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.
Abstract
The study aims to know the degree of secondary school managers' practice of servant leadership in Gaza from their teachers’ perspective. It further aims to examine whether there are any statistically significant differences at (α 0.05≥) between the means of the study sample’s members attributed to variables such as (gender, educational qualification, and years of experience). To achieve the objectives of the study, the study adopted the descriptive survey method, using a questionnaire consisting of (30) items distributed to four domains: (workers service, ethical dealing, motivation & influence, and building an organized, integrated society). Then, the questionnaire was distributed to t
... Show MoreThe aim of the study is to reveal the effect of the constructivist learning Model on the achievement and reflective thinking of the fifth grade literary Preparatory students in History subject. A random sample was chosen which consisted of 64 students divided into experimental and control groups, each group consisted of 32 students. The experimental group was taught via the constructivist learning model, and the control group was taught via the traditional method. The experiment was lasted for Eight weeks, each week taught two lessons. The researcher adopted the experimental design with partial control. The two groups were equalized statistically. The researcher used two instruments, the achievement test and the reflective thinking test.
... Show MoreAAA AL-NUAIMY, MH ABDLL-ABASS, Iraqi Journal of Agricultural Sciences, 2007
In this study, Titanium Dioxide Nanoparticles were synthesized by an easy and eco-friendly technique (green synthesis) using green tea leaves (Camillia sinensis), Nanoparticles were analyzed using structural and optical analysis, the X-ray pattern showed that Titanium Dioxide NPs had a tetragonal structure with (Face Centered Tetragonal) FCT crystal structure, the UV-visible recorded an absorbance peak near 350 nm and calculated energy band gap was 3.5 eV, all measurements were proved the purity and Nano size of prepared Nanoparticles. Biochemical parameters evaluation also mentioned in this research, these analyzes showed that Titanium Dioxide nanoparticles in particular dose (50 mg/kg) have the ability to reduce blood glucose
... Show MoreResveratrol, (RES), a phytoalexin, is well-known for its anti-inflammatory and anti-oxidant properties. SEB, a superantigen, is known to trigger ALI and cause mortality. In the current study, we tested the effect of RES in a dual-dose model of SEB exposure that triggers ALI and causes 100% mortality in C3H/HeJ-mice. The data revealed RES attenuated SEB-induced ALI and prevented mortality. Forty eight hours post-SEB exposure, lung-infiltrating mononuclear cells were tested for microRNA expression profile to determine the epigenetic regulation by resveratrol. SEB-activated splenocytes were pre-treated with 50 μM of RES or vehicle for metabolic profile analysis by measuring oxygen consu
Six house-hold Abyssinian pumps distributed in different villages of Mansoura (Mans-I, Mans-II and Mans-III) and Talkha (Talk-I, Talk-II and Talk-III) cities, Egypt, have been selected for regular seasonal water quality assessment during 2017. Water samples have been collected within the mid-periods of four seasons Standard assessment tools were employed for the integrated water quality assessment including Water Quality Index (WQI) and ISO standard algal toxicity test. WQI displayed remarkable local and seasonal variations with excellent (≥ 90) and good (70 - 89) only recorded for water samples collected from Mans-I pump located in sparsely populated area and far 50 meters only from the eastern (Damietta) branch of Nile River. WQI of
... Show MoreThe field of graphic design has witnessed a unique, unique form transformed in its construction and installation and superior to systems through its creation of foundational data for design ideas with functional aesthetics and utilitarianism and effective and moving formulation in light of modern trends and what globalization has brought about in terms of openness to the outside world and the processes of communication and communication with the international community through graphic design. Based on the above, this study marked (Aesthetics of the Design Idea and its Communication Role in the Graphic Outcome) comes to clarify the topic through three chapters, including the first chapter, which was devoted to the research methodology, th
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