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 aim of this study is to explain methods to be followed for the recovery Alsnav Hor, who represents the northwest portion of the Hammar Marsh in the province of Dhi Qar, after the drought in which that happened in 2008. The study included description of the region before the drought, the description of its natural and human environments, the economic events and activities, then the study included drought throughout the region, the environmental impacts caused by drought, its impact on social reality, economic and healthy for its environment, and then reached to the problems of social and economic in the region, depending on the Field studies and documented in the specialized government departments, information analysis for the
... Show MoreThe job that confronts players with the effectiveness of shooting with an air rifle is high, so it requires necessary functional adaptations that differ in their degrees from other sports. Regular training in air rifle shooting leads to physiological changes in most of the body's internal systems, and changes and responses can be identified. The functional accompanying physical activity through the presence of body components that reflect these physiological changes in the form of changes in some components, and the importance of research lies in studying the physiological changes accompanying the maximum physical effort and the consequent development of the level of achievement in the effectiveness of shooting with air rifle and body
... Show MoreThe problem of research is that there are differences between learners in processing in formation in general and there is variation at the learners level perform scrolling skill of the passes up and down by the volley ball .Therefore the researchers decided to conduct astudy through which identify the relationship between information processing and the skill of scrolling from the top and bottom by the volleyball. The researchers used the descriptive approach by themethod of interconnectivity .Asampleconsist of21 students from first staye in collage of physical education and sports science for Girls(university of Baghdad) and attest has been applied(process information and scroll up and down) on the research sample after the required
... Show MoreThe use of male mothers fur c meat Fabro to learn Effect concentrations of ammonium chloride NH4CL and Bacarbonnat sodium NaHCO3 in drinking water by heat stress and Altsoam during heat stress on some of the qualities of productivity and Alvesrgih divided animals to 6 transactions, namely: - control without adding NH4CL, NaHCO3 and Altsoam (treatment 1) Altsoam-1200 of 7-4 weeks old chicken meat to heat patrol 25-34-25 .. 7 weeks old Weight was measured gravimetric vivo increase feed consumption
The aim of the research is to measure the length between the variable the efficiency of the tax examiner with its dimensions represented by (scientific questions, practical process (experience), training and development, impartiality and independence, ethics of the profession) and the approved variable discovering the artificial adaptation of profits, and the degree of arrangement of those dimensions its importance and priority, and the research problem has been identified In a main question that is there any effect of copying the images of the image examiner in discovering the adaptation, the financial statements and reports of the companies (X, Y) and the banks (A, B) were relied on in the interpretation of the results, t
... Show MoreThe study aims to identify the role of Nizwa University in disseminating the concept of knowledge economy among students from the point of view of the faculty members. The researchers used the descriptive approach, as well as used a questionnaire consisting of (20) items distributed into (4) fields. It was administered to a sample of (93) Faculty members. The results of the study showed that the role of the Nizwa University in spreading the concept of knowledge economy among students from the point of view of the faculty members was of a moderate degree. The education and training field came first with the highest average, while the scientific research and innovation field came in the last level. There were no statistically significant d
... Show MoreA field experiment was conducted during the spring season 2020 in Karbala proving/ Al-Sharia Distrit, located at latitude N 32° 42' 13.8" and longitude E 43° 54' 36.6" and at an altitude of 27 m above sea level. The experiment included a study of two factors: the first, Irrigation Interval, three treatments were used: irrigation treatment every 2 days, Irrigation treatment every 4 days, and Irrigation treatment every 6 days. The second factor is the addition of soil conditioners, in which four treatments were used: the control treatment without any addition, the treatment of adding bio-organic fertilizers, the treatment of adding water-conserving technology (polymer), and the treatment of adding water-conserving technology + fertilizers O
... Show MoreFor a long time, the intensification of profit represented a major goal for the company management ,but this goal confirmed a series of restrictions such the constriction on short period, the time rather than on long and medium strategic goal, the relationships with customers ,the supplies, employees , This goal is replaced by another one (intensification of the company's value) ,and the fortune of the share holders itself ,for the purpose of creating value, the company must generate great outcomes to cover the operating expense and to insure the a suitable compensation to the invested capital (the market value added) is the indication used to estimate the company ability to create value –added the development
... Show MoreThis study was conducted to investigate the relationship between corticosterone hormone in the blood of local Iraqi white chicken mothers and the sexual ratio of the hatching chicks. A field experiment located at the Poultry Research Station, Livestock Department, Agricultural Research Department, Ministry of Agriculture for the period from 16 of September 2018 to 25 of December 2018. One hundred and forty birds of Iraqi local chicken mothers (100 females+ 40 males) at the age of 28 weeks were provided from the poultry research station. The birds were raised in individual cages and distributed sequentially to the cages after the numbering of the females. Data were recorded in three periods, each period was of 28 days, and then the general a
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