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 study sheds lights on the simple verbal formulas with its particular time suffixes as found in the Turgut Özakman’s play These Crazy Turks.
The introduction of the study sheds light on the life of the author and playwright, as well as traces the different types of the verbal formulas in Turkish language.
Oh Those Young is one of the most significant products of the Turkish literature of the young and Children where the literary messages of the playwright are addressed in a simple comic sarcastic style. Hence, the play, that has been studied and acted by many students and academics, drives its importance from this particular course of action.
... Show MoreThe virulent genes are the key players in the ability of the bacterium to cause disease. The products of such genes that facilitate the successful colonization and survival of the bacterium in or cause damage to the host are pathogenicity determinants. This study aimed to investigate the prevalence of virulence factors (esp, agg, gelE, CylA) in E. faecalis isolated from diverse human clinical collected in Iraqi patient , as well as to assess their ability to form biofilm and to determine their haemolytic and gelatinase activities. Thirty-two isolates of bacteria Enterococcus faecalis were obtained, including 15 isolates (46.87%) of the urine, 6 isolates (18.75%) for each of the stool and uterine secretions, and 5 isolates (15.62%) of the wo
... Show MoreExposing the dorsal superficial skin of rats to partial-depth burn leads to bacterial and microbes Invasion. Topical treatment is required in most superficial burn cases Moist exposed burn ointment (MEBO) protects wounds from infection and enhances healing without any harmful effects of purified chemicals is caused. The topical using of HA gel in rat models with full and partial thickness surgical wounds shows enhancement in wound repair. In this study, we compared the healing efficacy of topical use of hyaluronic acid gel products with MEBO as standard management in rats that were exposed to a partial-thickness burn. The experiment included twenty-four (24) adult albino rats of male sex with weight (150-220 gm) of 3 months’ age divided i
... Show MoreBigheaded carps (bighead carp, Hypophthalmichthys molitrix, and silver carp, Hypophthalmichthys nobilis) and their hybrids play an important ecological and economic role in their original habitat, while their introduced stocks may pose serious ecological risks. To address questions about the persistence and invasiveness of these fish, we need to better understand their population structures. The genetic structures of bigheaded carp populations inhabiting Lake Balaton and the Tisza River were examined with ten microsatellite markers and a mitochondrial DNA marker (COI). The Lake Balaton stock showed higher genetic diversity compared with the Tisza River stock. Based on hierarchical clustering, the Tisza population was characterized o
... Show MoreFor more than seven decades, the Palestinian-Israeli conflict has not ended, and every one claims his right to the land, waters, airspace and wealth of Palestine. This conflict was reflected in the political, military, social and cultural aspects, and the cinema had a prominent role in conveying messages to the world about this conflict. On the geopolitical dimensions and their impact on the cinematic image in the films of the Palestinian cause), the researchers divided the research into four frameworks that came as follows: (methodological framework) and included the research problem, its importance, research objectives, research limits and sealing the chapter by defining the terms. And (theoretical framework): it was divided into two s
... Show MorePurpose: This study aims to shed the light on allusions to real lab rats in Dashner’s trilogy: The Maze Runner (2009), The Scorch Trails (2010), and The Death Cure (2011). It also aims to trace the historical documents and chronicles essential to reveal the justifications behind the vague political and scientific crimes. Methodology: The researchers have used the literary analytical approach to study and analyze selected prominent aspects from each novel; such as the concept of lab rats and genocide crimes in The Maze Runner; references to weather experiments, the climate change conspiracy, gas chambers, and the Holocaust in The Scorch Trails; and finally, the man-made diseases and biological weapons in The Death Cure. Results
... Show MoreRoller compacted concrete (RCC) is a special type of concrete with zero or even negative slump consistency. In this work, it had aimed to produce an RCC mix suitable for roads paving with minimum cost and better engineering properties so, different RCC mixes had prepared i.e. (M1, M2, M3, and M4) using specified percentages of micro natural silica sand powder (SSP) as partial replacement of (0%, 5%, 10%, and 20%) by weight of sulfate resistant Portland cement. Additionally, M-sand, crushed stone, filler, and water had been used. The results had obtained after 28 days of water curing. The control mix (M1) had satisfied the required
Background:In this study,TiO2 layer was thermally grown as a diffusion barrier on CP Ti substrate prior to electrophoretic deposition of HA coatings, to improve the coating’s compatibility also macro and micro pores in nano Hydroxyapatite dual coatings were created and their effect on the bond strength between the bone and implant was evaluated. Materials and methods: Electrophoretic Deposition technique (EPD) was used to obtain coatings for each one of four types of Hydroxyapatite(HA)on CP Ti screws (micro HA, nano HA, dual nano HA with micro pores, dual nano HA with macro pores) where carbon particles used as fugitive material to be removed by thermal treatment to create porosity.For examination of the changes occurred on the subs
... Show MoreVarious activities taking place within the city of Baghdad have significantly contributed to organic pollution in Rivers Tigris and Diyala. The present study aimed to assess some physical, chemical and biological aspects of six sites on Rivers Tigris and Diyala as they flow through the city of Baghdad. Monthly samples were collected for the period January to December, 2005. Marked differences in the physical and chemical characteristics of water were noted between the two rivers’ sites. Average values during the study period of dissolved oxygen, biochemical oxygen demand, particulate organic matter, nitrate, phosphate and total dissolved solids for Tigris and Diyala were 7.8,4.7; 2.4,10.4; 350.1,921.4;7.8,13.9;1.2,4.8;814,2176 mg / l re
... Show MoreObjective(s): The present study aims at identifying the Iraqi Colleges of Nursing Deans' leadership
behaviors effectiveness and faculty members' motivation towards work in these colleges.
Methodology: Descriptive design has been used for the sample survey manner, which is the
appropriate approach to the study of social phenomena in the field where provides data on the reality of
these phenomena and relations between the causes and consequences and an analysis of it and perhaps
the factors affecting it and how it appears. The study relies on a questionnaire to collect data from the
participants which is composed of (86) items distributed on three axes: First, the demographic
characteristics which are composed of (8) i