistical tools were applied: the nominal group technique, matrix data analysis technique as well as the brainstorming tool to search for the best o
... Show MoreBackground: Investigating dental health knowledge among children is important. Knowing what behaviors are right in relation to dental health does not guarantee that children will practice those behaviors. However, lack of knowledge and misconceptions about dental health may lead to behaviors that are harmful to teeth and gum. Baseline data on knowledge levels are required to determine which particular areas of dental health education are in need of improvement for high-risk children living in different geographical areas. This research was conducted to study the oral health status, dental knowledge and behavior in relation to two different cities, among children in Baghdad and Thamar (republic of Yemen) governorate. Materia
... Show MoreThis research aims to examine the ability of impact of the cash flow statement indicators in the change in the market value of the industrial firms listed on the Palestine Stock Exchange. The research population consisted of (13) firms during the period (2015-2020). Data were collected from the annual financial statements of the firms. The research relies on the Pooled effects model to analyze the cross-section data (Panel Data), and the multiple regression method to test the hypotheses. The research finds a positive significant impact of (the ratios of cash flows from operating activities to sales, the return on assets from operating cash flows, and cash flows from operating activities to total current liabilities) in the change
... Show MoreBackground:Open reduction and internal fixation (ORIF) of using miniplates and screws is the treatment of choice of mandibular fractures. It is important to know both: the region where the bone providesafirm anchorage, andthe topography of the dental apices and inferior alveolar nerve to avoiddamaging them when inserting the screw. The aim of this study is to determine the thickness of buccal cortical plate and that of buccal bone at the parasymphysis and mandibular body, thereby determining the area that provide afirm anchorage and the maximum length of mono-cortical screws that can be safely placed in these regions without injuring the tooth roots or mandibular nerve. Materials and Methods:The sample of the present study was 110 Iraqi sub
... Show MoreThe aim of the research is to diagnose the nature of the relationship between the dimensions of organizational immunity with its dimensions represented by (organizational memory, organizational DNA, organizational learning) in enhancing the strategic capabilities of the company with its dimensions represented by (marketing capabilities, administrative capabilities, technological capabilities, creative capabilities), and the degree of arrangement of those dimensions According to priority, as well as revealing the differences in the respondents’ response to the two variables according to the personal and functional variables, and the importance of the expected results, the researchers adopted the questionnaire as a tool for collecting da
... Show MoreIn this study, from a total of 856 mastitis cases in lactating ewes, only 34 Streptococcus agalactiae isolates showed various types of resistance to three types of antibiotics (Penicillin, Erythromycin and Tetracycline). St. agalactiae isolates were identified according to the standard methods, including a new suggested technique called specific Chromogenic agar. It was found that antibiotic bacterial resistance was clearly identified by using MIC-microplate assay (dilution method). Also, by real-time PCR technique, it was determined that there were three antibiotics genes resistance ( pbp2b, tetO and mefA ). The high percentage of isolate carried of a single gene which was the Tetracycline (20.59%) followed by percentage Penicillin was
... Show MoreThis research aimed to identify the level of English language knowledge among the students of scientific colleges and the preparatory year (scholarship students) at the Islamic University of Madinah. The research was limited to identifying students at the meanings of vocabulary and grammar of the English language. The researcher used a descriptive approach to achieve study goals. It applied three tools to collect information from the targeted sample; first, a test for determining the level of students in the achievement of vocabulary which applied to (69) students. Second, a test to determine the level of students in the English language grammar, (73) students took part. Third, a survey to get students’ opinions about the program of te
... Show MoreThe photodynamic inactivation against Methicillin-resistant Staphylococcus aureus using two different lasers, 532 nm diode pumped solid state laser (DPSS) in combination with safranin O and 650 nm diode laser in combination with methylene blue was investigated in the present work. A hundred swab samples were collected from patients with burn and wound infections admitted to two hospitals in Baghdad (Specialized Burns Hospital in Medical City and Al Imamein Al Jwadein Medical City Hospital) from December 2015 to February 2016 Antimicrobial susceptibility was performed by using Kirby- Bauer method. The irradiation experiments included four groups; a control group, a photosensitizer only group, a laser irradiation only group and a laser irr
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